program director reading residents' emai

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

sikegeek

Full Member
10+ Year Member
15+ Year Member
Joined
Jul 27, 2007
Messages
283
Reaction score
3
This is a complicated issue, but I will briefly try to explain. Residents in our program find our call so deplorable that we sometimes "sell" it. This means that we pay other residents to take call that is assigned to us. We have more than sufficient call for "training" and "educational" purposes. This has been going on for years. There is no written (or spoken, until now) rule against it.

Anyway, a resident sent out an email titled "$ for call." Our PD happened to be sitting at a residents' computer doing something or other during supervision time when the notification box for this email popped up. She read it and said "you guys really shouldn't be selling call. I'm going to have to investiage this." Then she started confronting people who she suspected were doing the call-selling.

First of all, is there a known ACGME policy about selling call? Second, is it unprofessional for a PD to act on information she got by reading an email that was not addressed to her? She is making call off deals that were already in place (ie. return money and take call.) Is there anything that can be done?

Members don't see this ad.
 
This is a complicated issue, but I will briefly try to explain. Residents in our program find our call so deplorable that we sometimes "sell" it. This means that we pay other residents to take call that is assigned to us. We have more than sufficient call for "training" and "educational" purposes. This has been going on for years. There is no written (or spoken, until now) rule against it.

Anyway, a resident sent out an email titled "$ for call." Our PD happened to be sitting at a residents' computer doing something or other during supervision time when the notification box for this email popped up. She read it and said "you guys really shouldn't be selling call. I'm going to have to investiage this." Then she started confronting people who she suspected were doing the call-selling.

First of all, is there a known ACGME policy about selling call? Second, is it unprofessional for a PD to act on information she got by reading an email that was not addressed to her? She is making call off deals that were already in place (ie. return money and take call.) Is there anything that can be done?

Residency training is as stated in the title, "training", it's not a regular job where you can sell your shifts. If someone is selling the hours they're supposed to be in training, it is both unethical and an ACGME violation. The ACGME can come down hard on your program for this "call-selling".
 
If residents are swapping/selling call hours without the program knowing, then there is no way the program can tell whether or not it is complying with the ACGME duty hours requirements to which it is subject. I don't think the PD has any option but to stop any informal system which is doing this.

It may be possible for the program to set up a regulated system which does comply with the duty hours requirements. It could be complicated and take a bit of time to get going, and the PD would have to be persuaded of the benefits.

Given that the PD was made aware of the situation through no fault of her own - reading a pop-up on a computer she was legitimately using - I don't think she could properly ignore the information, given her obligation to run the program properly. Presumably you don't want the program you are training at to be put on probation or shut down altogether?
 
1) Residents generally aren't the best judge of how much call they need, or how many lectures they have to attend, or how many clinics they have to cover.

2) Call is part of the curriculum. If it's greater than every third night or if Night Float services are too close together, programs can be penalized for duty hour violations. But the issue should be dealt with directly rather than in a passive-aggressive manner that involves residents selling call.

3) Program Directors have to know what is going on in their program. This PD finding out in this manner was a fortuitous accident. Reading the email and acting upon it does not involve any kind of ethical breach.

4) No one should have any expectation of privacy when using a business email account.
 
This is bad. Paying each other to take call? That's a big no-no. I would prepare for some sort of backlash from your residency program.

Edit: how bad, exactly, was this call? Now I'm curious.
 
First of all, is there a known ACGME policy about selling call?

I doubt there is a specific policy. However part of the approved training scheme, as reviewed and accepted by the ACMGE, is going to include the amount.

Second, is it unprofessional for a PD to act on information she got by reading an email that was not addressed to her?

The email program was open on a computer she could easily access? No issues at all. I believe the term is "open and notorious." Frankly, if any of the emails were sent through the hospital system, then you should not expect any privacy.

She is making call off deals that were already in place (ie. return money and take call.) Is there anything that can be done?

Yes, you should all go to a bar and celebrate, since there are probably too many of you all involved to fire. Next, you should pray that she doesn't attempt to reconstruct all the trades and make you guys do all the back call that has been sold. Finally, you should expect probation or some other disciplinary action.

Did you really think such a thing was acceptable? Really?
 
So, I take it that swapping calls is also a violation? Or is this acceptable?

I'm soon to start, and was curious.
 
So, I take it that swapping calls is also a violation? Or is this acceptable?

I'm soon to start, and was curious.

