First Year Residents Allowed to Work Up to 28 Hours, Again

Longer shifts for first-year residents are set to start up again in July, according to new rules from the Accreditation Council for Graduate Medical Education (ACGME). Currently, first-year residents are restricted to 16-hour shifts, due to concerns voiced in 2011 that patient care could suffer if new trainees were too tired.

The cap for first-year residents will return to 24 hours, plus up to four hours for transition care/ handoffs. This is the same schedule that other residents and fellows follow.

Why the about face?

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“The disruption of team-based care and supervisory systems has had a significant negative impact on the professional education of the first- year resident, and effectiveness of care delivery of the team as a whole,” the ACGME states.

“The American public deserves to know that starting on Day One physicians in practice already have the real-world experience they need to ensure high quality patient care,” states Thomas J. Nasca, MD, MACP, chief executive officer of the ACGME and vice-chair of the Task Force, in a memo. “Residents also have the right to develop such experience under appropriate supervision to manage the lifetime of demands and stress that come with the privilege of patient trust.”

Change May Improve Derm Consults

“One of our biggest issues on the consult service is our recommendations are often not passed from team to team and therefore care is delayed and our time is wasted when the new resident calls for a consult, unaware of the previous engagement,” explains Adam Friedman, MD, FAAD, an associate professor of dermatology in the department of dermatology at George Washington School of Medicine and Health Sciences in Washington, DC where he also serves as the Residency Program Director and the Director of Translational Research. “Improving handoffs will hopefully negate these issues and improve engagement and collaboration between the primary team and consulting team.”

Change Flies in the Face of Public Opinion

The group Public Citizen conducted a survery this summer to assess public opinion regarding shift limits. A total of 86 percent of respondents opposed a proposal to eliminate the ACGME’s current 16-hour shift limit for first-year residents, according to a survery report released in September. Most survey respondents (80 percent) actually supported decreasing the shift limit from 28 hours to a maximum of 16 hours for residents in their second year and above. Additionally, just over three-quarters of respondents said that hospital patients should be informed if a medical resident treating them has been working more than 16 hours without sleep.

From left: Daniel Opel, MD, Eric Sorenson, MD, Brienne Cressey, MD, Valerie Yanofsky, MD, Sean Condon, MD

Residents Honored in Aruba

As part of the dermMentors™ Resident of Distinction Award program, sponsored by Beiersdorf Inc., five dermatology residents attended the 16th Annual Caribbean Dermatology Symposium, held in Aruba, Netherlands Antilles in January. The dermMentors™ Resident of Distinction awardees—Sean Condon, MD, of the Cleveland Clinic, Brienne Cressey, MD, of New York-Presbyterian Weill Cornell Weill Cornell Medical College, Daniel Opel, MD, of Loyola University Chicago, Eric Sorenson, MD, of The University of California-Los Angeles, and Valerie Yanofsky, MD of the Icahn School of Medicine at Mount Sinai—attended the Caribbean Dermatology Symposium scientific sessions as well as networking events with top thought leaders in dermatology. The residents presented new scientific research during an independent mentoring session.

Valerie Yanofsky, MD, a third-year resident in dermatology at The Icahn School of Medicine at Mount Sinai, was awarded the overall grand prize for her presentation, entitled: “Cyclosporine A Polarizes T Cells toward T22 and Induces IL-22 Receptor in Human SCC Cells in vitro: A Mechanism Driving IL-22 Induced SCC Proliferation.”