First Year Resident Medical Mistakes Increased, Despite Shorter Work Shifts

Despite new rules designed to reduce the number of hours medical trainees are required to work, new research suggests that first year residents are actually making more medical mistakes than before. 

According to a study published in the medical journal JAMA Internal Medicine, researchers from the University of Michigan looked at the effects of a 2011 rule by the Accreditation Council for Graduate Medical Education (ACGME), which called for shorter intern shifts. The rule cuts the maximum work hours a resident can be on shift from 24 to 16 hours.

According to data gathered from Harbor-University of California, Los Angeles, Medical Center, before the rule change about 19.9% of interns reported making medical mistakes that injured a patient. Following changes made after the new rules were implemented, that number jumped to 23.3%, a 15 to 20% increase in harmful medical errors.

Researchers indicate that interns reported having the same workload as before, but were now given less time to do it. That can lead to even more mistakes, despite the goal of the rule change to reduce medical errors by giving interns more of a break and allowing them to get more sleep.

In addition to being provided less time to do their work, the study suggests that the rules resulted in more interns handing off patients more frequently to other interns as their hours were shortened. That increases the risk of communication failures between healthcare professionals about patient needs.

In 2010, California researchers found a spike in hospital medication errors that led to deaths, and tied what is sometimes called the “July effect” to the annual influx of thousands of new doctors taking their first permanent positions.

The researchers involved in the “July Effect” study determined that the spike must be at least partly caused by the introduction of new medical residents. The researchers said that, considering their findings, hospitals should re-evaluate responsibilities assigned to new medical residents, increase the supervision of those residents and increase their education on medication safety.