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HMS Focus Online: Extended Shifts for Residents Called Risky for Patients

November 12, 2004

By Courtney Humphries, for Harvard Focus

"After 10 hours on the job, a truck driver must pull off the road. After 16 hours, an airline pilot can no longer legally fly a plane. But after 24 hours or more on the job, with perhaps an hour nap somewhere along the line, a first-year medical resident can perform a surgical procedure, write a prescription, or insert a chest tube.

"How much sleep is too little? It's a question that has plagued teaching hospitals for years and an issue that seemed to be at least temporarily resolved last year when the Accreditation Council for Graduate Medical Education (ACGME) created standards limiting residents' hours to 80 per week. But two articles in the Oct. 28 New England Journal of Medicine have brought the issue back to light. The studies show that the 80-hour workweek still causes significant fatigue and errors in first-year residents. The HMS researchers, led by Charles Czeisler, the Frank Baldino Jr., PhD professor of sleep medicine at Brigham and Women's Hospital, showed that an intervention cutting shift times in half reduced signs of fatigue in interns as well as serious medical errors in patient care."

Read the entire article on the Harvard FOCUS Online website.

Both of the NEJM papers are available at, where users can also report safety problems related to sleep deprivation.

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