NYS – ACGME Post-Graduate Trainee Work-Hour Regulations

Comparison Guide

Note: This document is intended to serve only as a general resource. Users are advised to reference NYSDOH 405 regulations and ACGME
Common Program Requirements for more details on specific programs and the full regulations/guidelines.
NYS 405
ACGME Policy regulations What rule needs to be followed to
Regulation Area NYS 405 Regulations
(effective July 01, 2017) compared to be in compliance with both the NYS
ACGME 405 regulations & ACGME Policy

A maximum of 80 hours per week

Limited to no more than 80 hours per averaged over 4 weeks, inclusive of
A maximum of 80 hours per week
week averaged over a 4-week period, all in-house clinical and
Maximum Work averaged over 4 weeks, inclusive of all
inclusive of all in-house clinical and Same educational activities, clinic
Hours per Week in-house activities, clinic assignments,
educational activities, clinical work done assignments, clinical work done
and moonlighting activities.
from home, and all moonlighting. from home, and all moonlighting
activities.
In rare circumstances, after handing off all
other responsibilities, a resident, on their
own initiative, may elect to remain or
return to the clinical site in the following
Work Hours- Surgical Exemption- please refer to
Surgical Exemption circumstances: to continue to provide Distinct
Exception Specialty Programs exemptions.
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.
Hospitals shall adopt and enforce Time spent by residents in internal and
specific policies governing dual All moonlighting hours worked are
external Moonlighting must be counted
employment. included in the total weekly work
Moonlighting towards the 80-hour maximum weekly Comparable
hours. PGY-1 residents are not
All moonlighting hours worked are limit. PGY-1 residents are not permitted
permitted to moonlight.
included in total weekly work hours. to moonlight.

Residents must be scheduled for a

minimum of one day in 7 free of clinical 24 hours off per week not averaged.
Mandatory Weekly
At least one 24-hour period off per week work and required education when Distinct At home call cannot be assigned on
Time Off
averaged over 4 weeks. At-home call the 24 hours off.
cannot be assigned on these free days.

NYS 405.4 Regulations Page 1 of 5

ACGME Common Program Requirements Section VI Tracked Changes February 2017 04/25/17
 NYS – ACGME Post-Graduate Trainee Work-Hour Regulations
Comparison Guide

Note: This document is intended to serve only as a general resource. Users are advised to reference NYSDOH 405 regulations and ACGME
Common Program Requirements for more details on specific programs and the full regulations/guidelines.
NYS 405
ACGME Policy regulations What rule needs to be followed to
Regulation Area NYS 405 Regulations
(effective July 01, 2017) compared to be in compliance with both the NYS
ACGME 405 regulations & ACGME Policy

All residents must have 8 hours off

Residents should have 8 hours off
between scheduled clinical
between scheduled clinical work and
Mandatory Rest / Scheduled on-duty assignments work/educational periods.
educational periods.
Time Off Between separated by not less than 8 non-working Distinct Residents must have at least 14
Work Periods hours Residents must have at least 14 hours
hours free of clinical work and
free of clinical work and education after
education after 24 hours of in-
24 hours of in-house call.
house call.

Continuous on-site duty, including

Clinical and educational work periods for
in-house call, must not be
Postgraduate trainees are not scheduled residents must not exceed 24 hours of
scheduled for/exceed 24
to work for more than 24 consecutive continuous scheduled clinical
consecutive hours. Residents may
hours. Residents may remain on duty for assignments. Up to 4 hours of additional
remain on duty for up to 3
Maximum Work up to 3 additional hours of transition time time may be used for activities related to
Distinct additional hours (total of 27 hours)
Period Length to be used for transfer of patient care, patient safety, such as providing effective
of transition time to be used for
rounds, or grand rounds. No new patient transitions of care, and/or resident
transfer of patient care, rounds, or
care may be assigned during the 3-hour education. Additional patient care
grand rounds. No new patient care
transition time. responsibilities must not be assigned
may be assigned during the 3-hour
during this time.
transition time.

NYS 405.4 Regulations Page 2 of 5

ACGME Common Program Requirements Section VI Tracked Changes February 2017 04/25/17
 NYS – ACGME Post-Graduate Trainee Work-Hour Regulations
Comparison Guide

Note: This document is intended to serve only as a general resource. Users are advised to reference NYSDOH 405 regulations and ACGME
Common Program Requirements for more details on specific programs and the full regulations/guidelines.
NYS 405
ACGME Policy regulations What rule needs to be followed to
Regulation Area NYS 405 Regulations
(effective July 01, 2017) compared to be in compliance with both the NYS
ACGME 405 regulations & ACGME Policy

Residents must be scheduled for in-

Maximum On Call Every 3rd night averaged over 4
Programs utilizing Surgical Exemption, house call no more frequently than every
(In-house) Comparable weeks.
call is limited to every 3rd night. third night, averaged over a four-week
Frequency
period. Every 3rd night if using surgical
exemption.

