Duty Hours Resources

The University of Minnesota Graduate Medical Education (GME) Administration and its training programs are committed to ensuring that residents and fellows receive a superior educational experience balanced with maintaining trainees' well-being. 

This web page is designed to provide resources for program directors, coordinators, site directors, residents and fellows to help you understand and maintain compliance with the revised Accreditation Council for Graduate Medical Education (ACGME) Duty Hour Requirements effective July 1, 2011.  

Please review GME's Institution Duty Hours (Transitions of Care) Policy for complete details:

Duty Hours (Transitions of Care) Policy

EPIC training and moonlighting regulations

This message is intended to clarify which residents may or may not contract with a hospital to become an EPIC trainer for compensation.

J1 Visa holders

In accordance with ECFMG and GME policies (referenced below), J1 Visa holders are NOT allowed to be EPIC trainers, because they may receive compensation only for activities that are part of the designated training program. (The Form DS-2019 states the training program name and the allowed stipend amount.) An exchange visitor who engages in unauthorized employment shall be deemed to be in violation of his or her program status and is subject to termination as a participant in an exchange visitor program.

H-1B Visa holders

Per the GME Visa Sponsorship Policy: A resident/fellow on an H-1B visa wishing to moonlight must obtain a separate H-1B visa for each facility where the resident/fellow works outside the training program.

G1 residents

In accordance with ACGME Program Requirements related to duty hours, PGY-1 residents are not allowed to moonlight and therefore may not contract with hospital(s) to be EPIC trainers for compensation.

G2 residents and beyond

Residents are allowed to contract with hospital(s) to become EPIC Trainers for compensation. However, this is considered moonlighting and requires prior permission from their program director and the hours must count towards their 80 hour maximum for duty hours.

Reference

  1. Visa Sponsorship Policy
  2. ACGME requirements
  3. GME Moonlighting Policy

Questions? Contact Carol Sundberg at sundb001@umn.edu or Rachel Whitcomb at whitcomb@umn.edu.

Reporting duty hour violations

In accordance with the Institution Duty Hour Policy, trainees concerned about continuous duty hour violations by their program can contact the Designated Institution Official or send a confidential email to gme@umn.edu.

Recording duty hours

In accordance with the Updating and Approving Assignments in RMS Policy, all trainees are required to accurately and honestly enter their duty hours on a daily basis.  Trainees must use the "Comment" area when logging duty hours to explain any violations that occur. 

Monitoring duty hours in RMS

  • Institution Responsibilities: Programs with duty hour concerns, whether it is due to reporting in RMS, or revealed during an Internal Review or on the annual ACGME Resident Survey, will be asked to provide documentation of their method of correction, which will be monitored by the GMEC until resolved. 
  • Program Responsibilities: Programs must monitor resident duty hours on a regular basis.  Violations must be documented in the comments section of the Duty Hours module. 

Supervision

GME Supervision Policy

Moonlighting

GME Moonlighting Policy: Moonlighting procedures, including a link to the moonlighting request form.

Fatigue/sleep

Transportation and Safety Policy:  vouchers available for any trainee who feels or is deemed by another that they are too impaired to drive safely home.

Duty hour innovations

Call:

  • Neurosurgery: Has a "night resident" eliminating call for junior and intermediate residents
  • St. John's Family Medicine: Year 1 every 5-6th day from 5-10 PM from Mon-Thurs
  • UMMC-FV Family Medicine: Interns no longer taking call.  Now scheduled for day and evening shifts 

Supervision

  • OB-GYN: Have in house supervision 24/7 at almost all sites

Fatigue and sleep mitigation training

  • Neurosurgery: Annual review of departmental statement of Fatigue Mitigation; reinforcement of available courses; monitoring course utilization as well as formal documentation that will remind faculty and trainees about the issue
  • St. John's Family Medicine: Noon lectures and orientation sessions
  • OB-GYN: Moodle site resources and the SAFER Program

Management of 24+4

  • St. John's Family Medicine: PGY-2-3 finish up on established patients in the hospital

Transition of care

  • St. John's Family Medicine: Sign out rounds at 8:00 AM with faculty and resident team
  • OB-GYN: Developed structured hand offs as part of the resident retreat.  We arrange for only 2 group hand offs per 24 hours. Nightfloat team to day team at 7:00 AM and Day team to NF team at 6:00 PM