I find it hilarious to read the comments sections, since no one in the general public realizes that the intern limits are only 5 years old and this revision only reverts back to the pre-2011 rules (with a few tweaks).
The thing is, the rules get written by people who aren’t residents - I was a 3rd year peds resident in 2011, and when the changes were announced, it was obvious to everyone in the room that it wasn’t going to improve patient care. I actually found some of the rules made fatigue an even bigger deal. My program already had implemented a night float system in pretty much every rotation, and in the ICU’s that meant you did between 7 and 10 nights in a row. Not ideal (but my current job as an attending has me do a week of nights 5-6x/yr), but most people, once you had made the switch it wasn’t bad being nocturnal for a stretch, and then you only had to flip on to nights once and flip back once. The 2011 rules limited consecutive nights to no more than 6, which now meant if there were 3 residents in the NICU or PICU they were doing two stretches of 5 nights…now flipping days/nights a total of 4 times which is way more problematic. For us there was definite decrease in continuity of care for our patients as well. With two teams in the NICU in the old system, one resident would end up with a set of patients for the first 20 days of the month, a second would have the other set of patients the last 20 days of the month, and the third resident would start with one set for the first 10 days, go on to nights, and then take the other set of patients the last 1/3 of the month. With the 2011 system, there was a lot more flipping between teams which is not what you want for a bunch of NICU babies that have a lot of administrative things that have to happen in additional to medical things before they go home. Things definitely got dropped at a rate that didn’t happen under the previous rules. So there was more sleep disruption and complex patients had their care compromised…no one benefits.