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The Board of Directors of the Chicago-based Accreditation Council for Graduate Medical Education has approved new limits on duty hours for participants in medical residency training programs.
The Board of Directors of the Chicago-based Accreditation Council for Graduate Medical Education has approved new limits on duty hours for participants in medical residency training programs across the country. The standards affect residency programs in all healthcare disciplines in which medical school graduates complete their education by providing care under close supervision at academic medical centers and other institutions.
"Residents have more to do, in less time, with less support than ever before," said David Leach, executive director of the ACGME. "As the principal body to ensure quality educational programs in the context of quality patient care, the ACGME has responded with clear standards, strict compliance mechanisms and strong sanctions for violators."
The new standards for resident duty hours include:
•Â A limit of 80 hours per week, with some flexibility to increase hours up to 10% if the sponsoring institution can show an educational rationale and that the approach will promote safety of both patients and residents.
•Â Strengthened limitations on moonlighting to ensure control over total duty hours that residents are working.
•Â At least one full (24-hour) day out of seven free of patient care duties.
•Â A requirement that residents must not be on-call more often than every third night.
•Â A requirement that residents must have a minimum rest period of 10 hours between duty periods.
•Â A limit of 24 hours continuous time on duty, with no more than six hours additional time allowed for patient transfers and educational activities.
The new ACGME standards also address supervision and accountability at participating institutions and programs.
"Patient care and resident education are a collective responsibility, requiring close faculty supervision and strong institutional oversight and support," said Charles Rice, chair-elect of the ACGME. "These standards address the complete context of patient care and medical education. Limiting duty hours is not enough."
The standards ensure that faculty members are available for residents at all times, and make institutions responsible for resident duty hours and faculty schedules. Faculty and program directors must assess residents for signs of sleep loss and fatigue, and institutions are responsible for educating staff and faculty about sleep issues.
Concluded Rice: "These sanctions are real and severe. The ACGME is very serious about enforcing these reforms." PR