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Duty Hours Policy

The Department of Orthopaedic Surgery follows the University policy for supervision.

Housestaff Duty Hours Policy

The Department of Orthopaedic Surgery follows the Housestaff Duty Hours and Working Environment Policy set by UCSD.  Duty hours are defined as all clinical and academic activities related to the training program, i.e., patient care, administrative duties related to patient care, the provision for transfer of 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.

A.  Duty Hours

  1. Duty hours shall be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.  When a resident on off site, on call duty must return to the hospital, such time in the hospital shall be included in the 80 hour limit.
  2. Each resident shall have one day off in seven days averaged over no more than four weeks.  One day off is defined as once continuous 24-hour period free from all clinical, educational, and administrative activities.  Particular attention should be paid to individual Residency Review Committee program requirements in the event the "one day in seven"" is to be averaged over a shorter period, such as over as little as seven days.
  3. Each resident shall have an adequate time for rest and personal activities.  This shall consist of a 10 hour time period provided between all daily scheduled duty periods and after in-house call.

B.  On-Call Activities

  1. In-house call shall occur no more frequently than every third night, averaged over a four-week period.
  2. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours.  Residents may remain on duty for up to 6 additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics and maintain continuity of medical and surgical care.  Each program must consult with their individual RRC because further limitation may be imposed.
  3. No new patients may be accepted after 24 continuous hours on duty.  A new patient is defined as any patient for whom the resident has not previously provided care.  Exceptions will be elaborated in individual RRC program requirements.  Programs must consult their individual RRC for clarification.

At-home call (pager call) is defined as call taken from outside the assigned institution.

  • The frequency of at-home call is not subject to the every third night limitation.  However, at home call must not be so frequent as to preclude rest and reasonable personal time for each resident.  Residents taking at-home call must be provided with 1 day in 7 completely free from all educational and clinical responsibilities, averaged over a 4-week period.
  • When residents are called into the hospital from home, the hours residents spend in-house must be counted toward the 80-hour limit.
  • The training program director must monitor the demands of at-home call and make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue.