1.

Residents may not work in excess of 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.

2.

Residents must have one day in seven free from all clinical and educational responsibilities, averaged over a four-week period. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative responsibilities.

3.

Residents may not take call more frequently than every third night, averaged over a four-week period.

4.

Residents must leave the hospital within six hours after completion of each 24-hour call day. The purpose of this six-hour period is to participate in educational activities, maintain continuity of patient care, transfer patient care responsibility, and/or to participate in outpatient clinics. No new patient should be accepted during this six-hour period.

5.

Residents must report any difficulty in complying with these work hour limitations to Dr. Waxman, who has responsibility to monitor and enforce this policy.

6.

Moonlighting is not permitted for surgical residents.

Fatigue:

The resident must stop working and rest when fatigued. the resident must monitor him/herself for the signs suggestive of fatigue that usually occurs after prolonged periods of sleeplessness:

1.

Sluggish thought patterns, inability to concentrate;

2.

Inability to maintain wakeful state in the absence of external stimulation;

3.

Irritability, sudden anger, intolerance;

4.

Nausea or stomach cramps unassociated with physical illness;

5.

Tremors, particularly intention tremors while performing delicate procedures.