This article originally appeared in BMJ USA

As in Europe, interns and residents have played a critical role in the US health care system for decades. Generations of young physicians fresh from medical school have willingly exchanged up to 130 hours each week fulfilling the service and educational requirements of their training programs for the experience of patient care and the promise of a career in medicine. As we enter a new century however, this “rite of passage” endured by thousands of physicians has fallen under greater scrutiny by the American public.

In 1984, a young woman (Libby Zion) admitted to a New York hospital died due to an adverse drug reaction allegedly missed by a fatigued and overworked resident. Although a subsequent grand jury investigation found no fault with the physician or hospital, the public outcry surrounding the case resulted in strict regulations in the state of New York that mandated limits on resident work hours. …