AMA expected to take up resident work hours

By Dr. Sanjay Gupta
CNN Medical Unit

CHICAGO, Illinois (CNN) -- The American Medical Association is expected to address the hotly contested issue of resident work hours at its national meeting, which began Friday.

Federal regulations do not limit residents' work hours. It is not uncommon for the medical school graduates to work 80-100 hours a week, with surgical residents typically clocking more than 110 hours a week.

Dr. Richard Corlin, president of the doctors' organization, has called for a re-evaluation of the training process. "We need to take a look again at the issue of why is the resident there," he said. "The resident is not there for the purpose of providing service for patients that they [hospitals] don't have attending physicians for. The resident is there to learn his or her specialty."

RESOURCES American Medical Student Association   American Medical Association

Residents' long hours can endanger patients, critics charge. A recent article in the journal "Nature" found that staying awake for 24 hours impairs cognitive and motor performance to the same degree as having a blood alcohol level of 0.1 percent, above the legal driving limit in many states.

Exhausted residents are often asked to perform operations and make life-or-death decisions, the article said.

Jaya Agrawal, president of the American Medical Student Association, said the hours can also endanger the residents themselves. She cited a recent survey that found six of seven residents said they had fallen asleep while driving home.

The arduous schedule routinely required of residents is a tradition in medical training. Supporters argue that residents emerge better doctors, that the practice shows them continuity of care, even if it means staying in the hospital for more than 36 hours straight.

But a recent analysis showed residents spend up to 40 percent of their time performing ancillary care -- much of it administrative paperwork -- not related to patient care.

Advocates of changing the system suggest such duties could be delegated to other support staff in the hospital. Other proposed strategies of reducing the work hours include a more widespread use of physician's assistants.

Or more residents might be hired. But the AMA pointed out that the number of new hires is determined by the anticipated demand for physicians. If too many residents are hired now, it may lead to an over-supply of physicians in the future.