Penn Surgery

Colon and Rectal Surgery Residency Program

Policies and Procedures Manual

Duty Hours, Night Call, Service Coverage, and Workplace Environment Policy

  1. The resident will remain compliant with ACGME duty hour restrictions at all times.
    1. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.
    2. Residents must be provided with one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call.
    3. Adequate time for rest and personal activities must be provided. This should consist of a 10-hour time period provided between all daily duty periods and after in-house call.
    4. Duty hour periods of PGY-1 residents must not exceed 16 hours in duration. Duty hour periods of PGY-2 residents and above may be scheduled to a maximum of 24 hours of continuous duty in the hospital. In unusual circumstances, residents, on their own initiative, may remain beyond their scheduled period of duty to continue to provide care to a single patient. Justifications for such extensions of duty are limited to reasons of required continuity for a severely ill or unstable patient, academic importance of the events transpiring, or humanistic attention to the needs of a patient or family. Under those circumstances, the resident must: appropriately hand over the care of all other patients to the team responsible for their continuing care; and document the reasons for remaining to care for the patient in question and submit that documentation in every circumstance to the program director.
    5. Documentation of justifications for remaining beyond 16 hours (PGY1s) and 24 hours (PGY2 and above) must be summited at here.

  2. The primary daytime clinical responsibilities of the resident will be focused at PAH.
    1. The resident will be responsible for morning rounds each day at PAH and will communicate with the responsible attending(s) regarding daily plans for the patients on the colon & rectal surgery service at PAH.
    2. The resident will participate in surgeries, outpatient clinics, endoscopies, inpatient/ED consultations, and educational conferences at PAH.
    3. On days that the resident is assigned to operate at PPMC or HUP, he/she will be expected to complete morning rounds at PAH & directly communicate with the other general surgery resident(s) and physician extenders on the service regarding daily plans for the patients on the service prior to leaving.
    4. On these days, if the resident is not available to field calls regarding patients on the colon & rectal surgery service at PAH, calls should be directed to the other general surgery resident(s) and physician extenders on the service or the patient’s attending physician.
  3. On days the resident is assigned to PPMC and HUP, their primary responsibility will be participating in the operative care of patients.
    1. There are no outpatient clinic responsibilities at PPMC and HUP, and the resident is not required to round on patients at these institutions or see inpatient/ED consults.
    2. The rationale for this is to broaden the resident’s exposure to and experience with operative cases they may not be otherwise exposed to at PAH.
  4. Night call is taken from home, Monday through Thursday evenings and every third weekend.
    1. During weekend call, the resident will round on the patients on the colon & rectal surgery service at PAH and will communicate with the responsible attending(s) regarding daily plans for the patients.
    2. The resident is not required or expected to round on weekends he/she is not on call
    3. Cross-coverage with residents on the general surgery service will be arranged on weekends that the colon & rectal surgery resident is not on call.
  5. The program will be committed to and be responsible for promoting patient safety and resident well-being and to providing a supportive educational environment.
    1. The learning objectives of the program will not be compromised by excessive reliance on residents to fulfill service obligations.
    2. Didactic and clinical education will have priority in the allotment of residents’ time and energy.
    3. Duty hour assignments will recognize that faculty and residents collectively have responsibility for the safety and welfare of patients.

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