Flexible vs. Standard Duty-Hours Restrictions for Residents

In a randomized trial among surgical residents, flexible duty hours (i.e., allowing shifts longer than 16 hours, but maintaining an 80-hour weekly maximum and 1 day off per week) led to equivalent patient outcomes and resident satisfaction compared with restricted duty hours (i.e., prohibiting shifts longer than 16 hours; NEJM JW Gen Med Mar 1 2016 and N Engl J Med 2016; 374:713). In a subsequent study among internal medicine residents (iCOMPARE), researchers randomized 63 U.S. internal medicine residency training programs either to a flexible duty-hours schedule or to a standard restricted-hours schedule. Resident satisfaction outcomes from iCOMPARE have been reported previously (NEJM JW Gen Med May 1 2018 and N Engl J Med 2018; 378:1494).…