Clinical Responsibilities and Duty Hours

The delivery of high-quality medical care does not lend itself necessarily to regular and predictable working hours. Often, the need for urgent or emergent medical assessment, or the delivery and supervision of specialized procedures (e.g., hemodialysis) arises outside of normal working hours. Many fellows have families and/or other responsibilities, and we recognize this priority holds for everyone. For these reasons, the Renal Division uses a call system for attendings and fellows.

The on-call system is based on "normal working hours" defined generally as 8:00 AM - 6:00 PM Monday through Friday. During those hours fellows are expected to be available by pager or cell phone, to be on the Penn campus, and be ready to fulfill any urgent inpatient or outpatient responsibilities including consults, follow-ups, and procedures. In general, all fellows should complete their existing work sign out to the on-call fellow by 6:00 PM, and not field new phone calls after this time. If the service is light, or if necessary for other reasons, fellows can sign out early with the approval of the attending physician (this should almost always be granted) and the consent of the on-call fellow, who by this consent agrees to fully cover the signed out service. Attending physicians are expected to round early enough to enable the fellow to complete his/her work and leave the hospital by 6:00 PM. See also Report of the ACGME Work Group on Resident Hours. and Institutional Policy on Duty Hours

NOTE: Continuous on-site duty must not exceed 24 consecutive hours. Adequate time for rest and personal activities must be provided. This should consist of a 10-hour period provided between all daily duty periods and after in house call. From ACGME-Approved Specialty Specific Duty Hours Language.(Sections V.F.3.b and V.F.3.c. at http://www.acgme.org/DutyHours/dutyHrs_Index.asp), see also Implementation of ACGME Common Duty Hour Standards

LEAVE OF ABSENCE

Trainees may take up to one month per year of training for vacation time, parental or family leave, or illness (including pregnancy-related disabilities). Training must be extended to make up any absences exceeding one month per year. Vacation leave is essential and must not be forfeited to compensate for extended illness, late starts, parental leave, or other purpose.

JEOPARDY/UNPLANNED ABSENCE

Second and third year fellows serve as jeopardy fellows for four months during the academic year. The duties of the jeopardy fellows are to cover for first year fellows during periods of unplanned absences, such as sickness, urgent family matters or other emergency situations. Typically a third year fellow is appointed leader of a group of three fellows; he/she is responsible for organizing coverage when these situations occur. If circumstances arise, the clinical fellow should notify the supervising Attending and the Program Director at once. The Program Director will then contact the group leader, who will in turn, organizes appropriate coverage.