As you have all heard, the new ACGME duty hour regulations began at this year. In this post I discuss the confusing changes that have been made; in a separate post I discuss how these changes have affected me during internship. In 2003 the Accreditation Council for Graduate Medical Education (ACGME) adopted new rules that limited intern and resident to 80 work hours per week, averaged over a four week period. In addition, the 2003 regulations limited residents and interns to 30 continuous hours of work and stated that no new patients could be accepted after 24 hours. Residents were limited to no more than 1 call night in every 3 days (Q3). These restrictions included all clinical, surgical, didactic, and moonlighting activity. Click here to see the full list of 2003 regulations on the ACGME website.
In 2011 the ACGME added additional regulations, aimed mostly at first year residents, also known as ‘interns’ or post graduate year 1 (PGY1). The duty hours per week has remained the same at 80 hours, averaged over a four week time period. The continuous hours on service, however, was decreased to 16 hours with a mandatory break of 10 hours between shifts. What this means is there will be no more 24+6 = 30 hour call days for interns. Upper level residents (PGY2 and up) are still able to work 24 hours shifts, but the 24+6 strategy is no longer listed in the regulations and they are still restricted to no more than Q3 call. Additionally, interns and residents may not be scheduled for more than 6 consecutive days of ‘night float’. Click here to see all the new 2011 regulations on the ACGME website. Additionally, you can access ACGME’s main webpage for the new 2011 regulations which offers FAQ, a glossary of terms, and the committee’s letter of intent on the new regulations. Link to ACGME main 2011 regulations webpage.
These are the most dramatic changes, though the ACGME implemented a number of other “strategies” and “professionalism” comments to the new regulations. The ACGME website has produced a great chart comparing the new regulations to the old regulations. Click here to view the regulations comparison chart 2003 vs 2011.