Impact of work schedules of senior resident physicians on patient and resident physician safety: nationwide, prospective cohort study
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  • Published on:
    AASM Public Safety Committee response
    • Amy Licis, MD, Specialty: Sleep Medicine American Academy of Sleep medicine, Public Safety Committee member
    • Other Contributors:
      • Andrew M. Namen, MD, FAASM, FCCP Pulmonologist, sleep medicine specialist
      • Amara Emenike, MD, Internal Medicine and sleep medicine specialist

    Dear Editor,

    As members of the American Academy of Sleep Medicine (AASM) Public Safety Committee, we commend Barger LK et al. 1 for this important and timely study evaluating the impact of long weekly work hours and shifts of extended duration in senior resident physicians.
    Residency programs face increasing pressure to meet the rising demands in clinical workloads posed by insufficient staffing at medical centers. Meeting this demand requires that residents work both longer shifts and greater cumulative hours per week, and therefore become vulnerable to chronic sleep deprivation. Sleep deprivation compromises cognitive functions, including executive functioning, and impairs one’s own ability to perceive performance impairment.

    Accordingly, past data show that first-year residents experience an increased risk for personal safety and patient-care errors when they work longer than 16 hours per day, or more than 50 hours per week. Following a detailed review of the literature, the National Academy of Medicine (NAM)2 in 2011 issued its most recent work hour recommendations for physicians-in-training, which the Accreditation Council for Graduate Medical Education (ACGME) adopted. These rules imposed work hour restrictions specifically among first-year residents. Other data seemed to suggest that more senior residents (defined as > 1 year clinical training) experience less risk from the effects of sleep deprivation, including the risk for committing...

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    Conflict of Interest:
    None declared.