Just how long medical residents should be allowed to work during a shift has been hotly debated by professional organizations and patient safety experts. But policies that restrict residents’ hours may cause more harm than good, according to a controversial new study. The Flexibility in Duty Hour Requirements for Surgical Trainees Trial, known as FIRST concluded the risk of death and serious complication was not greater among patients cared for by surgeons who worked longer than recommended shifts.
In fact, continuity of care, which could lead to fewer mistakes, was more consistent during those longer shifts.
Medical residents had previously been allowed to work shifts of up to 30 consecutive hours, but some argued that sleep-deprived clinicians threaten patient safety.
In 2011, the Accreditation Council for Graduate Medical Education updated its standards, limiting first-year residents to work no more than 16-hour shifts or 80-hour workweeks, and other residents to 24-hour shifts.
The FIRST study aimed to compare the current standards with more flexible hours. Doctors participating in the study had to adhere to the ACGME duty hour requirements, but those working the flexible hour schedules were granted a waiver by the group to work longer shifts and have less time off between shifts when they felt it was necessary.