Newly revised duty hours have been approved by the ACGME and were effective July 1, 2011. Please visit the ACGME web site at www.acgme.org for full details or see link below to go directly to the approved new standards. The basic requirements are as follows:
- Maximum Hours of Work per Week - Duty hours must be limited to 80 hours per week, averaged over a 4 week period, inclusive of all in-house call activities and all moonlighting.
- Moonlighting - Time spent by residents in Internal and External Moonlighting must be counted towards the 80-hour Maximum Weekly Hour Limit. PGY-1 residents are not permitted to moonlight.
- Mandatory Time Free of Duty - Residents must be scheduled for a minimum of 1 day free of duty every week (when averaged over 4 weeks). At-home call cannot be assigned on these free days.
- Maximum Duty Period Length - Duty periods of PGY-1 residents must not exceed 16 hours in duration.
- Maximum Duty Period Length - Duty periods of PGY-2 residents and above may be scheduled to a maximum of 24 hours of continuous duty in the hospital. It is essential for patient safety and resident education that effective transitions in care occur. Residents may be allowed to remain on-site in order to accomplish these tasks; however, this period of time must be no longer than an additional 4 hours. Residents must not be assigned additional clinical responsibilities after 24 hours of continuous in-house duty.
- Minimum Time Off between Scheduled Duty Periods - PGY-1 residents should have 10 hours, and must have 8 hours, free of duty between scheduled duty periods.
- Minimum Time Off between Scheduled Duty Periods - Intermediate-level residents (PGY-2) should have 10 hours free of duty, and must have 8 hours between scheduled duty periods. They must have at least 14 hours free of duty after 24 hours of in-house duty.
- Minimum Time Off between Scheduled Duty Periods - Residents in the final years of education (PGY-3 and PGY-4) must be prepared to enter the unsupervised practice of medicine and care for patients over irregular or extended periods. These residents should have 8 hours free of duty between scheduled duty periods. Circumstances of return-to-hospital activities with fewer than 8 hours away from the hospital by PGY-3 and PGY-4 residents must be monitored by the program director.
- Maximum In-House On-Call Frequency - PGY-2 residents and above must be scheduled for in-house call no more frequently than every 3rd night (when averaged over a 4-week period).
The Ob/Gyn RRC defines circumstances of return-to-hospital activities with fewer than 8 hours away from the hospital by PGY-3 and PGY-4 residents as: required continuity of care for a severely ill or unstable patient, or a complex patient with whom the resident has been involved; events of exceptional educational value; or, humanistic attention to the needs of a patient or family. Residents during the their final years of training (PGY-3 and PGY-4) should notify the Administrative Chiefs whenever they have returned to duty with less than 8 hours between shifts and the circumstance; this will be monitored by the Program Director for frequency of occurrence.