Common Program Requirements
Duty Hours Language
VI.
Resident Duty Hours in the Learning and Working Environment
A. Principles
1.
The program must be committed to and be responsible for
promoting patient safety and resident well-being and to providing a
supportive educational environment.
2.
The learning objectives of the program must not be compromised
by excessive reliance on residents to fulfill service obligations.
3.
Didactic and clinical education must have priority in the allotment of
residents’ time and energy.
4.
Duty hour assignments must recognize that faculty and residents
collectively have responsibility for the safety and welfare of
patients.
B.
Supervision of Residents
The program must ensure that qualified faculty provide appropriate
supervision of residents in patient care activities.
C. Fatigue
Faculty and residents must be educated to recognize the signs of fatigue
and sleep deprivation and must adopt and apply policies to prevent and
counteract its potential negative effects on patient care and learning.
D.
Duty Hours (the terms in this section are defined in the ACGME Glossary
and apply to all programs)
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.
VI.D.
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.
E. 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)
a)
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.
b)
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.
c)
When residents are called into the hospital from home, the
hours residents spend in-house are counted toward the 80-
hour limit.
F. 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.
Duty Hours Language 2
Effective: July 1, 2007
VI.
G.
Duty Hours Exceptions
A Review Committee may grant exceptions for up to 10% or a maximum
of 88 hours to individual programs based on a sound educational
rationale.
1.
In preparing a request for an exception the program director must
follow the duty hour exception policy from the ACGME Manual on
Policies and Procedures.
2.
Prior to submitting the request to the Review Committee, the
program director must obtain approval of the institution’s GMEC
and DIO.
***
ACGME Approved: February 13, 2007
Effective: July 1, 2007
Duty Hours Language 3
Effective: July 1, 2007
