Long Work Hours Linked to Injuries in Residents

More than 80 percent in violation of ACGME work-hour limits a year after implementation

TUESDAY, Sept. 5 (HealthDay News) -- Medical residents continue to work long hours in the clinic and the practice often results in serious mistakes that affect both resident and patient health, according to two reports the Sept. 6 issue of the Journal of the American Medical Association.

In a study of 2,737 residents in programs during 2002 and 2003, Charles A. Czeisler, Ph.D., M.D., of Brigham and Women's Hospital, Harvard Medical School in Boston, and colleagues found that longer hours and night-shift work increased the risk for percutaneous injuries during their first year of clinical training. Injuries occurred more often when residents worked extended shifts -- day to overnight -- and nearly doubled during night work compared with day work.

In a second study by Czeisler and colleagues, residents reported little change in their work schedules a year after work-hour limits imposed by the Accreditation Council for Graduate Medical Education (ACGME) went into effect in 2003. The investigators found that 83.6 percent of 1,278 residents surveyed reported work hours in violation of ACGME limits, including working longer than 30 hours in one shift and over 80 hours a week.

Work hour limits are just one variable in a complex system controlling resident training and quality patient care, adds ACGME member Ingrid Philibert, M.H.A., M.B.A. in an accompanying editorial. "High-quality learning is impossible in the absence of high-quality patient care; likewise, high-quality patient care is impossible without high-quality learning. Attention to both is needed."

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