Abstract

The culture of graduate medical education is changing. Over the last decade, forces both inside and outside the medical community have initiated a re-examination of how this country trains physicians. One area that has received significant attention is the extended work hours historically experienced by medical residents. In June of 2002 the Accreditation Council for Graduate Medical Education (ACGME) instituted work hour limitations for all resident training programs. There are three main components to these new rules: 1) limiting the work week to 80 hours, 2) limiting continuous time on duty to 24 hours (with 6 additional hours to complete all tasks) and 3) requiring 24 consecutive hours off out of every 7 days. The future will likely involve even further restrictions. Federal legislation is pending that would impose stricter limitations on work hours, transfer enforcement from a private agency (ACGME) to the Department of Health and Human Services and impose significant fines for violations. The state of New York has already passed laws limiting resident work hours, and other states are considering similar legislation. Work hour restrictions are not unique to this country, either. In 2004 the European Union enacted laws that by 2009 will limit all physicians, residents included, to a 48-hour work week.