Doctors training at hospitals should limit how long they work without a sleep break to reduce the chances of fatigue-related medical errors and improve their learning environment, an expert panel in the U.S. recommended.

The report by the Institute of Medicine, an independent organization that advises the U.S. government on health, recommended that residents working the maximum 30-hour shift should get an uninterrupted five-hour break for sleep after 16 hours or work a maximum of 16 straight hours.

"Fatigue, spotty supervision and excessive workloads all create conditions that can put patients' safety at risk and undermine residents' ability to learn," committee chair Michael Johns, chancellor of Emory University in Atlanta, said in a release Tuesday.

Committee members said they found violations of the current limits were common and residents seldom complained.

The report also recommended that:

• Experienced physicians supervise residents more closely.
• Residents' schedules include overlaps to reduce chances for error from poor communication as one doctor hands over care of patient to the next team.
• The number of mandatory days off each month is increased.

To enact the changes, the report's authors called for more funding for teaching hospitals, which they estimated would cost $1.7 billion US per year.

An earlier report by the same group said the extra medical costs of treating medication errors amounted to at least $3.5 billion US a year.

'Step in right direction'

In 2003, the Accreditation Council for Graduate Medical Education, or ACGME, a nonprofit group that evaluates and accredits U.S. medical residency programs, limited the number of hours per week a resident could work.

Before then, residents in some specialties could log an average of 110 hours a week.

The ACGME will meet in early March 2009 to review the report as part of its discussion on possible adjustments to the rules, the council said.

Residency training takes three to seven years.

"It ought to be rigorous," said institute panelist Dr. Daniel Munoz of Johns Hopkins University School of Medicine in Baltimore. "But it also ought to be humane, and it ought to be safe for both patients and for residents."

Rebecca Sadun of the American Medical Student Association said the recommendations are "unambiguously a step in the right direction."

Sadun, a medical student at University of Southern California's Keck School of Medicine, said residents have told her association that the 80-hour work weeks really add up to 100-hour work weeks.

Fatigue is a key factor for safety in hospitals, sleep experts told a medical safety conference in Edmonton in 2004.

With files from Associated Press, Reuters