European rules insisting junior doctors work only a 48-hour week have been lifted for at least 50 hospitals.
Britain has been granted a temporary reprieve after health chiefs claimed the EU Working Time Directive might put patient safety at risk.
Doctors at 38 trusts which have been granted permission to derogate from the rules will be allowed to work 52 hours a week averaged over six months until 2011.
The extra hours will only apply to certain specialties such as obstetrics and paediatrics at the hospitals involved, not all junior doctors working there.
The Royal College of Surgeons earlier this week argued that the 48-hour week was interfering with patient care in the NHS, and might be putting patients at risk.
Two thirds of the 900 NHS surgeons surveyed said quality of care had become worse since the introduction of the new working week, while most said doctors were being forced to break the rules to protect patients.
Under the old system, junior hospital doctors would often work 80-hour weeks - which doctors' leaders claimed also endangered patients because they were being treated by tired medics.
In August rules were imposed limiting their working week to 48 hours.
National Clinical Advisor for European Working Time Directive Dr Wendy Reid said most doctors' rotas in NHS hospitals were already complying with the 48-hour week rule.
But she acknowledged that others could not safely cut back hours at present.
She said: 'I am pleased that the overwhelming majority of UK doctors in training are compliant with the working time directive as we know that this will improve patient safety and their work life balance.
'People will remember the stories of junior doctors working 80-hour week and it is great news that these days are gone.
'Patient safety is our top priority in the NHS. We have always said that we would keep the situation under close review and where there is a genuine need for extra time to safely implement the directive we would allow derogation.
'A very small number of services have made this request in order to effectively implement plans and be able to sustain them by 2011.
'The UK remains absolutely committed to enabling all junior doctors to work and train safely, in compliance with the working time directive.'
Dr Shree Datta, chairman of the British Medical Association's Junior Doctors Committee, said: 'We recognise the need for pragmatism in cases where the safe delivery of patient care cannot be guaranteed within a 48-hour week.
'However, there is an urgent need to rethink how junior doctors work and train.
'This is not a new EU rule suddenly imposed on the NHS this year. Trusts have known the Working Time Directive was coming for over ten years, and it is worrying to find that some are so poorly prepared.
'The crux of the matter is that hospitals must work with doctors to find solutions which avoid disruption to patient services, and maintain the quality of training.'
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