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To the Editor: In their article detailing new requirements of the Accreditation Council for Graduate Medical Education (ACGME) for resident work hours, Ms Philibert and colleagues¹ suggest that statutes in New York State have been ineffective in regulating work hours. Their statement that "54 of the state's 82 teaching hospitals" were cited for work-hour violations in 2002 is misleading. Regulation of work hours is not the difficulty in New York. Rather, weak enforcement has been the major problem. Lack of adequate enforcement in the mid 1990s led to news stories detailing the excessively long work days of New York house staff.² In 2001, an independent health care quality improvement organization was charged by the governor to act as the state enforcement agency and to conduct annual, unannounced inspections.

The 54 citations this past year³ represents a higher standard placed on hospitals and residency programs. These citations demonstrate the effectiveness of . . . [Full Text of this Article]

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