Interns continue to work overly long shifts, study finds

That intern working on you at the hospital may be so sleep-deprived his or her performance is no better than that of a drunk. That's one conclusion of a national study by investigators at the Harvard Medical School.

Earlier surveys of a variety of medical centers found that sleepy doctors-in-training endanger both patients and themselves. To cut off federal attempts to solve this serious problem by legislation, the Accreditation Council for Graduate Medical Education, in 2003, put a cap on hours that residents and interns training to be medical doctors can work. (Interns are those in their first year of training.) The rules limited shifts to a maximum of 30 consecutive hours and no more than 80 hours a week. In addition, residents and interns must have one day off in every seven.

Researchers at the Harvard Medical School and Brigham and Women's Hospital in Boston did a nationwide study of interns' working hours before and after the new rules and found that interns still put in dangerously long shifts, despite the accreditation council's claims to the contrary.

The council "developed the duty-hour standards out of concern for the effects of excessive resident work-hours on patient and resident safety," notes Christopher Landrigan, an assistant professor at Harvard Medical School. "Staying awake for 24 consecutive hours induces decrements in human performance similar to a blood alcohol level of 0.1 percent." That's high enough to get you arrested for drunk driving in most states.

Referring to a 2004 Harvard report on sleep-deprived interns, Charles Czeisler, Baldino Professor of Sleep Medicine, says, "Interns made 36 percent more serious medical errors during a traditional work schedule than during a schedule that eliminated marathon 24-hour work shifts."

Long hours can be as hard on the interns as on their patients. In a study published last year, Czeisler and colleagues found that "the odds interns will have a documented motor vehicle crash on their commute after an extended work shift were more than double those after a nonextended shift."