Resident Duty Hours

The implementation by the ACGME of resident duty hours standards represents a significant initiative designed to create an environment in which residents have time to learn medicine, and to safely and effectively participate in patient care and educational activities. In addition to the UFCOM-J Polices and the ACGME Common Duty Hour Requirements, each Program may implement policies that meet or exceed these standards for Resident Duty Hours. Please see your individual Program policies for any specific requirements beyond those of the Common Requirements set forth by ACGME.

We have established several methods of oversight of resident duty hours to ensure all programs are compliant with the requirements. Two such methods are:

1. Duty Hour Hotline enables Residents and Fellows to report duty hour noncompliance issues in a secure and confidential environment. The UFHSCJ treats all submissions in a serious and confidential manner. Please review the ACGME Standards (below) to be sure that there is, in fact, an issue of noncompliance.
2. Duty Hours Assessment/Survey: residents and fellows will be periodically be asked to log on to the confidential web-based residency management software New Innovations to provide documentation and assessment of actual duty hours.

Accreditation Council for Graduate Medical Education
Common Program Requirements Effective July 1, 2007

Duty hours are defined as all clinical and academic activities related to the program; i.e., patient care (both inpatient and outpatient), administrative duties relative to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled 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, 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.

On-call Activities

1. In-house call must occur no more frequently than every third night, averaged over a four-week period.
2. 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.
3. No new patients may be accepted after 24 hours of continuous duty.
4. At-home call (or pager call)
   • The frequency of at-home call is not subject to the every-third-night, or 24+6 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.
   • When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit.

Moonlighting

1. Moonlighting must not interfere with the ability of the resident to achieve the goals and objectives of the educational program.
2. Internal moonlighting must be considered part of the 80-hour weekly limit on duty hours.

Prevention and Identification of Fatigue

In conjunction with Duty Hours requirements is the focus on the impact of fatigue on a resident during his/her training. ACGME requires that all residents and faculty are trained to recognize the signs and symptoms of fatigue. In addition to program level required training, the informative article, "Prevention, Identification, & Management of Fatigue in Graduate Medical Education," developed by the Office of Graduate Medical Education at Duke University Hospital, is provided.

Resources

ACGME Common Program Requirements and related resources:

ACGME Common Duty Hours Requirements*

Duty Hours FAQ* (very useful)

Duty Hours - Glossary of Terms*

Information Related to the ACGME's Effort to Address Resident Duty Hours and Other Relevant Resource Materials

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