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October 2017

Perspective of the FIRST Trial Investigators on Accreditation Council for Graduate Medical Education Changes in Resident Work Environment and Duty Hours

Author Affiliations
  • 1Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
  • 2American College of Surgeons, Chicago, Illinois
  • 3American Board of Surgery, Philadelphia, Pennsylvania
JAMA Surg. 2017;152(10):903-904. doi:10.1001/jamasurg.2017.2218

In 2003 and 2011, the Accreditation Council for Graduate Medical Education (ACGME) placed limits on resident duty hours, but on March 10, 2017, the ACGME issued a national policy change repealing some of these duty hour restrictions, in addition to other changes to protect resident well-being. What is notable here is that the policy change was triggered in part by high-level evidence from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial,1 a national prospective cluster-randomized trial. These new policy changes go into effect July 1, 2017, and are a reversal in direction for the ACGME with respect to duty hours.