The Accreditation Council for Graduate Medical Education (ACGME) announced that, effective July 1, 2017, first-year medical residents will again be allowed to work 24-hour shifts in hospitals, plus up to four hours to manage care transitions. This represents an increase over the current limit of 16-hour shifts for first-year residents.
"It is important to note that 24 hours is a ceiling, not a floor," said the ACGME in a March 10, 2017, memo announcing the change. "Residents in many specialties may never experience a 24-hour clinical work period. Individual specialties have the flexibility to modify these requirements to make them more restrictive as appropriate, and in fact, some already do."
The following elements of the existing ACGME's Common Core Requirements, which cap the total number of clinical and educational hours for residents and fellows, will remain in place:
- A maximum of 80 hours per week;
- One day free from clinical experience or education in seven; and,
- In-house call no more frequent than every third night.
Pennsylvania Medical Society (PAMED) Advocacy
The safety and well-being of medical residents in Pennsylvania has been the focus of recent PAMED advocacy efforts. In October 2015, PAMED's House of Delegates approved a resolution that called on PAMED to:
- Advocate for physician residency programs in Pennsylvania to offer the option of safe transportation home, as well as sleep facilities in their institution, for residents who may be too fatigued to safely return home after an overnight shift
- Ask all physician residency programs in Pennsylvania to create and make publicly available via the internet and in internal literature, such as resident physician program handbooks, a clearly articulated protocol for the use of their sleep facilities and transportation services for residents who have overnight shifts.
In 2016, PAMED sent a letter sent to medical school deans to request clearer articulation of literature on transportation and sleeping arrangements and to make this information available to students. PAMED also sent a letter to ACGME requesting that policy be change to require school to provide both transportation and sleeping arrangements for students instead of only providing one or the other.
PAMED will continue to monitor the issue to ensure that the safety of medical residents and the patients they serve remains a priority in Pennsylvania.