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October 2017

Perspective of Residency Program Directors on Accreditation Council for Graduate Medical Education Changes in Resident Work Environment and Duty Hours

Author Affiliations
  • 1Department of Surgery, University of North Carolina at Chapel Hill
  • 2Department of Surgery, North Florida/South Georgia Veterans Health System, Gainesville
  • 3University of Florida, Gainesville
  • 4Department of Surgery, Oregon Health and Science University, Portland
JAMA Surg. 2017;152(10):905-906. doi:10.1001/jamasurg.2017.2206

The Accreditation Council for Graduate Medical Education (ACGME) recently finalized major changes to section VI of the common program requirements for resident training that will go into effect July 1, 2017. Building on data from the Flexibility in Duty Hour Requirements for Surgical Trainees trial, among others, these changes are broadly supported by members of the surgical community, including both program directors and residents, who indicated a desire for greater flexibility in training based on data analyzed from the Flexibility In Duty Hour Requirements for Surgical Trainees trial.1-4 The ACGME solicited and thoughtfully evaluated data from a variety of sources, importantly considering the perspective of residents. While much discussion will rightly focus on changes to the duty hour regulations, the new requirements signal a clear effort by the ACGME to take a broader philosophical approach to training inclusive of the global resident work environment, wellness, and quality of care. There is increased emphasis on patient safety and quality improvement, further aligning the program requirements with the ACGME Clinical Learning Environment Review program. An expanded portion of the requirements is devoted to well-being, and the language devoted to duty hours is more broadly subtitled clinical experience and education, of which work hours is only a single aspect. These changes recognize that training residents extends beyond how many hours they work and includes a number of important aspects of development for the modern physician.

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