A national panel of medical experts proposed significant and costly changes for training new doctors in the nation’s hospitals, recommending mandatory sleep breaks and more structured shift changes to reduce the risk of fatigue-related errors. The experts’ report, issued by the Institute of Medicine on Tuesday, focused on the grueling training of medical residents, the recent medical school graduates who care for patients under the supervision of a fully licensed physician. The medical residency, which aims to educate doctors by immersing them in a particular specialty and all aspects of patient care, is characterized by heavy workloads, 80-hour workweeks and sleep deprivation. But while popular television shows like “Grey’s Anatomy” glamorize residency training as a gratifying rite of passage for doctors, the worry is that the huge workload imposed on residents poses a risk to patient safety. The long hours of often unsupervised residents were found to have contributed to the 1984 death of 18-year-old Libby Zion in New York City, a finding that eventually led to a series of changes, including limiting residents to an 80-hour workweek and 30-hour shifts. But the expert panel said those reforms were not enough. Caps on work hours are often not enforced, and many residents still do not get enough sleep, putting doctors and patients at risk for fatigue-related mistakes. While the new recommendations do not reduce overall working hours for residents, the report says no resident should work longer than a 16-hour shift, which should be followed by a mandatory five-hour nap period. The committee also called for better supervision of the doctors-in-training; prohibitions against moonlighting, or working extra jobs; mandatory days off each month; and assigning chores like drawing blood to other hospital workers so residents have more time for patient care.
Please click on the link below to read the complete New York Times article:
http://www.nytimes.com/2008/12/03/health/03doctors.html?_r=1&ref=health
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