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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