The Accreditation Council for Graduate Medical Education (ACGME) issued a multicenter research trial waiver and seed funding to the “Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial” for the 2016−2017 academic year, based on the recommendation of the ACGME Review Committee for Surgery.” The ACGME Task Force reviewing Common Program Requirements for residency training in the U.S. determined that in order to comprehensively evaluate the clinical education and experience environment, “it is premature to issue any proposed modifications to Requirements for the upcoming academic year.”

The American College of Surgeons and American Board of Surgery will continue to collect data during this one-year expansion of the FIRST Trial. During this time, new programs that meet the requirements as of July 1, 2016, will be allowed to enroll in the Trial, and those programs already enrolled will be able to add ongoing data to support future reviews of residency program standards. The one-year expansion will conclude in June 2017.

FIRST Trial results were released online February 2 in the New England Journal of Medicine and presented concurrently at the 2016 Academic Surgical Congress in Jacksonville, FL, by the Trial's principal investigator, Karl Y. Bilimoria, MD, MS, FACS. The findings indicated that surgical residents can work more flexible hours than currently allowed by the ACGME without compromising surgical patient safety.

In addition to the patient safety findings, FIRST Trial results indicated that flexibility allowed for greater continuity of patient care, fewer handoffs to other care providers, and increased resident satisfaction.