Duty Hours Policy

It is the policy of the University of Arizona College of Medicine – Phoenix (COM – P) to follow Accreditation Council for Graduate Medical Education (ACGME) duty hour requirements for residents, and to support maximum educational benefit for all clinical medical student rotations.

Duty Hour Limits

• Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house clinical activities and mandatory didactics.
• Duty periods of students may be scheduled to a maximum of 24 hours of continuous duty in the hospital. It is essential for patient safety and education that effective transitions in care occur. Students may be allowed to remain on-site in order to accomplish these tasks; however, this period of time must be no longer than an additional four hours. Students must not be assigned new or additional clinical responsibilities after 24 hours of continuous in-house duty.
• Students must be scheduled for a minimum of one day free of duty every week (when averaged over four weeks). At-home call cannot be assigned on these free days.
• Students must have eight hours between scheduled duty periods. They must have at least 14 hours free of duty after 24 hours of in-house duty.
• Students must not be scheduled for more than six consecutive nights of night float.
• In-house call must not be more frequent than every third night (when averaged over a four-week period).
• Time spent in the hospital by students on at-home call must count toward the 80-hour maximum weekly hour limit. The frequency of at-home call is not subject to the every third night limitation, but must satisfy the requirement for one-day-in-seven free of duty (when averaged over four weeks). At-home call must not be so frequent or taxing as to preclude rest or reasonable personal time for each student. Students are permitted to return to the hospital while on at-home call to care for new or established patients. Each episode of this type of care, while it must be included in the 80-hour weekly maximum, does not initiate a new off-duty period.

In addition, to ensure the safety of students, COM – P will:

• Educate all students to recognize the signs of fatigue and sleep deprivation.
• Educate faculty members and students in alertness management and fatigue mitigation processes.
• Adopt fatigue mitigation processes to manage the potential negative effects of fatigue on patient care, learning and personal safety, such as strategic napping and personal strategies for safe transportation home.

Documenting Duty Hours

Students are expected to record their duty hours. Students are exempt from this requirement while participating in electives that do not require call of any type.

Required Clerkships or Selectives with call:

1. Students must complete recording of their duty hours by the deadline stated in the syllabus.
   • Curricular Unit Directors and/or Coordinators routinely review cumulative duty hour data and correct any systemic problems that prevent compliance with the stated Duty Hours Policy.
   • If students anticipate a violation of duty hour limits based on their schedule, they should proactively discuss this with their supervising faculty or Curricular Unit Director to make any necessary schedule adjustments.
   • Where students report a violation of duty hour limits, they must indicate the reason for the violation within the duty hour report.
   • Students are not penalized for accurate reporting of excessive duty hours, nor is duty hour information used to determine grades or for student evaluations.
   • Duty hour reports are retained in the electronic database systems.
   • Students who do not log duty hours by the deadline stated in the syllabus will be assigned a Level 1 assessment for professionalism.
2. Curricular Unit Directors or Coordinators report duty hour compliance to the Curriculum Committee annually.