Last month something extraordinary happened at teaching hospitals around the country: Young interns worked for 16 hours straight ? and then they went home to sleep. After decades of debate and over the opposition of nearly every major medical organization and 79% of residency-program directors, new rules went into effect that abolished 30-hour overnight shifts for first-year residents. Sanity, it seemed to people who had long been fighting for a change, had finally won out. Doctors, influenced by their own residency experiences, often see hospital hazing as the most effective way to learn the practice of medicine. But over the last three decades, a counterpoint archetype has emerged: the sleep-deprived, judgment-impaired young doctor in training who commits a serious medical error. "Doctors think they're a special class and not subject to normal limitations of physiology," says Christopher Landrigan, MD, an associate professor at Harvard Medical School and one of the most influential voices calling for work-hour reform. A large body of research on the hazards of fatigue ultimately led to the new rule on overnight shifts by the Accreditation Council for Graduate Medical Education, the independent nonprofit group that regulates medical-residency programs.
