How would you feel if you knew the doctor putting the stent in your heart was in the 24th hour of his shift? Understandably so, most likely worried. The thoughts running through your head definitely include what would happen if this doctor fell asleep or inadvertently caused a serious injury due to drowsiness. Unfortunately, these are realities that all patients treated in teaching hospitals face. Medical residents often work unimaginably long shifts, sometimes exceeding 24 hours. Fatigue levels at the end of these work periods have contributed to injuries and accidental deaths; It's no secret that humans make more mistakes when they're tired (Bates). Why not just limit shifts to a standard eight- or twelve-hour day? Continuity of care. This concept has led doctors to widely believe that they are immune to the symptoms of fatigue. Only recently has the medical community begun to implement some restrictions on working hours. While continuity of care is certainly important for patient safety and equally important for teaching residents, the potential benefits do not justify the inevitable risks. Fatigue in medical residents is a serious problem and cause for concern for patients around the world. Fatigue and drowsiness are a concern both in and out of the medical field. Humans who work at night often experience disruptions to circadian rhythms. Working for long periods of time can cause memory degradation, inattention and poor coordination. Recently, an oil tanker ran aground near Rhode Island while being piloted by a captain who hadn't slept in 36 hours. In Pedro, Wyo., a driver and brakeman on a train fell asleep and crashed into another train (Moore-Ede). These conditions... middle of paper... phenelzine expressive. Next, the resident ordered meperidine, a medication that should not be taken with phenelzine. Shortly thereafter, Sion suffered respiratory failure and died. The incident led to an investigation, and the grand jury found that the resident had been working for more than 22 hours at the time the medication was ordered. The report cited “poor medical care” and described the residency system as a whole as “counterproductive in providing quality medical care” (“Medical Resident Fatigue”). Regulations have become stricter since 1984, but residents often still work shifts longer than 22 hours. Therefore, the work hour restrictions recently put in place by the ACGME still need to be studied and revised to provide residents with ample time to rest and recover during long shifts to adequately ensure patient safety..