Clinical and Educational Work Hours

Maximum Hours of Clinical and Educational Hours per Week

When averaged over any 4-week rotation or assignment, fellows must not spend more than 80 hours per week on patient care duties and educational experiences. Work hours are generally 8:00 a.m. to 5:30 or 6:00 p.m. weekdays, although on busy services, work rounds may extend later into the evening. Night call is taken at home via pager. In compliance with ACGME guidelines, fellows must take one day (including weekend days) off per week, on average, on all rotations. This translates to an average of at least two weekends off per month. The one day off per week rule does not include vacation or sick leave time. Days off can be used for elective academic or educational activities, at the fellow's discretion, but not for required educational activities such as the national IDSA meeting.

Rotation Protocol and Quarterly Surveys

The fellowship program has implemented Rotation Protocol; all rotations have established an average number of hours on clinical rotations and reporting to the hospitals to allow for the payment for physician services in teaching settings. Fellows will be surveyed on a quarterly basis regarding clinical and educational hours and their effect on the well-being of each fellow. The program is responsible for reporting any violations or patterns of concerns to the GME Office. These surveys are mandatory and any concerning response will be followed up directly by the program director.

Religious Holidays / Scheduling

Fellows are asked to communicate any religious holidays or needs they may have to the program coordinator. Likewise, fellows are asked to share any significant personal events that are happening and the program will do everything that can be done to accommodate such occasions.

Call schedules for each site are prepared by the site’s administrator and are posted at each site; fellows will not be scheduled for more than two weekends of call during a monthly clinical rotation. Please communicate any concerns or needed changes to the site coordinator and/or program coordinator as soon as possible.

Fatigue and Trainee Safety

Sleep deprivation training is part of the GME orientation process for each fellow. It is important for fellows and faculty to recognize the signs of fatigue and sleep deprivation, its management, mitigation, and to act when needed. Continuity of patient care must be ensured. If at any time a fellow needs to leave the hospital and take a taxi or ride-share home, any cost will be reimbursed by the program.

Safety and security escorts are addressed by each site where the fellow rotates. Please see individual site orientation through the Fellowship Google site.

Moonlighting

Moonlighting is defined as any work performed as a physician outside of the fellowship program that generates revenue.

All fellows who secure moonlighting positions must obtain approval from the fellowship program director prior to starting the position.

In general, the Department of Medicine discourages moonlighting activities by fellows. Moonlighting while on call is strictly prohibited. Moonlighting during the hours of 8:00 am to 5:30 pm on weekdays is strongly discouraged and requires discussion with the program director before consideration. It may be considered on a case-by-case basis during research months. If moonlighting while doing VA research, fellows must be at the VA for a minimum of 40 hours per week and 6 hours each weekday.

Moonlighting must not interfere with the fellow’s performance of patient care or educational responsibilities on any rotation during fellowship training. Fellows violating this policy may be subject to probation, suspension without pay and/or disciplinary action including, but not limited to, termination. Any fellow actively involved in a formal improvement plan or probation will not be allowed to moonlight. If they had been moonlighting previously, privileges will be temporarily suspended. If a fellow successfully remediates, moonlighting privileges may be reinstated at the discretion of the program director.

Moonlighting is discouraged during any rotation in which the fellow has clinical responsibilities. Any moonlighting that is done during clinical rotations must not interfere with the fellow's clinical responsibilities or work hour requirements.

To be approved, the fellow must possess a medical license, provide to the program the organization and site of the moonlighting activity, the nature of work (i.e. urgent care, chart review, etc.), the name and telephone number of the immediate supervisor, and the anticipated hours of work per month. This information must be provided to the program director/coordinator by using a GME standardized moonlighting form.

Clinical and educational work hours must be limited to no more than 80 hours per week, averaged over a four-week period, inclusive of all in-house clinical and educational activities, clinical work done from home, and all moonlighting.

Professional liability insurance coverage is the responsibility of the fellow and/or hiring institution. The insurance coverage provided by the University of Minnesota during fellowship does not cover any moonlighting activities.

Fellows holding J1 visas under sponsorship of the ECFMG may NOT moonlight

GME has a website for Clinical Experience and Education Hours Resources.