The pediatric cardiology fellowship program complies with the institution and departmental policy regarding duty as listed below.
- Fellow duty hours will not be excessive and must be consistent with the program requirements of the RRC. While individual programs may impose more stringent duty hour restrictions, none may have policies less restrictive than these institutional policies.
- On-call time and duty hours should be consistent with the educational needs of the fellow and not be motivated by excessive reliance on the fellows to fulfill institutional service obligations.
- Duty hours are defined as all clinical and academic activities related to the residency program, i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, all activities associated with the transfer of care of patients, time spent in-hospital 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.
- Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-hospital call activities and all moonlighting.
- Fellows must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities. At home call may not be assigned on these free days.
- Adequate time for rest and personal activities must be provided. 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 fellow.
- Fellows 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 fellows are called into the hospital from home, the hours fellows spend in-hospital are counted toward the 80-hour limit.
- Fellows are permitted to return to the hospital while on at-home call to care for new or established patients. While travel time to and from the hospital and time spent in the hospital do count toward the 80-hour limit, these episodes do not initiate a new “off-duty” period. Program directors and faculty must carefully monitor fellows taking home call to be certain that they are not excessively fatigued. Fellows noted to be fatigued from home call activities must be relieved from duty as soon as possible.
- Consistent with Institutional Policy, all outside activity (moonlighting) must comply with all of the duty hours restrictions noted above.
- All policies must be in compliance with all Institutional and RRC specific policies for the specialty.
- Programs must demonstrate valid and reliable methods to demonstrate compliance with the duty hour rules. New Innovations is strongly suggested as the method to monitor duty hours.
- The GMEC will monitor compliance of programs via Internal Reviews, periodic fellow surveys and interviews when needed. Aggregate duty hours violations will be monitored by the GME office using the New Innovations Dashboard function.
- During weeknights, if the fellow is in the hospital after 1 AM, the fellow will call in to sign out to the consult cardiologist and fellow on service at 8 AM and have a post call day. The fellow will not have any clinical responsibilities that day. This will be logged as a day off in New Innovations.