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IOM Recommends Resident Duty Hour Revisions


The Institute of Medicine (IOM) issued a report this month calling for limits to shifts worked by residents, a move that, if implemented, likely means more work for in-house hospitalists, according to one hospital medicine leader.

IOM recommends no change to the current maximum 80-hour workweek for residents, or to the maximum shift length of 30 hours. The report does, however, recommend residents only treat patients for up to 16 hours during their shift, down from the current recommendation of 24 hours. It also suggests residents take an uninterrupted five hours for a continuous sleep period between 10 p.m. and 8 a.m.

In 2003, the Accreditation Council for Graduate Medical Education restricted resident workweeks in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. As mentioned in "While Residents Rest…" in The Hospitalist (August 2006), the resulting shift in workload stressed many hospitals relying on residents for coverage, and some believe it helped boost the need for hospitalists.

In teaching hospitals that follow the IOM recommendations, "I do think this work will go to hospitalists," says Sameer Badlani, MD, a hospitalist and instructor at the University of Chicago. "This is a good thing, in my opinion, as it will enhance the value a hospitalist program brings to an institution."

Dr. Badlani warns hospitals must be willing to help supplement additional costs to their hospitalist service.

The IOM report, "Resident Duty Hours: Enhancing Sleep, Supervision, and Safety," is available for purchase online, or you can download a report brief at

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