Recent news and AMA policy

• Uptick in work-hour violations
  American Medical News, Dec. 11, 2006
• AMA Resident Work Hours Policy
• Resident duty hours reform: Are we there yet?

Background
Suboptimal work conditions, including excessive hours, have a significant impact on resident and fellow physicians. Work conditions affect one's educational environment, quality of patient care, and personal well-being. The AMA Resident and Fellow Section is committed to advocating for improved resident and fellow working conditions to safeguard residents and their patients.

2006-2007 – Resident working conditions and hours remain a primary concern for the AMA-RFS. The AMA-RFS adopted several recommendations regarding enforcement and compliance with the ACGME Duty Hour requirements and developing a method to safely report violations. In addition, the RFS Assembly fully supported a program module, developed by the American Academy for Sleep Medicine, to educate residency training programs on sleep deprivation and fatigue.

Virtual Mentor
American Medical Association journal of ethics.

2004-2005 – The AMA moves forward and investigates the effects of resident working conditions through various means such as surveys, focus groups, and continued discussions. A MemberConnect® survey examined the effect of the ACGME guidelines (PDF, 77KB) on medical students' and residents' work-hour experiences during their most recently completed rotation. Specifically, the survey probed members' opinions on:

• Duty hours worked and on-call schedule;
• Effects of sleep deprivation/fatigue; and
• Reporting of excessive work-hours.

September 2003 – ACGME penalizes first residency program for duty hour violations

Johns Hopkins University 's internal medicine residency program received notice on August 20 that its accreditation would be summarily withdrawn if supporting documentation demonstrating its compliance with the new duty hours requirement was not provided within 45 days.
Read the AMNews article online.

July 1, 2003 – ACGME implements guidelines for resident duty hours

The ACGME guidelines limit resident physicians to 80 duty hours per week, averaged over a four-week period, including all in-house call activities. Continuous, on-site duty (including in-house call) cannot exceed 24 consecutive hours and a minimum of 10 hours of rest between duty periods is required. Furthermore, residents must also have 1/7 days free from all educational and clinical responsibilities, averaged over a 4-week period

June 2002 –- The AMA House of Delegates significantly shifted its long-standing policy on the work environment for resident physicians, allowing broader advocacy to improve patient and resident safety. The AMA expanded its policy by adopting specific resident work hour standards for the first time at the 2002 Annual Meeting.
Read AMA Policy, H-310.927 Resident Physician Working Conditions.

November 2001 – At the 2001 Interim Meeting, the AMA adopted policy allowing it to pursue any regulatory and administrative strategies in addressing the issue of resident work hours and conditions. This extensive policy change resulted from resolutions submitted by the Resident and Fellow Section.

2001 – Citing studies on the effects on patient safety, the RFS submits reports and resolutions instructing the AMA to adopt policy to set guidelines for resident work hours. Access the RFS Digest of Actions (PDF, 383KB) to see the issuance of reports and adoption of policies on resident work hours.