New ACGME Work-Hour Guidelines and Their Impact on Current Residency Training Practices

Headnote

Objective: Accreditation Council for Graduate Medical Education (ACGME) has introduced new work-hour guidelines for residents in ACGME accredited programs that were implemented in July 2003. The new ACGME policies impact several practices in various psychiatry residency programs across the U.S., even though psychiatry has not been at the forefront of the debate regarding work hours.

Methods: The authors surveyed all psychiatry residency programs in the U.S. and identified several current practices that may infringe on the new ACGME work-hour guidelines.

Conclusion: Further interpretation of the new guidelines is needed.

Academic Psychiatry 2005; 29:279-282

There are limited data on working hours for psychiatry residents. While concern over work hours for residents in some medical specialties (e.g., surgery, medicine, obstetrics) has grown, psychiatry residents have largely been ignored in this debate, as their work hours have traditionally been more manageable. However, as the Accreditation Council for Graduate Medical Education (ACGME) enacts new guidelines on residents' duty hours and working conditions, psychiatry residency programs, like all other residency programs, will have to adhere to the new guidelines. These guidelines mandate that: resident duty hours are limited to 80 hours per week; on-call assignments are limited to 24-hours per call, with up to 6 additional hours to transfer care of patients and educational activities; on-call shifts are limited to no more than one per third night; residents are to be off for 24 hours every 7 days; and a rest period of at least 10 hours between consecutive working days is required (1).

The policy has been introduced due to concerns over residents' long working hours and the potential effect these hours on patient safety (2). From July 1,2003, all ACGMEaccredited residency programs were required to adhere to these new requirements or risk losing their accreditation.

The impact of these new guidelines on current practices of psychiatry residency programs is unknown. A search that we conducted on MEDLINE, PubMed, and Ovid did not produce any literature on working hours for psychiatry residents. Therefore, we researched trends in working hours for psychiatry residents to determine whether current practices in psychiatry residency programs might conflict with the new guidelines. In order to investigate this, we surveyed all psychiatry residency programs in the U.S. using a specially developed questionnaire.

Method

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