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Duty Hours

The department is dedicated to following duty hour regulations set forth by the ACGME:

  • Clinical and educational work hours must be limited to no more than 80 hours per week, averaged over a four-week period, inclusive of all in-house clinical and educational activities, clinical work done from home, and all moonlighting.
  • Residents should have eight hours off between scheduled clinical work and education periods
  • Residents must have 14 hours free of clinical work and education after 24 hours of in-house call
  • Residents must be scheduled for a minimum of one day in seven free of clinical work and required education (when averaged over four weeks). At-home call cannot be assigned on these free days.
  • Clinical and educational work periods for residents must not exceed 24 hours of continuous scheduled clinical assignments
  • Up to four hours of additional time may be used for activities related to patient safety, such as providing effective transitions of care, and/or resident education
  • In rare circumstances, after handing off all outer responsibilities, a resident, on their own initiative, may remain or return to clinical site in the following circumstances: to continue to provide care to a single severely ill or unstable patient; humanistic attention to the needs of a patient or family; to attend unique educational events. These additional hours of care will be counted towards 80-hours weekly limit (Must Be approved by GMEC, DIO and Program Director and submitted to the Review Committee).
  • Moonlighting must not interfere with the ability of the resident to achieve the goals and objectives of the education program, and must not interfere with the resident’s fitness for work nor compromise patient safety and must be counted towards the 80-hour maximum weekly limit
  • Time spent on patient care activities by residents on at-home call must count towards the 80-hour maximum weekly limit. The frequency of at-home call is not subject to every-third-night limitation, but must satisfy the requirement for one day in seven free of clinical work and education, 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 resident
  • Residents are permitted to return to the hospital while on at-home call to provide direct care for new or established patients. These hours of inpatient patient care must be included in the 80-hour maximum weekly limit

Duty hours are reported weekly by the fellows thru the MedHub system under the “Resident Work Hours”. The hours are then approved by the program coordinator monthly.


The Department of Rheumatology fellowship program does not allow Fellows-In-Training to moonlight as it would interfere with the fellow’s required educational expectations and duty hour regulations.