Duty Hour Extension
On occasion, individual programs could determine a need to extend the 80-hour work rule to a maximum of 10% above the current limit or a total of 88 hours per week.No other extension of the ACGME guidelines is permitted unless specifically stated by the ACGME.Not all RRC's accept applications to extend the 80-hour guideline.
If the request to extend work hours has been approved by the GMEC, then Program Directors must petition the RRC for permission to extend hours.The letter from the GMEC must be used when communicating to the RRC.
Program Directors must use the following guidelines to petition the GMEC.
- Program Directors requesting an extension of duty hours must do so in writing to the Associate Dean for GME.
- Blanket exceptions for the entire educational program should be considered the exception, not the rule.
- The letter must include the following information:
- A description of the resident's work week to delineate specific problem areas
- A clear explanation of why the program cannot maintain the 80-hour limit,
- A clarification of the RRC requirements the program will not meet if residents work 80 or fewer hours,
- Planned monitoring procedures to assure that residents will not work greater than 88 hours per week,
- Information describing how the program will monitor, evaluate and ensure patient safety with extended resident work hours,
- A sound educational rationale that should relate to the program's stated goals and objectives for the particular assignments, rotations and levels of training for which the increase is requested,
- The program's moonlighting policies and how the program will assure that it is accounting for these hours,
- Call schedules for the rotation in question and
- Evidence of faculty development activities regarding the effects of residents fatigue and sleep deprivation.
- The GMEC Subcommittee on Duty Hours will review requests for extensions of duty hours only if the RRC permits.
- The written findings and recommendations of the Sub-committee will be presented at the next regularly scheduled meeting of the GMEC.
- Members of the GMEC, based on the letter from the Program Director and the findings and recommendations of the Sub-committee, will develop its report and send this report to the Program Director.
- The decision of the GMEC is final.
- Program Directors will not implement the extension of duty hours until approved by the ACGME.
- Program Directors must monitor resident work hours on a more intense basis if the ACGME has granted an extension.