- October 29, 2019
A move that capped residents’ work hours at 80 hours a week in 2003 did not make a difference in terms of patient mortality within 30 days of being hospitalized, readmissions or inpatient spending, according to the study published in the British Medical Journal (BMJ). In 2003, the Accreditation Council for Graduate Medical Education (ACGME) reduced medical resident hours from more than 100 hours a week to 80 a week. The reduction in hours left some worried that fewer hours in training could result in less prepared physicians and poorer care for patients.
To answer that question, researchers compared outcomes among patients treated by internists who began their residency after the 2003 work reforms with physicians who completed their residency before the reform. They found no post-training differences when it came to patient mortality, readmissions or costs of care. “These findings suggest that the large reductions in residency work hours in the U.S. were not associated with declines in the quality of physician training,” the study concluded.
The ACGME capped the training hours for medical residents following a series of high-profile patient injuries and deaths from clinical errors blamed on physician fatigue after working such long hours. “This is probably the most hotly debated topic in medical education among physicians,” said lead author Anupam B. Jena, M.D., of Harvard Medical School and Massachusetts General Hospital, in an announcement about the study. “Many doctors trained under the old system think that today’s residents don’t get enough training under the new system. You hear a lot of senior physicians looking at younger doctors coming out of training and saying, ‘They’re not as prepared as we were.’”
However, the findings of the study allay those fears. The researchers looked specifically at outcomes for high-risk patients to see if fewer training hours made a difference. “We looked at patients who were particularly ill. In these cases, one little mistake could mean the difference between life and death,” Jena said. “Even for these sickest patients, we found that the reduced training hours had no effect on patient mortality.”
The study only looked at the performance of internists and the researchers noted that other specialties may perform differently.
REFERENCE: Fierce HealthCare; 11 JUL 2019; Joanne Finnegan