ACS in the news

Editor’s note: Media outlets across the U.S., including social media, reported on the February 2 release of the results from the Flexibility In duty hour Requirements for Surgical Trainees Trial (FIRST Trial)—the first national multicenter randomized trial of resident duty hour policies. This month’s “ACS in the News” exclusively presents brief excerpts from news stories covering the FIRST Trial. To access the news items in their entirety, visit the online FIRST Trial Newsroom.

Rookie docs can work longer flex hours safely, study finds

Associated Press, February 2

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

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

Study suggests surgical residents can safely work longer shifts

National Public Radio, February 2

“‘We’re very encouraged by the findings,’ said Dr. Maya Babu, a neurological surgery resident at the Mayo Clinic [Rochester, MN] and [chair] 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.’”

Long shifts for young surgeons don’t threaten patient safety

Reuters, February 2

“The Resident and Associate Society of the American College of Surgeons cheered the results in a statement e-mailed 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.”

Back to extremely long shifts for new surgeons? Study finds few negatives

Washington Post, February 2

“‘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 [MD, MS, FACS], director of the surgical outcomes and quality improvement center at Northwestern Feinberg School of Medicine [Chicago, IL]. [Dr.] Bilimoria led the study, which was published online in the New England Journal of Medicine.”

Surgical residents’ shift length not a factor in patient safety

Health Leaders, February 3

“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.’”

Study: Long shifts by doctors in training do not harm patients

Philadelphia Inquirer, February 25

“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.’”

Flexible schedule for residents allows for safe care, study finds

General Surgery News, March 2

“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, [MI], and [V]ice-[C]hair 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 [a] shift.’”

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