Current and proposed resident work limits

Current and proposed resident work limits

Current ACGME standard (2003)

80-hour work week averaged over four weeks, including in-house call;

Maximum onsite work shift of 24 hours with up to six additional hours of educational or patient transfer-related activities (a maximum 30-hour shift);

In-hospital call limited to one night in every three, averaged over four weeks;

One day in seven off without educational or clinical duties, averaged over four weeks.

Institute of Medicine Recommendations

80-hour work week, averaged over four weeks;

Maximum shift length of 16 hours. For training to continue with a 30 hour shift, it must provide a mandatory five-hour protected sleep period between 10 p.m. and 8 a.m., with no new patients admitted after 16 hours;

In-hospital call limited to one night in every three (not averaged over four weeks)

At least one 24-hour period off per week (no averaging) and at least of one 48-hour period off per month;

Night work must not exceed four consecutive nights and must be followed by a minimum of 48 continuous hours off, if three or four shifts are worked;

At least 10 hours off after a regular work shift, 12 hours off after night work, and 14 hours off after an extended duration (> 24-hour) work shift (and the physician must not return before 6 a.m. the next day).

ACGME Proposed Standard (2010)

80-hour work week, averaged four weeks (weekly work-hour exceptions of up to 88 hours per week;

Maximum shift length of 16 hours for first-year resident physicians; Maximum 24-hour shifts plus up to four hours for education and patient transfer responsibilities (28 hours) for intermediate- and senior-level resident physicians;

In-hospital call limited to one night in every three, no averaging;

One day off per week, averaged over four weeks;

Night work must not exceed six consecutive nights;

At least eight hours off between work shifts, with some exceptions.

OSHA Petition Request:

80-hour work week (no averaging);

Maximum shift length of 16 consecutive hours for all resident physicians and subspecialty resident physicians;

In-hospital call limited to once every three nights, no averaging;

At least one 24-hour period of time off of work per week (no averaging) and at least one 48-hour period of time off of work per month (no averaging);

At least 10 hours off after a day shift, and a minimum of 12 hours off work after a night shift;

Night work must not exceed four consecutive night shifts, with a minimum of 48 hours off after a sequence of three or four night shifts.