Tag Archives: Medical Residents

EU reviewing limits to physician work weeks

The Telegraph‘s Andy Bloxham writes that the European Union’s 48-hour-a-week average working time limit is under review, at least as far as doctors are concerned.

euPhoto by dimnikolov via Flickr

The limit has been in place since August, 2009, and doctors have a limited opt-out clause. According to Bloxham, European health providers have been hit hard by the rule, which cut back their hours “drastically.” Critics have said that “junior doctors, who used to work very long hours, were being stopped from learning or building up experience as quickly as in the past.”

The EU has committed to either reviewing or overhauling the law, and Bloxham lists a few possible modifications.

One way of altering the rules could see doctors’ hours spent on call at hospital rather than on duty counted differently to the hours spent treating patients.

It might also permit them to return from their breaks sooner than the law currently allows in cases where staff shortages are more severe.

The weekly average for American doctors is around 51, which is down from 55 in 1996.

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For more European health news, see AHCJ’s Covering Europe initiative.

Controversy arises over residents’ sleep

Fatigued medical residents need protected sleep periods and increased supervision of work-hour limits to improve patient safety and their training environment, according to a new Institute of Medicine report.

The study, which was funded by the Agency for Healthcare Research and Quality, reviewed the relationship between resident work schedules, their performance and the quality of care they provide. Not surprisingly, the study confirms that scientific evidence shows fatigued residents are more likely to make mistakes.

Recommendations include changes to the existing 80-hour-per-week limit on work hours, such as protected sleep periods. The Accreditation Council for Graduate Medical Education’s rules allow residents to work a maximum 30-hour shift. The IOM recommends a change to require residents who complete a 30-hour shift to only treat patients for up to 16 hours. They must then have a five-hour protected sleep period between 10 p.m. and 8 a.m.

However, Public Citizen Health Research Group chastised the IOM approach. “Giving the ACGME, a group with neither the appetite nor the ability to enforce significant work-hour reductions, the primary authority over resident work hours creates an irresolvable conflict of interest,” the group says.

The consumer group also complains that ACGME enforcement of existing guidelines has been lax and enforcing a guideline on sleep within shifts will be even more difficult by maintaining that sleep will not be “protected,” and that “protected sleep” programs have limited impact on total sleep time and no impact on objective measures of alertness and performance.