AOA Work Hour Preamble: It is recognized that excessive nu= mbers of hours worked by intern and resident physicians can lead to errors in judgment and clinical decision-making.&nbs= p; These can impact on patient safety through medical errors, as well as the safety of the physician trainees through increased motor vehicle accide= nts, stress, depression and illness related complications. The training institution and, dire= ctor of medical education (DME) and intern program director must maintain a high degree of sensitivity to the physical and mental well being of interns and = make every attempt to avoid scheduling excessive work hours leading to sleep deprivation, fatigue or inability to conduct personal activities.

= AOA INTERNSHIP &nb= sp; = &nb= sp; A= OA RESIDENCY<= /p>

The intern shall not= be assigned to work physically on duty in excess of eighty hours (80) per we= ek averaged over a four (4) week period, inclusive of in-house night call.

The resident shall n= ot be assigned to work physically on duty in excess of eighty hours (80) per we= ek averaged over a four (4) week period, inclusive of in-house night call.

The intern shall not= work in excess of twenty-four (24) consecutive hours inclusive of morning and noon educational programs= . Allowance for, but not to exceed= up to six (6) hours for inpatient and outpatient continuity, transfer of care, educational debriefing and formal didactic activities may occur. Interns may not assume responsib= ility for a new patient after twenty-four (24) hours.

The resident shall n= ot work in excess of twenty-four (24) consecutive hours inclusive of morning and = noon educational programs= . Allowance for, but not to exceed= up to six (6) hours for inpatient and outpatient continuity, transfer of care, educational debriefing and formal didactic activities may occur. Residents may not assume responsibility for a new patient after twenty-four (24) hours.=

Moonlighting is not permitted by interns. =

If moonlighting is permitted, all moonlighting will be inclusive of the eighty (80) hour per week maximum work limit and must be reported. (See Moonlighting Policy)

The intern shall have alternate week forty-eight (48) hour periods off or at least one (1) twenty-four (24)= hour period off each week.

The resident shall h= ave alternate week forty-eight (48) hour periods off or at least one (1) twenty-four (24)= hour period off each week.

Upon conclusion of a twenty-four (24) hour duty shift, interns shall have a minimum of twelve = (12) hours off before being required to be on duty again. Upon completing a lesser hour du= ty period, adequate time for rest and personal activity must be provided.

Upon conclusion of a twenty-four (24) hour duty shift, residents shall have a minimum of twelve (12) hours off before being required to be on duty again. Upon completing a lesser hour du= ty period, adequate time for rest and personal activity must be provided.

All off-duty time mu= st be totally free from assignment to clinical or educational activity.

All off-duty time mu= st be totally free from assignment to clinical or educational activity.

Those rotations requ= iring the intern to be assigned to Emergency Department duty shall not be assig= ned longer than twelve (12) hour shifts.

Those rotations requ= iring the resident to be assigned to Emergency Department duty shall not be assigned longer than twelve (12) hour shifts

The intern and train= ing institution must always remember the patient care responsibility is not precluded by this policy. I= n the case where an intern is engaged in patient responsibility, which cannot be interrupted, additional coverage should be provided to relieve the intern involved as soon as possible.

The resident and tra= ining institution must always remember the patient care responsibility is not precluded by this policy. I= n the case where a resident is engaged in patient responsibility which cannot be interrupted, additional coverage should be provided to relieve the reside= nt involved as soon as possible.

The intern may not be assigned to call more often than every third night averaged over any consecutive four (4) week period.

The resident may not= be assigned to call more often than every third night averaged over any consecutive four (4) week period.

The training institu= tion shall provide an on-call room for interns, which is clean, quiet, safe and comfortable, so to permit rest during call. A telephone shall be present in = the on-call room. Toilet and sh= ower facilities should be present in or convenient to the room. Nourishment shall be available d= uring the on-call hours of the night.

The training institu= tion shall provide an on-call room for residents, which is clean, quiet, safe = and comfortable, so to permit rest during call. A telephone shall be present in = the on-call room. Toilet and sh= ower facilities should be present in or convenient to the room. Nourishment shall be available d= uring the on-call hours of the night.

