Work Hours Regulations for House Staff in Psychiatry: Bad or Good for Residency Training?
- 21 Downloads
The movement to limit work hours for house staff has gained momentum in recent years. The authors set out to review the literature on work hours reform, particularly as it applies to psychiatric residency training and to provide two different viewpoints on the controversy.
The authors present the historical background of work hours reform in the United States and review recent literature about resident work hours limitations. Using a debate format, the authors discuss whether the new regulations are having a positive or negative impact on residency training in psychiatry.
Drs. Lomonaco and Auchincloss argue that currently-existing work hours restrictions may have unintended consequences for the health of patients and an untoward impact on residents’ professional development and academic medicine’s overall structure. Dr. Rasminsky argues that work hours restrictions do not go far enough in protecting residents and patients from the harmful effects of fatigue, and that our definition of professionalism needs to be reexamined in light of emerging scientific literature.
There should be some limitation on resident work hours, with exact numbers to be determined by growing scientific knowledge about the effects of prolonged wakefulness. More study is needed, particularly in the area of psychiatric residency training.
KeywordsAcademic Psychiatry Residency Training Academic Medicine House Staff Resident Work
Unable to display preview. Download preview PDF.
- 1.NY State Codes R & Regs, Sect 405.4 (b). 1989Google Scholar
- 2.Resident Assessment: Compliance with Working Hours and Supervision Requirements. New York, New York State Department of Health, 1998Google Scholar
- 3.Gurjala A, Lurie P, Wolfe S: Committee of Interns & Residents, American Medical Students Association. Petition to the Occupational Safety and Health Administration requesting that limits be placed on hours worked by medical residents (HRG Publication #1570). 2001Google Scholar
- 4.AAMC Policy Guidance on Graduate Medical Education: Assuring Quality Patient Care and Quality Education. 2001Google Scholar
- 5.Accreditation Council for Graduate Medical Education: Common Program Requirements for Resident Duty Hours (July 1, 2003, Updated July 1, 2007). Available at http://www.acgme.org/acWebsite/dutyHours/dh_ComProgrRequirmentsDutyHours0707.pdf.
- 6.Kohn LT, Corrigan JM, Donaldson MS (eds): To Err Is Human: Building a Safer Health System. Washington, DC, National Academies Press, 2000Google Scholar
- 11.Conyers J: HR 3236: The Patient and Physician Safety and Protection Act of 2001. 2001Google Scholar
- 22.Krupnick JL, Sotsky SM, Simmens S, et al: The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. J Consult Clin Psychol 1996; 64: 532–539PubMedCrossRefGoogle Scholar
- 23.National Sleep Foundation: Public Favors Limiting Work hours for Doctors and Others, According to New National Sleep Foundation Poll. April 2, 2002. Available at http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2417361/k.4D69/Public_Favors_Limiting_Work_Hours.htm
- 34.The ACGME’s Approach to Limit Resident Duty Hours 2005–06: A Summary of Achievements for the Third Year Under the Common Requirements. 2006Google Scholar
- 37.American Medical Association: Report on the Council on Medical Education, CME Report 8-A-04. Subject: Resident/Fellows Work and Learning Environment, Resolution 322 (A-03). 2004.Google Scholar
- 38.American Medical Association: AMA Resident and Fellows Section, Results of resident work hours survey. June 15, 2005. Available at http://www.ama-assn.org/ama/pub/category/15185.html