Duty Hours Policy
The Vanderbilt Internal Medicine Program is committed to compliance with the ACGME duty hour guidelines.
In accordance with the new common program requirements dated July 1, 2011: as of July 1, 2011 the following requirements apply to the Internal Medicine Residency Training Program at Vanderbilt:
1. Maximum hours worked per week:
Duty hours must be limited to eighty hours, averaged over a four-week period per rotation or a four-week period, inclusive of all in-house call activities and all moonlighting.
Moonlighting must not interfere for the ability of the resident to achieve the goals and objectives of the education program. Time spent moonlighting must be counted towards the 80-hour maximum weekly hour limit
3. Mandatory time duty free
Residents must be scheduled for a minimum of one day free of duty every week (when averaged over four weeks).
4. Maximum duty period length
Duty periods of the PGY-1 resident must not exceed 16 hours in duration.
Duty periods of the PGY-2 residents and above may be scheduled to a maximum of 24 hours of continuous duty in the hospital. The program encourages residents to use alertness management strategies in the context of patient care responsibilities. Strategic napping, especially after 16 hours of continuous duty and between the hours of 10pm and 8am, is strongly encouraged. It is essential for patient safety and resident education that effective transition in care occur.
Resident may be allowed to remain on-site in order to accomplish these tasks. However, this period of time must be no longer than an additional four (4) hours. Residents must not be assigned additional clinical responsibilities after 24 hours of continuous in-house duty.
In unusual circumstances, 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.
5. Minimum time off between scheduled duty periods
PGY-1 Residents SHOULD have 10 hours, and MUST have 8 hours, free between scheduled duty periods.
PGY-2 residents and above SHOULD have 10 hours, and MUST have 8 hours between scheduled duty periods. They MUST have at least 14 hours free of duty after 24 hours of in-house duty.
6. Maximum frequency of in-house night float
Residents must not be scheduled for more than 6 consecutive nights of night float
7. Maximum number of in-house call frequency
PGY-2 residents and above must be scheduled for in-house call no more frequently than every third night (when averaged over a 4 week period)
8. Logging duty hours
House Staff are responsible for keeping track of the duty hours by logging them 24/7 on the New Innovations web site. This includes any hours spent working in in-house moonlighting.