Unintended Consequences: The Accreditation Council for Graduate Medical Education Work-Hour Rules in Practice

This past July, for the first time in the hospital's 108-year history, the internal medicine residents on call stopped admitting patients at 9:30 p.m. and left the grounds when their work was completed, resulting in paradigm changes in the structure and function of house-officer teams on the wards.

Abstract

On Being a Doctor5 July 2005Unintended Consequences: The Accreditation Council for Graduate Medical Education Work-Hour Rules in PracticeJason Ryan, MD, MPHJason Ryan, MD, MPHFrom Beth Israel Deaconess Medical Center, Boston, MA 02215.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-1-200507050-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Seventy-nine-year-old Doris K. was admitted to the hospital with weakness at a bad time for my team and me, especially considering the limits of the new 80-hour workweek. It had been a frenetic day. We were swamped with 11 patients who came before Doris K., and her weakness brought us to a dozen. Keeping up was exacting, made worse by the pace: Six new admissions hit the floor in just 3 hours. As one of the interns succinctly put it, we were "getting spanked." But in addition to the volume of admissions, our night felt increasingly overwhelming from a unique ... Author, Article, and Disclosure InformationAffiliations: From Beth Israel Deaconess Medical Center, Boston, MA 02215.Corresponding Author: Jason Ryan, MD, MPH, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215; e-mail, [email protected]harvard.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUnintended Consequences Ellis M. Knight Unintended Consequences Steven J. Zanders Unintended Consequences Jason Ryan Metrics Cited byFour Fundamental Educational Principles"The Benefits Make Up for Whatever Is Lost"Regulation of Medical Student Work Hours: A National Survey of DeansPatient Handoffs: Pediatric Resident Experiences and Lessons LearnedTime and learning efficiency in Internet-based learning: a systematic review and meta-analysisRedesigning Residency Education — Moving beyond Work HoursAdapting Web-based Instruction to Residents' Knowledge Improves Learning EfficiencyPerceived Impact of Duty Hours Regulations: A Survey of Residents and Program DirectorsAttaining Resident Duty Hours Compliance: The Acute Care Nurse Practitioners Program at Olive View???UCLA Medical CenterGraduate Medical Education and Patient Safety: A Busy—and Occasionally Hazardous—IntersectionKaveh G. Shojania, MD, Kathlyn E. Fletcher, MD, MA, and Sanjay Saint, MD, MPHUnintended ConsequencesEllis M. Knight, MDUnintended ConsequencesSteven J. Zanders, DOAre 80 Hours Per Week Enough or Too Little for Residents and Fellows? 5 July 2005Volume 143, Issue 1Page: 82-83KeywordsFatigueGraduate medical educationHealth careHistory of medicineHospital medicineLength of stayPatientsResidencySleepSleep deprivation ePublished: 5 July 2005 Issue Published: 5 July 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...