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Report of the Council on Medical Education
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          Feature Articles: Advocacy Connects Residents to Larger Purpose.

AMA APPLAUDS OSHA DECISION ON RESIDENT WORK HOURS.     CHICAGO – November 9, 2011 – The American Medical Association (AMA) applauded the Occupational Safety and Health Administration (OSHA) decision to allow the Accreditation Council for Graduate Medical Education (ACGME) to continue to serve as the regulatory body for medical resident work hours.
       “The ACGME is the appropriate body to regulate and monitor resident duty hours, as it is optimally suited to oversee resident and fellow physician duty hours on behalf of both the profession and the public,” said AMA President Peter W. Carmel, M.D. “We are pleased that OSHA agrees.”
         Last year, Public Citizen petitioned for OSHA to regulate resident work hours instead of ACGME. In response, the AMA sent a letter to OSHA in September of 2010 in support of ACGME as the proper oversight body for resident work hours. OSHA recently denied Public Citizen’s petition, allowing ACGME to continue to regulate resident work hours.

Study: Medical Residents Often Dissatisfied, Suffering From Burnout.   The Minneapolis Star Tribune (9/7, Crosby) reports, "Finding ways to keep a lid on the pressure is becoming ever more difficult for doctors-in-training, according to a new Mayo Clinicstudy " published in the Sept. 7 issue of the Journal of the American Medical Association. "Large numbers are burned out, depressed and becoming increasingly cynical about their work." In addition, "they're deep in debt and finding it impossible to balance work and life." 
         HealthDay (9/7, Doheny) report that after evaluating the "results of surveys and exams given to nearly 17,000 internal medicine residents, who were said to represent about 75 percent of all US internal medicine residents in the 2008-9 academic year," asking them about their quality of life, work-life balance, amount of educational debt, and whether they experienced burnout, researchers found that 46% "said they were feeling emotionally exhausted at least once a week," while over 50% admitted to at least one symptom indicative of burnout. 
         Medscape (9/7, Lowes) reports, "Internal medicine (IM) residents experienced more symptoms of burnout and scored lower on a standardized medical test if their educational debt was higher." Notably, "the same pattern emerged for two manifestations of burnout: emotional exhaustion and depersonalization, which presents itself as a calloused, cynical mindset." In fact, "these scores climbed in tandem with educational debt." 
         Majority Of US Medical Schools Offer Insufficient Mental Health Coverage. Medscape (9/7, Brauser) reports, "Most medical schools in the United States do not offer health insurance plans that sufficiently cover mental health or substance abuse treatment," according to a research letter published in Sept. 7 issue of the Journal of the American Medical Association. Only about one third of the institutions "evaluated offered unlimited monetary and visit benefits." The study authors noted that "this is particularly 'worrisome,' because past research has shown that requiring copayments or coinsurance often discourages students from seeking help for their mental health or substance abuse problems."

Report Calls For Limiting All Resident Physician Shifts To No More Than 16 Hours:  Reuters (6/24, Seaman) reports that, according to a report published today in the Nature & Science of Sleep journal, a group consisting of 26 physicians and experts on patient safety are urging that limits be placed on the length of work shifts of all resident physicians so that shifts do not last more than 12 to 16 hours at a stretch. As of July 1, first-year medical residents will no longer have to work more than 16 consecutive hours at a time, but this rule does not apply to other medical residents. Reuters points out that the new resident shift rules going into effect next week are grounded in recommendations made by the Institute of Medicine. 

RESIDENTS’ AND FELLOWS’ BILL OF RIGHTS: The AMA today adopted a “Residents’ and Fellows’ Bill of Rights,” which outlines the rights of residents and fellows in the areas of education, supervision, evaluations of performance, safe workplace, compensation and benefits, duty hours, complaints and appeals process, and protection when reporting violations. The policy was adopted as part of a report from the AMA’s Council on Medical Education.