Implementation of resident duty hour policies has resulted in a need to document work hours accurately. We compared the number of self-reported duty hour violations identified through an anonymous, resident-administered survey to that obtained from a standardized, ACGME-sanctioned electronic tracking system.

10 cross-sectional surveys were administered to general surgery residents over five years. A resident representative collected and de-identified the data.

A median of 54 residents (52% male) participated per cohort. 429 responses were received (79% response rate). 111 violations were reported through the survey, while the standardized electronic system identified 76, a trend significantly associated with PGY-level (p < 0.001) and driven by first-year residents (n = 81 versus 37, p = 0.001).

An anonymous, resident-run mechanism identifies significantly more self-reported violations than a standardized electronic tracking system alone. This argues for individual program evaluation of duty hour tracking mechanisms to correct systematic issues that could otherwise lead to repeated violations.

A resident-run duty hour reporting mechanism identifies significantly more self-reported violations among general surgery residents than an institutional electronic tracking system, a trend associated with PGY-level and primarily attributed to increased reporting among first-year residents. An anonymous, peer-to-peer reporting system represents a practical and sustainable strategy to identify resident work hour violations and can generate more complete duty hour data than traditional electronic self-reporting methods alone.