Resident Hours and Call Schedule

Graduate medical education in surgery requires a commitment to continuity of patient care. This always takes precedence regardless of the time of the day, day of the week, number of hours already worked, or on-call schedule. Transition of care is kept to the minimum and a detailed sign out sheet has been developed to prevent errors during the sign out. At the same time residents providing this continuity of care should be healthy, alert, and responsible and have adequate rest  and in a state of mind capable of communicating well with their colleagues, attendings and other staff members. They should meet all the duty hour requirements by ACGME and Bell Commission.

The residents are provided with sleeping rooms, lounge, reading room and food within the hospital facilities. The residents are provided with laboratory, medical records and radiologic information systems to assist in appropriate quality and timely care of patients. They are also provided with support services to enable them to concentrate on patient care. The residents do have back up support with physician assistants being available during the day  and at night. The on-call schedule is arranged so that continuity of care of patients is maintained. 

To achieve this goal, residents, PGY 11 and above, are divided into 3 teams with each team made up of a resident from each of the different services.  Each team is on call every third night to ensure that each service has a resident on call at all times.  The on-call schedule is designed to meet the provisions as required by the ACGME and Bell Commission. That:

  • Residents are on-call not more often than every 3rd night;
  • Residents are on duty less than 80 hrs/week averaged over a 4 week period;
  • Residents get one day (24 hours) out of seven days free from all clinical and educational responsibilities averaged over a 4 week period;
  • Residents are off duty after 24 hours on-call;
  • There is a 10 hour period provided between daily duty periods for rest and personal activities.
  • Residents are on call 2-3 days per week averaged over 4 weeks.

The PGY1 residents or interns are divided into two groups working during the day and as night floats. The interns:

  • Work for not more than 80hrs per week.
  • Work for not more than 16 hours per day
  • Are on duty for not more than 6 consecutive days/nights
  • When on night float work for not more than two consecutive months and not more than three months in a year. There is at least two months between each night float. 
  • Get one day out of seven free from all clinical activities as the other residents.
  • Get at least 10 hours of rest between daily duty periods. 

Napping time is arranged between 10:00pm and 4:00am for all residents working at night. The program director and faculty monitor the residents for the effects of sleep loss and fatigue. Residents who are fatigued are allowed to sleep in the on call room and if transportation home is needed arrangement is made for such.

Moonlighting by residents is not permitted by the program. The schedule is arranged to make up for vacations and outside rotations.  There is a quarterly   review by the institution of the on-call schedule for the department to make sure these requirements are met.  A report is generated and reviewed by the Advisory Committee.  There is daily login of work hours by the residents to make sure all of the requirements are met.