Medical residency in the United States aims to prepare recent medical school graduates to practice medicine independently. One fundamental requirement of resident education is in-depth, firsthand experience caring for patients. During the three to seven years of training, residents often work long hours with limited time off to catch up on their sleep. They can experience fatigue on the job, contributing to increased errors and accidents. However, many medical educators believe extensive duty hours are essential to provide residents with the educational experiences they need to become competent in diagnosing and treating patients.
Resident Duty Hours: Enhancing Sleep, Supervision, and Safety, a December 2008 report from the IOM, asserts that revisions to medical residents’ workloads and duty hours are necessary to better protect patients against fatigue-related errors and to enhance the learning environment for doctors in training. The report recommends that residency programs provide regular opportunities for sleep each day and each week during resident training. In addition, it recommends that the Accreditation Council for Graduate Medical Education provide better monitoring of duty hour limits and that residency review committees set guidelines for residents’ patient caseload. Patient handover procedures and supervision of residents should also be strengthened. Until these changes take place, residency programs are not providing what the next generation of doctors or their patients deserve.