Policies and procedures

HUP

RP4: Interns

• Bathroom, shower, two computers, bed

RP6: Interns

• Bathroom, shower, one computer, bed

RP7: Interns

• Bathroom, shower, one computer, bed

Gates 514: Chiefs

• Computers, beds, lockers, couch 

Dulles 2- SODs

• Multiple keypads for entry. DSE will get everyone badge access. Request access when going into the lab

Silverstein 2: Students

• Three computers, lockers, shred box, closet to store scooters 

Pavillion

11-294: General use

• No swipe entry.
• When the shred box fills, you literally just have to call EVS.
• Printer toner is ordered through DSE.

12-313: PGY2s overnight

• PMR uses this room daytime, and we use it nighttime. It is swipe access only and the hospital monitors how often we use it.

PAH

If you have any issues with any of the PAH call rooms, contact Marialaina Scafidi who is the GME contact at PAH

6 Schiedt

• Most active room in terms of renovations.
• Need code

3 Cathcart

• Need code

9 Schiedt 

• Need a key to access and code

PPMC

6 Wright Saunders

• Two Trauma rooms

Trauma

• The call room has moved from WS to Myrin Basement (by the trauma bay). 
• This was an effort to help reduce the travel time to the trauma bay.
• If you follow the back way to the Myrin building of the ED and enter the door that says Medical Records, take the stairs down, directly to the right.
• Follow to the basement level. Follow hallways around past the ED admin suite and continue to where medical records is located.
• Across from the medical records office is the M05 Cardiology sign. Enter the suite and the first door on the right with a keypad is the resident call room.

The surgery call rooms are dispersed throughout the hospital and are used by multiple residents at different levels on different services. There are certain call rooms that are traditionally used by certain services/residents (mostly based on proximity to their patients). However, these designations are flexible. Please be respectful of the shared space and keep the call rooms clean. Environmental Services will not change linens if personal items such as book bags are left on the bed and will clean around any items left on the floor. Please be mindful of this. Additionally, please do not leave any valuables in the call rooms as it is a shared space. The hospital and Department of Surgery is not responsible for any lost or stolen items that are left in the call rooms.

Annual Salaries

Paycheck Distribution

Housestaff are paid biweekly. Housestaff are strongly encouraged to enroll in Direct Deposit by signing up on the Penn for People (intranet link).

Paychecks for individuals who do not use Direct Deposit will be mailed to their home address on file.

Housestaff are encouraged to utilize a number of alternatives to pursue complaints or grievances relating to any aspect of their experience during residency training. These include discussions with:

1. The Program Director
2. Director, Surgery Education Administration
3. Program Coordinator
4. The Chairman of the Department of Surgery
5. The Graduate Medical Education Committee Staff including the Designated Institutional Officer
6. The Resident Executive Council for the Department of Surgery or a subcommittee thereof.
7. Ombudsperson (determined by the housestaff committee) (GME Policy intranet only)
8. Surgical Trainee Event Monitoring Systems (STEMS intranet only)

Principles

1. Attendings are accountable and responsible for all consultative care; housestaff do not provide independent consultative care without supervision.
2. Each surgical service shall respond appropriately to consultation requests at both the housestaff and attending level.
   1. Although a first year resident can educationally participate in the consultative process by fact-finding, the initial consultative advice must be provided by a more senior resident or Attending who personally sees the patient.
3. Except for E.R. patients who are not admitted, all consults will be personally seen by a Surgery Attending within an appropriate time frame not to exceed 48 hours of receipt.
4. All consultation reports will be signed by an Attending with their comment.

Logistics

1. The Department shall have a plan to guide the communication of request for consultation.
   1. Elective consults can be directed to individual Faculty at the discretion of the consult resident.
   2. Non-Elective Consults
      1. Each surgical service shall have a HOUSESTAFF and FACULTY on-call system for non-elective consults to their service and its individual Faculty members.
      2. Such on-call schedules are posted, distributed and maintained by the Page Operator.
      3. The Department will have a mid-level resident (second-third year) in the Hospital AT ALL TIMES to function as the initial consultant to the Emergency Room physicians as their sole function (E.R. Resident). This E.R. Resident does not have any specific INPATIENT bed responsibilities during this assigned tour.
2. Administrative Responsibility
   1. The Department will have a senior resident (fourth-seventh year) in the Hospital AT ALL TIMES to function as the senior administrative officer of the Department as their sole function (S.O.D.). This S.O.D. does not have any specific INPATIENT bed responsibilities during their assigned tour of duty. All non-elective problems regarding these issues should be referred to this individual for resolution.

