“That’s one of the things the ACGME stresses, that physicians receive education in terms of recognizing fatigue and fatigue mitigation,” Dr. Vasan added. “It is important for physicians to have an opportunity to rest; that goes hand-in-hand with having these doctors work potentially 24 hours now.”
Dr. Rodney said that the 16-hour limit on interns meant that they could work a few of those shifts in a row, which could be more dangerous for them. “Sixteen hours on paper looks better than 24, but working 16 hours day after day instead of 24 hours with a post-call day off does not result in better quality of life,” she said, “and may actually lead to worse quality of life for the resident.”
Maintaining a Balance
Dr. Zetterman emphasized that while first-year otolaryngology residents and their program directors may be focused on raising the hours cap, the newly unveiled revision to the ACGME Common Program Requirements, the formal name of the rules that govern residents, is much broader. The five-year review placed a greater emphasis on patient safety and quality improvement, added a section to address the critical importance of physician well-being to graduate medical education and patient care, and implemented more explicit requirements regarding team-based care and professionalism, coupled with a framework for clinical and educational work hours that allows for flexibility, with a maximum that aims toward the ultimate goals of physician education and patient care (available at acgmecommon.org).