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Group: Study’s Longer Hours For Medical Residents Need To End

November 24th, 2015

Emory University and Morehouse School of Medicine internal medicine residents are participating in a study looking at how residents working longer hours affect patient care and death rates.

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The American Medical Student Association and a watchdog group, Public Citizen, are concerned by a federally funded study that includes medical residents from Emory University and the Morehouse School of Medicine.

The iCOMPARE study, led by Johns Hopkins University, the University of Pennsylvania and Harvard Medical School looks at how internal medicine residents working longer shifts of 28 hours or more, affect patient care.

The 63 schools were given waivers by the Accreditation Council for Graduate Medical Education to allow residents to work longer hours. But Dr. Michael Carome, director of health research at the Public Citizen, said it needs to stop immediately.

“You cannot do this type of research without appropriate ethics review by an institutional review board and without the informed consent of the subjects,” Carome said. “There’s an increased chance that they could suffer medical error that could lead to serious injury or death.”

Carome said letting first-year medical residents work longer hours puts residents and patients at risk, especially since patients aren’t being told they’re part of an experiment.

Work Hour Limits

But Susan Phillips at the University of Pennsylvania said the purpose of the study, which doesn’t involve consent because it’s considered to be “minimal” risk, is to see if medical restrictions on work hours should be lifted so that medical residents get better training.

Morehouse School of Medicine and Emory University internal medicine residents are participating in a study looking at how residents working longer hours affect patient care and death rates.
CREDIT TASNIM SHAMMA / WABE

Medical residents said they have lied to get around the limits.

“The goal of iCOMPARE is to determine if the current limitations on work hours for physicians in training should be changed,” Phillips said. “This NIH-funded study began because there is considerable concern among experts in the field that the current duty hour system of residency education may limit the nation’s ability to train physicians effectively.”

The study sets the maximum hours per week residents can work to an average of 80 hours per week over a month-long period, with one day off every seven days and only one night call every three days.

‘Unethical’ Trials

But Carome said the trials are unethical and it’s already well-documented that working longer hours puts patients at risk. He said that’s why a first-year medical student can only work 16 consecutive hours and other residents are limited to 28 hours.

“If there are problems with work hour restrictions, the right way to deal with that is not going back to long hours,” Carome said. “Maybe that involves hiring more staff physicians to oversee residents.”

Emory and Morehouse School of Medicine residents are just two of 63 university medical programs participating in the study, which began this July and is expected to be complete by July 2016.

Emory University general surgery residents also participated in the Flexibility in Duty Hour Requirements for Surgical Trainees trial, led by Northwestern University. It involved 159 medical schools and was completed in June 2015.

In a statement, Emory said it continues to participate in the iCOMPARE trial because it has been approved by national medical groups and Morehouse School of Medicine said it’s following “top medical standards.”