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Fitness for Duty

In a culture of professionalism that supports patient safety and personal responsibility, it is the obligation of everyone involved in the program to recognize symptoms of fatigue hindering a fellow’s fitness for duty.

A fellow who does not feel fit for duty should:

  • Immediately call the attending on consult and talk to them directly (no voicemail) to ensure your condition is communicated properly

  • Request that you be relieved from duty immediately after assuring a smooth transition of patient care by establishing the work type and the duration that the coverage is needed for.

  • Consult the current program director, program coordinator or Employee Health

A supervisor or another fellow who has concerns regarding a resident or fellow’s fitness for duty should:

  • Ask the individual if they are indeed fatigue

  • If the fellow answers yes to the above question, immediately relieve the fellow from patient care duties after assuring a smooth transition of patient care by establishing the work type and the duration that coverage is needed for.

  • If the fellows answer is no, but you are still concerned you should contact the individual’s supervisor

  • Consult the program director, program coordinator or Associate Dean for Graduate Medical Education

As a general rule, each resident/fellow will be expected to complete an equal share of weekend and holiday calls. If the resident/fellow is unable to meet this responsibility due to illness or another situation as listed above, the resident/fellow will complete the requisite number of calls at a later date as determined by the Program Director or Chief. It should be understood that receiving return coverage is a courtesy but is not an absolute requirement and may not be possible in all situations. SUNY Upstate Medical University’s institutional policy allows employees to be out for a number of sick days without consequences. It is in this regard that professionalism and courtesy should exist.

 NOTE: Repayment of coverage may never result in an ACGME or New York State duty hour’s regulation violation, no matter what the circumstances.

If a resident/fellow is out sick greater than three days, documentation must be brought to the Program Director’s attention within 24 hours of returning to work. Documentation needs to show the name, date, time, and place where the resident/fellow was seen. Diagnosis does not need to be disclosed as this information is confidential. Failure to comply with the documentation requirement could lead to comments regarding professionalism in the final evaluation of the resident/fellow or disciplinary action.

For extended absences/illness, please refer to the Department of Rheumatology Time Off Policy. Residents and fellows should be mindful of individual Board requirements that may set limits on the amount of leave one may take at any level. In most cases, vacation time cannot be forfeited for leave.

While every attempt will be made to cover a resident or fellow with another resident or fellow, the final authority for patient care and supervision lies with the attending. In all cases when another resident or fellow cannot cover or cannot be reached, the attending on service will provide this coverage.