The Accreditation Council for Graduate Medical Education (ACGME) Board of Directors has announced that first-year residents will be able to work 24-hour shifts, with an additional 4 hours to manage necessary care transitions. The total number of clinical and educational hours for residents has been set to a maximum of 80 hours per week.

The ACGME Common Program Requirements for the 2017 to 2018 academic year will also include work at home toward the 80-hour work week, and residents must also have 1 day free from clinical experience or education.

The 24-hour cap for first-year residents will replace the current 16-hour cap implemented in 2011. Since then, 2 national, multicenter trials compared the 16-hour work week with more flexible schedules. Data from the FIRST trial, published in the New England Journal of Medicine, found that allowing for some flexibility in the 16-hour limit did not worsen patient outcomes and did not negatively affect residents’ overall well-being.

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The iCOMPARE trial for internal medicine, which also investigates the impact of the 16-hour work week compared with more flexible shift schedules, is still ongoing.

 “The question of work hour standards appropriately provokes great emotion in both the graduate medical education community and among segments of the general public,” stated Thomas Nasca, MD, MACP, Chief Executive Officer of the ACGME.

“For its part, the ACGME is committed to a learning environment that serves the best interests of both patients and residents, and will pursue that commitment with open-minded, evidence-based policy making,” Dr Nasca continued. “The ACGME’s oversight of the professional preparation of the next generation of physicians to care for the American public requires nothing less.”


  1. Accreditation Council for Graduate Medical Education. Memo from Thomas J. Nasca, MD, MACP, chief executive officer, March 10, 2017. 
  2. Bilimoria KY, Chung JW, Hedges LV, et al. National cluster-randomized trial of duty-hour flexibility in surgical training. N Engl J Med. 2016;474:713-727. doi:10.1056/NEJMoa1515724