ACGME Home call rules

[bustbones26]

Okay, I have debated this with another, I will see if anybody here has insight on this.

Let us say that a program has its chief residents take a week of second call. That mean that whenever a junior resident is on call, they must "staff" the case over the phone with the chief resident. The actual staff attending never gets called and doesn't need to be involved unless the patient in question is being discharged from the emergency room or is being admitted to the ICU (a rarity). The chief resident must go in to assist the junior resident if there is any doubt or question about the case, or if the junior resident is just overwhelmed. In addition to taking a week of second call, the chief residents also have to take three first calls during the month.

Now, to be honest, in this particular program, the chief residents on this second call have NEVER had to go in (even though it could happen). They quite honestly are sitting at home taking phone calls from a junior resident acting as "an attending".

Is this system in any violation with ACGME rules. I say no, others say yes.

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[IndyXRT]

The way I understand the rules, home call is not a violation as long as you stay at home. If you are called into the hospital, then you are on the clock. You either have to leave early the next day, or you have to make sure there are 10 hours between when you leave the hospital and when you return (so taking care of things until 9pm or so wouldn't be a problem, but after that, you either stay home or leave early the next day). That's how we ran things in my radiation oncology residency (always home call a week at a time).

 

[Winged Scapula]

As noted above, home call, regardless of the length of time (ie, 1 week vs 49 weeks), even if you have to come in, is not, in and of itself, a violation of the ACGME regulations.

What aspect of this do your colleagues think is a violation bustbones?

 

[Blade28]

Taking call from home doesn't count towards your hours (this is a great way for a program to circumvent the 80-hour workweek rules). Only the hours spent actually driving into, and working in, the hospital in the middle of the night count.

 

[nabeya]

theres nothing unusual about this at all. At my particular program, we take call throughout our 3 years but there is one particular program in my area where they exceed the required number of calls during intern year, and just do "home calls" during 2nd and 3rd year. Like what you're describing, they are just "backup" and I haven't really heard of them actually having to come to the hospital at all.