[NPInfo] Residents still over worked

[David Mittman]

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Medical residents lack sleep, despite policy change
By Liz Szabo, USA TODAY
A policy that reduced workweeks for medical residents hasn't helped  
junior doctors get more sleep, and it hasn't kept them from making  
mistakes or getting into car accidents, a new study shows.
In the past, residents sometimes worked 36 hours straight, putting in  
100 hours a week. A 2003 policy from the Accreditation Council for  
Graduate Medical Education cut shifts back to 24 to 30 hours, with a  
maximum of 80 hours per week.

Doctors hoped that cutting back hours would prevent exhausted  
residents from making life-threatening medical errors and keep sleepy  
doctors from falling asleep at the wheel, says Christopher Landrigan,  
author of a study in today's Pediatrics .

But a study of 220 residents — doctors who, like the characters in  
Grey's Anatomy, are in their first few years out of medical school —  
shows little change:

• While 80% of residents worked shifts of more than 30 consecutive  
hours before 2003, 56% of residents worked 30 or more hours at a  
stretch after the policy change.

• The length of extended work shifts decreased 3%, to 28.5 hours at a  
stretch.

• Residents got the same amount of sleep — 7 ½ hours a day — during  
the spring after the rules went into effect as they did in the spring  
before the policy.

• Residents made about the same number of mistakes — 1½ mistakes for  
every 100 orders given.

• Residents had just as many accidental needle-sticks and car wrecks.

• About 20% of residents met criteria for depression, both before and  
after the policy change.

On the plus side, rates of burnout among residents fell from 75% to  
57%. But the study shows doctors are still working too many hours  
without rest, Landrigan says.