My doctor friends always joke not to get sick around the first of July. That’s when the new class of interns, those recent medical school graduates, arrive at the hospital. They’re not only less experienced, but they’re also subject to harsh work routines. As fatigue increases, so does the likelihood of medical error.
Under proposed new guidelines, interns would be limited to 16-hour shifts (down from 30 hours at a stretch) and receive more supervision. The accreditation agency would also increase monitoring and penalties for programs that fail to adhere to the new rules.
Seems sensible enough, but there are arguments on both sides. Some say 16-hour stretches are still to long to ensure sound judgment. Others fear that shortening work shifts will lead to more disruptions in patient care.
My sense is that one goal of residency is to initiate M.D.s into being a doctor, so to make the rite of passage more effective, there must be a period of disorientation and suspension of normal rules. To prove themselves ready, many residents will want to work longer hours. The key change seems to be not in the number of hours worked, but in the amount of supervision offered. That will help guarantee satisfactory patient outcomes.
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