In early August, we wrote about the benefits of providing aspiring physicians with additional education on medical malpractice law, prevention and related patient safety issues. Failure to educate medical students, interns and residents properly can lead to critical gaps in their patient safety knowledge. Patients then suffer the consequences of these knowledge gaps in the forms of diagnosis errors, preventable injury and other patient safety-related harm.

In an effort to prevent fatigue-related medical errors, the Accreditation Council for Graduate Medical Education decided to limit the number of hours residents could work each week. During the ten years that have followed the initial implementation of that rule, an interesting trend has developed. Though strict adherence to an 80 hour work limit has not directly harmed patient safety rates through increasingly fragmented care, it has reduced the amount of time that residents spend with their patients. Two recent studies published in the Journal of General Internal Medicine have confirmed this trend.

Direct exposure to patients and patient care is critical to the educational development of aspiring physicians. Educational gaps are harder to measure than various injury rates. However, building a solid educational foundation based in experience is unquestionably critical to ensuring that physicians remain conscious of patient needs and patient safety issues.

This trend does not immediately suggest that residents should be working more than 80 hours in any given week. However, it does raise the question of whether residents are spending enough time directly caring for patients during those 80 hour weeks.

Source:, “Limiting residents' work hours didn't hurt patient safety, but cut time spent with patients, studies say,” Andis Robeznieks, Aug. 14, 2013