DUTY HOURS

 


Any resident that feels unsafe to drive themselves home after work is must either sleep in a call room until they are safe to drive OR call for a cab and be reimbursed by Medical Education.  Submit receipts to Connie Farrington or Diane Ramirez.   

Since July 2003, our program has adhered to the mandatory ACGME duty hour limits with regard to the schedules and expectations by faculty and residents.  The program will assist you if you are exceeding your hours and will make necessary changes.  Please do not wait to be asked if you need assistance.  Contact your resident, chief residents, attending or any other faculty if you require assistance in managing patients, managing time, checking out post-call or adhering to the following rules.

The definitions of these limits come from the ACGME and are further defined in the following excerpts from the “frequently asked questions” document at http://www.acgme.org/acWebsite/dutyHours/dh_faqs.pdf.  Direct excerpts are indicated by italics:

“Duty hours are defined as all clinical and academic activities related to the residency program, ie, patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

a.     Duty hours must be limited to 80 hours per week when averaged over a four-week period, inclusive of all in-house call activities AND ALL MOONLIGHTING.

b.     Residents must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

c.     Duty periods of PGY-1 residents must not exceed 16 hours. 

d.     Duty period of PGY-2 residents and above may be scheduled to a maximum of 24 hours of continuous duty in the hospital.  The activity that drives the 24-hour limit is “continuous duty”.  If a resident spends 24 hours of “continuous duty” time, they are limited to up to four additional hours during which his/her activities are limited to participation in didactic activities, transfer of patient care, and maintaining continuity of medical and surgical care. 

e.     Strategic napping, especially after 16 hours of continuous duty and between the hours of 10:00pm and 8:00am is strongly suggested.

f.     PGY-1 residents should have 10 hours, and must have eight hours, free of duty between scheduled duty periods. 

g.     PGY2, 3 and 4 residents must have eight hours between scheduled duty periods (modified based on December 2011 ACGME IM RRC newsletter).  They must have at least 14 hours free of duty after 24 hours of in-house duty..

Since July 2003, our program has adhered to the mandatory ACGME duty hour limits with regard to the schedules and expectations by faculty and residents.   In 2015, we joined the iCOMPARE trial and were assigned to the “flex schedule”.  Medical students continue to adhere to the ACGME duty hour rules rather than iCOMPARE

 

 “Duty hours are defined as all clinical and academic activities related to the residency program, ie, patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

  1. Duty hours must be limited to 80 hours per week when averaged over a four-week period, inclusive of all in-house call activities AND ALL MOONLIGHTING.

  2. Residents must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

  3. PGY-2 residents and above must be scheduled for in-house call no more frequently than every-third-night (when averaged over a four-week period).

Additional ACGME Rules that are not applicable from 2015-July 2017 due to the flex assignment of iCOMPARE

  1. Duty periods of PGY-1 residents must not exceed 16 hours. 

  2. Duty period of PGY-2 residents and above may be scheduled to a maximum of 24 hours of continuous duty in the hospital.  The activity that drives the 24-hour limit is “continuous duty”.  If a resident spends 24 hours of “continuous duty” time, they are limited to up to four additional hours during which his/her activities are limited to participation in didactic activities, transfer of patient care, and maintaining continuity of medical and surgical care. 

  3. Strategic napping, especially after 16 hours of continuous duty and between the hours of 10:00pm and 8:00am is strongly suggested.

  4. PGY-1 residents should have 10 hours, and must have eight hours, free of duty between scheduled duty periods. 

  5. PGY2, 3 and 4 residents must have eight hours between scheduled duty periods (modified based on December 2011 ACGME IM RRC newsletter).  They must have at least 14 hours free of duty after 24 hours of in-house duty.