A recent cluster-randomized trial found no significant differences in patient outcomes or resident satisfaction between residency programs with flexible duty hours and those with standard duty hours. This survey examined surgical program directors' perceptions within this trial. Respondents from flexible duty hours programs reported a more positive effect of duty hours on patient safety, continuity of care, and attendance at educational activities. These results echo earlier studies that found clinical faculty had concerns about duty hour restrictions leading to a loss of educational opportunities, decreased continuity of care, and worsened resident–patient relationships.