A report has said that to ensure patient safety medical residents should get a five hour sleep break after working for 16 hours. The Accreditation Council for Graduate Medical Education (ACGME), in 2003 has set hours for residents where they work no more than 80 hours a week over a four week average, and do no more than a 30 hour straight shift with a 10 hour break for sleep. The latest recommendations by The Institute of Medicine say residents should get a five hour sleep break after working a 16 hour shift to ensure quality of work as well as patient safety.

The author’s of the new report focused on increasing sleep rather than decreasing the work hours to less than 80 hours as they felt this could hamper the resident’s training. The report was written by an expert committee convened by the Institute of Medicine (IOM) at the request of Congress and the Agency for Healthcare Research and Quality. The IOM is a part of the National Academies of Science, which advises the federal government on science and technology.

Carolyn Clancy, director of the research agency said long work hours "is deeply ingrained in the medical training culture. We believe it teaches them dedication, stamina and responsibility."

Jenny Blair, a New Haven, Conn., emergency medicine doctor who's written about residents' fatigue said despite the ACGME limits, "30 hours is pretty much the minimum" that residents work at a stretch. Michael Johns, IOM committee chair and chancellor of Atlanta's Emory University said, "The science clearly shows that fatigue increases the chances of errors." His panels recommendations are that the residents should get five days off in a month which is one more than the ACGME’s recommendation. They also recommend that residents put in no more than four straight night shifts and get 48 hours off after three or four and that hospitals provide a ride for any resident who is too tired to drive home safely. The report also recommends limiting resident’s patient loads, relieving them of tasks that don't increase their education and increasing supervision by experienced doctors.

Dr. Johnson said, "Obviously anytime you could get more rest in a shift, I think you know from a stand point it will make your life outside work easier. Patient care is better and you can think more clearly."

At the news conference several people were of the opinion that shifts should end at 16 hours and not continue after a five hour of "protected sleep." Harvard sleep researcher Charles Czeisler said that surveys indicate that half of the residents don’t take full advantage of facilities of sleeping at the hospital and neither do a majority of them turn their pagers off when they sleep.

Peter Lurie, deputy director of the Public Citizen Health Research Group, a Washington, D. C.-based consumer advocacy group, said the "protected sleep" requirement could be even trickier to enforce than the current ACGME work limits.