Rules would reduce hours for hospital doctor interns

Hospitals would be required to reduce physician interns' working hours and be inspected yearly to ensure the first-year doctors are properly supervised and getting enough time off under newly proposed rules.

The Accreditation Council for Graduate Medical Education, a nonprofit organization that evaluates more than 8,800 residency programs, outlined the proposed policies in a paper published in the New England Journal of Medicine. The procedures would trim the length of time interns can be on call to 16 hours from 30 and require greater supervision of the new doctors.

Long schedules for interns, medical school graduates in their first year of hospital training, were once a rite of passage, with reports that some new doctors worked 140 hours a week. In July 2003, the accreditation council restricted intern working hours to no more than 80 a week and 30 at one stretch after a 1999 Institute of Medicine report found medical errors claimed 44,000 to 98,000 lives annually.

"Patient safety in teaching hospitals is not just about duty hours, it is much more about supervision," said Thomas Nasca, chief executive officer of the council, on a conference call. Among the responsibilities are "controlling workload, establishing effective teamwork and communications, establishing policies and procedure for transitions in care," he said.

The council has commissioned an external review of the "financial implications" for hospitals of the new standards for physician interns, Nasca said.

The reduction in hours for physician interns will challenge traditional teaching hospitals financially, John Mendelsohn, president of the Houston-based University of Texas MD Anderson Cancer Center, said.

"I am a product of the old system - you learn how to take cat naps," Mendelsohn said. "But I'm for the new system because frankly, it would be nice to have more time at home" for the interns, he said. Medical educators may comment on the proposed rules until Aug. 9, the association said. The changes will likely take effect in July 2011, the organization said.