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Radiology Resident Duty Hours & Working Environment

DEPT: MEDICAL EDUCATION

POLICY #: 8240.10.2

GOAL

To provide guidelines for compliance to ACGME requirements for resident clinical experience and education (formerly duty hours and the working environment).

POLICY

1. The Radiology Residency Program is to schedule resident assignments to be in compliance with all applicable ACGME requirements. Clinical and educational work hour assignments must recognize that faculty and residents collectively have responsibility for the safety and welfare of patients. The program must be committed to and be responsible for promoting patient safety and resident well-being and to provide a supportive educational environment. This policy is to be communicated to the residents and faculty annually and applies to all participating sites where residents are trained. On a quarterly basis, resident must log their clinical and educational work hours for a 28-day period. The clinical experience and education work hour report will be submitted to the GMEC for review.

2. Maximum Hours of Clinical and Educational Work per Week: Clinical and educational work hours are limited to no more than 80 hours per week, averaged over a 4-week period, inclusive of all in-house clinical and educational activities, clinical work done from home, and all moonlighting (both external and internal).

3. Mandatory Time Free of Clinical Work and Education:

a) The program must design an effective program structure that is configured to provide residents with educational opportunities, as well as reasonable opportunities for rest and personal well-being.

b) Residents should have eight hours off between scheduled clinical work and education periods.

i) There may be circumstances when residents choose to stay to care for their patients or return to the hospital with fewer than eight hours free of clinical experience and education. This must occur within the context of the 80-hour and the one-day-off-in-seven requirements.

c) Residents must have at least 14 hours free of clinical work and education after 24 hours of in-house call.

d) Residents must be scheduled for a minimum of one day in seven free of clinical work and required education (when averaged over four weeks). At-home call cannot be assigned on these free days.

4. Maximum Clinical Work and Education Period Length

a) Clinical and educational work periods of radiology residents are limited to 24 hours of continuous scheduled clinical assignments in the hospital or other training site. The resident may remain on-site for transition of care and/or to attend an educational conference when that transition is completed, but may not be assigned additional clinical responsibilities during those 4 hours. The program encourages the resident to use alertness management strategies in the context of patient care responsibilities.

5. Clinical and Educational Work Hour Exceptions

a) In rare circumstances, after handing off all other responsibilities, a resident, on their own initiative, may elect to remain or return to the clinical site in the following circumstances:

(1) to continue to provide care to a single severely ill or unstable patient;

(2) humanistic attention to the needs of a patient or family; or,

(3) to attend unique education events.

b) These additional hours of care or education will be counted toward the 80-hour weekly limit.

6. In-House Night Float: Night float must occur within the context of the 80-hour and one-day-off-in-seven requirements.

7. Maximum frequency of in-house call: Residents must be scheduled for in-house call no more frequently than every-third-night (when averaged over a four-week period). There is no at-home call.

DEFINITIONS

Clinical Experience and Education Activities: All clinical and academic activities related to the program. This includes patient care, administrative duties relative to patient care, provision of transfer of patient care, on-call time spent in-house, and scheduled activities such as conferences.

COTTAGE HEALTH POLICY

RECOMMENDED BY: B. Chow, M.D. (PD) DATE: 9/14
ORIGINAL POLICY EFFECTIVE DATE: 7/11
APPROVED BY: GMEC/E. Wroblewski, M.D. (CMO) DATE: 9/18
DATE REVISED: 1/18
DATE REVIEWED: 9/14