Swapping call, 1:1, is often fine, as long as it falls within work ours. You can probably even pay someone to help convince them to swap call. The other key point is to make sure the PD and scheduler are aware of and approve of any swap. Transparency will protect you in the long run.
 
So, I take it that swapping calls is also a violation? Or is this acceptable?

I'm soon to start, and was curious.

Call swaps that don't break duty hour rules are fine: I'm on call Friday the 4th, you're on call Friday the 11th--we swap after telling the appropriate chain of command (whatever that is for your program). It's all good. Just be sure the swap doesn't make one or the other of you go above 80 hrs for the week and that you both still average one day off in seven when looked at in a 4-week window.

Or you can keep to the call schedule as written and schedule your personal life to accommadate it.

As a coordinator there is very little as unpleaseant as discovering a duty hour violation after the fact, caused by a call switch I knew nothing about. (All duty hour violations require written justification so that the GME office can see if there is a systemic problem that has to be fixed.)
 
Call swaps that don't break duty hour rules are fine: I'm on call Friday the 4th, you're on call Friday the 11th--we swap after telling the appropriate chain of command (whatever that is for your program). It's all good. Just be sure the swap doesn't make one or the other of you go above 80 hrs for the week and that you both still average one day off in seven when looked at in a 4-week window.

Or you can keep to the call schedule as written and schedule your personal life to accommadate it.

As a coordinator there is very little as unpleaseant as discovering a duty hour violation after the fact, caused by a call switch I knew nothing about. (All duty hour violations require written justification so that the GME office can see if there is a systemic problem that has to be fixed.)


OK great, thanks.

How do programs address a resident who is to be on call who is also genuinely sick? I know we call in, and it'll still sound bad regardless of how sick one may be. I doubt it happens commonly, but I'm sure it DOES happen. Curious about that, too. :oops:
 
1) Residents generally aren't the best judge of how much call they need, or how many lectures they have to attend, or how many clinics they have to cover.

2) Call is part of the curriculum. If it's greater than every third night or if Night Float services are too close together, programs can be penalized for duty hour violations. But the issue should be dealt with directly rather than in a passive-aggressive manner that involves residents selling call.

3) Program Directors have to know what is going on in their program. This PD finding out in this manner was a fortuitous accident. Reading the email and acting upon it does not involve any kind of ethical breach.

4) No one should have any expectation of privacy when using a business email account.

I feel like passive aggressive is a strong term to use here. It might very well be that the call schedule sucks, and the administration is unwilling to do anything about it. Consequently, residents found a way to work around the system. I think lots of us in all sorts of bureaucracies find ways to do that. It's not passive aggressive. It's often appropriately proactive, and it's what you've got to do to survive.

As for judging how much call or clinic you need, we can all look at ACGME references and at call schedules at other programs to figure out what the norm is. If your program is requiring more, or scheduling call in boneheaded ways (hey, it happens), the residents might very well be right. Lots of times the admin types don't even know enough about the details of stuff like the call schedule to know what's going on anyway. Especially when you're in psych like the op and everyone wants to be fluffy and not detailed oriented about admittely boring stuff like call schedules.

As for selling, I'm actually uncertain on the ethics thing. It's OK to swap calls. It's also OK to have people occasionally offer to take calls to help someone out. I get how selling stuff is a little different, but I'm not sure it's absolutely horrible.

Hopefully the PD will realize that you guys have adopted extreme measures to deal with your call schedule and see that as a chance to do some reflection and maybe reorganization if possible.
 
OK great, thanks.

How do programs address a resident who is to be on call who is also genuinely sick? I know we call in, and it'll still sound bad regardless of how sick one may be. I doubt it happens commonly, but I'm sure it DOES happen. Curious about that, too. :oops:

Programs normally have a back up system in place so someone else can take over the call. At my program, we have both a person scheduled for back up call and then a person on jeopardy, making it almost certain that someone will be able to cover for you.
 
OK great, thanks.

How do programs address a resident who is to be on call who is also genuinely sick? I know we call in, and it'll still sound bad regardless of how sick one may be. I doubt it happens commonly, but I'm sure it DOES happen. Curious about that, too. :oops:

Varies by type and size of program.

My IM program had 6 people on jeopardy. One intern and 1 resident who had no other clinical duties other than continuity clinic for that 1-2 week period and 2 interns and 2 residents who were on consult or ambulatory rotations and could get pulled once the first jeopardy person was already covering.

It is not uncommon for surgery programs to pull research residents for sick coverage.
 
