More than a matter of time.

Few topics in graduate medical education have provoked as much comment and controversy as the recent decision of the Accreditation Council for Graduate Medical Education to limit resident “duty hours,” defined as all clinical and academic activities related to the residency program. Regulations that went into effect July 1, 2003, limit duty hours to 80 hours per week, averaged over a 4-week period. In addition, residents may spend no more than 24 consecutive hours on duty, although they may remain on duty for up to 6 additional hours, for a total of 30 hours, to participate in didactic activities, transfer care of patients, conduct continuity clinics, and maintain continuity of inpatient medical care. No new patients, defined as any pa-tient for whom the resident has not provided care during the previous 24-hour period (except for patients who are part of the resident’s continuity panel or the panel of the resident’s continuity team), may be accepted after 24 hours of continuous duty.1 One might ask: “Why the fuss in pediatrics?” Many pediatric training programs have been close to 80 hours per week for some time. The requirement that housestaff take on new … Reprint requests to (M.D.J.) Children’s Hospital, B065, 1056 E 19th Ave, Denver, CO 80218. E-mail: jones.doug{at}tchden.org