Policy on Resident Duty Hours

Residents and faculty must be familiar with and comply with the following policy concerning duty hours and call, which is taken from the standards of the Accreditation Council for Graduate Medical Education.

1. Duty Hours Duty hours are defined as all clinical and academic activities related to the residency program, ie, patient care, administrative duties related to patient care, time spent in-house during call activities, and scheduled academic 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 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.
   3. There must be a minimum 10-hour time period provided between all daily duty periods and after in-house call.
   4. 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 care.
   5. No new patients/cases may be accepted after 24 hours of continuous duty.
2. On-Call Activities
   1. In-house call is defined as those duty hours beyond the normal workday when residents are required to be immediately available in the assigned institution.
      1. In-house call must occur no more frequently than every third night, averaged over a four-week period.
   2. At-home call (pager call) is defined as call taken from outside the assigned institution.
      1. Residents taking at-home call must be provided with 1 day in 7 completely free from all educational or clinical responsibilities, averaged over a 4-week period.
      2. When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit.
3. Moonlighting
   1. Because residency education is a full-time endeavor, moonlighting activities must not interfere with the ability of the resident to achieve the goals and objectives of the educational program.
   2. Moonlighting that occurs within the residency program and/or the sponsoring institution (e.g. St. Paul Hospital, Medical Examiner) must be counted toward the 80-hour weekly limit on duty hours.
4. Compliance and oversight
   1. All residents and faculty must be familiar with and comply with the policies and procedures governing resident duty hours and the working environment.
   2. Back-up support systems must be provided when patient care responsibilities are unusually difficult or prolonged, or if unexpected circumstances create resident fatigue sufficient to jeopardize patient care. The Chief Residents and directors of service rotations are responsible for the organization of back-up support systems.
   3. Monitoring of duty hours is required with frequency sufficient to ensure an appropriate balance between education and service. The Residency Office will periodically monitor compliance with regulations concerning duty hours. Residents are expected to participate in this documentation.