Medical Residents Petition OSHA to Limit Work Hours

The Committee of Interns and Residents was one of several groups to recently petition OSHA to limit the number of hours medical residents must work.

The Committee of Interns and Residents (CIR) was one of several groups to recently petition OSHA to limit the number of hours medical residents must work.

The petition was filed by Public Citizen, a 150,000-member national consumer advocacy organization; CIR, a union representing more than 11,000 medical residents and a national affiliate of the Service Employees International Union; the American Medical Student Association; Dr. Bertrand Bell, who wrote a New York State health code restricting resident work hours; and Dr. Kingman Strohl, director of the Center for Sleep Disorders Research at Case Western University.

Currently, there is no national work-hour limit for medical residents.

Residents regularly work 95 hours a week, sometimes logging as many as 136 out of the available 168 hours in a week, according to CIR.

"By not capping the hours of these residents, OSHA is abdicating its responsibility to ensure a safe workplace and protect those who care for the nation''s sick and dying," said Anandev Gurjala, a second-year medical student at Northwestern Medical School currently doing research for Public Citizen. "The hours required now can endanger the health of the residents and the patients they are treating."

In addition, the petition calls for a limit of on-call shifts to every third night, a minimum of 10 hours between shifts, and at least one 24-hour period of off-duty time per week.

To ensure compliance, the petition requests strict enforcement of work-hour regulations, including frequent unannounced inspections.

Residents schedules should be recorded and kept as public record, an official and confidential procedure should be established to report violations, and violations should lead to strict penalties, the petition states.

CIR said the petition is based on a multitude of studies.

For example, emergency medical residents are almost seven times more likely to be in auto accidents during their residencies compared to before their residencies.

Sleep-deprived residents report greater rates of depression, with rates as high as 32 percent while working in the intensive care unit.

Research also shows that high levels of work-related fatigue are associated with obstetric complications among women residents.

"When we became physicians, all of us promised to devote ourselves to improving our patients'' quality of life," said Dr. Sonya Raminsky, a resident in psychiatry at Cambridge Hospital in Massachusetts and co-president of the Cambridge branch of CIR. "But it is a painful irony that we are forced to treat our own lives with less respect as a result."

The closest thing to a national standard is a set of requirements drawn up by the Accreditation Council for Graduate Medical Education (ACGME), an organization responsible for overseeing residency programs. The organization has drawn up work-hour requirements that vary by specialty, but compliance with even these requirements is voluntary.

The petition notes that the government has set strict work-hour limits for truckers, pilots and railroad operators.

"Our government rightly recognizes the importance of capping work hours for those who could kill people if they get too tired, such as truckers and pilots," said Dr. Sidney Wolfe, director of Public Citizen''s Health Research Group. "The government''s obligation should be no less for doctors-in-training, who usually work even longer hours."

by Virginia Sutcliffe

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