I’ve previously reported on the issue surrounding resident work hours, but intern work hours are back in the spotlight. A piece from Kaiser Health News last week highlights some of the problems with maximizing intern shifts at 16 hours.
Newly minted doctors straight out of medical school are called interns during their first year of residency in their chosen specialty. In the past, interns and residents alike worked grueling hours, often exceeding 24 hours. In 2003, the Accreditation Council for Graduate Medical Education (ACGME) limited residents to working 80 hours a week (which btw is the equivalent of two full time jobs). But the ACGME went a step further in 2011, limiting intern to no more than a 16 hours shift, down from 30. The sixteen hour mark is the point at which studies have found performance begins to deteriorate.
Researchers at Johns Hopkins University and the University of Michigan have found that shorter shifts means simply forcing interns to cram more work into fewer hours. Doing more work in less team also means depriving them of valuable education and limiting the time they can spend treating patients whose illnesses evolve. An editorial in JAMA Internal Medicine called the standard inflexible and noted that increasing “shift work” for interns meant more hand-offs and transfers of patients from doctor to doctor – increasing the risk for communication errors.
Certainly a return to the old way of doing things is not ideal for patient care, but the new resident work hours may be problematic as well. It begs the question – cant there be a happy medium?