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Duty Hours: Now Versus Then

The 2011 "Resident Duty Hours in the Learning and Working Environment" replaced 2003 regulations from the ACGME. Here is a comparison of some of the 2003 and 2011 standards:

Maximum Hours Per Week

2003: Duty hours limited to 80/week, averaged over a 4-week period, inclusive of in-house call activities.

2011: Also counts moonlighting hours in the 80-hour limit.

Exceptions

2003: A review committee may grant exceptions for up to 10% or a maximum of 88 hours to individual programs.

2011: Same.

Moonlighting

2003: Internal moonlighting must be counted toward the 80-hour limit.

2011: Also counts external moonlighting hours toward the limit.

Maximum Duty Period

2003: Continuous on-site duty must not exceed 24 consecutive hours. Residents may remain on duty for up to 6 additional hours for didactic activities, transfer care of patients, outpatient clinics, or to maintain continuity of care. No new patients may be accepted after 24 hours of continuous duty.

2011: Maximum 16 consecutive hours for first-year residents. For second-year residents and above, in-hospital duty periods must not exceed 24 consecutive hours. Strategic napping is strongly suggested, especially after 16 hours of duty and between 10 p.m. and 8 a.m. Residents may remain on-site for up to 4 more hours for essential transitions of care but must not be assigned additional clinical responsibilities after 24 hours of continuous in-house duty. In unusual circumstances, residents may take the initiative to stay beyond the duty period to care for a single patient.

Time Off

2003: One day in 7 free of responsibilities, averaged over 4 weeks, inclusive of call. Ten hours off between duty periods and after in-house call should be provided.

2011: Time off between duty periods must be at least 8 hours and should be 10 hours. Intermediate-level residents must have at least 14 hours free after 24 hours of in-house duty. No more than 6 consecutive nights of night float allowed.

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The 2011 "Resident Duty Hours in the Learning and Working Environment" replaced 2003 regulations from the ACGME. Here is a comparison of some of the 2003 and 2011 standards:

Maximum Hours Per Week

2003: Duty hours limited to 80/week, averaged over a 4-week period, inclusive of in-house call activities.

2011: Also counts moonlighting hours in the 80-hour limit.

Exceptions

2003: A review committee may grant exceptions for up to 10% or a maximum of 88 hours to individual programs.

2011: Same.

Moonlighting

2003: Internal moonlighting must be counted toward the 80-hour limit.

2011: Also counts external moonlighting hours toward the limit.

Maximum Duty Period

2003: Continuous on-site duty must not exceed 24 consecutive hours. Residents may remain on duty for up to 6 additional hours for didactic activities, transfer care of patients, outpatient clinics, or to maintain continuity of care. No new patients may be accepted after 24 hours of continuous duty.

2011: Maximum 16 consecutive hours for first-year residents. For second-year residents and above, in-hospital duty periods must not exceed 24 consecutive hours. Strategic napping is strongly suggested, especially after 16 hours of duty and between 10 p.m. and 8 a.m. Residents may remain on-site for up to 4 more hours for essential transitions of care but must not be assigned additional clinical responsibilities after 24 hours of continuous in-house duty. In unusual circumstances, residents may take the initiative to stay beyond the duty period to care for a single patient.

Time Off

2003: One day in 7 free of responsibilities, averaged over 4 weeks, inclusive of call. Ten hours off between duty periods and after in-house call should be provided.

2011: Time off between duty periods must be at least 8 hours and should be 10 hours. Intermediate-level residents must have at least 14 hours free after 24 hours of in-house duty. No more than 6 consecutive nights of night float allowed.

The 2011 "Resident Duty Hours in the Learning and Working Environment" replaced 2003 regulations from the ACGME. Here is a comparison of some of the 2003 and 2011 standards:

Maximum Hours Per Week

2003: Duty hours limited to 80/week, averaged over a 4-week period, inclusive of in-house call activities.

2011: Also counts moonlighting hours in the 80-hour limit.

Exceptions

2003: A review committee may grant exceptions for up to 10% or a maximum of 88 hours to individual programs.

2011: Same.

Moonlighting

2003: Internal moonlighting must be counted toward the 80-hour limit.

2011: Also counts external moonlighting hours toward the limit.

Maximum Duty Period

2003: Continuous on-site duty must not exceed 24 consecutive hours. Residents may remain on duty for up to 6 additional hours for didactic activities, transfer care of patients, outpatient clinics, or to maintain continuity of care. No new patients may be accepted after 24 hours of continuous duty.

2011: Maximum 16 consecutive hours for first-year residents. For second-year residents and above, in-hospital duty periods must not exceed 24 consecutive hours. Strategic napping is strongly suggested, especially after 16 hours of duty and between 10 p.m. and 8 a.m. Residents may remain on-site for up to 4 more hours for essential transitions of care but must not be assigned additional clinical responsibilities after 24 hours of continuous in-house duty. In unusual circumstances, residents may take the initiative to stay beyond the duty period to care for a single patient.

Time Off

2003: One day in 7 free of responsibilities, averaged over 4 weeks, inclusive of call. Ten hours off between duty periods and after in-house call should be provided.

2011: Time off between duty periods must be at least 8 hours and should be 10 hours. Intermediate-level residents must have at least 14 hours free after 24 hours of in-house duty. No more than 6 consecutive nights of night float allowed.

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Duty Hours: Now Versus Then
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