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Surgery Residents Welcome Flexible Duty Hour Policies

By HealthLeaders Media News  
   November 28, 2016

Trainees reported more satisfaction with patient safety and continuity of care, but their wellbeing took a hit, according to FIRST Trial analysis.

Not only do general surgery residents strongly prefer flexible policies that allow them to work longer when needed, but such policies also didn't negatively affect patient care, according to new analysis of the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial.

The trial included 3,700 surgeons and compared 59 general surgery residency programs with standard Accreditation Council for Graduate Medical Education surgical resident duty hour requirements to 58 programs that tested a policy waiving certain ACGME rules about maximum shift lengths and mandatory time off between shifts.

Eighty-six percent of the FIRST Trial participants preferred flexible duty (work) hour policies over standard duty hours, or had no preference, according to an analysis of the trial published on the Journal of the American College of Surgeons website.

The surgeons in training preferred policies that allow them the flexibility to work longer when needed to provide patient care, rather than standard, more restrictive work schedules. That preference only grows as they move through their training, according to the study.


Surgical Residents' Shift Length Not a Factor in Patient Safety


Waiving the rules allowed residents to stay longer when they needed to provided patient care or participate in education. Both groups were limited to an 80-hour workweek averaged over four weeks.

An earlier analysis published in the New England Journal of Medicine in March showed that flexible duty hours didn't worsen outcomes or adversely affect overall resident well-being.

The more recent analysis gauged interns, junior residents, and senior residents' perceptions of patient safety, continuity of care, resident education and clinical training, and resident well-being.


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