Lax Rules for Medical Residents an 'Abuse of Trust'

NOTE:  New rules on medical residents' hours issued by The Accreditation Council for Graduate Medical Education became effective July 1, 2011.

A sweeping revamp of the rules that govern the nation's hospital residency programs is needed immediately to protect patients from the serious preventable errors that have been linked to the long working hours of exhausted physicians in training.

That's the message from a group of more than two dozen patient safety, medicine and research organizations, who are calling for the implementation of recommendations set forward in 2009 by the Institute of Medicine.

A white paper published in the current issue of the online journal Nature & Science of Sleepsays the rules for residency training set to take effect on July 1 "stop considerably short" of patient safety best practices. The report calls on hospital administrators and residency program directors to install additional safeguards.

"The current system amounts to an abuse of patient trust," Lucian Leape, MD, adjunct professor of health policy at the Harvard School of Public Health and a coauthor of the report, said in a media release. "Few people enter a hospital expecting that their care and safety are in the hands of someone who has been working a double-shift or more with no sleep. If they knew, and had a choice, the overwhelming majority would demand another doctor or leave."

The report examining residency work hours, supervision, and safety is the product of a conference at Harvard Medical School last year that was held to draw a road map for implementation of the IOM recommendations. Those recommendations included eliminating shifts exceeding 16 hours without sleep for all resident physicians. The recommendations have yet to be implemented.