Med School Hell – 56 Hour Work Week Is On The Horizon

This post is raw and holds nothing back. If you’re uncomfortable with vulgar language, please turn back.

May 22, 2008
By: Hoover


The Committee on Optimizing Graduate Medical Trainee Hours and Work Schedules from the Institute of Medicine in Washington, DC is making their final report in nine months and recommend decreasing maximum work hours from 80 to 56 per week. That’s the inside word, anyway.

All I can say is about f’ing time.

It looks like strong support for the care of patients as well as the care of those providing that care is fueling this fire, and I believe the old-schools are probably shaking in their boots right now. This rule change looks to be garnering quite a bit of support.

Additionally, training programs consistently violating the rules as if they’re part of some game probably have a lot to do with the proposed rule changes as well:

Furthermore, we know that despite rules being put in place in 2003 to govern resident work schedules that the culture and traditions remain very strong. What we need are some levers—maybe even some financial levers—to make it easier for people to do the right thing.

Like I said in a post way back — it’s all about the Benjamins. On one hand this could mean yanking funding and even hefty fines (i.e. hundreds of thousands to millions) for training programs that don’t play nice this time around. On the other hand, “levers” could also mean an increase in funding to those programs who are rule-abiding citizens. Either way, it’s about f’ing time.

The primary task of this committee will be to focus on four areas:

  • Synthesis of the current evidence base on graduate medical trainees hours and works schedules and their impact on safety.
  • Identification and development of strategies, practices, interventions, and tools that can be used to implement reasonable work hours.
  • Analysis of both the potential benefits and harms of updating work hours and schedules.
  • Short- and long-term recommendations for action by various stakeholders and interim strategies and policies for implementing these recommendations.

According to the thread at SDN, the only problem yet to be tackled is length of training. But, it’s a big one.

I’d say that many people are willing to put up with the extra-long work hours in order to be done with an Internal Medicine residency (for example) in three years. However, there are undoubtedly countless others who would prefer to live a more “normal” state of being and extend training by a year or two.

I guess it really all boils down to how much you really want it, but I see this coming out into the light sooner rather than later. No matter how you slice it, “only” 80 hours per week is the biggest joke I’ve seen in a long damn time.

Update: Six years afterwards, there is still no 56 hour workweek maximum. Bummer.

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This article is part of Hoover’s Med School Hell series. Med School Hell reveals the crazy truth about the crappiness of the US medical education and healthcare system … while making you laugh so hard, you’ll crap in your pants.

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