The intern-resident-fellow work hour issue keeps on being at the forefront of controversy. A recent survey of residents appearing in NEJM found that 51% of residents agreed that new rules from Accreditation Council for Graduate Medical Education (ACGME) would improve their quality of life and well-being, but nearly half also said they would hinder their education. Beginning in July, residents’ duty hours are limited to an average of 80 hours /week, with first-year residents limited to 16-hour days and second-year residents to 24-hour days.

At the Association of American Medical Colleges (AAMC) meeting in November, there was a panel discussion entitled “The New ACGME Standards: A Call for Fundamental Change in Graduate Medical Education” which included Tom Nasca MACP, CEO of ACGME and UCSF CEO Mark Laret as panelists. Colleagues I highly respect and trust noted at the meeting that the medical students, residents, and fellows in attendance at the AAMC are thinking the new restrictions go too far.  During the question and answer period, a hematology oncology fellow from Memorial Sloan Kettering shared a concern -- with other trainees agreeing -- that there is a lack of pedagogical evidence to support the further work-hour restrictions being proposed, raising the question as to whether trainees in the current environment will be competently trained as practicing physicians. What are your thoughts on the restrictions?

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