Science Times: The FIRST Trial: Implications for Neurosurgery

The first concerns about resident duty hours came in the highly publicized aftermath of the Libby Zion case in 1984. In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted national limitations on resident duty periods to 80 h/wk, mandated minimum off-time between duty periods, and shortened overnight shifts. Additionally, in 2011, the ACGME shortened maximum duty periods for interns and increased off-time for residents after overnight call. These policies have elicited considerable criticism from the surgical community, citing studies that show equivocal impact of the policies on improved patient outcomes and resident education and well-being. Many studies have shown that in surgical settings these policies may have made no difference or indeed may have worsened postoperative outcomes and resident education.1,2 Still other studies have suggested an improvement in resident well-being and decreased fatigue since the ACGME policy implementation.

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