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Research Letter
September 2018

Evaluation of Reasons Why Surgical Residents Exceeded 2011 Duty Hour Requirements When Offered Flexibility: A FIRST Trial Analysis

Author Affiliations
  • 1Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
JAMA Surg. 2018;153(9):860-862. doi:10.1001/jamasurg.2018.1047

On July 1, 2017, the Accreditation Council for Graduate Medical Education instituted duty hour requirement flexibility by waiving the limits on daily shift lengths while maintaining the 80-hour-per-week cap.1 Of importance, residents can stay only after a 24-hour call if it is their choice to stay longer. Our objectives were to understand how often and why residents in the flexible arm of the Flexibility in Duty Hour Requirement for Surgical Trainees (FIRST) trial (ClinicalTrials.gov identifier NCT02050789) were exceeding duty hour requirements and to determine whether their decision to stay longer was voluntary or attributable to coercion by attending surgeons or senior residents.

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