KANSAS CITY, KAN. ? After firing tank cannons during the Gulf War, Ty Baylor finds the physical challenges of being a resident at KU Med relatively simple.

But even he admits the long hours which sometimes require residents to be on call more than 24 consecutive hours can be grueling for the doctors-in-training.

Mandy Sander-Prather, a first year resident at KU Med, checks a patient's chest X-ray Friday in the hospital's emergency room. A national hospital accrediting organization last month said it would change its guidelines to limit residents' work weeks work to 80 hours. KU Med has had its own similar restrictions for the last six years.

“It’s a concern, but you have to know when you’re tired and just take longer to do things,” Baylor said. “You have to slow down and do it right. You have to concentrate.”

A national hospital accrediting organization last month said it would change its guidelines to limit the number of hours a resident could work. But the change won’t have much effect at KU Med, which has had similar restrictions for six years.

Residents at some hospitals put in 120 hours or more per week. They are sometimes on call as often as every third night, meaning they work a day, then deal with emergencies through the night and the next day.

The Accreditation Council for Graduate Medical Education’s new guidelines, expected to take effect in a year, generally would limit residents to 80 hours of work per week in shifts of no more than 24 hours straight with a 10-hour break in-between.

The KU School of Medicine, which administers the residency program at KU Med, began studying the issue of long hours in the mid-1990s, said Dr. Glendon Cox, the school’s associate dean. It used a computer program to track hours and found residents in several programs, including surgery, averaged 100 hours per week.

In 1996, the hospital limited residents to 90 hours per week. Now, surgery residents average the most hours per week at 79.2, Cox said.

“I think we realized residents who are rested are able to deliver the best patient care,” he said. “I think we’re pretty ahead of the curve.”

Cox attributed the lower workload of residents to better scheduling of support staff such as physician assistants, laboratory assistants and extended-practice nurses.

But cutting back hours could place financial burdens on less successful hospitals, he said.

“Residents have been a cheap source of labor for hospitals,” he said. “If we’re going to regulate the number of hours they work, hospitals are going to have to replace the cheap labor with more expensive wage labor. That’s going to drive up the cost for the health-care system. It’s another unfunded mandate being pushed onto hospitals, schools of medicine and the health-care consumer.”

The change hasn’t come without some opposition. Cox said some residents may begin treating a patient and then pass the patient off to another doctor.

“There are some people who have said he can’t do that (limit hours) without compromising education,” he said. “Tracking a patient through their hospital stay is an important part of graduate medical education. There are times when patient care suffers by having patients pass through too many hands in a 36- or 48-hour period.”

KU Med has 280 residents who spend from three to eight years working under attending physicians. The School of Medicine administers the residency program for 110 more residents at other Kansas City-area hospitals.

Baylor, a third-year resident in the medicine department, said he favored the change, especially the limit of consecutive hours residents can work. He works one 24-hour call per week from 8 a.m. to 8 a.m. and sometimes stays at the hospital as late as 2 p.m. the second day to check on patients.