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University of Texas-Houston Medical School (UTHMS) Graduate Medical Education Committee (GMEC) Policy for Review of Requests from Programs for Extension of the 80-Hour per Week Limit on Resident Duty Hours

BACKGROUND:  

The Accreditation Committee for Graduate Medical Education (ACGME) has proposed a limit of 80-hours per week on resident duties in all approved programs.  In the most recent iteration of that proposal dated 17 September 2002 there is provision for extension of the duty hours as follows: 

D.6.  An RRC may grant exceptions for up to 10% of the 80-hour limit, to individual programs based on a sound educational rationale.  However, prior permission of the institution’s GMEC is required.

This policy delineates the mechanism by which applications for duty hours extension submitted by residency programs at UTHMS may be approved by the GMEC.

POLICY:

1. A Program Director may request an extension of resident duty hours of up to 10% beyond the 80-hour limit set by the ACGME.

2. Such request must be addressed to the Assistant Dean for Graduate Medical Education and must contain the following information:

1. Documentation that the program is currently in good standing with the ACGME
2. Documentation of current resident duty hours by rotation and PGY level
3. Delineation of those rotations and PGY levels for whom exemption is sought
4. A concise statement of those which ACGME educational requirements cannot be met with current resident duty hours
5. A clearly stated plan for remediation of the educational deficiencies with implementation of the proposed additional duty hours
6. And a specific date, not more than three years from the date of the request, before which the Program will return to full compliance with the 80 hour duty limit

3. Upon receipt of the request from the Program Director, the Assistant Dean for Graduate Medical Education will appoint an ad hoc committee that will review the proposed duty hour extension and make recommendations regarding its adoption to the GMEC.  That committee will be comprised of:
   1. Two program directors from other specialties and
   2. Three residents from other specialties
   3. One of the two program directors will be appointed as chairperson of the committee.

4. The ad hoc committee will report its findings to the GMEC within two months of the receipt of the request by the Assistant Dean for GME.

5. The GMEC will, after reading the proposal from the Program Director, hearing the report of the ad hoc committee and unlimited discussion vote to support or deny the request on the day of its presentation.  The decision will be made by simple majority of the voting members of the GMEC.

6. If the request is denied by the GMEC the applying program may not again apply for exemption for a period of one year from the date of the original request.

7. If the request is approved by the GMEC the Chairman of the GMEC will write a letter to that effect to accompany the request of the Program Director to the appropriate Residency Review Committee (RRC).

8. If the request of the Program Director is approved by the RRC, the GMEC will monitor the duty hours of all residents within the subject program on a quarterly basis.

9. This policy will be appropriately updated by the GMEC to reflect changes in the Requirements of the ACGME.