Dec. 1, 2016
The Accreditation Council for Graduate Medical Education (ACGME) has posted its task force's recommendations for Section VI of the Common Program Requirements, which addresses resident duty (work) hours. The American Board of Surgery (ABS) endorses the task force's revisions, which promote improved continuity of care for patients and greater individual responsibility and professionalism for residents, while also incorporating additional safeguards for patient safety and resident well-being. The changes also permit greater flexibility in resident training by removing the strict 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 (pdf) will be available on the ACGME website for review and comment through December 19, 2016. We strongly encourage members of the surgical community to submit individual comments so that the voice of Surgery is heard in this debate. Based on the comments received, the task force will present its final recommendations to the ACGME Board of Directors for approval in February. If approved, the new requirements would take effect July 1, 2017.
The ABS has encouraged the implementation of greater flexibility in surgical resident work hours, in part through support of the FIRST Trialthe first-ever national multicenter randomized trial of resident work hours. The initial results of the trial showed that permitting more flexibility in resident work hours within the 80-hour workweek had no impact on postoperative complications. Residents with more flexible hours also reported improved experiences with continuity of care, patient safety, skills acquisition, autonomy, and operative volume. Subsequent studies have shown that surgical residents overwhelming prefer more flexible work hours and are using this flexibility selectively when needed to address critical stages in patient care.
The ABS believes that surgical residency training must develop the whole surgeon, including knowledge, skills, professionalism, and above all an overriding duty to the patient. These revisions will contribute to that goal.