On-call duties are an important source of learning to trainees, but the frequency or intensity should not compromise the educational objectives of training. Fellows are not required to stay in house during call, but are expected to come into hospital on an as-needed basis with support from on-call medical residency house staff. Circumstances warranting direct evaluation include admissions to the Coronary Care Unit, acute MI, and hemodynamic instability. The number of hours per week and night call frequency for cardiovascular fellows at Lahey are well below stated guidelines. Duty hour guidelines, formulated by the ACGME, are strictly adhered to throughout training at Lahey Clinic These include:
- Having one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call.
- In-house call must occur no more frequently than every third night, averaged over a four-week period.
- Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. Residents may remain on duty for up to six additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics, and maintain continuity of medical and surgical care as defined in Specialty and Subspecialty Program Requirements.
- When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit.
- Moonlighting is counted toward the 80-hour weekly limit on duty hours.