ACGME Work Hours Regulations

Resident duty hour regulations developed by the ACGME went into effect in July 2003 and were preceded by much debate among medical educators. The regulations have forced change in the structure of many residency programs. All programs, regardless of specialty, have been forced to re-evaluate the structure of patient care systems in the academic setting where the resident role in service has been pivotal. Along with creating new service models, which hopefully will benefit both residents and patients, program directors are also faced with a new layer of administrative burden in providing documentation of compliance with the regulations in order to avoid citation by the ACGME and bad publicity. We write as new (Dr. Kissela) and more seasoned (Dr. Peltier) neurology program directors and consider the challenges of the duty hour regulations. Kissela:There is a need for work hour regulations in training programs because there is convincing scientific evidence that cognitive performance declines with sleep deprivation. Although no one has proven that reducing resident work hours actually translates into improved patient safety, the value of the regulations will not be debated here. Rather, we will discuss the universal frustrations in trying to enact and enforce them.Well-rested residents should provide better patient care. Each resident’s ability to learn and their overall quality of life should improve with more reasonable working conditions. As a physician trained prior to duty hours regulation, I might have been happier as a resident, and would certainly have been a better …