Report: Rules are changing, but most residents still won’t get enough sleep

The sleep-deprived medical resident, working marathon shifts, is a familiar fixture in American hospitals.

But this week, a group of experts argues -- for the umpteenth time -- that sticking to the system that spawned the bleary-eyed resident doesn’t make good sense for doctors or their patients.

It’s time to change the work rules, they wrote in a report published Friday in the journal Nature and Science of Sleep.

The push to limit resident work hours has been picking up steam for decades, and seemed to be gaining momentum last summer when the authors of this report met at the Harvard Medical School. They convened to discuss Institute of Medicine (IOM) guidelines, released in 2009, that called for limits on hours and workloads for residents, increased supervision and other changes to the medical training system.

Then, in September, the Accreditation Council for Graduate Medical Education (ACGME), which sets rules for medical training programs, implemented some of the IOM’s recommendations -- but only for first-year resident physicians. The first class of new residents who’ll enjoy work shifts limited to 16 hours will report to work on July 1. Hopefully, they’ll benefit from the extra rest. Their slightly-more-experienced peers in the second, third and fourth years of training will have to keep chugging the Red Bull to stay perky for patients.

If that’s even possible. Research has demonstrated repeatedly that sleep deprivation and fatigue have a negative impact on performance, whether you’re a physician or a steelworker -- and whether you think you’re impaired or not. (See related stories, at left, for more on why research on this subject remains ongoing, even though it seems obvious that lacking sleep would impair a doctor’s work.)

The report’s authors urged hospitals to look beyond the ACGME guidelines and establish their own system of shorter hours.

Visit this page to read the report and learn more.

The IOM’s guidelines for residents are here.