This policy is formulated in accordance with the ACGME requirement that institutions sponsoring residency training programs have written policies that address the duty hours required of residents training at that institution, and reflects the ACGME Common Program Requirements for Resident Duty Hours. This policy applies to residents who will be part of the Urology Residency Training Program at MMC.
Physicians will be expected to have a strong sense of personal responsibility for patient care and recognize that their obligation to patients is never automatically discharged to residents. This continuity of care must take precedence without regard to the time of day, day of the week, number of hours already worked, or on-call schedules. In no circumstance should residents go off duty until the proper care and welfare of their patients is ensured. At the same time, patients have a right to expect a healthy, alert, responsive physician dedicated to delivering effective and appropriate care.
The purpose of after-hours calls are to provide patient care, assume clinical responsibility, teach and supervise medical students, and accumulate clinical experience including skill maintenance. Night and weekend duties must be sufficient to permit implementation of the concept of continuity of patient care, and development of clinical skills. Support services are available so residents do not spend an inordinate amount of time in non-educational activities that can be discharged properly by other personnel.
Duty hours are defined as all clinical and academic activities related to the residency 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.
Duty hours will be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.
Residents will 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 1 continuous 24-hour period free from all clinical, educational, and administrative duties. Adequate time for rest and personal activities will be provided. This will consist of a 10-hour time period provided between all daily duty periods and after in-house call.
On-Call Duty Hours
Residents will not be assigned in-house, overnight call duty more often than every third night when averaged over a four-week period.
Urology resident night call may be taken from home at the discretion of the attending staff. If in-hospital night call is required residents will be provided with adequate sleeping, lounge and food facilities. When taking in-house, overnight call, residents will not assume responsibility for new patients after 24 continuous hours on duty.
After a period of up to 24 continuous hours on duty, residents may remain on duty for up to 6 additional hours to maintain continuity of care, transfer care of patients, conduct outpatient clinics, and participate in didactic activities.
Residents are required to record their duty hours weekly in New Innovations and are monitored by the program director. The penalties for noncompliance are outlined in a separate policy “Department of Surgery / Division of Urology Policy on Administrative Compliance”.