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Medical Residents Want Relief

Medical residents are pressing the Occupational Safety and Health Administration to set limits on the hours they may work each week.

The physicians-in-training say they regularly clock 95 hours a week and as many as 136 hours, increasing their risk of auto accidents, depression and other health problems.

"Any system allowing its workers to be subjected to such direct threats to their well-being is seriously flawed," said a petition being filed Monday by medical residents and health advocates.

"For OSHA not to regulate resident work hours is to abdicate its responsibility to protect the health of those who care for the nation's sick and dying."

Previous appeals to limit work hours have focused on risks to patients, not to the medical residents.

The petition asks OSHA to:

  • Limit work week to 80 hours.
  • Limit shifts to a maximum of 24 consecutive hours.
  • Limit on-call shifts to every third night.
  • Require a minimum of 10 hours off between shifts.
  • Require at least one 24-hour off-duty time per week.

    Limit shifts to 12 consecutive hours for emergency room residents who work in the busiest hospitals — those with more than 15,000 unscheduled patient visits a year.

    The petition was being filed by the consumer and health advocacy group Public Citizen; the Committee of Interns and Residents; the American Medical Student Association; Dr. Bertrand Bell, author of a New York state health code restricting resident work hours, and Dr. Kingman P. Strohl, director of the Center for Sleep Disorders Research at Case Western Reserve University.

    "What organized medicine has told us is that good medicine requires us to choose between our own welfare and the welfare of our patients," said Sonya Rasminsky, a psychiatry resident at Cambridge Hospital in Massachusetts. "What this petition says is that the best medicine cannot ignore either one."

    The petition cited various surveys and studies of residents that have found:

    The average resident reported going as long as 37.6 hours without sleep.

  • A fourth of respondents reported being on call in the hospital more than 80 hours a week.
  • Six out of seven surgical residents reported falling asleep while driving.
  • Nearly a third of residents experienced depression.

    New York is the only state to even attempt to limit resident work hours through legislation, and it appropriated $168 million for enforcement, the petition said.

    Six countries and jurisdictions in the last 15 years have limited work hours: Australia, to 70 hours; Denmark, fewer than 45 hours; United Kingdom, 56 hours; the European Union, 48 hours by 2003; Germany, 56 hours; and the Netherlands, 48 hours.

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