Duty Hour Policy

revised September 08

The Internal Medicine Residency Program is committed to complying with the ACGME duty hour requirements:

Duty hours are defined as all clinical and academic activities related to the 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.
  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 one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call.
  3. Adequate time for rest and personal activities must be provided. This should consist of a 10-hour time period provided between all daily duty periods and after in-house call. (RRC-IM Requirements VI.D)

Duty Hour Reporting

Residents are required to verify all duty hours at least weekly on the program’s data management system. The Residency Program will distribute duty hour tracking completion compliance reports to all residents and program leadership the beginning of each work week.

Duty Hour compliance reports will be generated and sent to Program Directors, Service Chiefs, and Chief Residents weekly. Service Chiefs are responsible for ensuring systems are in place at each of their facilities to ensure residents can comply with duty hour requirements. Chief residents will communicate duty hour violations with attending faculty and residents, and will work with all parties to identify the source of violations.

When residents are required to return to the medical centers from to care for patients, all hours spent in the hospital must be entered as Home-Call in VerinformRM. In addition to reporting duty hours on Verinform, residents are expected to inform the Chief Medical Resident if the demands of home call are excessive so that a Back-Up coverage plan can be implemented as outlined in the Guidelines for Backup Coverage.

Monitoring Fatigue and Excessive Service Demands

Chief Medical Residents, Service Chiefs and Program Directors receive annual training in assessing fatigue and the assessment of sleep deprivation. Chief Residents and faculty are expected to monitor resident fatigue and institute alternative coverage as outlined in the Guidelines for Backup Coverage.

In the event that service demands exceed patient safety standards, Service Chiefs and Chief Residents will work with Program Directors to initiate alternative coverage as outlined in the Guidelines for Backup Coverage.

Moonlighting

The UW School of Medicine the Internal Medicine residency program do not encourage moonlighting. Only R3s and R4s may request permission to moonlight and must comply with the School of Medicine Moonlighting Policy. Approved moonlighting activities must not interfere with the ability of residents to achieve the goals and objectives of the educational program.

Any resident/fellow who wishes to engage in moonlighting activities must complete a Resident/Fellow Disclosure and Request for Approval of Moonlighting Activities and receive approval from the Program Director and the Assistant Dean for Graduate and Medical Education. The approval of a Request for Approval is only valid for one academic year. The resident/fellow must submit a new Request for Approval each year.

All hours spent engaging in moonlighting activities (including both internal and external moonlighting) must comply with the duty hours standard described above. Noncompliance with the duty hours policy will result in revocation of approval to engage in moonlighting activities.