Training for fitness: reconsidering the 80-hour work week

Perspectives in Biology and Medicine
Catherine V Caldicott, James W Holsapple

Abstract

The medical literature is replete with articles about the Accreditation Council for Graduate Medical Education's 2003 resident duty hour restrictions. Most of these papers describe creative and thoughtful responses to the new system. However, others express concern that the "80-hour work week" could hamper continuity of care and educational activities. Nevertheless, if fatigue impairs resident learning and medical care quality, then work hour restrictions seem worthwhile. We add our voices to the critics' for additional reasons. Data support that fatigue occurs even with reasonable work schedules, and residents do not reliably use time off from work to rest. Regulated work schedules can interfere with adequate rehearsal of the physical and mental stamina required in certain specialties, yet patients have a right to expect their physicians to be trained in the particular demands of those specialties. Similarly, residents have a right to a realistic understanding of authentic clinical practice. Further, while self-sacrifice need not be routine, trainees should feel that occasional self-sacrifice is appropriate and acceptable for a physician. We reject uniform, arbitrary duty hour limits for all specialties. Rather, we propose tha...Continue Reading

Citations

Jul 27, 2017·Academic Medicine : Journal of the Association of American Medical Colleges·Taryn S TaylorLorelei Lingard
Dec 9, 2008·Journal of Surgical Education·Jocelyn M Logan-CollinsTimothy A Pritts

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