title: Effects of the new Accreditation Council for Graduate Medical Education work hour rules on surgical interns: a prospective study in a community teaching hospital.
abstract: BACKGROUND
  On July 1, 2011, the Accreditation Council for Graduate Medical Education (ACGME) eliminated 30-hour call in an attempt to improve resident wakefulness. We surveyed interns on the Newton Wellesley Hospital (NWH) surgery service before and after the transition from Q4 overnight call to a night float schedule.
  
  
  METHODS
  For 15 weeks, interns completed weekly surveys including the Epworth Sleepiness Scale (ESS). The service changed to a night float schedule after 3 weeks (ie, first to 3-4 and then to 6 nights in a row).
  
  
  RESULTS
  The average ESS score rose from 9.8 ± 5.2 to 14.9 ± 3.1 and 14.4 ± 4.5 (P = .042) on the 3/4 and 6/1 schedules, respectively. Interns were more likely to be abnormally tired on either night float schedule (relative risk = 2.86; 95% confidence interval, 1.17-6.97, P = .029).
  
  
  CONCLUSIONS
  The new ACGME work hours increased the ESS scores among interns at NWH and caused interns to be more tired than interns on the Q4 schedule. This is likely caused by the multiple nights of poor sleep without a post-call day to make up sleep.
authors: Department of Surgery, Newton Wellesley Hospital, MA 02462, USA. tkamine@bidmc.harvard.edu
authors: Tovy Haber
authors: TH
authors: Kamine
authors: Rebecca J
authors: RJ
authors: Barron
authors: Agnieszka
authors: A
authors: Lesicka
authors: John D
authors: JD
authors: Galbraith
authors: Frederick H
authors: FH
authors: Millham
authors: Janet
authors: J
authors: Larson
mesh_terms: D000068:Accreditation; D000328:Adult; D000704:Analysis of Variance; D004503:Education, Medical, Graduate; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008404:Massachusetts; D009551:Night Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D011446:Prospective Studies; D012107:Research Design; D012306:Risk; D015983:Selection Bias; D012892:Sleep Deprivation / Q000150:complications* / Q000209:etiology; D012894:Sleep Stages; D013043:Specialties, Surgical / Q000193:education*; D011795:Surveys and Questionnaires; D014481:United States; D014940:Work Schedule Tolerance; D000078329:Workforce; D016526:Workload / Q000592:standards / Q000706:statistics & numerical data