1. ACGME Duty Hour Standards No more than 6 consecutive nights of night duty (night float) Specialty-specific requirements apply Maximum Frequency of In-Hospital Night Duty PGY 2 and above can take in-house every third night, average over four weeks Every third night, on average Maximum In-Hospital On-Call Frequency • PGY-1 residents cannot exceed 16 hours of continuous duty. • PGY-2 and above are limited to a maximum of 24 hours of continuous duty with additional 4 hours for transition of care • Strategic napping is strongly suggested, especially after 16 hours of continuous duty. Maximum 24-hour in-house call with additional 6 hours for didactics, clinic, or completion of patient care. Maximum Duty Period Length 80/wk, averaged over 4 wks 80/wk, averaged over 4 wks Maximum hours of work per week 2011 Duty Hour Standards 2003 Duty Hour Standards

2. ACGME Duty Hour Standards • Time spent in the hospital during at-home call must count towards the 80-hour maximum weekly hour limit, but is not subject to the every-third-night limitation • Time spent in the hospital does not initiate a new “off-duty period” The frequency of at-home call is not subject to the every-third-night, or 24+6 limitation. When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit. Home Call • Internal and external moonlighting must be counted towards the 80 hour limit and PGY-1 residents are not permitted to moonlight Internal moonlighting must be considered part of the 80-hour weekly limit on duty hours Moonlighting 24 hrs off per 7-day period, averaged over 4 weeks 24 hrs off per 7-day period, averaged over 4wks, inclusive of call Mandatory Time Off Duty • PGY-1: suggested 10 hours, but must have 8 hours off between shifts • PGY-2 and above: 14 hours free of duty after 24 hours call • Residents in their final years of education may have less than 8 hours off between shifts There should be a 10-hour time period provided between all daily duty periods and after in-house call Minimum Time Off between Scheduled Duty Periods 2011 Duty Hour Standards 2003 Duty Hour Standards