Programs normally have a back up system in place so someone else can take over the call. At my program, we have both a person scheduled for back up call and then a person on jeopardy, making it almost certain that someone will be able to cover for you.

Thanks for the reply!
 
Varies by type and size of program.

My IM program had 6 people on jeopardy. One intern and 1 resident who had no other clinical duties other than continuity clinic for that 1-2 week period and 2 interns and 2 residents who were on consult or ambulatory rotations and could get pulled once the first jeopardy person was already covering.

It is not uncommon for surgery programs to pull research residents for sick coverage.

Gotcha, thanks!
 
What is more distressing is that the PD didn't (or doesn't) have control enough to know who was on-call at the time, and doesn't know ex post facto who was on-call for a certain day. That seems to me that she isn't involved to a degree to which I am accustomed with training. Alternately, if that has been delegated to the chief resident(s), then someone in that position might find themselves complicit and soiled by association by allowing it to occur, "because we've always done it that way".

I'm wondering how much a call is worth. I had to pony up $100 as an attending to get mercenary colleagues to work my shift (on top of being paid for it). I didn't have $100 spare when I was a resident.
 
What is more distressing is that the PD didn't (or doesn't) have control enough to know who was on-call at the time, and doesn't know ex post facto who was on-call for a certain day. That seems to me that she isn't involved to a degree to which I am accustomed with training. Alternately, if that has been delegated to the chief resident(s), then someone in that position might find themselves complicit and soiled by association by allowing it to occur, "because we've always done it that way".

I'm wondering how much a call is worth. I had to pony up $100 as an attending to get mercenary colleagues to work my shift (on top of being paid for it). I didn't have $100 spare when I was a resident.

Guys in my group often offer up to $500 to get a shift covered (+ pay for the shift of course). My group frequently offers an extra $150 to $250 to get a tough shift covered.
 
It has been known for residents in my program to sell their ED shifts in order to work a moonlighting shift. I would imagine anyone actually caught doing so would suffer some consequences - but our PD is rather out-of-touch.

Considering you get ~$1500 for a moonlighting shift...you can pay a junior resident a relatively appealing amount.
 
I feel like passive aggressive is a strong term to use here. It might very well be that the call schedule sucks, and the administration is unwilling to do anything about it. Consequently, residents found a way to work around the system. I think lots of us in all sorts of bureaucracies find ways to do that. It's not passive aggressive. It's often appropriately proactive, and it's what you've got to do to survive.

As for judging how much call or clinic you need, we can all look at ACGME references and at call schedules at other programs to figure out what the norm is. If your program is requiring more, or scheduling call in boneheaded ways (hey, it happens), the residents might very well be right. Lots of times the admin types don't even know enough about the details of stuff like the call schedule to know what's going on anyway. Especially when you're in psych like the op and everyone wants to be fluffy and not detailed oriented about admittely boring stuff like call schedules.

I guess we are going to have to agree to disagree. I strongly believe that residents with issues regarding any aspect of their training should address concerns with their PD rather than finding their own solutions that bypass the PD. They could be pleasantly surprised when the PD agrees with them and changes a policy, procedure or schedule. Or they could learn that there is a reason behind the policies, procedures and schedules that exist. Otherwise it seems like the residents can develop something of a shadow program (the way things really run as opposed to the way the program administrators think it runs) with potentially vast differences in actual experience among the residents. This would cause major problems during a site visit.
 
I guess we are going to have to agree to disagree. I strongly believe that residents with issues regarding any aspect of their training should address concerns with their PD rather than finding their own solutions that bypass the PD. They could be pleasantly surprised when the PD agrees with them and changes a policy, procedure or schedule. Or they could learn that there is a reason behind the policies, procedures and schedules that exist. Otherwise it seems like the residents can develop something of a shadow program (the way things really run as opposed to the way the program administrators think it runs) with potentially vast differences in actual experience among the residents. This would cause major problems during a site visit.

It probably depends on if you're at a program where things work how they should (the admin is on top of things, the call schedule is well thought out, people are responsive to criticism, etc.), or if you're at a program where the people who should be paying attention really aren't. When you've got an inattentive or hands off type of administration, you have to find ways to route around the problem, which sometimes means doing things like creatively shifting calls. As apollyon pointed out, it's a little concerning that all this call shifting is entirely news to the PD, which suggests to me that maybe she isn't keeping on top of stuff the way she should.


