A new landmark national study led by Northwestern Medicine showed allowing surgical residents the flexibility to work longer hours in order to stay with their patients through the end of an operation or stabilize them during a critical event did not pose a greater risk to patients.
The highly anticipated seminal study was published in the New England Journal of Medicine and presented at the Academic Surgical Congress on February 2.
“It’s counterintuitive to think it’s better for doctors to work longer hours,” said principal investigator Dr. Karl Bilimoria, associate professor within the Institute for Public Health and Medicine. “But when doctors have to hand off their patients to other doctors at dangerous, inopportune times, that creates vulnerability to the loss of critical information, a break in the doctor-patient relationship and unsafe care.”
The study also found surgical residents reported no worsening in their overall wellbeing and personal safety when working longer hours. In fact, they noted considerable improvements in patient safety and the quality of their training. Surgical residents have finished medical school and are training for five to seven years to become a general surgeon.
“These results suggest flexible duty hours are safe for patients and beneficial for residents in numerous ways,” Dr. Bilimoria said.
The FIRST (Flexibility in Duty Hour Requirements for Surgical Trainees) trial is the first national randomized trial of resident duty hour policies. Prior smaller studies have suggested there may be worse surgical patient outcomes after the duty hour limits were established in 2003, Dr. Bilimoria said. Thus, the Institute of Medicine requested these types of national trials to be performed in its 2008 report, and the FIRST Trial is the first.