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Academic Success

Policy on Student Clinical and Educational Work Hours in the Second 100 Weeks

The Zucker School of Medicine adopts the clinical and educational work hour regulations followed by the graduate medical education programs sponsored by Northwell Health. These regulations comply with the New York Codes, Rules and Regulations (NYCRR), Title 10, Section 405.4, and Accreditation Council of Graduate Medical Education (ACGME) Common Program Requirements, The Learning and Working Environment (Duty Hours).
 
Maximum Hours of Clinical and Educational Work per Week

  • Clinical and educational work hours must be limited to no more than 80 hours per week, averaged over a four (4)-week period.

Mandatory Time Free of Clinical Work and Education

  • Students should have eight (8) hours off between scheduled clinical work and education periods;
    • There may be circumstances when students choose to stay to care for their patients or return to the hospital with fewer than eight (8) hours free of clinical experience and education. This must occur within the context of the 80-hour and one-day-off-in-seven requirements;
  • Students must have at least 14 hours free of clinical work and education after 24 hours of in-house call;
  • Students must be scheduled for a minimum of one day in seven free of clinical work and education. At-home call cannot be assigned on these free days.

Maximum Clinical Work and Education Period Length

  • Clinical and educational work periods for students must not exceed 24 hours of continuous scheduled clinical assignments;
    • Up to three hours of additional time may be used for activities related to patient safety, such as providing effective transitions of care, and/or student education;
      • Additional patient care responsibilities must not be assigned to a student during this time.

Clinical and Educational Work Hour Exceptions

  • In rare circumstances, after handing off all other responsibilities, a student, on their own initiative, may elect to remain or return to the clinical site in the following circumstances:
    • To continue to provide care to a single severely ill or unstable patient;
    • Humanistic attention to the needs of a patient or family; or
    • To attend unique educational events;
  • These additional hours of care or education will be counted toward the 80-hour weekly limit.

In-House Night Float/Night Rotation

  • Night float/night rotation must occur with the context of the 80-hour and one-day-off-in-seven requirements.

Maximum In-House On-Call Frequency

  • Students must be scheduled for in-house call no more frequently than every third night (when averaged over a four-week period).

Monitoring Clinical and Educational Work Hours

  • For two weeks during each trimester of the Advanced Clinical Experience (ACE), students are expected to record their clinical and educational work hours via the online one45 work hours reporting feature;
  • Compliance with this policy is monitored regularly by the associate dean for advanced clinical learning.

Addressing Violations

Clinical and educational work hour violations can be reported at any time to the associate dean for advanced clinical learning or to the associate dean of student affairs. Clinical and educational work hour violations may also be discovered by the associate dean for advanced clinical learning through regular monitoring. In the event of a duty hour violation, the associate dean for advanced clinical learning or his/her designee will investigate the circumstances of the violation to determine if the violation represents a systematic problem or a situation unique to the student. If the investigation reveals a problem in the system, the associate dean for advanced clinical learning will make changes in the system to rectify the problem. If the investigation reveals a situation unique to the student, the associate dean of advanced clinical learning will discuss the situation with the student and his/her supervisors, and counsel them, as necessary, to prevent further violations.  

References to Regulations and/or Other Related Policies:
New York Codes, Rules and Regulations (NYCRR), Title 10, Section 405.4
Accreditation Council of Graduate Medical Education (ACGME) Common Program Requirements, The Learning and Working Environment (Duty Hours)
LCME Element 8.8: Monitoring Student Time

Last Updated: March 2019


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