The Institute of Medicine's 2008 report Resident Duty Hours: Enhancing Sleep, Supervision, and Safety recommended further changes to housestaff work hours, including reducing shift length and mandating protected sleep time. This position paper from the American College of Surgeons raises the concern that such changes would compromise the education of surgical trainees, resulting in residents lacking the skill and confidence to enter independent practice. The authors argue against further reductions in duty hours, and call for flexibility in the implementation of new regulations in order to preserve trainees' case volume and overall educational experience.