NCPA - National Center for Policy Analysis


February 10, 2005

Grueling medical residencies force doctors-in-training to work shifts longer than 24 hours, a practice which results in increased car crashes, according to a new study in the New England Journal of Medicine (NEJM).

The researchers followed 2,554 interns during their first year of training. When the interns logged an average of 71 hours a week, researchers found:

  • The interns reported a total of 320 motor vehicle crashes, 40 percent of which occurred as they drove home from the hospital after their extended shift.
  • Extrapolating from this data, the authors estimate that sleepy interns cause more than 23,000 car crashes yearly.

Guidelines set by the Accreditation Council for Graduate Medical Education limit interns and residents to an average of 80 hours a week, with no shift exceeding 30 hours. Unions and others are pressing for federal legislation that would limit the number of hours doctors-in-training may work. But paring back the 80-hour work week would have its own problems, says NEJM:

  • Medical students would require longer residency programs to complete the same amount of training.
  • More importantly, it would mean finding money to pay for additional interns and residents.

Neither Medicare -- which funds resident salaries -- nor hospitals have the resources, say experts. Alternatives, such as nurses or physician assistants, are even more costly than residents, who typically earn $40,000 a year, explains NEJM.

Source: Karen Kaplan, "Sleepy Medical Interns Called a Road Hazard," Los Angeles Times, January 13, 2005; based upon: Laura Burger et al., "Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns," New England Journal of Medicine, January 13, 2005.

For NEJM abstract:


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