“On July 1, 2003, a change in resident duty hour guidelines was implemented. These guidelines were adopted in February 2003 by the Accreditation Council for Graduate Medical Education (ACGME), an independent organization responsible for the accreditation of nearly 7,800 residency programs, including 110 specialty and subspecialty areas of medicine.
Residents have long been utilized by academic medical institutions and hospitals with residency programs, with the mutually beneficial goal of educating and providing clinical experience for physicians-in-training. However, over the years, hospitals have come to rely on residents in excess of 80-120 hours per week. Although beneficial and part of the clinical education process, such practices have also come to be recognized as negative to resident health and more importantly, patient care and safety.”
Duty Hours Rules
Per ACGME, duty hour regulations are:
- Residents are limited to a maximum of 80 duty hours per week, including in-house call, averaged over four weeks. In certain cases, starting in July 2004, residency programs will be allowed to increase duty hours by 10 percent if doing so is necessary for optimal resident education and the program receives approval from the appropriate RRC. (ACGME noted in an e-bulletin of February 2008 that ACGME Residency Review Committees for Anesthesiology, Emergency Medicine, Family Medicine, Internal Medicine, Neurology, Pediatrics and Diagnostic Radiology and the Transitional Year Review Committee will NOT grant the 10 percent exception).
- Residents must be given one day out of seven free from all clinical and educational responsibilities, averaged over four weeks.
- Residents cannot be scheduled for in-house call more than once every three nights, averaged over four weeks.
- Duty periods cannot last for more than 24 hours, although residents may remain on duty for six additional hours to transfer patients, maintain continuity of care or participate in educational activities.
- Residents should be given at least 10 hours for rest and personal activities between daily duty periods and after in-house call.
- In-house moonlight counts toward the weekly limit. In addition, program directors must ensure that external and internal moonlighting does not interfere with the resident's achievement of the program's educational goals and objectives. “ ACGME News Release July 1,2003.
ACGME duty hours standards now in effect for all residency programs.
- Marshfield Clinic and Marshfield Medical Center Division of Education policy on duty hours.