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Study: medical interns ignore ethics code
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by Pamela Buechel
Tuesday, September 12, 2006
An overwhelming majority of first-year medical residents continue to ignore a well-known ethics code, according to a study released earlier this month.
Conducted by Harvard Medical School, the study revealed 84 percent of medical interns work more than the average 80 hours per week that the code permits.
In addition to the maximum hour provision, the Accreditation Council for Graduate Medical Education code states interns should have shifts that last no longer than 30 hours and receive at least ten hours between shifts.
Bob McDonald, resident coordinator for general surgery at UW Hospital, said UW interns are responsible for making sure they do not violate the ethics code.
"Interns are well aware of the rules and are in charge of keeping track of their own hours through a computer system," McDonald said. "Any violations of the code will be addressed directly with the intern."
Acknowledging McDonald's sentiments, some interns said they do not see the point in violating these rules.
"We know the rules and don't want to bend them," said Mark Hilier, a first-year UW resident. "Sure, there are some weeks where we work over 80 hours, but other weeks we work less than the 80. Besides, we need our rest just like everyone else."
The ethics code is based on averages per month. For example, an intern could work 85 hours one week and 75 the following without violating the code.
Additionally, the code states interns should be granted an average of one day per week in which they do not have to see patients. Also based on averages, this rule states that as long as an intern gets four days off every 28 days, they are still in compliance with the code.
The code, which was implemented in 2003, was designed to limit intern fatigue as well as ensure a safe environment for their patients.
Despite Harvard's findings, the Accreditation Council found drastically different results in a similar study. Their study, released on the Council's website, showed that a mere five percent of interns violated the ethics code.
According to one of the authors of the Harvard study, Christopher P. Landrigan, this gap can be attributed to the way in which the two sets of data were collected. In a report, Landrigan said the Harvard study asked more open-ended questions than the Accreditation Council study.
The Accreditation Council study, however, gathered more specific results. Its website noted that if a single intern does not comply with the guidelines, it does not jeopardize the entire hospital. That hospital would instead be labeled "substantially compliant" with the code.
Anonymous (September 12, 2006 @ 11:45am):
I fail to see how an intern "could work 85 hours one week and 75 the following without violating the code" and still be able to "limit intern fatigue as well as ensure a safe environment for their patients." I'm hoping i'm not admitted during that 85-hour+ week!