Surgical Exemption: On-call duty in the

hospital during the night shift hours by
trainees in surgery shall not be included
in the 24-hour on-call and 80-hour limits
if the hospital can document that during
A Review Committee may grant rotation-
such night shifts, postgraduate trainees: If using the surgical exemption:
specific exceptions for up to 10% or a
Specialty Program - are generally resting; documented 4-5 must meet NYS surgical exemption
maximum of 88 clinical and educational Distinct
Exemptions hours uninterrupted rest/sleep criteria with a maximum of 28 hours
work hours to individual programs based
- on-call no more than every 3rd night from start to end of on-call shift.
on a sound educational rationale.
- the on-call duty is followed by a non-
working period of no less than 16 hours
- policies and procedures are in place to
immediately relieve a postgraduate
trainee due to fatigue.
Time spent on patient care activities by
residents on at-home call must count Time spent on patient care
When called into the hospital from home,
toward the 80-hour maximum weekly activities when on at home call are
the hours the residents spend in-house
limit. The frequency of at-home call is not counted toward the 80-hour limit.
Home Call are counted toward the 80-hour limit. At Comparable
subject to the every third night limitation, At home call cannot be scheduled
home call cannot be scheduled on the
but must satisfy the requirement of one on the day that satisfies the day off
day that satisfies the day off per week.
day in 7 free of clinical work and per week.
education when averaged over 4 weeks.

NYS 405.4 Regulations Page 3 of 5

ACGME Common Program Requirements Section VI Tracked Changes February 2017 04/25/17
 NYS – ACGME Post-Graduate Trainee Work-Hour Regulations
Comparison Guide

Note: This document is intended to serve only as a general resource. Users are advised to reference NYSDOH 405 regulations and ACGME
Common Program Requirements for more details on specific programs and the full regulations/guidelines.
NYS 405
ACGME Policy regulations What rule needs to be followed to
Regulation Area NYS 405 Regulations
(effective July 01, 2017) compared to be in compliance with both the NYS
ACGME 405 regulations & ACGME Policy

Night float must occur within the

context of the maximum work
Night float must occur within the context hours per week, mandatory weekly
Night float must occur within the context of the 80-hour and one day off in 7 time off, and mandatory time off
Night Float of the maximum work hours per week, requirement. The maximum number of between work periods.
Maximum mandatory weekly time off, and consecutive weeks of night float and Comparable
Frequency mandatory time off between work maximum number of months of night float The maximum number of
periods. per year may be further specified by the consecutive weeks of night float
Review Committee. and maximum number of months of
night float per year may be further
specified by the Review Committee.
While on duty in the emergency Up to 12 consecutive hours on duty
No more than 12 consecutive work hours
department, residents may not work assignment in the ER, followed by
per on-duty assignment in the ER.
longer than 12 consecutive hours. There at least an equal period of
Residents may remain on duty for up to 3
must be at least an equal period of continuous time off.
Maximum "High additional hours of transition time to be
continuous time off between scheduled Distinct
Intensity" Shift used for transfer of patient care, rounds, No more than 60 scheduled hours
work periods. A resident must not work
and educational activities. No new per week seeing patients in the ED
more than 60 scheduled hours per week
patient care may be assigned during the and no more than 72 total hours per
seeing patients in the ED and no more
3-hour transition time. week.
than 72 total hours per week.

NYS 405.4 Regulations Page 4 of 5

ACGME Common Program Requirements Section VI Tracked Changes February 2017 04/25/17
 NYS – ACGME Post-Graduate Trainee Work-Hour Regulations
Comparison Guide

Note: This document is intended to serve only as a general resource. Users are advised to reference NYSDOH 405 regulations and ACGME
Common Program Requirements for more details on specific programs and the full regulations/guidelines.
NYS 405
ACGME Policy regulations What rule needs to be followed to
Regulation Area NYS 405 Regulations
(effective July 01, 2017) compared to be in compliance with both the NYS
ACGME 405 regulations & ACGME Policy

Supervision shall be provided by

physicians who are board certified or Although the attending physician is
admissible in those respective specialties ultimately responsible for the care of the
or who have completed a minimum of 4 patient, for many aspects of patient care,
postgraduate years of training in such the supervising physician may be a more
specialty. There shall be sufficient advanced resident or fellow. Other
number of these physicians present in portions of care provided by the resident
person in the hospital 24 hours/day 7 can be adequately supervised by the
days/week to supervise the postgraduate immediate availability of the supervising
trainees in their specific specialties. In faculty member, fellow, or senior resident
hospitals that can document that the physician, either onsite or by means of
patients attending physicians are telephonic and/or electronic modalities.
immediately available by telephone and Some activities require the physical
readily available in person when needed, presence of the supervising faculty
NYS requires on-site supervision
Resident the onsite supervision of routine hospital member.
Distinct 24/7 by the attending or
Supervision care and procedures may be carried out
The program must demonstrate that the supervising physician.
by postgraduate trainees who are in their
appropriate level of supervision in place
final year of or who have completed at
for all residents is based on each
least 3 years of postgraduate training.
resident’s level of training and ability, as
Supervision by attending physicians of
well as patient complexity and acuity.
the care provided to surgery patients by
Supervision may be exercised through a
postgraduate trainees must include at a
variety of methods as appropriate to the
minimum: a) personal supervision of all
situation.
surgical procedures requiring general
anesthesia or an operating room Senior residents or fellows should serve
procedure, b) preoperative exam and in a supervisory role of junior residents.
assessment by the attending physician, Initially, PGY-1 residents must be
and c) postoperative exam and supervised either directly or indirectly with
assessment no less frequently than daily direct supervision immediately available.
by the attending physician.

NYS 405.4 Regulations Page 5 of 5

ACGME Common Program Requirements Section VI Tracked Changes February 2017 04/25/17