How would you feel if your surgeon had just waken up from a "strategic nap" before operating on your brain? Here's a snippet from a recent New England Journal of Medicine commentary titled, "The ACGME’s Final Duty-Hour Standards — Special PGY-1 Limits and Strategic Napping." You'll see that I've highlighted the section on strategic napping:
On September 28, the Accreditation Council for Graduate Medical Education (ACGME) released new standards to which residency programs must adhere or risk losing their accreditation. Recognizing societal demands for improved patient safety, the task force that developed the standards has embraced stricter duty-hour limits and greater supervision for trainees in the first postgraduate year (PGY-1). The new standards reflect many of the recommendations made by the Institute of Medicine (IOM) in a 2008 report1 but differ from them on one critical issue — how graduate medical education (GME) programs can best prevent harmful medical errors committed by sleep-deprived residents. The IOM recommended that resident shifts longer than 16 hours include an uninterrupted 5-hour sleep period. The ACGME task force concluded that such a long sleep period was unworkable, instead recommending “strategic napping” during long shifts.
Are we kidding here? Do we really think that we're going to reduce medical errors by ensuring that our medical and surgical residents are taking "strategic naps?"