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A paradox for young docs: New work-hour restrictions may increase, not decrease, errors
Date:3/25/2013

estrictions took effect felt that they were expected to do the same amount of work as in previous years, but in a more limited amount of time, leading to more harried and tiring work schedules despite working fewer hours. Overall, they felt that there was less 'down time' during the work day compared to pre-2011 work schedules, which may partially explain some of the unexpected findings."

Breck Nichols, M.D., MPH, the program director of the combined Internal Medicine and Pediatrics residency program at the University of Southern California, and another co-author on the paper, concurs.

"In 2000 a typical call day lasted 36 hours. We have very specifically reduced that for interns from 36 hours to 30 hours in 2003, and now with the latest 2011 work hours change it has been reduced even further to 16 hours," he says. "For most programs the significant reduction in work hours has not been accompanied by any increase in funding to offload the work. As a result, though many programs have made some attempts to account for this lost work in other ways, the end result is that current interns have about 20 less hours each week to complete the same or only slightly less work. If we know that timed tests result in more errors than untimed ones, we should not be surprised that giving interns less time to complete the same amount of work would increase their errors as well."

All the interns assessed in this study were working under the duty hour restrictions that went into effect in 2003 limiting residents to no more than 80 hours of work in a week, and other restrictions. Some studies have suggested that these rule changes, recommended by the Accreditation Council for Graduate Medical Education, did result in better safety for patients cared for by residents. But in an effort to achieve even greater safety, the ACGME recommended further changes that were implemented in 2011.

Each year, Sen and colleagues send out surveys to students enter
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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