Resident Work Hour Restrictions

Abstract

Maggie is in the fifth month of her general surgery internship. She, along with the other interns, has been consistently working more than 90 hours a week even though she is aware that she is exceeding the 80-hour work week limit established by the Accreditation Council for Graduate Medical Education (ACGME). But she has enjoyed staying overtime to scrub in on interesting cases. One night, for example, at the urging of the attending surgeon, Maggie stayed late and was able to graft a saphenous vein for the first time. Maggie recently ran into another intern, Justin, in the resident lounge. “Dr Smith made me stay for an appendectomy post-call, and it was the fifth time this month I’ve stayed, ” he complained. “I keep falling asleep during morning conference! ” After talking with other interns, Maggie discovered that they all have been working more than 80 hours a week. Some of them revealed that they felt pressured to stay and would prefer stricter adherence to the ACGME policy. A month later an ACGME representative visited the hospital to investigate compliance with the new work hour regulations. That morning, a number of residents were told that they will be interviewed by the site visitor. The residents discussed how they would handle the interview, and some of the senior residents suggested that they lie to prevent jeopardizing the hospital’s accreditation status. Maggie felt that the additional time she had spent in the hospital had been beneficial to her learning experience and that working less would have limited her education, but she also understood that she could be risking her hospital’s residency program if she told the truth. Furthermore, many of the other residents may not have found the extra hours as valuable and instead have viewed the extra time as a nuisance. Maggie was still contemplating what to say when she was called for the interview