Policy Duty Hours

Graduate medical education takes place in the context of provision of direct patient care. Fellows assume progressive responsibility for the care of patients. Of necessity, these experiences require the opportunity to care for patients at all hours, and in varied settings. Recognizing that fellowship is demanding of time and energy, the educational goals of the program and learning objectives of Fellows must not be compromised by excessive reliance on Fellows to fulfill institutional service obligations. Control of the total number of assigned duty hours of the Fellow is an important component of balancing the service versus education in the fellowship. Fellow duty hours and on-call time periods must not be excessive. Duty hours, however, must reflect the fact that responsibilities for continuing patient care are not automatically discharged at specific times. The structuring of duty hours and on-call schedules must focus on the needs of the patient, continuity of care, and the educational needs of the Fellow. Duty hours must be consistent with the Institutional and Program requirements, in accordance with ACGME guidelines as outlined below.

Duty hours are defined as all clinical and academic activities related to the residency/fellowship 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 call activities, and scheduled academic activities, such as conferences. Duty hours do not include reading and preparation for 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 activities.
Trainees 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. This should consist of a 10- hour time period provided between all daily duty periods and after in-house call. The RRC will not consider requests for a rest period that is less than 10 hours.