Policy – Duty Hours

The Department of Medicine will comply with the ACGME and UCLA GME Office policies on Duty Hours.

Duty Hours (ACGME)

While the actual number of hours worked by residents may vary, residents should have sufficient off-duty time to avoid undue fatigue and stress. The program director must monitor on-duty schedules for residents to ensure that these assignments do not interfere with education, performance, or clinical care and judgment. The monitoring should ensure

a. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities;

b. 1 full day out of 7 free of program duties;

c. On average, on call no more than every third night;

d. Residents may not work for longer than 30 continuous hours (they may be on call for 24 hours and then have 6 hours to transition care to another physician and to leave the hospital;

e. Adequate backup if patient care needs create resident fatigue sufficient to jeopardize patient care or resident welfare during or following on-call periods;

f. That residents are provided adequate rest between scheduled duty hours;

g. That during on-call hours, residents are provided with adequate sleeping, lounge, and food facilities;

h. That support services are such that residents do not spend an inordinate amount of time in non-educational activities that can be properly discharged by other personnel

Written policies on these matters should be established. Formal educational activity shall have high priority in all the allotment of the resident’s time and energies.

Duty Hours (GME House Staff Manual)

The Program Director or designate will endeavor to:

A. Avoid assigning house officers to continuous hours extended over an unreasonable period of time or to onerous on-call schedules;

B. Fairly schedule duty time of each house officer, including the provision of adequate off duty hours;

C. In addition, a resident’s obligation to patients is not automatically discharged at any given hour of the day or any particular day of the week. Daytime hours and night and weekend call must be sufficient to permit implementation of the concept of responsibility for patients and to provide for adequate patient care. Each Program Director or designate must decide on the frequency of nightcall for house officers in the program. This must be advertised in the appropriate program brochure; anticipated changes to night call requirements must be published in writing prior to implementation.

The Program Director or designate will endeavor to equitably distribute holiday call among house officers at the same postgraduate level subject to patient care requirements (generally observed holidays are New Year’s Day, Martin Luther King Day, President’s Day, a Spring administrative holiday, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day).

Duty Hours (UCLA Department of Medicine)

The Department of Medicine will comply with the ACGME and UCLA GME Office policies on Duty Hours.
All post-call residents need to leave the hospital within 6 hours after their 24-hour call period ends
On the General Medicine Wards, there is no overnight call Mon-Thurs.

The long call team will have a day float join their service the following morning to assist the team with incomplete responsibilities at 7:30 am, Monday through Friday
The medicine float comes in at 5 pm ready to take sign-out from the day float covering the post long call team and the 4 non-long call teams. On Saturday and Sunday the medicine float comes in at 12 noon to take sign out from the post-long call team and any other team that are ready to leave.

The CCU team is comprised of 3 residents and 5 interns. Interns are on overnight call every 5^th night and residents are on overnight call every 6^th night. All post-long call housestaff must leave within 6 hours after their call ends. Interns and residents are expected to sign out to fellow team members.
The MICU team is comprised of 3 residents and 4 interns. Interns are on overnight call every 4^th night and residents are on overnight call every 6^th night. All post-long call housestaff must leave within 6 hours after their call ends. Interns and residents are expected to sign out to fellow team members.
The Solid Oncology service is comprised of 1 resident and 2 interns, and the Bone Marrow Transplant service (J) is comprised of 1 resident and 3 interns. Overnight call is every 5^th night for interns. Residents take home call only, every 4^th night. Post-long call interns sign-out to fellow interns by 1 pm.
All three PGY levels have a first and second jeopardy person available at all times. If at any time excessive patient care needs create resident fatigue sufficient to compromise patient care or resident welfare during or following on-call periods, the chief residents are to be notified and jeopardy will be called in to relieve the houseofficer.