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Work Where You Live or Live Where You Work? Resident Work and Sleep Patterns While on "Home Call".

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Summary

Residents on home call often spend significant time in the hospital, reducing sleep. This challenges Accreditation Council for Graduate Medical Education (ACGME) postcall duty hour protections, especially for junior residents during intensive call types.

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Area of Science:

  • Medical Education
  • Surgical Training
  • Resident Duty Hours

Background:

  • The Accreditation Council for Graduate Medical Education (ACGME) does not mandate postcall days for home call shifts.
  • Home call shifts may not adequately protect residents from excessive duty hours, despite not being in-house.
  • Residents may still spend a majority of their shift physically present in the hospital during home call.

Purpose of the Study:

  • To investigate the actual time spent in the hospital and sleep duration for residents on home call.
  • To determine if current home call practices align with ACGME postcall duty hour regulations.
  • To compare sleep and hospital time across different types of home call (hand, face, triple call).

Main Methods:

  • A prospective survey study was conducted at a Level 1 trauma center.
  • Junior and senior residents completed overnight call shifts between January and April 2023.
  • Data collected included hospital trips, time spent in the hospital, and hours of sleep.

Main Results:

  • A high response rate of 97.5% (195/200 shifts) was achieved.
  • Junior residents reported significantly less sleep (0.73-3.92 hours) and more hospital time during intensive home call types.
  • Senior residents also experienced reduced sleep with hand and face call compared to general call.

Conclusions:

  • Sleep duration during home call varies significantly based on the type of call.
  • Intensified home call duties reduce resident sleep and increase hospital presence, potentially undermining ACGME protections.
  • Further discussion is needed regarding ACGME duty hour regulations for residents on home call.