Work Hours

In-House Call refers to that period of duty during which the resident is required to remain in the hospital.

Out-of-House or Home Call refers to that period of duty in which the resident is allowed to leave the hospital premises, but be available to be called back to the hospital.

Weekend is defined as 0800 Saturday to 0800 Monday.

Work Week is defined as 0800 Monday to 0800 Saturday inclusive.

Article 9.2

Both parties hereto accept that, in order to provide adequate service and care to patients and to enhance the medical education of Residents and so facilitate the realization of their educational objectives, that duty hours be limited to provide a balance of patient care, clinical experience and academics. No Resident will be required to do more than 1 in 4 in-house call averaged over an academic rotation. The duty period referred to is from 1700 - 0800 hours Monday through Friday, and 0800 - 0800 hours Saturday, Sunday and statutory holidays. This duty period shall be referred to as “in-house-on-call” duty.

In services where in-house call is scheduled as partial or split-shifts (scheduled as less than 1700-0800 weekdays or 0800-0800 weekends), each part of the partial call shift or split-shift constitutes one call duty period for the purposes of call frequency maximums and call stipends.

Exceptions, based on academic need or exceptional situations, will be monitored by RDoS and the College of Medicine. Where concerns arise, discussion will be held at a Joint Consultative Committee meeting.

Article 9.3

In the event that a Resident performs In-House call duty in excess of 1 in 4 by assignment, such work will be paid at the following rates:

Article 9.4

No resident will be required to do more than one (1) in four (4) ICU/CCU call averaged over an academic rotation.

In the event that a Resident works 24 hours on/24 hours off ICU/CCU, rotations in excess of the principle of one (1) occasion in four (4)days averaged over an academic rotation, he/she will be paid a stipend as per the chart below.

For the purposes of determining the remuneration for rotations in excess of the principle of one (1) in four (4) averaged over an academic rotation, the calculation will not include rotations that result from the granting of education leave, examination leave, compassionate leave, paternity leave, and the six (6) days off during the Christmas/New Year’s period to other residents on the service. With the agreement of the Program Director or the Administrative Resident where this duty has been delegated by the Program Director, the existing practice whereby residents may interchange duty hours amongst themselves is recognized, provided that adequate patient care is provided. Additional remuneration will not be provided in such cases. Permission for such interchange will not be unreasonably withheld, but consecutive twenty-four (24) hour shifts will never be considered. The reason for the rotation in excess of the principle of one (1) in four (4) averaged over an academic rotation must be clearly defined so as to be able to determine that the Resident doing the excess rotation is to be remunerated.

Extra rotations in excess of the principle of one (1) in four (4)averaged over an academic rotationwill be voluntary and must have the mutual consent of the Resident and the Program Director.

Article 9.6

A Resident will be scheduled to work a reasonable number of hours. The training/employing organizations will undertake to limit the average number of hours, having due regard for sound patient care and treatment, and the educational requirements of the Resident’s program.

Article 9.7

Residents who are not on call may be contacted and invited to participate in a case. However, except in the event of an emergency of qualified medical personnel not being available, all residents will be free to decline such invitations.

Residents who are not scheduled to be on call will not be expected to attend rounds on
Saturdays and Sundays that are for service purposes only. However, this does not preclude the scheduling of teaching sessions on weekends, which Residents will be expected to attend.

Article 9.8.1 Home Call

Residents are to be relieved of clinical responsibilities after twenty-six (26) hours from the previous day’s start time on the first post-call day at the Resident’s professional discretion at such point as they feel their ability to safely care for patients may be compromised.

Article 9.8.2 In-House Call

A Resident who is required to provide care of a continuing or intensive nature shall be relieved after patient care handover. Patient care handover shall commence at the 24th hour and not exceed two (2) hours. No new clinical duties shall be assigned or undertaken after twenty-four (24) hours barring emergent circumstances. The Resident shall resume work on regularly scheduled hours the subsequent work day.

For those Residents who participate in shiftwork, including but not limited to Emergency Medicine, Internal Medicine, and Pediatrics; shifts shall not be scheduled in excess of 5 shifts per week, with maximum duty hours pro-rated by duration of shift. For example, CTU float shifts at 12 hours per shift, and ER shifts at 8 hours per shift. No resident shall be expected to participate in clinical duties for 12 hours preceding and after the shift.

For Residents with extra clinical duties, for example Family Medicine Residents with obstetrical duties, any excess clinical duties shall be restricted per call frequency and duration expectations. This includes maximum number of days spent performing excess duties per month, as per current call and shiftwork restrictions. If the Resident’s duties meet the requirements for call conversion, the resident shall be appropriately compensated and be entitled to a post-call day.