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A Times Editorial
© St. Petersburg Times, published June 14, 2002
Would you want to be operated on by a surgeon who worked 110 hours that week and had been on-call for 36 hours straight? Of course not. People who are sleep deprived and overworked are far more prone to error. Yet, because medical residents come so cheap, teaching hospitals have routinely demanded they work dangerously long hours.
The issue has been simmering for years. Residents who must spend three to seven years working in hospitals in their specialty after graduating from medical school are often expected to work 100 hours or more in a week and remain on call. Some doctors see the ordeal as a rite of passage. But there is nothing romantic about the thousands of patient deaths resulting from hospital errors every year, some of which may be attributed to sleep-deprived doctors.
Our regulatory priorities seem out of whack. The government tells truck drivers how long they can drive without a break, but the nation's medical residents can be required to care for sick patients for days on end. Pressure on the profession to regulate itself has been building in recent years, and some states, including New York, have already issued rules regulating residents' hours. Congress has before it legislation to do the same.
This week, the council that accredits teaching hospitals finally decided to act. The Accreditation Council for Graduate Medical Education, an organization that oversees 7,800 specialty training programs, said that, beginning July 2003, residents' work weeks can be no longer than 80 hours. It also said residents must be given 10 hours rest between shifts and that no shift can last longer than 24 hours. The council promises to rigorously enforce the rules once they are implemented.
There are more than 100,000 residents currently working in hospitals across the country. They are making decisions on complex combinations of drugs, monitoring surgical patients for complications and reacting to whatever emergencies may arise. No one can do that kind of work at peak performance on just a couple of hours sleep.
For decades residents have been exploited by the profession they will be joining. The rule changes envisioned by the council are long overdue.