Knock Knock Eye: ACGME Wants to Cut Resident Rest Hours

Coming to you from a hotel patio in Lebanon, New Hampshire, this week I dig into the ACGME's newly released revisions to resident work-hour restrictions. We walk through what's actually being proposed: eliminating the mandatory 8-hour rest period between ordinary shifts, cutting required rest after a 24-hour call from 14 hours down to 12, and loosening call frequency from every third night to every second night. Despite some pushback that current restrictions have made residents "soft," I think these changes go too far and put both patients and physicians at risk.

Then it's back to more familiar territory: eyeballs. After getting my own eyes irritated in the indoor hotel pool, I break down the actual science behind why your eyes turn red around chlorine. Spoiler: it's not (directly) pee, it's a gas called chloramine that forms when chlorine reacts with body oils, sweat, and other impurities, stripping the protective oil layer off your tear film.

Takeaways:

• The ACGME has proposed eliminating the 8-hour rest period between ordinary scheduled shifts for residents, with a public comment period open until October 22nd.
• The proposal would also reduce required rest after a 24-hour in-house call from 14 hours to 12, and change call frequency from every third night to every second night.
• I oppose the proposed changes, arguing that sleep-deprived residents make more medical errors and that the current 80-hour work restrictions strike a reasonable balance.
• Red, irritated eyes after swimming aren't caused by direct contact with urine, but by chloramine gas, formed when chlorine reacts with sweat, body oils, and other impurities in the water.
• Chloramine gas strips the protective oil layer off the eye's tear film, causing redness, burning, and dryness.

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