Overworked Medical Residents to Share Experiences on Work Hours Via New 'Hourswatch' Website; Opportunity to Share Best Practices, 'Blow Whistle'

12/9/2003

From: Kim Becker of the American Medical Student Association, 703-620-6600, ext. 207 or prel@www.amsa.org; or Cara Metz, 212-356-8100 or cmetz@cirseiu.org, or Justin Wood, 212-356-8100 or jwood@cirseiu.org; both of the Committee of Residents and Interns

RESTON, Va., Dec. 9 -- Today, medical students and residents joined forces to launch a new Website, http://www.HoursWatch.org, to anonymously share their stories, educate themselves on legislative initiatives regarding work hours and learn best practices for adhering to current hours regulations.

HoursWatch is dedicated to ending unsafe work hours for medical residents, and finding solutions that enhance patient care and medical education. HoursWatch is jointly sponsored by the Committee of Interns and Residents/SEIU (CIR/SEIU) and the American Medical Student Association (AMSA), two organizations that have led the fight to reduce dangerous and unhealthy overwork of medical trainees.

The current regulations are set by the Accreditation Council for Graduate Medical Education (ACGME), and state that medical residents cannot work more than 30 hours per shift and 80 hours per week, averaged over four weeks. However, there are many weaknesses to the system:

-- The ACGME's only method of enforcement-revoking accreditation rtatus-is punitive for residents, and discourages them from reporting violations.

-- The regulations allow for averaging over a one-month period (so hours can be greater than 80 in a week).

-- Research suggests that physicians are impaired by sleep deprivation after 24 hours without sleep, yet ACGME rules allow residents to be held in the hospital for an additional 6-hour "hand-off" period after 24 hours of duty.

-- Programs may file for exemptions from the 80-hour restriction if they can demonstrate "sound educational rationale."

-- The ACGME will not review anonymous reports of violations.

"ACGME's enforcement mechanism is inadequate and discourages residents from reporting violations for fear of jeopardizing their professional careers," said AMSA National President Lauren Oshman, M.D., M.P.H. "It is time to rectify the excessive work hours that are forced upon residents. We hope that HoursWatch will serve as an independent "watchdog," monitoring and lobbying for enforcement mechanisms that offer better protections to residents."

"We're finding that hospitals are best able to address problems of excessive work hours when they give residents ample opportunity for input, and take that input seriously. HoursWatch will allow residents who have successfully lobbied for reforms in their programs to share ideas and strategies with housestaff across the country," said CIR President Ruth Potee, M.D.

Over 41 percent of resident-physicians attribute their most serious mistakes to fatigue. According to a recent report from The Institute of Medicine, nearly 100,000 annual deaths resulting from medical errors.

According to a recent study, after 24 hours of wakefulness, cognitive function deteriorates to a level equivalent to having a 0.1 percent blood alcohol level. These doctors would be considered too unsafe to drive, yet could still treat patients for 12 more hours.

About the American Medical Student Association

The American Medical Student Association (AMSA), with more than a half-century history of medical student activism, is the oldest and largest independent association of physicians-in-training in the United States. Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing the concerns of physicians-in-training. With approximately 40,000 members, including medical and premedical students, residents and practicing physicians, AMSA is committed to improving medical training as well as advancing the profession of medicine. AMSA focuses on five strategic priorities, including universal healthcare, disparities in medicine, diversity in medicine, leadership development and transforming the culture of medicine. To learn more about AMSA, our strategic priorities, or joining the organization, visit the website at http://www.amsa.org/

About the Committee of Interns and Residents

The Committee of Interns and Residents (CIR/SEIU) is the largest housestaff union in the country, representing more than 12,000 residents in California, Florida, Massachusetts, New Jersey, New York and Washington, D.C. Founded in 1957, CIR seeks to protect the rights of resident physicians and enhance patient care through collective bargaining and advocacy. CIR is affiliated with the Service Employees International Union, which represents 650,000 health care workers across the country. To learn more about CIR/SEIU, visit http://www.cirseiu.org.