Physician Practice Patterns Resemble ACGME Duty Hours

Since July 2003, all residency and fellowship programs in the United States have adapted to and developed innovative ways to comply with the Accreditation Council for Graduate Medical Education (ACGME) duty hours regulation for physicians-in-training. ACGME introduced these standards in response to increased patient acuity and research showing that sleep deprivation may have negative effects on clinical and educational performance. In addition to education, other concerns contributing to the need for the new duty hours regulation were patient safety and physician fatigue and well-being. ¹ A 1999 Institute of Medicine report urged an investigation of the relationship between duty hours and medical fatigue, alertness, and sleep deprivation. ² ACGME defines duty hours as all clinical and academic activities related to the training program—that is, patient care (both inpatient and outpatient), administrative duties related to patient care, provision for transfer of patient care, time spent in-house during call activities, and scheduled activities such as conferences. Duty hours do not include reading and preparation time spent away from the work site.