And seriously, how could this program not have caught this stuff before if it was causing ACGME violations. We have to log our duty hours regularly, and the logging system tracks any violations. Someone should have noticed way before now if any of this call selling was putting the program in danger of violating work hours.
 
Guys in my group often offer up to $500 to get a shift covered (+ pay for the shift of course). My group frequently offers an extra $150 to $250 to get a tough shift covered.

That really makes me think: what is going on there? First, why would someone need some day off so severely, but not knowing beforehand, which is not an emergency, that they would have to pony up half of one large as a bounty? Second is, how is the cohesiveness of the group that such relatively large amounts of bonus have to be offered? Or are you that understaffed, that people are already working a bunch?

Or is it that you are NOT "understaffed", per se, but that is the mindset of the group - that they will squeeze as much out of $$ - whether individual or corporate - as they can, knowing that the same will come to lean on them in future times?

Or, what are the tough shifts? Is it time, or location? In a democratic group, either everyone takes their turn, as everyone has to take a bite of the **** sandwich, or, an extra amount is offered to work that shift regularly (instead of having to beg someone with a carrot on a stick).

(Sorry for the derail.)
 
That really makes me think: what is going on there? First, why would someone need some day off so severely, but not knowing beforehand, which is not an emergency, that they would have to pony up half of one large as a bounty? Second is, how is the cohesiveness of the group that such relatively large amounts of bonus have to be offered? Or are you that understaffed, that people are already working a bunch?

Or is it that you are NOT "understaffed", per se, but that is the mindset of the group - that they will squeeze as much out of $$ - whether individual or corporate - as they can, knowing that the same will come to lean on them in future times?

Or, what are the tough shifts? Is it time, or location? In a democratic group, either everyone takes their turn, as everyone has to take a bite of the **** sandwich, or, an extra amount is offered to work that shift regularly (instead of having to beg someone with a carrot on a stick).

(Sorry for the derail.)

We're pretty cohesive and we help each other out for stuff like sick family members and the like. The checkbooks come out for more frivolous stuff like needing time off for a social event or an extra vacation day. Often the money is a faster way of getting it done rather than calling and begging multiple people, they just put out a blast email offering the dough.
 
People swap calls all the time, in fact some may offer a monetary amount for someone to take their call. Again, their is a third party involve because of course the call schedule has to be updated with the person actually taking call so also the nurses know who to page and such and such. Maybe its not clear in this program due to OP just having to hold a call pager, but I would imagine more than just the people who swap calls would need to know.

Like someone said earlier, where is the chief resident's involvement in all of this??
 
what about the chief resident? In my program of 17 residents per year we didnt expect our PD to know who was on call for ICU, CCU, night float etc every night but we knew the chief resident was aware of who was doing what in case an emergency happened.
 
Thanks, you guys have given me a lot of different perspectives which I appreciate.

Call-selling in our program has been going on for years. Most people have done it to moonlight and make more money. There have even been attendings who have given us guidance about the practice, ie. fair prices. So we've been getting mixed messages.

I did it because of medical issues beyond the scope of this discussion that, if I had taken the call, would have necessitated a medical leave of absence. The call in question was home call, which, at least for us, only counts toward duty hours when you get called in, which only happens on about half of call nights.

The PD finding out because she read another residents' email seemed Orwellian to me.
 
The call in question was home call, which, at least for us, only counts toward duty hours when you get called in, which only happens on about half of call nights.

Wait...you guys are selling home call? Unless it's Q2, that is the weakest sauce I have ever even heard of.
 
Some thoughts:

I'm not sure which is more absurd, selling home call or characterizing it as "deplorable."

Sending a secret squirrel email to a work account is idiotic. The idiot who sent the email deserved to get caught just for being so stupid.

This has huge ACGME implications for the program. Imagine this coming to light during an RRC visit. The program wouldn't be able to prove work hours compliance or adequate supervision.

Calling this "the PD read our email" makes her actions seem way worse than what they are. She was sitting at a computer that rocket scientist resident #2 left logged in. His outlook account was open and the email popped up at the bottom of the screen for a few seconds. Impossible not to notice and a total red herring where the real issue is not doing something that you were assigned.

A resident "gets more than enough call" therefore he can sell it?!??? I'm sorry, you don't get to decide that.

The more I think about how entitled this sounds, the more I would be pissed. If this were me, I'd make every resident give me a calendar of the call they actually took over the past year. I'd compare the calendars and sort out the discrepancies. Anyone who had sold more than they bought would do extra call until they caught up and I'd delay graduation until they did.
 
