Duty Hour Evaluation Purpose
The ACGME requires all Sponsoring Institutions and programs to monitor resident and fellow duty hours—also called clinical and educational work hours—to ensure a safe, supportive, and educational environment.
At BIDMC, the purpose of duty hour monitoring is to:
Protect patient safety by reducing fatigue and ensuring appropriate supervision.
Support resident and fellow well-being by providing adequate rest and work-life balance.
Preserve the quality of education by balancing service with protected learning opportunities.
Quick Tips:
Direct access to ACGME resources: ACGME Duty Hours Overview
Duty Hour Evaluation Process
Duty hour evaluations are distributed directly to trainees through MedHub by the GME office three times per year, covering the months of December, March, and August. Trainees are given two weeks to complete and submit their evaluations which provide detailed information about their hours worked.
Once the submission window has closed, program-level results are compiled and shared. Programs identified as being in violation or non-compliance in submitting data will be required to provide a formal response to the Duty Hour Oversight Committee, led by Carlo Rosen and Carrie Tibbles.
Duty Hour Evaluation Criteria and Requirements
Frequently Asked Questions (FAQs): These FAQs contain clear guidance on ACGME duty hour standards, including the 80-hour weekly limit, days off, call frequency, shift length, and rest periods.
Institution-Specific Processes: BIDMC’s monitoring requirements, including survey expectations and how duty hours are reviewed.
Maximum of 80 hours per week, averaged over 4 weeks (includes in-house clinical activities, clinical work from home, and moonlighting).
Minimum of one day off in seven, averaged over 4 weeks (no at-home call on these days).
In-house call no more than every third night.
Continuous work not to exceed 24 hours, with up to 4 additional hours for safe transitions and education (no new patient care assigned during this time).
At least 14 hours off after a 24-hour shift.
Patient care responsibilities must remain manageable within duty hour limits.
Duty Hour Evaluation Templates
Below are sample Duty Hour Evaluation forms (Accredited and NST) that trainees receive through MedHub. These templates are useful for programs to review, as they show the exact format and language trainees see. Reviewing them can help identify where trainees may misinterpret questions or respond incorrectly and can guide programs in providing clarification up front.
Daily Logging
The ACGME expects programs to maintain accurate duty hour data. While not an explicit requirement in the Common Program Requirements, the ACGME has stated that daily logging is the recommended best practice to ensure compliance.
Daily or near-real-time logging helps programs in several key areas:
Internal Review Support: If an internal survey requires more detailed duty hour information, daily logs provide stronger, more accurate data.
Citations & Monitoring: If a program receives a citation related to duty hours, daily logging demonstrates proactive compliance and makes corrective action easier to document.
Annual ACGME Surveys: Programs with lower compliance on the ACGME survey often benefit from daily logs, as they provide a clearer picture of actual trainee work hours.
Program-Level Oversight: Programs may elect to use daily logging practices if they wish to track duty hour patterns more closely and gain more actionable data.
To support this, we are providing step-by-step video guides on how to use MedHub for daily logging:
We encourage programs to consider adopting daily logging for more reliable data, stronger compliance, and improved support in the event of an internal review or ACGME follow-up.