ACP American College of Physicians - Internal Medicine - Doctors for Adults

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Resident Work Hours

A Position Statement by the ACP Council of Associates

The American College of Physicians (ACP) Council of Associates represents over 20,000 Internal Medicine residents and subspecialty fellows training in the United States, Canada and Latin America and is the largest advocacy group for Internal Medicine residents in the United States.

The working environment of Internal Medicine residents and subspecialty fellows is an area of major concern for the ACP Council of Associates (COA). The issue of resident work hours is an integral component of this larger debate on resident working conditions. The Accreditation Committee for Graduate Medical Education (ACGME) oversees residency and fellowship training programs in the United States and has established guidelines for Internal Medicine that limit residents to an 80-hour work week. Unfortunately, many Internal Medicine residents continue to work over the recommended limit. Working over 80 hours per week limits a resident's time for studying, pursuing activities with family and friends, and obtaining the necessary rest to deliver quality patient care. Furthermore, research has linked excess work hours during postgraduate training with motor vehicle accidents, anxiety, and depression, and a higher incidence of pre-term deliveries. Thus, excessive work hours are a significant health hazard during Internal Medicine residency and subspecialty training.

Recently, the Committee of Interns and Residents along with the American Medical Student Association and Public Citizen petitioned the Occupational Health and Safety Administration to regulate resident work hours. In response to these recent developments, the ACP Council of Associates has adopted the following position statement regarding resident work hours:

1. Improving and maintaining safe working conditions for Internal Medicine residents and fellows remain top priorities for the ACP Council of Associates (COA).
2. The COA acknowledges that many residents and fellows continue to work an excessive number of hours per week despite regulation and monitoring by the ACGME. The COA encourages the ACGME to improve its systems of monitoring and enforcing their current regulations.
3. The COA believes the medical profession itself needs to be more responsible in monitoring and regulating the working conditions of Internal Medicine residents and fellows.
4. The COA fully supports the efforts of other national organizations in addressing and reforming resident work hours.
5. The COA feels that further systematic study of this issue is needed.
6. The COA feels strongly that any change in resident and fellow working conditions will require the resident's own involvement at an individual program level in order to overcome current traditions.

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