| Comparison of Proposals to Limit Resident Work Hours |
|
|
HR 3236 and
S 2614 (1)
|
OSHA Petition (2)
|
ACGME (3)
|
AMA (4)
|
AAMC (5)
|
|
Maximum Hours per Week
|
80 hours, no averaging
|
80 hours, no averaging
|
88 hours averaged over 4 weeks 6
|
84 hours averaged over 2 weeks 7
|
80 hours, no averaging
|
|
Maximum Shift Length
|
24 hours
|
24 hours
|
30 hours 8
|
30 hours9
|
24 hours
|
|
Specific Exemption from Maximum Shift Length for Post-Call Clinic
|
No
|
No
|
Yes
|
No
|
No
|
|
Minimum Time Off Between Shifts
|
10 hours
|
10 hours
|
10 hours
|
10 hours
|
8 hours
|
|
Maximum On-Call Frequency
|
Every third night,
no averaging
|
Every third night,
no averaging
|
Every third night, averaged over 4 weeks
|
Every third night, averaged over 2 weeks
|
Every third night, averaged over 4 weeks
|
|
Mandatory Off-Duty Time
|
24 hours off per week, 1 weekend off per month, no averaging
|
24 hours off per week, no averaging
|
24 hours off per week, averaged over 4 weeks
|
24 hours off per week, averaged over 2 weeks
|
24 hours off per week, no averaging
|
|
Whistleblower Protections
|
Yes
|
Yes
|
No
|
No
|
No
|
|
Enforcement
|
Civil penalties
|
Civil penalties
|
Voluntary approach10
|
Defers to ACGME
|
None mentioned
|
|
Public Disclosure of Violating Hospitals
|
Yes
|
Yes
|
No
|
No
|
No
|
|
Provides for Additional Funding
|
Yes
|
Not applicable
|
No
|
No
|
No
|
1 http://thomas.loc.gov/; Then type in the appropriate bill number.
2 http://www.citizen.org/publications/release.cfm?ID=6771
3 http://www.acgme.org/new/resHrsLanguage.asp (no longer available).
4 http://www.ama-assn.org/ama1/upload/mm/annual02/RefcomC.Annot.doc (no longer available).
5 http://www.aamc.org/hlthcare/gmepolicy/gmepolicy.pdf
6 Individual programs may apply to their sponsoring institution’s Graduate Medical Education Committee for up to a 10% increase over the 80-hour limit if they can provide a “sound educational rationale.”
7 Under certain circumstances, a 5% increase over the 80-hour limit may be granted.
8 A 24-hour limit on in-house call duty, with an added period of up to 6 hours for transfer of patient care, educational debriefing, didactic activities and post-call continuity clinic.
9 A 24-hour limit on in-house call duty, with an added period of up to 6 hours for transfer of patient care, educational debriefing and didactic activities.
10 The ACGME proposes voluntary enforcement of their guidelines by intensifying information collection, shortening residency review cycles, increasing their response time to alleged violations, and enhancing programs’ and institutions’ accountability for compliance.
Last updated 10/17/02
|