The purpose of this site is to facilitate a better understanding of the current opinions of neonatologists. Your participation is desired and needed. Please carefully read and fill out the 2 minute survey below. This survey is time limited and will close soon. ONLY NEONATOLOGISTS SHOULD COMPLETE THIS SURVEY! Please do not attempt to take the survey more than once.
This year (July 2011), the ACGME has required that interns’ time in the hospital be limited to no more than 16 hours per day, no more than six days worked out of seven, and one full weekend off in four. The Council of Pediatric Subspecialists (CoPS) has written strong positions statements against these changes, in part because they likely herald a rapid progression towards restriction of all housestaff hours.
The Institute of Medicine has recently recommended that all housestaff have their inhouse hours be restricted, similar to those recently enacted by the ACGME for interns. The primary reasons for this are housestaff errors, needle sticks, housestaff motorvehicle accidents post call as well as a prospective study demonstrating reduced medical errors after reduced work hours from Q 3 call nights to the 30h, Q 4 call night rule.
Public sentiment appears to be in favor of resident hour restrictions, based on well performed poll data. CoPS, the ONTPD (organization of neonatal program directors) and many other pediatric subspecialty groups have publically informed the ACGME of the substantial difficulties facing pediatric subspecialties (including neonatology) with the newest proposed residency hour restrictions.
Past changes in pediatric residencies include the mandatory weekly continuity clinic, weekly half day didactics, the moratorium on NICU time to 3 months, the 30 hour in house limit, and 80 hour work week. While almost all agree that some of these interventions were long overdue, the moratorium in combination with mandatory absences from the NICU and fewer available procedures in the modern NICU has resulted in a dramatic change in experience level for the average first year neonatology fellow. Most neonatology program directors, if candid, will agree that in comparison to the prior decade, today’s fellows spend their first year in procedural remediation. There seems to be little national leadership from our various bodies (including the ONTPD) as to how to fix this (and little integrity about the true procedural competency of our pediatric graduates at the ACGME).
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