Reader Poll: Relax Residents' Duty-Hour Restrictions?

February 19, 2016

Longer hours by surgical residents don’t pose a greater risk to patients or compromise the health and well-being of doctors in training, a controversial new study claims.

The goal of the FIRST (Flexibility in Duty Hour Requirements for Surgical Trainees) study was to examine the duty-hour restrictions imposed in 2003 by the Accreditation Council for Graduate Medical Education (ACGME). ACGME guidelines limit residents to an 80-hour work week, shifts no longer than 28 consecutive hours, and minimum time off. Of the 117 general surgery residency programs that participated in the randomized trial during the 2014-2015 academic year, about half relaxed duty-hour rules.

The study found that there was practically no difference between residents with standard shifts and those with longer ones, in terms of surgery patients dying or developing serious complications within 30 days. In addition, residents with the more flexible schedules rated their overall well-being and the overall quality of training about the same as those who worked under the stricter rules. But not everyone agrees with the study’s findings. Public Citizen and the American Medical Student Association said the researchers put patients and residents at risk by waiving shift limits. The groups also charged the New England Journal of Medicine, which published the trial, with breaking its own editorial policies by accepting a study that did not afford its subjects proper protection.

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