Any professional cli= nical activity (moonlighting) performed outside of the official residency progr= am may only be conducted with the permission of the program administration (DME/Program Director). A written request by the resident must be approve= d or disapproved by the Program Director and DME and be filed in the institution’s resident file. All approved hours are included in the total allowed work hours un= der AOA policy and are monitored by the institution’s graduate medical education committee. This p= olicy must be published in the institution’s housest= aff manual. Failure to report a= nd receive approval by the program may be grounds for terminating a resident’s contract.

The intern shall not= be assigned to work physically on duty in excess of eighty hours (80) per we= ek averaged over a four (4) week period, inclusive of in-house night call.	The resident shall n= ot be assigned to work physically on duty in excess of eighty hours (80) per we= ek averaged over a four (4) week period, inclusive of in-house night call.
The intern shall not= work in excess of twenty-four (24) consecutive hours inclusive of morning and noon educational programs= . Allowance for, but not to exceed= up to six (6) hours for inpatient and outpatient continuity, transfer of care, educational debriefing and formal didactic activities may occur. Interns may not assume responsib= ility for a new patient after twenty-four (24) hours.	The resident shall n= ot work in excess of twenty-four (24) consecutive hours inclusive of morning and = noon educational programs= . Allowance for, but not to exceed= up to six (6) hours for inpatient and outpatient continuity, transfer of care, educational debriefing and formal didactic activities may occur. Residents may not assume responsibility for a new patient after twenty-four (24) hours.=
Moonlighting is not permitted by interns. =	If moonlighting is permitted, all moonlighting will be inclusive of the eighty (80) hour per week maximum work limit and must be reported. (See Moonlighting Policy)
The intern shall have alternate week forty-eight (48) hour periods off or at least one (1) twenty-four (24)= hour period off each week.	The resident shall h= ave alternate week forty-eight (48) hour periods off or at least one (1) twenty-four (24)= hour period off each week.
Upon conclusion of a twenty-four (24) hour duty shift, interns shall have a minimum of twelve = (12) hours off before being required to be on duty again. Upon completing a lesser hour du= ty period, adequate time for rest and personal activity must be provided.	Upon conclusion of a twenty-four (24) hour duty shift, residents shall have a minimum of twelve (12) hours off before being required to be on duty again. Upon completing a lesser hour du= ty period, adequate time for rest and personal activity must be provided.
All off-duty time mu= st be totally free from assignment to clinical or educational activity.	All off-duty time mu= st be totally free from assignment to clinical or educational activity.
Those rotations requ= iring the intern to be assigned to Emergency Department duty shall not be assig= ned longer than twelve (12) hour shifts.	Those rotations requ= iring the resident to be assigned to Emergency Department duty shall not be assigned longer than twelve (12) hour shifts
The intern and train= ing institution must always remember the patient care responsibility is not precluded by this policy. I= n the case where an intern is engaged in patient responsibility, which cannot be interrupted, additional coverage should be provided to relieve the intern involved as soon as possible.	The resident and tra= ining institution must always remember the patient care responsibility is not precluded by this policy. I= n the case where a resident is engaged in patient responsibility which cannot be interrupted, additional coverage should be provided to relieve the reside= nt involved as soon as possible.
The intern may not be assigned to call more often than every third night averaged over any consecutive four (4) week period.	The resident may not= be assigned to call more often than every third night averaged over any consecutive four (4) week period.

The training institu= tion shall provide an on-call room for interns, which is clean, quiet, safe and comfortable, so to permit rest during call. A telephone shall be present in = the on-call room. Toilet and sh= ower facilities should be present in or convenient to the room. Nourishment shall be available d= uring the on-call hours of the night.	The training institu= tion shall provide an on-call room for residents, which is clean, quiet, safe = and comfortable, so to permit rest during call. A telephone shall be present in = the on-call room. Toilet and sh= ower facilities should be present in or convenient to the room. Nourishment shall be available d= uring the on-call hours of the night.

	Any professional cli= nical activity (moonlighting) performed outside of the official residency progr= am may only be conducted with the permission of the program administration (DME/Program Director). A written request by the resident must be approve= d or disapproved by the Program Director and DME and be filed in the institution’s resident file. All approved hours are included in the total allowed work hours un= der AOA policy and are monitored by the institution’s graduate medical education committee. This p= olicy must be published in the institution’s housest= aff manual. Failure to report a= nd receive approval by the program may be grounds for terminating a resident’s contract.