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Shorter shifts proposed for first-year doctors

Associated Press / June 24, 2010

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CHICAGO — Patients will be told when they are being treated by rookie doctors, who would get shorter shifts and better supervision under proposed work changes for medical residents.

The draft regulations aim to promote patient safety and reduce medical errors by enhancing work conditions for sometimes sleep-deprived junior physicians.

The proposal slightly revises regulations adopted seven years ago and would have the biggest effect on interns — new doctors in their first year of residency training programs after graduating from medical school. They would be more closely supervised by experienced doctors, and the maximum length of their work shifts would be cut from 24 hours to 16 hours.

Maximum work shifts would remain 24 hours for residents in their second year and beyond.

All residents and their supervisors also would be required to explain their roles to patients and explain that supervisors are ultimately in charge of their care.

The proposal comes from the Accreditation Council for Graduate Medical Education. Dr. Thomas Nasca, the group’s CEO, said the changes are needed to meet the main goals of graduate medical education: assuring patient safety while teaching new doctors professionalism and putting patients’ needs above their own.

Residency programs, typically lasting three to seven years, give new doctors on-the-job training in patient care along with expertise in their chosen specialty. The programs often involve notoriously long hours that can lead to sleep deprivation, which research shows can contribute to medical errors.

Violations to the accrediting group’s 2003 regulations are common. Some groups, including the influential Institute of Medicine, have pressed for stricter regulations.

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