Residency Education: Fewer Hours = More Cost

Implementing new IOM duty-hour recommendations will be expensive and might have unexpected consequences.

In 2003, the Accreditation Council for Graduate Medical Education (ACGME) introduced reforms to combat resident fatigue. Studies of these reforms have not resulted in conclusively better patient care, perhaps because residents still work extended shifts, duty-hour mandates are not always followed, and more handoffs occur. In 2008, the Institute of Medicine (IOM) released the results of an investigation of resident duty hours, “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety,” which includes new duty-hour recommendations.

Researchers in California developed a probability model to estimate labor and mortality costs for the four new IOM recommendations that were deemed to be most costly to implement:

Requisite 5-hour uninterrupted …

Reviewing Author

Kimberly D. Manning, MD