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The ACGME wants to cut your rest after call. Tell them not to by October 22.
Its proposal shortens the time off after a 24-hour call from 14 hours to 12 and removes the every-third-night call cap, the eight hours between shifts and specialty limits. The reason it gives, again and again: schedules that follow today’s rules are a burden to build.
Two minutes. Pick your reasons, edit the draft, paste it into the ACGME’s form.
What changes
| Rule | Today | Proposed |
|---|---|---|
| Time off after a 24-hour in-house call 6.31 | 14 hours | 12 hours |
| In-house call no more than every third night 6.38 averaged over four weeks | Required | Removed |
| Eight hours off between shifts 6.30 | Expected | Removed |
| Specialty limits on runs of night shifts 6.37 “night float”: a week or more of nights in a row | Allowed | Removed |
| Tighter work-hour limits set by a specialty emergency medicine’s shift limits, for one | Allowed | Removed |
From the ACGME’s proposed Common Program Requirements and its impact statement [1]. The changes would take effect July 1, 2028, for every residency it accredits.
What it means for you
- Two hours less sleep after every 24-hour call.Post-call rest is when you sleep before you drive and before you work again. Interns were 2.3 times as likely to report a car crash after an extended shift, and every extended shift in a month raised their risk of a crash on the commute home by 16% [3].
- Call can come around more often.With the every-third-night cap gone, nothing but the 80-hour average and one day off in seven limits how often you take 24-hour call. Specialties also lose the power to set tighter limits for their own residents [1].
- Your patients feel it.In a randomized trial, interns on an every-third-night schedule of 24-hour-plus shifts made 36% more serious medical errors than on a schedule without them [2]. The proposal removes even that every-third-night limit.
Their reason, in their words. Why cut post-call rest from 14 hours to 12?
“to reduce burden related to developing resident schedules, while retaining sufficient time for rest.”
And asked how the change improves education or patient safety, the ACGME’s own impact statement answers: “No impact is anticipated.” [1]
Write your comment
Choose the points you agree with. We draft a short comment in your voice; change anything you like. Nothing is sent anywhere until you choose to.
You’ve edited the draft, so your choices on the left no longer change it.
On the ACGME’s form, enter your name, email and role, then paste your comment where it asks about the work-hour requirements (Section 6) or for general comments, and submit before October 22.
The tool asks for a name, specialty, role (resident, chief resident, program director or faculty, other), an optional program, the reasons the person agrees with and an optional personal line. It writes a short comment in their voice that they can edit, copy, and paste into the ACGME’s comment form at https://acgme.qualtrics.com/jfe/form/SV_7NEm7TaI8AQBSSy (Common Program Requirements, Residency, major revision; comments close October 22, 2026). The reasons offered: keep 14 hours of rest after a 24-hour call (6.31); keep the every-third-night in-house call cap (6.38); keep eight hours off between shifts (6.30); let specialties keep their own work-hour limits; let specialties keep limits on night float (6.37); “too hard to schedule” is a tooling problem, not a reason to cut rest; tired residents make more errors and patients pay for it; removing a protection should require evidence it is safe; six weeks is too short a comment period.
Why we made this
My wife is an OB-GYN resident. She routinely works 80-hour weeks. Asking residents like her to give up rest after call so that schedules are easier to build is just unfair.
The ACGME posted this rewrite on September 8 and gave six weeks to comment. That is a short window for rules every resident will work under, and not a very democratic one. It needs a lot of voices, quickly. If this page helped you, send it to your residency.
Jackson Cantrell
- ACGME, Common Program Requirements (Residency), proposed major revision, and its Rationale and Impact Statement, September 8, 2026, requirements 6.29–6.39; deadline on the ACGME review and comment page.
- Landrigan CP et al. Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med 2004;351:1838–48.
- Barger LK et al. Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med 2005;352:125–34.
- American College of Emergency Physicians, Make sure we define EM training: comment by Oct. 22, October 8, 2026.
About jacks. jacks builds resident schedules inside every one of these rules and checks each draft instantly. The burden of building schedules is real; it is a tooling problem, not a reason to cut rest.
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