Work Hours FAQ

Is it a violation to work over 80 hours in 1 week?

It is not strictly a violation to work over 80 hours in 1 week, although the averaged hours over 4 weeks must be under 80 per week. The ACGME Common Program Requirements state, “While the ACGME acknowledges that, on rare occasions, a resident may work in excess of 80 hours in a given week, all programs and residents utilizing this flexibility will be required to adhere to the 80-hour maximum weekly limit when averaged over a four-week period. Programs that regularly schedule residents to work 80 hours per week and still permit residents to remain beyond their scheduled work period are likely to exceed the 80-hour maximum, which would not be in substantial compliance with the requirement.” Violations of the 80-hour requirement will likely lead to ACGME citations for the program and may adversely impact institutional accreditation for UB GME and its affiliated hospitals. 

If a resident is scheduled for 24 hours off immediately following 24 hours of in-house call, does this count as their required 1 day/7 free?

Yes. The ACGME Common Program Requirements state, “Residents must have at least 14 hours free of clinical work and education after 24 hours of in-house call.” In this case, the 24-hour period off counts as both the required 14-hour period free after 24-hour in-house call and the required 1 day/7 free.

Should residents log work hours when working on research?

If a resident is scheduled by the program for research (i.e. during a scheduled research rotation), then the time spent on research should be logged as scheduled work hours. Time spent on reading and/or research during hours not specifically scheduled by the program should not be logged.

Should unscheduled time residents elect to spend on reading/preparation for specific cases be logged/counted?


When are residents allowed to trade shifts?

Residents must always have approval of the program director or their designee prior to trading shifts in order to ensure compliance with all work hours requirements and regulations and optimize resident wellbeing. Individual programs should further specify expectations and procedures in their policies.  

Are residents allowed to report early for their scheduled shifts?

For example: A program schedules a resident for in-house call from 6:00 AM on Saturday until 6:00 AM on Sunday and then to report for morning rounds at 7:00 AM on Monday with their required 1 day/7 free occurring from 6:00 AM Sunday until 7:00 AM Monday. The resident feels the need to come in at 5:30 AM Monday to pre-round, chat with colleagues, or do some reading in the hospital and logs this as scheduled work hours.

This scenario would result in a violation of the requirement that residents must have at least 1 day in 7 free from scheduled duty (the resident in this case would have 23.5 hours off). Residents must adhere to their work hours as scheduled by the program and log them accurately in order to ensure compliance with all work hours requirements and regulations. If the resident in this case is concerned about their performance or feels that program schedules do not allow sufficient time for safe and effective patient care, the resident should discuss this with their program director and/or GME.

How should residents log work hours during home call?

For example: a resident is assigned home call from 7:00 PM on Thursday until 7:00 AM on Friday. During that time, the resident receives four calls that each result in about 15 minutes of patient care between the phone call and notes.

In this case, the resident should log a lump sum of one hour as “clinical work from home.” These hours count toward the 80 hours/week limit, but do not “re-start the clock” on a required 8-hour period off. If home call assignments result in resident fatigue and/or other significant impediments to wellbeing, residents should discuss this with their program director and/or GME. 

How/to whom should a resident report concerns about work hours (or anything else)?

Residents should first discuss concerns with their chief resident(s), program director, or program administrator if comfortable doing so. Residents must be able to report concerns in a confidential manner that is free from retaliation and/or retribution. If a resident is uncomfortable raising a concern to their program director, they should contact the Designated Institutional Official for GME (Dr. Gregory Cherr), Assistant Designated Institutional Official for GME (Ms. Katy Cich), or the GME Ombudsman (Dr. Susan Orrange). Contact information for all GME staff can be found here.