OSHA has rejected the petition of three groups that asked the agency to restrict the hours medical residents can be required to work.

The petition was filed last April by Public Citizen, the Committee of Interns and Residents (a New York–based union), and the American Medical Student Association (AMSA). The groups sought to limit residents’ workweeks to 80 hours, plus one day off a week, and work shifts of no more than 24 hours. The petitioners claim that sleep-deprived residents are at increased risk of auto crashes, depression, and giving birth to premature infants. Their goals include federal legislation to set restrictions on residents’ hours. Leaders of the fight for regulation say the OSHA decision will not hamper their efforts at reform.

In June 2002, the Accreditation Council for Graduate Medical Education (ACGME), which accredits nearly 8,000 residency programs in the United States, set new standards on resident work hours. It plans to enforce those beginning this July. The petitioners say they sought federal action because ACGME has been unable to solve the problem. ACGME has noted an increase in citations for duty hour standards violations. The council’s penalty for noncompliance is removal of accreditation, which it reportedly has not invoked. During its annual meeting in June, the American Medical Association backed the accreditation council’s move, and adopted work-limit recommendations.

In a letter to the petitioners, OSHA administrator John Henshaw explained the agency’s decision to deny the petition because, “OSHA believes that the ACGME and other entities are well-suited to address work-duty restrictions of medical residents and fellows.” Another reason given was that “the issues involved with medical resident hours go well beyond job safety and affect hospital patient safety.”

Ruth Potee, MD, who heads the Committee of Interns and Residents, stated that more must be done to give residents a better training environment. “If they can’t train us to be good physicians in 80 hours a week, then something’s wrong,” she concluded.

Those involved in the issue agree that there have been few studies that specifically link medical errors with overworked and fatigued residents. A conference on the role of sleep deprivation on medical education and physical performance will be held by the AMA and the American Academy of Sleep Medicine this spring