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Studies: long shifts may contribute to medical error

by Madeleine Baran

Oct. 29, 2004 – Medical school interns routinely work 30-hour shifts, but two new studies say the workload is both dangerous and excessive, and are calling for interns' hours to be cut in half.

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The year-long studies, conducted at Brigham and Women’s Hospital (BWH) and released by the Harvard Medical School yesterday, measured how sleep affects job performance.

Christopher Landrigan, BWH Director of the Sleep and Patient Safety Program and lead researcher for one of the studies, found that interns working average legth shifts make 36 percent more serious medical errors and five times more serious diagnostic errors than interns working a maximum of 16 hours per shift.

"The data indicate that the tradition of working 30-hour shifts may be the Achilles heel of the medical education system," Charles Czeisler, chief of the Division of Sleep Medicine at Harvard Medical School and chief author of both studies, told the Harvard Crimson. "We are subjecting patients to increased hazards, impairing the ability of the interns to learn and potentially subjecting the intern to health and safety risks."

Medical residents are not allowed to work more than 80 hours a week or more than 30 hours per shift, according to educational guidelines put in effect last July. However, interns continue to work longer shifts, despite the rules. Harvard Medical School instructor Stephen Lockley told the Crimson that the average work shift is about 32 hours.

Federal laws restrict the length of shifts in other professions, like truck driving. No such laws regulate medical interns.

A 1999 study by the Institute of Medicine found that medical errors are the eighth leading cause of death in the US.

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The NewStandard ceased publishing on April 27, 2007.

Madeleine Baran is a contributing journalist.

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