Residency Hours: How do long hours and exhaustion play into medical training?

How does the length of resident shift impact patients? How does it impact prospective doctors? These are important questions that have been at the forefront of public health dialogue in recent months.

According to a recent study in the New England Journal of Medicine, when doctors training to be surgeons are able to work longer shifts patients suffer no additional harm. For the study, 58 surgical residency programs loosened their rules regarding shifts while 59 residency programs did not. Patient outcomes for both program groups were tracked, and the study found that patients do not die or suffer complications any more often when the rules were loosened versus when they were not.

This research comes amidst critiques of the current resident requirements, which forbid residents from working extremely long shifts or back-to-back shifts. The criticism is that these rules often force interns to leave while they are treating a patient or performing surgery. The president of the Resident and Associate Society of the American College of Surgeons and current neurological surgery resident, Dr. Maya Babu, said she felt encouraged by the new findings. “We feel very strongly that flexibility is important to provide opportunities to learn and to have patient ownership, to see patients from the time they're admitted through surgery the next day.”

Others interpret the data differently. In the New York Times, Professor Aaron E. Carroll argued that working shorter shifts also does not cause any additional harm to patients. Thus, the better option is what is better for the residents, which he believes to be shorter shift requirements. Resident health is, after all, also a concern lately: another recent study shows that almost a third of residents exhibit signs of depression and almost 10 percent of fourth-year medical students have admitted to having recent suicidal thoughts.
Erica Liao

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