Snyder L, for the American College of Physicians Ethics, Professionalism and Human Rights Committee. American College of Physicians Ethics Manual. Sixth edition. Ann Intern Med. 2012; 156:73-104.
Agency for Health and Research Quality Patient Safety Network. Patient safety primer: physician work hours and patient safety. Accessed at http://psnet.ahrq.gov/primer.aspx?primerID=19 on 6 September 2013.
Szymczak JE, Brooks JV, Volpp KG, Bosk CL. To leave or to lie? Are concerns about a shift-work mentality and eroding professionalism as a result of duty-hour rules justified? The Milbank Quarterly. 2010; 88:350-81.
Charap M. Reducing resident work hours: unproven assumptions and unforeseen outcomes. Ann Intern Med. 2004; 140:814-5.
Skeff KM, Ezeji-Okoye S, Pompei P, Rockson S. Benefits of resident work hours regulation. Ann Intern Med. 2004; 140:816-7.
Scherger J. The new resident work hours – are we training shift workers? Accessed at http://blog.stfm.org/2012/05/29/the-new-resident-work-hours-are-we-training-shift-workers/ on 6 June 2013.
Desai SV, Feldman L, Brown L, Dezube R, Yeh HC, Punjabi N, Afshar K, Grunwald MR, Harrington C, Naik R, Cofrancesco J. Effect of the 2011 vs 2003 duty hour regulation – compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial. JAMA Intern Med. 2013; 173:649-54.
Horwitz LI, Kosiborod M, Lin Z, Krumholz HM. Changes in outcomes for internal medicine inpatients after work-hour regulations. Ann Intern Med. 2007; 147:97-103.
Reed DA, Fletcher KE, Arora VM. Systematic review: association of shift length, protected sleep time, and night float with patient care, residents/ health, and education. Ann Intern Med. 2010; 153:829-42.
Drolet BC, Christopher DA, Fischer SA. Residents’ response to duty-hour regulations – a follow-up national survey. N Engl J. Med. 2012; 366:e35 (1) – (4). Accessed at http://www.nejm.org/doi/pdf/10.1056/NEJMp1202848 on 31 May 2013.
Antiel RM, Thompson SM, Reed DA, James KM, Tilburt JC, Bannon MP, Fischer PR, Farley DR. ACGME duty-hour recommendations – a national survey of residency program directors. N Engl J Med. 2010; 363:e12(1) –(6). Accessed at http://www.nejm.org/doi/pdf/10.1056/NEJMp1008305 on 31 May 2013.
Block L, Habicht R, Wu AW, Desai SV, Wang K, Silva KN, Niessen T, Oliver N, Feldman L. In the wake of the 2003 and 2011 duty hours regulations, how do internal medicine interns spend their time? J Gen Intern Med. 2013; 28:1042-7. Accessed at http://link.springer.com/article/10.1007%2Fs11606-013-2376-6#page-1 on 10 June 2013.
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Sen S, Kranzler HR, Didwania AK, Schwartz AC, Amarnath S, Kolars JC, Dalack GW, Nichols B, Guille C. Effects of the 2011 duty hour reforms on interns and their patients: a prospective longitudinal study. JAMA Intern. 2013; 173:657-62.
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Author of Case History

Annie E. Katz, MD

Resident (PGY-3), Internal Medicine, Stanford University Hospital and Clinic, Stanford, California

Disclosures

Disclosure: Annie E. Katz, MD, has disclosed no relevant financial relationships.

Author of Commentary

Michele Mathes, JD

Senior Associate, Center for Ethics and Professionalism, American College of Physicians, Philadelphia, Pennsylvania

Disclosures

Disclosure: Michele Mathes, JD, has disclosed no relevant financial relationships.

Editor

Lois Snyder Sulmasy, JD

Director, Center for Ethics and Professionalism, American College of Physicians, Philadelphia, Pennsylvania

Disclosures

Disclosure: Lois Snyder Sulmasy, JD, has disclosed no relevant financial relationships.

CME Author

Charles P. Vega, MD

Associate Professor and Residency Director, Department of Family Medicine, University of California, Irvine

Disclosures

Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.

CME Reviewer

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

CME

Resident Duty Hours: To Hand Over or Gloss Over?

Authors: Case History by Annie E. Katz, MD; Commentary by Michele Mathes, JD
CME Released: 5/13/2014; Reviewed and Renewed: 7/5/2017
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 7/5/2018

Start Activity

Target Audience and Goal Statement

This activity is intended for all physicians who participate in residency training programs.

The goal of this activity is to evaluate ethical issues in limitations on resident work hours.

Upon completion of this activity, participants will be able to:

Distinguish limitations on work hours required by the Accreditation Council for Graduate Medical Education
Analyze the impact of limitations on work hours on residents
Evaluate whether residents are always beholden to report work hours

Disclosures

Author of Case History

Annie E. Katz, MD

Resident (PGY-3), Internal Medicine, Stanford University Hospital and Clinic, Stanford, California

Disclosures

Disclosure: Annie E. Katz, MD, has disclosed no relevant financial relationships.

Author of Commentary

Michele Mathes, JD

Senior Associate, Center for Ethics and Professionalism, American College of Physicians, Philadelphia, Pennsylvania

Disclosures

Disclosure: Michele Mathes, JD, has disclosed no relevant financial relationships.

Editor

Lois Snyder Sulmasy, JD

Director, Center for Ethics and Professionalism, American College of Physicians, Philadelphia, Pennsylvania

Disclosures

Disclosure: Lois Snyder Sulmasy, JD, has disclosed no relevant financial relationships.

CME Author

Charles P. Vega, MD

Associate Professor and Residency Director, Department of Family Medicine, University of California, Irvine

Disclosures

Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.

CME Reviewer

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

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From American College of Physicians Ethics Case Studies

CME

Resident Duty Hours: To Hand Over or Gloss Over?

Authors: Case History by Annie E. Katz, MD; Commentary by Michele Mathes, JDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME Released: 5/13/2014; Reviewed and Renewed: 7/5/2017

Valid for credit through: 7/5/2018

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Introduction

This case study is one in a series of case histories with commentaries by the American College of Physicians (ACP) Ethics, Professionalism and Human Rights Committee and the Center for Ethics and Professionalism. The series uses hypothetical examples to elaborate on controversial or subtle aspects of issues not addressed in detail in the College's Ethics Manual, the Physician Charter on Professionalism, or other College position statements. The sixth edition of the ACP's Ethics Manual, the Physician Charter, and additional College policies on ethics, professionalism, and human rights issues are available at http://www.acponline.org/running_practice/ethics/ or by contacting the Center for Ethics and Professionalism at 215/351-2839.

Figure 1.

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JC Duffy, illustrator

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Case History

CME Information

Introduction
Case History
Commentary

References

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Disclaimer

The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Author of Case History

Annie E. Katz, MD

Author of Commentary

Michele Mathes, JD

Editor

Lois Snyder Sulmasy, JD

CME Author

Charles P. Vega, MD

CME Reviewer

Nafeez Zawahir, MD

CME

Resident Duty Hours: To Hand Over or Gloss Over?

Target Audience and Goal Statement

Disclosures

Author of Case History

Annie E. Katz, MD

Author of Commentary

Michele Mathes, JD

Editor

Lois Snyder Sulmasy, JD

CME Author

Charles P. Vega, MD

CME Reviewer

Nafeez Zawahir, MD

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Resident Duty Hours: To Hand Over or Gloss Over?

Introduction

Figure 1.

Table of Contents