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In an effort to balance resident wellness and service, the ACGME (Accreditation Council for Graduate Medical Education) has formally recommended limiting all housestaff to 6000 per steps school. In recent years, ACGME has recommended limittinh housestaff work by either “capping” residents to the number of patients they can manage per day or by specifying work-hours restrictions.

The ACGME feels that by enforcing a strict limit on the total number of steps a resident can take during the day, the proper balance will be struck. Each resident will be given a “Fit-Bit” like device to be worn at all times when in the hospital.

“We had some growing pains as a pilot program for the ACGME,” noted Annie Fellahey, MD, one of the internal medicine core faculty at Southwest Connecticut Health Center. “We had a few residents who nervously paced and seemed to eat up their step limit too fast,” Fellahey continued, “but in the end we think 6000 steps is just right.”

Dr. Mary Mahoom, another faculty member at involved in the pilot program said the attendings had to be vigilant to be sure the residents were not trying to go over their step limit. “We caught one extremely motivated second year resident who wanted to match in a Cardiology Fellowship who made his interns push him through the hospital in a wheelchair so he would never be over his steps. We found him riding in his wheelchair to every code just so he could practice putting in central lines. In the end, we spoke to this resident and had to teach him how dangerous it is to practice medicine when you’ve taken too many steps in a day.”

ACGME has been criticized in the past allowing housestaff to become “soft” and not be ready to tackle the real world needs of being an attending. While ultimately senior residents may go up to 7000 steps per day, the ACGME feels they have struck just perfect balance.

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