In 1990 the 80-hour weekly limit (average over 4 weeks) was established. In 2011 ACGME capped 1st-year resident shifts at 16 hours after research came out that fatigue due to working many hours at a time was leading to medical errors/deaths. In order to keep duty hours down, many programs opted to work shorter shifts with more residents working and handing off to each other at change of shift. Updated guidelines, which went into effect on July 1, 2017, include changes based on research which found that increased frequency of hand-offs is associated with an increased error rate. The change allows 1st-year residents to work a total of 28-hour shifts (24 hours for shift and additional 4 hours for transitional activities). The rest of the guidelines remain the same. So what does this mean for residents and programs? Each program will have to decide how to incorporate the new guidelines into their call coverage/duty hours. One benefit to the new hour regulations is that fewer residents are necessary to cover weekend and night shifts which allows for more free time/weekends off. In addition, the extra time allotted for transitional activities will allow residents to follow-up on patients they admitted or rounded on throughout the shift. On the flip side, working more hours in a row and changing shifts often still causes the same issues as described above. More research will be done to evaluate whether the change has positively affected medical errors. http://www.acgme.org/What-We-Do/Accreditation/ClinicalExperience-and-Education-formerly-Duty-Hours/History-of-DutyHours Dr. Sachs is a member of the Berks County Medical Society's Executive Council. SUMMER 2017 | 21http://www.kos-spine.com/ http://www.acgme.org/What-We-Do/Accreditation/Clinical-Experience-and-Education-formerly-Duty-Hours/History-of-Duty-Hours http://www.intouchbysah.com/