Duty Hours and Working Environment Policy

  1. Duty Hours

    USF Orthopaedic Surgery Residency Training ProgramDuty 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 hospital site.

    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.

    Each resident shall have one day off in seven days averaged over no more than four weeks. One day off is defined as one 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.

    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.
  2. On-Call Activities

    In-house call shall occur no more frequently than every third night, averaged over a four-week period.

    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.

    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 program director monitors the demands of at-home call and make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue.
  3. Moonlighting

    As identified by the ACGME, residency education is a full-time endeavor. As such, the program director must ensure that moonlighting does not interfere with the ability of the resident to achieve the goals and objectives of the training program. The program director must comply with USF and ACGME policies and procedures regarding moonlighting.

    Any hours a resident works for compensation at the sponsoring institution or any of the sponsor's primary clinical sites must be considered part of the 80-hour weekly limit on duty hours. This refers to the practice o internal moonlighting.
  4. Supervisory Back-up

    Appropriate faculty and/or supervisory resident backup will be provided for every house officer for consultation, education and supervision.

    The University of South Florida's policies and procedures on the residents working environment can be found at the Graduate Medical Education website. These are also distributed at orientation and are available in the program office. Duty hours are monitored frequently to ensure an appropriate balance between education and service.
  5. Resident Fatigue

    Faculty and residents shall be educated to recognize the signs of fatigue. Back up supports systems are provided when patient care responsibilities are unusually difficult or prolonged, or if unexpected circumstances create resident fatigue sufficient to jeopardize patient care.
  6. Leave

    PGY1 residents receive 2 weeks of vacation annually. Residents in PGY2 and above receive 3 weeks of vacation annually.