Thanks, you guys have given me a lot of different perspectives which I appreciate.

Call-selling in our program has been going on for years. Most people have done it to moonlight and make more money. There have even been attendings who have given us guidance about the practice, ie. fair prices. So we've been getting mixed messages.

I did it because of medical issues beyond the scope of this discussion that, if I had taken the call, would have necessitated a medical leave of absence. The call in question was home call, which, at least for us, only counts toward duty hours when you get called in, which only happens on about half of call nights.

The PD finding out because she read another residents' email seemed Orwellian to me.

Well, it's certainly bad luck for you guys that she read it. And if it's been going on forever, and even attendings are discussing fair prices with you, I can see how it just seems like a normal thing to do. It's not something I've seen done here, but we're encouraged to freely switch calls as needed. In fact, that this whole ability to switch calls is used sometimes as a justification for creating particularly crappy call schedules like where someone is on 3 weekends back to back (and by weekends, I mean a Saturday or a Friday/Sunday combo). Selling feels different, but I'm having trouble seeing where it's educationally worse. And here, yeah, we do way more call than most psych residents everywhere, so even if you did miss out on some call, I don't think you'd be educationally behind. Our call is definitely more about service than education.

It seems like a lot of the people who are particularly bothered by this (or just really surprised by its practice) are in fields like IM where call is just really different. In general, I think psych programs are more flexible (and yeah, a little less attentive) about these things.
 
My academic center considers business email to be public record. I could request to have my PDs emails printed and sent to me. The "records" department blacks out HIPAA stuff and sends the rest.

At least this is what a Dean told me. If you use your business email for personal things, expect to get in trouble. All our residents converse via private email accounts.
 
This has huge ACGME implications for the program. Imagine this coming to light during an RRC visit. The program wouldn't be able to prove work hours compliance or adequate supervision.

This is the biggest thing to me. Unless all this call buying/selling was completely above board and was being accurately recorded in your schedules/duty hours logs, then you would have to assume that everyone's work hours were falsified and unverifiable. HUGE problem for an RRC visit.
 
This is the biggest thing to me. Unless all this call buying/selling was completely above board and was being accurately recorded in your schedules/duty hours logs, then you would have to assume that everyone's work hours were falsified and unverifiable. HUGE problem for an RRC visit.

I would guess that everybody was recording their hours accurately, which is why it's weird that no one noticed until now. If they were lying on their hours logs, that's a whole other issue. I'd also guess that most residents would sell one call at the most because I would bet it's a pretty expensive thing to do. Which then might explain why no one has noticed because it really didn't change the schedule all that much.

I'm also giving the residents at this program the benefit of the doubt in that I'm assuming they know the hours requirements and that they make sure they don't take on a call that would put them in violation. We can switch calls freely at my program, and I don't think switching calls and then violating hours is much of an issue.
 
what's happening in this Residency program is just unbelievable! The Residents it seems that, are taking undue advantage of the poor leadership of the PD! I hoping to start PGY1 soon and don't want this buying-selling of calls taking place there!
 
There's nothing technically wrong with this as long as duty hours were recorded accurately and the call schedule of record was correct.

This is fairly commonplace and im surprised so many of you think it's some kind of big deal.

Upper levels in my program paid lower levels to take their call so the upper levels could moonlight. Everyone ended doing the same amount of call in the end as the upper levels had taken the call of their seniors before them and so on.

Was a great system that benefited everyone involved. Lower levels got to make extra money and upper levels got to moonlight, and the number of calls taken was a wash in the end.
 
There's nothing technically wrong with this as long as duty hours were recorded accurately and the call schedule of record was correct.

This is fairly commonplace and im surprised so many of you think it's some kind of big deal.

Upper levels in my program paid lower levels to take their call so the upper levels could moonlight. Everyone ended doing the same amount of call in the end as the upper levels had taken the call of their seniors before them and so on.

Was a great system that benefited everyone involved. Lower levels got to make extra money and upper levels got to moonlight, and the number of calls taken was a wash in the end.
The problem with this sort of setup is the person who does not take extra call as a lower level, then sells call as an upper level, doesn't end up with a wash.

Another problem with selling call is that it may not be legal from an employment standpoint. When you are hired as an employee, you are usually not allowed to subcontract out work. For example, you can't be hired as a secretary, then pay someone else less money to do the job and keep the difference. In the same way, you can't be hired to do a certain number of shifts and then sell those shifts to other people. Swapping shifts would be OK.
 
