Supreme Court ruling on medical residents sparks renewed calls for worker protections

A U.S. Supreme Court ruling Tuesday that medical residents are workers, not students, is rekindling debate over the length of their shifts.

"The U.S. Supreme Court's ruling Tuesday that resident physicians are properly deemed workers — not students — for purposes of paying Social Security taxes further bolsters the case that residents should also have other protections afforded to workers," Sidney Wolfe, director of Public Citizen's Health Research Group, said in a statement. "This includes a good night's sleep."

Public Citizen is part of a coalition of consumer and labor advocates that has been petitioning the Occupational Safety and Health Administration (OSHA) to assume jurisdiction over the work hours of physician residents — and to put strict limits on what those hours can be. 

The groups — which include the Service Employees International Union and the American Medical Student Association — say the rules established by the Accreditation Council for Graduate Medical Education (ACGME) that currently monitors residents' work hours don't go far enough to ensure the safety of residents and the patients they see.

Newly proposed ACGME standards, for instance, would still allow interns to work 20 consecutive 16-hour shifts, the critics argue.

Among the reforms, the petitioners want OSHA:

• To cap the workweek at 80 hours "without averaging." (ACGME limits the workweek to 80 hours — averaged over four weeks.)

• To establish a limit on single shifts of 16 consecutive hours. (ACGME set the maximum shift at 24 hours, while also allowing an additional six hours of educational activities. That, the groups write, "has been universally interpreted as a 30-hour shift.")

• To require at least one full day off per week, without averaging. (ACGME allows one day off per week, averaged over four weeks.)

• To limit the frequency of in-hospital on-call duty to once every three nights, without averaging. (ACGME has the same limit, averaged over four weeks.).