University of Colorado Denver School of Medicine Office of Graduate Medical Education

ACGME Duty Hour Requirements Summary Effective July 1, 2011

Maximum Hours of 80 hours per week, averaged over a 4 week period
Work per Week 1. In-house call, all moonlighting, time spent in the hospital for at-home call, count
toward 80 hrs
2. Patient care tasks, even if performed at home, count toward the 80 hrs
3. Academic preparation for presentations and journal club, reading, studying, etc., away
from the duty site do not count toward duty hour requirements
Moonlighting Internal and External Moonlighting must be counted towards the 80-hour maximum
PGY 1 residents cannot moonlight
Mandatory Time Free of 24 hours off per 7 day period, averaged over 4 weeks
Duty At-home call cannot be assigned on these free days
4 days off per month, vacation time excluded
Maximum Duty Period PGY 1 - 16 hour maximum
Length PGY 2 and above - 24 hour maximum
(24+4) Additional 4 hours if needed to ensure appropriate, effective, safe
transition of care after 24 hours
No new patients, procedures or clinics after 24 hrs of continuous in-house duty
Residents, at their discretion, may attend educational conferences
Strategic napping strongly suggested after 16 hours of continuous duty and
between the hours of 10pm 8am.
Minimum Time off All Residents - Should have 10 hrs must have 8
between Scheduled PGY 2 and above - Must have 14 hours after 24 hour in-house
Duty Periods Resident in final year - May return fewer than 8 hours w/ RRC approval, and must be
within 80 hrs and 1 day off in 7
Maximum Frequency of Must not be scheduled for more than 6 consecutive nights of night float
In-House Night Float May be further specified by Review Committees
Maximum In-House PGY 2 and above every 3rd night (when averaged over a 4 week period)
Call Frequency
At-Home Call 1. PGY 1 residents may not take at-home call
2. At-home call must not be so frequent/taxing as to preclude rest or reasonable
personal time
3. Time spent in the hospital on at-home call must count toward the 80 hour limit
4. Must comply with 1 day in 7 free of duty, when averaged over 4 weeks
5. Not subject to every 3rd night limitation
6. Residents are permitted to return to hospital to care for new or established patients.
Each episode of care counts toward 80 hrs but will not initiate a new off-duty
period
Unusual Resident Care of a single patient continuity for severely ill or unstable patient, academic
Initiated Extensions importance of the events transpiring, or humanistic attention to the needs of the patient
Additional Duty or family.
Resident must appropriately hand over care of all other patients to the team responsible
and document reasons for remaining to care for patient in question, and submit to
program director for each episode
Program director must review each submission of additional service, and track both
individual resident and program wide episodes of additional duty
Important Notes: 1. Programs must have a duty hour monitoring procedure which details how violations
are addressed, resolved, and prevented from occurring in the future
2. Averaging must occur by rotation 4 week period, 1 month period, or the period of a
rotation if less than 4 weeks.
3. Vacation and leave must be excluded when calculating duty hours, call frequency or
days off.