Adapting to Duty-Hour Limits — Four Years On

On July 1, 2003, prompted by the medical profession's concerns about patient safety and the working conditions and education of resident physicians, the Accreditation Council for Graduate Medical Education (ACGME) instituted one of the most substantial redesigns of the country's resident training system in more than a century. Among other changes, the duty hours of residents were tapered to 80 per week, averaged over 4 weeks, and shifts were limited to 30 hours, with a minimum 10-hour rest period between them.Welcomed or criticized, the ACGME rules were anything but ignored. To comply with them, residency program leaders had to . . .