Q2? I've done 2 weeks of home call at a time. 2 WEEKS.

OP, were your co-residents really selling home calls to one another?!

That's kind of what I was thinking. Our surgery residents will often do a week or so of Q2 home call at a stretch, longer if there are vacations and the like mixed in. Just part of the bidness.

FTR, we (fellows) routinely take 5-7 day stretches of home call. Granted, this only happens 2 or 3 times a year, and we rarely actually have to go in (moonlighters are in house to cover our inpatients and take admits) but we do take all outpatient, consult (in-house and remote...many of the smaller Hem/Onc groups in the state don't take call...just have an answering service for established patients so they call us...they figure we're up anyway) and ED.
 
That's kind of what I was thinking. Our surgery residents will often do a week or so of Q2 home call at a stretch, longer if there are vacations and the like mixed in. Just part of the bidness.

I think what Buzz Me was referring to was q1 home call for 2 weeks at a time. That was not unheard of in my program either.

Or maybe you understood that and I misunderstood. :p
 
I think what Buzz Me was referring to was q1 home call for 2 weeks at a time. That was not unheard of in my program either.

Or maybe you understood that and I misunderstood. :p

I don't know what Buzz meant. You've made me question my understanding.

But I've definitely heard of Q1 home call for other surgery programs (ours is pretty humane all things considered) but usually for Chiefs and seniors with somebody lower on the totem pole in-house to take most of the abuse.
 
what's happening in this Residency program is just unbelievable! The Residents it seems that, are taking undue advantage of the poor leadership of the PD! I hoping to start PGY1 soon and don't want this buying-selling of calls taking place there!

Now I'm wondering if there's some sarcasm here or if this is just unintentionally funny. Poor PD for having poor leadership that those mean residents are taking advantage of. :eek:
 
Seriously...it's psych.


I knew it,they used to do that at my husband's program, and he finished like 15 years ago, and they sold their calls for 100, sometimes for 150, and yes.... Psych
 
Last edited:
I'm sure you guys aren't going to believe me, but psych call can suck horribly. Sometimes it's incredibly busy (and at some places, it's apparently busy all the time), and you deal with so much BS that it's emotionally exhausting. Since most of you probably have never done psych call (and doing psych call is a med student is way different from doing it as a resident), why do you automatically assume it's so lightweight? At least we psych people have done medicine call, so we know how call works on at least one other specialty.
 
I don't know what Buzz meant. You've made me question my understanding.

But I've definitely heard of Q1 home call for other surgery programs (ours is pretty humane all things considered) but usually for Chiefs and seniors with somebody lower on the totem pole in-house to take most of the abuse.

As WS stated, I've taken two weeks straight of home call at a time. (Not two weeks of Q2 - that's nothing. We have rotations where we take Q2 home call for 6 weeks at a time.)

And these are not "easy" home calls. You get called it pretty much every single night. I once went into the hospital on Friday morning for pre-rounds and didn't return home until Sunday night.
 
This thread should be deleted or locked...


#1 - The first rule of Fight Club is, you do not talk about Fight Club.

#2 - The second rule of Fight Club is, you DO NOT talk about Fight Club.


This is the only way to address this subject...
 
I would guess that everybody was recording their hours accurately, which is why it's weird that no one noticed until now. If they were lying on their hours logs, that's a whole other issue. I'd also guess that most residents would sell one call at the most because I would bet it's a pretty expensive thing to do. Which then might explain why no one has noticed because it really didn't change the schedule all that much.

I'm also giving the residents at this program the benefit of the doubt in that I'm assuming they know the hours requirements and that they make sure they don't take on a call that would put them in violation. We can switch calls freely at my program, and I don't think switching calls and then violating hours is much of an issue.

There is no way they were logging things accurately and the PD didn't notice that Mr X never seemed to be on call, while Ms Y hit 80 hours each month. More likely they were either logging in the hours they would have worked before the sale, or it was the kind of place where everybody simply gives in timecards that add up to some number under 80, because if you don't, you get asked to redo it. Either way, that's fraud number one. Fraud number two is the representation the PD is making to ACGME each year regarding what their training consists of and how many hours people are spending in the ICU, etc.
So the PD really had no choice but to shut this down once s/he found out about it.

As far as the PD reading an email seems Orwellian, I think folks in residency don't have a good sense of what it's like to work in the private sector. Your bosses can read emails you send on their facility's computer network. They also have significant rights over email and web usage you do while on company time. That's the norm out there.
 
Top