CHAIRPERSON'S COLUMN
Significant changes are occurring in medical education. Last spring the Accreditation Council for Graduate Medical Education directed the 24 Residency Review Committees to introduce new standards on residents' work schedules and supervision.
Recently, the Residency Review Committee for Internal Medicine proposed a maximum work week of 80 hours averaged over 4 weeks, 1 day away from the hospital each week, and a maximum shift of 12 hours in the emergency room for all residents in internal medicine programs. The new standards also specify that a first-year resident should be responsible for no more than 4 to 6 new patient admissions and for the ongoing care of 8 to 12 patients per day.
These recommendations are similar to the regulations that will become effective in July 1989 in New York; however, the New York regulations affect all major specialties. Several states, including California, Pennsylvania, Hawaii, and Massachusetts, are considering regulations designed to control resident working conditions. In Massachusetts it has been recommended that academic medical centers maintain control over resident work hours, rather than the state government. A report summarizing state activities in regulating resident work hours is available on request from the Department of Medical Student Services.
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