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FIRST Trial News Coverage

November 2016

Surgery Residents Welcome Flexible Duty Hour Policies
HealthLeaders Media, November 28, 2016

"Not only do general surgery residents strongly prefer flexible policies that allow them to work longer when needed, but such policies also didn't negatively affect patient care, according to new analysis of the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial.

The trial included 3,700 surgeons and compared 59 general surgery residency programs with standard Accreditation Council for Graduate Medical Education surgical resident duty hour requirements to 58 programs that tested a policy waiving certain ACGME rules about maximum shift lengths and mandatory time off between shifts."

Surgery Residents Use Flexible Hours to Enhance Patient Care
Medscape, November 25, 2016

"When surgical residents choose to extend their work hours, they do so selectively and to enhance patients' safety, two new studies indicate.

Karl Y. Bilimoria, MD, director of the Surgical Outcomes and Quality Improvement Center at Northwestern University Feinberg School of Medicine in Chicago, Illinois, and colleagues conducted a survey in conjunction with the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial."

Medical educators consider longer hours for doctors in training

Philadelphia Inquirer, November 23, 2016

"The Philadelphia-based American Board of Surgeons contends that residents — who spend up to six years in training — need flexibility and autonomy to uphold their commitment to patients. The board cited a new survey of surgery residents that found most preferred the freedom to work longer hours when needed to care for patients."

May 2016

ACGME Won't Extend Resident Shifts in 2016-2017
Medscape, May 23, 2016

“That study, the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST), was funded by the ACGME, the American College of Surgeons (ACS), and the American Board of Surgery. In February, the New England Journal of Medicine (NEJM) published the results of FIRST from the 2014-2015 academic year. They showed that longer shifts and less rest in between did not affect the rate of surgical fatalities or serious complications.”

April 2016

Surgery directors like flexible schedules for trainees
Reuters, April 14, 2016

“Compared to program directors at hospitals with restricted work hours, those with flexible hours overwhelmingly reported more positive effects on patient safety, uninterrupted patient care and freedom for residents to attend educational activities.

Most doctors in either group also said flexible hours would improve patient care and resident education and wellbeing, the researchers report in the Journal of the American College of Surgeons.”

March 2016

Flexible Schedule for Residents Allows for Safe Care, Study Finds
General Surgery News, March 2, 2016

"The RAS-ACS 'believes that flexibility in duty hours is not only safely possible; it is essential to provide surgical residents with exposure to the variety and complexity of educational experiences necessary to become fully trained and competent surgeons,' according to the statement.

The residents’ association stressed that residents working in the flexible duty-hour group did not work more hours than those in the standard-policy group, but they worked more effectively because increased flexibility allowed scheduling that provides better continuity of care for patients and minimizes patient handoffs.

They also noted that lack of flexibility in resident duty hours is likely to lengthen surgical training, with some specialties already requiring upward of 10 years of training.

Nicolas Mouawad, MD, a vascular surgeon in Bay City, Mich., and vice chair of the RAS-ACS, was in residency when the 2011 ACGME changes were implemented. 'It’s very difficult for a resident to have to leave in the middle of a case because he or she is at the end of their shift.'"

February 2016

Study: Long shifts by doctors in training do not harm patients
Philadelphia Inquirer, February 25, 2016

"The lead author, Karl Bilimoria, a surgical-outcomes expert at Northwestern University's Feinberg School of Medicine, said the idea that residents often work to the point of extreme exhaustion 'is a misconception.'

'This study was about flexibility, not longer hours,' Bilimoria said. 'It's almost unheard of to work 24 hours without a break. There's always downtime and time to catch naps. We train our residents in fatigue mitigation techniques.'

Surgical Residents' Shift Length Not a Factor in Patient Safety
Health Leaders, February 3, 2016

“The first-ever national randomized trial of resident duty hours involving 117 general surgery residency programs and 151 hospitals found that less-restrictive policies are safe for patients, reduce complications arising from handoffs, and increase resident satisfaction, said study author Karl Bilimoria, MD. He is a faculty scholar at the American College of Surgeons and director of the Surgical Outcomes and Quality Improvement Center at Northwestern University Feinberg School of Medicine in Chicago.”

“The Resident and Associate Society of the American College of Surgeons, which represents more than 13,000 surgical trainees, said in a media release that the study was needed ‘to inform surgical resident duty hour policy. Up until now, there has not been high-level prospective evidence on this important issue.’”

Rookie docs can work longer flex hours safely, study finds
Associated Press, February 2, 2016

“A Mayo Clinic neurosurgery resident, Dr. Maya Babu, said the study results were not at all surprising. She's head of an American College of Surgeons' residents group.

Under the limits, Babu said she has sometimes had to clock out at inopportune times, even in the middle of brain tumor operations, missing important learning opportunities.”

Long shifts for young surgeons don't threaten patient safety
Reuters, February 2, 2016

“The Resident and Associate Society of the American College of Surgeons cheered the results in a statement emailed to Reuters Health, however.

‘Based on the trial’s results, the RAS-ACS firmly believes that flexibility in duty hours is not only safely possible, it is essential to provide surgical residents with exposure to the variety and complexity of educational experiences necessary to become fully trained and competent surgeons,’ the statement said.”

Study Suggests Surgical Residents Can Safely Work Longer Shifts
National Public Radio, February 2, 2016

"‘We're very encouraged by the findings,’ said Dr. Maya Babu, a neurological surgery resident at the Mayo Clinic and president of the Resident and Associate Society of the American College of Surgeons.

‘We feel very strongly that flexibility is important to provide opportunities to learn and to have patient ownership, to see patients from the time they're admitted through surgery the next day.’"

Back to extremely long shifts for new surgeons? Study finds few negatives
Washington Post, February 2, 2016

"They told us very clearly that they thought patient care was better” when residents could work longer shifts within more flexible schedules, said Karl Bilimoria, director of the surgical outcomes and quality improvement center at Northwestern Feinberg School of Medicine. Bilimoria led the study, which was published online in the New England Journal of Medicine."