Post call policies while switching rotations

Started by littlefred
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littlefred

littlefred

Dr. Fred
Verified Member
Physician
15+ Year Member
Is there an ACGME policy regarding duty hours while transitioning from one rotation to another?My question is because I'm in a service that won't budge changing schedule even though they know I start another rotation the next day. I'd like to have evidence from acgme if possible.
 
littlefred said:
Is there an ACGME policy regarding duty hours while transitioning from one rotation to another?My question is because I'm in a service that won't budge changing schedule even though they know I start another rotation the next day. I'd like to have evidence from acgme if possible.
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Is this as a med student?
Technically the ACGME duty hours do not pertain to medical students...only residents and fellows
Most schools however use them as a guide for med students (but they don't have to)
If you want to utilize the ACGME hours...will you exceed 80 hours in the week (averaged over 4 weeks of course) or violate the 10 hours between shifts(that is not averaged), or the 1 in 7 off (averaged over 4 weeks)? Then you may want to talk to the clinical clerkship office at your school, otherwise there wouldn't be a violation...

And it happens in residency as well...overnight call in icu ending the morning of starting a ward month...as a resident they will try to adjust that otherwise you can take your day off for that day
 
rokshana said:
Is this as a med student?
Technically the ACGME duty hours do not pertain to medical students...only residents and fellows
Most schools however use them as a guide for med students (but they don't have to)
If you want to utilize the ACGME hours...will you exceed 80 hours in the week (averaged over 4 weeks of course) or violate the 10 hours between shifts(that is not averaged), or the 1 in 7 off (averaged over 4 weeks)? Then you may want to talk to the clinical clerkship office at your school, otherwise there wouldn't be a violation...

And it happens in residency as well...overnight call in icu ending the morning of starting a ward month...as a resident they will try to adjust that otherwise you can take your day off for that day
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I'm a resident. The issue here is if a rotating resident can be overnight on transition day between two different rotations.
 
littlefred said:
I'm a resident. The issue here is if a rotating resident can be overnight on transition day between two different rotations.
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talk to your chief…sometime they just miss it…been OC in ICU and then OC the next day as the ward resident…they just changed which team i was one and that problem went away….stayed til 12n to round then left for the afternoon….had one of the other residents on one of the other teams help if the interns needed it.

if you are just on call the last day, but its not an overnight, and you start another rotation the next day…eh, they probably won't change it…

the only ACGME that possibly could be in play is the 10 hours between shifts…

or you could just take the 1st day as your day off.
 
If you're an intern, you cannot work more than 16 hours in a row, and that clock only resets once you've been out of the hospital 8-10 hours. (should be 10, must be 8). So if you're overnight as an intern, no, they cannot make you work the following day (well, they can make you work, but not past 11am or so).

If you're a pgy 2 or higher? You can work up to 28 hours in a row. Have fun.
 
As stated above, it depends.

If your last day on a rotation is a 24 hour overnight shift, then no, you can't be assigned to a new rotation. You can work 24 hours + 4 hours for transition of care. In those last 4 hours you're not allowed to pick up any new patients, so picking up a new service isn't allowed.

If your last day on a rotation is "night float" and you're working 8P -> 8A (a 12 hour shift), then they can have you work the next day. We don't do this -- all overnight residents have the next day off. But it's perfectly "legal".

If you're an intern, then none of this is OK as you can only work 16 hours. Assuming you work a 12 hour overnight shift, there really isn't much you can do with the last 4 hours.
 
NotAProgDirector said:
As stated above, it depends.

If your last day on a rotation is a 24 hour overnight shift, then no, you can't be assigned to a new rotation. You can work 24 hours + 4 hours for transition of care. In those last 4 hours you're not allowed to pick up any new patients, so picking up a new service isn't allowed.

If your last day on a rotation is "night float" and you're working 8P -> 8A (a 12 hour shift), then they can have you work the next day. We don't do this -- all overnight residents have the next day off. But it's perfectly "legal".

If you're an intern, then none of this is OK as you can only work 16 hours. Assuming you work a 12 hour overnight shift, there really isn't much you can do with the last 4 hours.
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Well, the intern could legally do the night shift, then stay till noon on the new service and still be perfectly legal (plus they could easily preround, round with the senior, write notes, and do floor work in that time frame in certain specialties-such as surgery). Not that it is desirable.
 
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