Mar. 10, 2017
The Accreditation Council for Graduate Medical Education (ACGME) announced (pdf) earlier today the final set of revisions to Section VI of its Common Program Requirements, which addresses resident work hours. The American Board of Surgery (ABS) endorses these revisions, posted last fall for public comment, which promote improved continuity of care for patients and greater responsibility and professionalism for residents. The revised requirements will take effect July 1, 2017.
The changes permit more flexible resident work hours and better continuity of patient care by removing the 16-hour shift limits for first-year residents, and by allowing individual residents to exercise greater autonomy in their decisions to stay with patients during critical phases of care. The revised requirements also institute important new safeguards for patient safety and resident well-being, while providing enough flexibility within the 80-hour workweek so residents are prepared for the realities of independent practice once residency is completed.
These changes follow evidence obtained by the FIRST Trial, the first-ever national multicenter randomized trial of resident work hour policies, that more flexible work hours did not adversely affect postoperative complications or overall resident well-being. In addition, residents in the trial used flexible hours selectively and infrequently, extending shifts when needed to manage key stages in patient care, such as facilitating care transitions or stabilizing critically-ill patients. Residents in the trial also reported preferring more flexible work hours by a large majority.
"The ABS was pleased to see that the approved revisions reflect the results of the FIRST Trial, which showed greater flexibility in surgical resident work hours can prevent disruptions in patient care and surgical education without an adverse effect on patient outcomes," said Dr. Frank Lewis, ABS executive director. "Moreover, the revisions provide the flexibility needed to ensure that residents' ultimate duty is to the patient, not the clock."
We appreciate the many societies, diplomates and residents who submitted comments regarding these revisions.