NEW ACGME regulations

[schrute]

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Follow-up for those who have read the regulations:

i get the impression that PGY1s CAN take in-house call, correct? the 'in-house call requirements' statement about no less than Q3 call mentions "PGY2 and above"...it doesn't say anything about PGY1...so can PGY1s still take in-house call? or is it "implied" that they can't take call period?

I guess you can interpret that statement either way: 1.) implied that PGY1s can't take in-house call period, or 2.) implied that the 'not less than Q3 rule' only applies to PGY2 and above, and PGY1s CAN take call more frequently.

 

[lipomas]

Well, simple logic would dictate that if PGY1s never take call, then call isn't being "dumped" on anyone. Because when these PGY1s advance they will start taking the "extra" call also.

 

[gschl1234]

Well, simple logic would dictate that if PGY1s never take call, then call isn't being "dumped" on anyone. Because when these PGY1s advance they will start taking the "extra" call also.

Not for the people who are no longer first years and took call their first year before the new rules.

 

[icpshootyz]

Not for the people who are no longer first years and took call their first year before the new rules.

Yeah, it's going to suck for senior residents if this goes through. But they're not getting "dumped" on, a major rule change is taking place that's out of everyone's control. At my program we've already talked about easing the burden - so whereas all our AP call used to be done by 1st years, it will likely now be divided hierarchically amongst 3rd and 4th years and even rarely the fellows. Won't be fun, but it won't compare to the load that we used to place on 1st years, either.

 

[KCShaw]

"Question: Can PGY-1 residents take at-home call, and if so what are the work-hour restrictions for this? Answer: PGY-1 residents are limited to a 16-hour shift and are not allowed to take at-home call. Note: a shift can be defined as 7:30 AM to 11:30 PM."

Finally found that this is from the Standards FAQ found at www.acgme-2010standards.org

I agree this would be phenomenally idiotic. Furthermore, as far as I can tell, this is the only place that remotely makes such a claim; the standards as written and even some of the other Q&A's from the FAQ I believe imply otherwise, and certainly don't flatly preclude at-home call as this isolated statement tries to.

 

[lipomas]

Not for the people who are no longer first years and took call their first year before the new rules.

Yeah but how much call, really, did you take first year? I doubt it was that burdensome.

 

[Whakeen Feenix]

These are the specialty specific "regulations" for Pathology from the ACGME site:

Each PGY-1 resident must be directly supervised during
performance of, at least, his or her three initial procedures in the
following areas:
autopsies (complete or limited)
gross dissection of surgical pathology specimens by organ
system
frozen sections
apheresis
fine needle aspirations and interpretation of the aspirate

A PGY-3 or PGY-4 resident, pathology assistant or attending
pathologist may directly supervise the gross dissection of
surgical pathology specimens and/or autopsies.

Blood banking/transfusion medicine fellows, PGY-3 or PGY-4
sts may directly supervise residents, or attending pathologi
apheresis.

Also PA's can supervise grossing and autopsy prosection:
Q: Can pathology assistants supervise residents?
A: Although pathology assistants are not licensed independent
practitioners, they may be authorized by a department to provide
ection of surgical specimens and supervision or oversight of diss
for a patient’s care, however, lies autopsies. The ultimate responsibility
with the attending physician, and cannot belong to a pathology
assistant.