Duty Hour Policy
The Quincy Family Medicine Residency Program recognizes that resident education is maximized by a balance between patient care, programmatic education, and self-study. Additionally for resident well being, adequate time must be provided for rest and attention to personal needs. 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 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.
- Duty hours are limited to 80 hours per week averaged over four weeks, including all moonlighting and time at the hospital during at home call. Call will occur no more frequently than every third night averaged over four weeks. Residents have an average of one day in seven free from all educational and clinical responsibilities. Usually this is provided as two weekends off for each four week block. The notable exception is the Emergency Medicine block where residents receive one day off each week.
- PgY1 residents work a maximum of 16 hour work periods.
- PgY2 and PgY3 residents maximum work period is 24 hours plus an additional period of four hours. During these four hours, no morning continuity clinic will be scheduled. The resident is encouraged to use this time for patient care transfer, program conferences, clinical tasks, attending rotation and/or self-directed activities.
- In unusual circumstances, PgY2 or PgY3 residents, on their own initiative, may remain beyond their scheduled period of duty to continue to provide care to a single patient. Justifications for such extensions of duty are limited to reasons of required continuity for a severely ill or unstable patient, academic importance of the events transpiring, or humanistic attention to the needs of a patient or family. Under those circumstances, the resident must appropriately hand over the care of all other patients to the team responsible for their continuing care; and, document the reasons for remaining to care for the patient in question and submit that documentation in every circumstance to the program director. The program director must review each submission of additional service, and track both individual resident and program-wide episodes of additional duty.
- For at home call, time in the hospital (actively engaged in patient care) counts toward the eighty hour limit. At home call is not subject to every third night limitation but the resident must be off one day every week averaged over four weeks. The PgY2 or PgY3 may return to the hospital to care for new or established patients. This time is included in the eighty hour limit but does not initiate a new "off duty" period.
Duty hours will be monitored in the following ways:
- Routine review at Director and Chief Resident Conferences.
- Regular evaluation in New Innovations.
- The chief resident will review/investigate any reported concerns from New Innovations and/or Duty Hour Incident Form and report programmatic issues to the faculty. Program changes will be made if needed.
- Institutional evaluation.
- As needed if signs of resident fatigue are noted.
Amended: July 2011
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