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The author of the article on limits to resident work hours in the
U.S. incorrectly states that under ACGME guidelines that "Shifts are never
to last more than 24 hours."
A close reading of the actual, ACGME, new language shows that
"Residents may remain on duty for up to 6 additional hours to participate
in didactic activities, transfer care of patients, conduct outpatient
clinics, and maintain continuity of medical and surgical care."
Since almost every U.S. medical resident can thus be held longer for
these regular and recurring (non-emergency) activities, this ACGME-
created, giant loophole turns 24 hours into 30 hours.
While a 30 duty hour cap truly is less than 36, 40, or no limit --
and may indicate an initial ACGME step in the right direction -- it
certainly is not the advertised 24 hour limit.
Because of this kind of ACGME loophole and the lack of any
established quick and certain enforcement, many medical students and
residents continue to remain uncertain what changes residents will see in
No competing interests
05 March 2003
Mark L. Levy
Executive Director , Committee of Interns and Residents (USA)