Residents face increased safety risks when subjected to extended work hours

Jan 17 2005

The United States' largest, independent medical student organisation, The American Medical Student Association (AMSA) has commended a new study which will be published in the forthcoming edition of the New England Medical Journal. The Study "Extended Work Shifts and the Risk of Motor Vehicle Crashes Among Interns" highlights the need for improvements in intern work hour regulations.

Residents face increased safety risks when subjected to extended work hours.

The study found that for every extended shift in a month, an intern's risk of a motor vehicle crash increases by over 16 percent during their commute. Forty-one percent of the reported motor vehicle crashes included significant damage and were caused on the commute from work. The authors note that the findings "have implications for medical residency programs, which routinely schedule physicians to work more than 24 consecutive hours."

Over one year ago, the Accreditation Council for Graduate Medical Education implemented guidelines for resident work hours, which state that residents cannot work over 30 hours per shift. AMSA believes that this six-hour deviation needs to be amended, as these work shifts are unsafe for residents, patients and motorists.

The study reports that interns worked shifts averaging 32 hours and on 86 percent of the participating interns' monthly surveys, interns reported working extended shifts without any night-float coverage. These data illustrate that many residency programs are not even adhering to the current guidelines-forcing residents to work extended hours despite the increased safety concerns.

"Evidence continues to build that physicians working extended hours are putting themselves as well as their patients at risk," says Dr. Brian Palmer, AMSA national president. "Physicians are being forced to work more consecutive hours than deemed safe-almost the entire workweek of another profession-then drive. It's time to demand an improved working environment that ensures patient and physician safety without compromising medical education."

AMSA supports the Patient and Physician Safety and Protection Act, which would enforce work hour regulations through civil penalties rather than a loss of accreditation and appropriate needed funds for hospitals to hire more auxiliary staff, and provide whistleblower protection to resident physicians who report violations.