RESIDENT DUTY HOURS STATEMENT OF POLICY Residents’ duty hours must reflect and reinforce the physician’s obligation for adequate, continuous patient care while at the same time recognizing that prolonged and difficult hospital duties detract from this obligation. It is further recognized that adequate leisure time is important for the resident’s personal development and health. A. Duty hours are defined as all clinical and academic activities related to the residency program, i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during on-call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site. B. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities. "In-house" moonlighting must be counted toward the 80-hour limit. Moonlighting in any MUSC facility, the Ralph H. Johnson VA Medical Center, St. Francis Hospital, Roper Hospital, Trident Hospital, East Cooper Hospital or any facility affiliated with a specific residency program, is considered "in-house" moonlighting. C. Residents must be provided with one day in seven, averaged over a four-week period, free from all educational and clinical responsibilities inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities. D. In-house call must occur no more frequently than every third night, averaged over a four week period. Certain specialities have more restrictive requirements regarding the scheduling of in-house call. (See your RRC Program Requirements for more details.) E. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. Residents may remain on duty for up to six additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics and maintain continuity of medical and surgical care (unless further limited by the relevant Program Requirements.) F. No new patients may be accepted after 24 continuous hours on duty. A new patient is defined as any patient for whom the resident has not previously provided care (unless otherwise defined in the relevant RRC Program Requirements.) G. Adequate time for rest and personal activities must be provided. This should consist of a ten (10) hour time period provided between all daily duty periods and after in-house call. If a resident is called into a facility from home call, the ten-hour interval does not reset. It is based on the initial time the resident left the facility or ended his/her duty period. H. The frequency of at-home call (pager 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 one day in seven completely free from all educational and clinical responsibilities, averaged over a four-week period. At-home call is defined as call taken from outside the assigned institution. I. When residents are called into the hospital or clinic from home, the hours they spend in the facility are counted toward the weekly 80-hour limit. J. 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. K. An RRC may grant exceptions for up to 10% of the 80-hour limit, to individual programs based on a sound educational rationale. However, prior permission of MUSC's GMEC is required. L. Faculty and residents must be educated to recognize the signs of fatigue and adopt and apply policies to prevent and counteract the potential negative effects. PROCEDURES:
- All residents are required to report their duty hours using the E*Value system. Residents must log their duty hours a minimum of once every fifteen days. If fifteen days pass without a resident logging his/her duty hours, a verbal warning will be issued by the Program Director. At the second occurrence the resident will be sent home using a vacation day so that s/he may immediately log delinquent duty hours. Repeated failure to report duty hours or falsification of duty hours will result in suspension and/or termination from the residency program.
- Residents who encounter problems or difficulty complying with the ACGME duty hours requirements should resolve this matter with his/her program director. If the matter cannot be resolved with the program director or if the resident encounters violations, s/he should contact the Designated Institutional Official for GME.
|