Residents' hours of work

We need to assess the impact of the new US reforms

To many, “resident physician” conjures up an image of long hours of work, fuelled by caffeine and adrenaline. This overlooks the reality that residency is an educational experience that completes a physician's preparation for independent practice. About 100 000 resident doctors in the United States—as providers of care and as learners—will be affected by reforms regarding their hours of duty, which were recently announced by the US Accreditation Council for Graduate Medical Education.1 Under the new rules, set to take effect in July 2003, residents will work no more than 80 hours per week, have shifts that are no longer than 24 hours, and have 10 hours of rest between shifts.

The literature on sleep deprivation supports these reforms. Many articles show that sleep deprivation in laboratory and field studies has shown a negative effect on the performance of residents.2^–4 Reduced performance due to sleep deprivation may be associated with increased errors and contribute to adverse events when fatigued members of staff participate in the care of patients.5

Accreditation is a voluntary approach of professional self regulation. The consequences of failed self regulation are often regulatory interventions, which are costly. …