A resident physician is pushing back against a proposal by the Accreditation Council for Graduate Medical Education to loosen residency work hour protections. In a MedPage Today commentary, Chloe Nazra Lee, MD, MPH, describes her own 24-hour shifts that stretched to 28 hours, during which she felt too exhausted to remember key events. She argues that reducing mandatory rest periods would hurt residents and, in turn, the patients they care for.
Lee traces the current system to Johns Hopkins surgeon William Halsted, who had residents live in the hospital and work unlimited hours — a model she notes was likely fueled by a severe cocaine addiction. She cites the 1984 death of Libby Zion as a turning point that exposed how routinely residents worked over 100-hour weeks, and she points to decades of evidence linking sleep deprivation to worse physician performance.
The author acknowledges that residency should be challenging and that some specialties may legitimately need long shifts. But she questions the real motivation behind the ACGME's proposal, suggesting residents are cheap labor and too vulnerable to push back without risking their careers. For her, the answer is not to remove protections, but to ensure training stays rigorous without sacrificing safety.