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.
Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.
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.
Adequate time for rest and personal activities must be provided between all daily duty periods. This should consist of a 10-hour time period provided between all daily duty periods, and after in-house call. Residents who extend their work time for patient care or educational opportunities will be exempted by the Program Director from morning rounds or conference to comply with the 10 hour rule. This must be documented at the time of extension via email to the Program Director, Service Chief and Director, Surgery Education Administration.
The objective of on-call activities is to provide residents with continuity of patient care experiences throughout a 24-hour period. In-house call is defined as those duty hours beyond the normal work day when residents are required to be immediately available in the assigned institution.
In-house call must occur no more frequently than every third night, averaged over a four-week period.
At-home call (pager call) is defined as call taken from outside the assigned institution.
- The frequency of at-home call is not subject to the every third night limitation. However, at-home call must not be so frequent as to preclude rest and reasonable personal time for each resident. Residents taking at-home call must be provided with 1 day in 7 completely free from all educational and clinical responsibilities, averaged over a 4-week period.
- When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit.
- The program director and the faculty must monitor the demands of at-home call in their programs and make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue.
The master schedule for all residents
must meet the following rules:
- Minimum time off between shifts = 11 hours
- Maximum shift length PGY 1 = 16 hours
- Maximum shift length PGY 2-5 = 24 hours
- Minimum defined overlap between shift changes = 1 hour
- Minimum time off for 1 in 7 purposes = 25 hours
- Maximum weekly hours = 75 hours