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9%-94.3%, P less then 0.05). Although well-being decreased over time (85.1%-81.5%, P = 0.01), this was seen globally with no difference between study arms [odds ratio (OR) 0.96 (0.74-1.25)]. Likewise, at the end of the study period, there was no association between flexible policy and duty-hour violations [OR 1.25 (0.95-1.61)] or satisfaction with duty hours [OR 0.80 (0.55-1.19)] compared to standard policy. Residents in flexible duty-hour programs reported significantly fewer lapses in continuity than standard policy residents, until a