Charles P. Clayton
In a September 2, 2010, letter to the Occupational Safety and Health Administration (OSHA), Public Citizen, the Committee of Interns and Residents (CIR), and the American Medical Student Association (AMSA) petitioned the agency to regulate duty hours for residents and fellows. The petition calls for OSHA to limit duty hours to 80 per week without averaging and mandate 10 hours off between daytime duty periods. The petitioners also call on OSHA to make resident schedules public records that are open to inspection and to inspect teaching hospitals "on a frequent basis."
The petition reads, in part, "In order to fulfill OSHA's mission 'to send every worker home whole and healthy every day,' you must act now to address the dangers that extreme work hours pose for resident physicians." Public Citizen, CIR, and AMSA point to studies that connect resident duty hours to motor vehicle accidents, depression and memory deficit, pregnancy complications, and on the job needlestick injuries. The organizations argue that long work hours are not needed to prepare resident physicians for future practice as current practitioners work, on average, oughly 50 hours per week. The petition also claims that the Accreditation Council for Graduate Medical Education (ACGME) is "not up to the job" of enforcing duty hour regulations.
In a September 2 press release, OSHA Administrator David Michaels, PhD, stated, "We are very concerned about medical residents working extremely long hours, and we know of evidence linking sleep deprevation with an increased risk of needle sticks, puncture wounds, lacerations, medical errors and motor vehicle accidents." He added, "Hospitals and medical training programs are not exempt from ensuring that their employees' health and safety are protected."
Public Citizen petitioned OSHA to regulate duty hours in 2001. Citing the work of ACGME, OSHA denied the request in 2002.
The Alliance for Academic Internal Medicine (AAIM) supports ACGME as the organization to set and enforce duty hour regulations. AAIM and its partner organizations in the academic medicine community are reviewing the petition to OSHA and setting an action plan in response.