NP Fellowship: DUTY HOURS

  1. Standard:

    Fellows are required to serve regular duty hours, as designated by the coordinating teaching faculty members and the Program Director. In general, standard duty hours will be between the hours of 7:00 A.M. and 6:00 P.M Monday through Friday. During standard working hours, the supervising teaching faculty members are available in person; other faculty members are available by scheduled appointment, by phone, or by pager.
     
  2. Formative Evaluations

    A program of formative evaluations is the second method for evaluations. These consist of tasks identified by the department as representative of core competencies needed to practice neuropathology. Tasks will be appropriate to the trainee’s level of training and will include elements of the 6 core competencies identified by ACGME. Mastery of individual tasks is documented by staff signature and progress will be documented in the six-month evaluation described below.
     
  3. Duty Hours (ACGME Mandatory):

    Duty hours are defined as all clinical and academic activities related to the training program, i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty Hours DO NOT include reading and preparation time spent away from the duty site.

    Duty hours are limited to 80 hours per week, averaged over a four-week period, inclusive of all in house call activities. Since the neuropathology fellow does not take in house call, it would be rare for the fellow to work more than 55-60 hours per week. Because of this, the program does not keep a formal log of fellow work hours.

    Residents are provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities. Duty periods cannot last for more than 24 hours, residents may remain on duty for six additional hours to participate in didactic activities, and maintain continuity of patient care. Residents are allowed 10 hours for rest and personal activities between daily duty periods and after in house call that has extended up to the 24 hour limit. Faculty members will provide or arrange for alternative means of covering resident’s call responsibilities when needed to maintain compliance with ACGME standards.

    The number of continuous hours worked by a fellow rarely exceeds 12-14 hours/day, and residents should have >12 hours between shifts. The fellow is not scheduled for weekend call, and will average >1day/7 free of clinical, educational, and administrative activities. The neuropathology faculty cover after hours (5 PM-8 AM) and week-end call.

    The program director and the faculty monitor the demands of the service responsibilities in this program and make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue. Fellows are informed of the policies regarding Duty Hours, and are instructed to inform the program director immediately if they feel they are approaching 80 work hours in a given week. The teaching faculty members are also made aware of the resident Duty Hour policies.
     
  4. Coverage for fellow time off:

    When the fellow is off for illness, vacation, meeting attendance or other valid reasons, the attending on service will generally cover the fellow’s responsibilities. If a senior AP resident is on service, he or she will take over some of the fellow’s responsibilities, but it is generally assumed that the resident will not have the appropriate experience of knowledge of the system to assume all responsibilities.
     
  5. Moonlighting:

    Moonlighting is permitted for fellows only when 1) it clearly does not interfere with the resident’s academic goals, 2) total worked hours (OHSU hours + moonlighting) are within ACGME standards as outlined elsewhere, and 3) patient care and other service responsibilities are not adversely affected. The program director reviews all moonlighting activity, including the number of total hours the fellow is working, during quarterly evaluations.