Medical Affairs and the GME require that we have a Credentialing process covering the independent insertion of central venous lines, bronchoscopes, and chest tubes. You must compile the record necessary to be credentialed as an independent inserter. Our detailed Department policy is below.

CY-1 and CY-2 housestaff are NOT credentialed until ALL of the following have taken place:

1. The resident has successfully inserted at least 10 central venous catheters, under the DIRECT supervision of a physician who has previously been certified as an independent inserter.
2. The resident has successfully removed at least 2 central venous catheters, under the DIRECT supervision of a physician who has previously been certified as an independent inserter.
3. The resident has successfully completed 5 bronchoscopes under the DIRECT supervision of a senior resident and/or faculty member.
4. The resident has successfully inserted at least 5 chest tubes under the DIRECT supervision of a senior resident and/or faculty member.
5. The COMPLETE record of the above has been entered into MedHub.

Specific to Department of Surgery

1. Unfavorable performance appraisals may occur in response to a variety of events:
   1. inadequate academic performance, e.g., substandard performance on an in-training examination
   2. inadequate clinical care, e.g., a breach of Hospital clinical care standards
   3. appropriate conduct, e.g., violation of Hospital or Departmental policies
   4. adverse annual review (by the Education Committee or Program Director)
   5. adverse clinical performance evaluation.
2. The Program Director is responsible for enacting all disciplinary measures of Department of Surgery residents. Following a review of all pertinent facts, the Program Director will decide an appropriate course of action and will communicate in writing to the resident, Faculty Advisor, Chairman, and DIO. If warranted, professional counseling, medical evaluation or a leave of absence may be suggested or required.
3. Within 30 days of disciplinary action, a resident may appeal by addressing a written statement to the chair of the Graduate Medical Education Committee in accordance with the GME policy (intranet only).

Duty hours are defined as all clinical and academic activities related to the residency program, ie, patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.

Residents must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

Adequate time for rest and personal activities must be provided between all daily duty periods. This should consist of a 10-hour time period provided between all daily duty periods, and after in-house call. Residents who extend their work time for patient care or educational opportunities will be exempted by the Program Director from morning rounds or conference to comply with the 10 hour rule. This must be documented at the time of extension via email to the Program Director, Service Chief and Director, Surgery Education Administration.

On-Call Activities

The objective of on-call activities is to provide residents with continuity of patient care experiences throughout a 24-hour period. In-house call is defined as those duty hours beyond the normal work day when residents are required to be immediately available in the assigned institution.

In-house call must occur no more frequently than every third night, averaged over a four-week period.

At-home call (pager call) is defined as call taken from outside the assigned institution.

• The frequency of at-home call is not subject to the every third night limitation. However, at-home call must not be so frequent as to preclude rest and reasonable personal time for each resident. Residents taking at-home call must be provided with 1 day in 7 completely free from all educational and clinical responsibilities, averaged over a 4-week period.
• When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit.
• The program director and the faculty must monitor the demands of at-home call in their programs and make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue.

Schedule Compliance

The master schedule for all residents must meet the following rules:

1. Minimum time off between shifts = 8 hours
2. Minimum time off after 24 hours of in-house call = 14 hours
3. Maximum shift length PGY 2-5 = 24 hours
4. Minimum of 1 day off in 7 days (averaged over 4 weeks)
5. Maximum weekly hours = 80 hours (averaged over 4 weeks)

Attendance and participation in the Weekly Resident Conference (Thursdays from 8:00 am - 9:00 am), Surgery Grand Rounds (select Thursdays, 7:00 am - 8:00 am) and Surgery Case Management Conference (Thursdays, 7:00 am - 8:00 am); is required of all surgery housestaff except for EMERGENCY clinical duties.

An attendance database is kept by the DSE who provides quarterly reports to the Program Director and Chairman. Attendance at surgical conferences is noted on resident bi-annual performance review.

Attendance is expected above the 90th percent excluding the following assignments: Clinical Trips, on Research Trips, CTSICU, All Night Float rotations, CHOP, Neurosurgery, Urology, Orthopedics, OMFS.

The Department of Surgery supports high quality resident education and safe and effective patient care.

Excessive sleep loss, fatigue, and stress are serious matters that can compromise patient safety and physician well-being.

• All faculty and residents are instructed to closely observe their colleagues for any signs of fatigue or undue stress.
• Faculty and residents are expected to report concerns of resident absences, tardiness, sleepiness, inattentiveness, or other indicators of fatigue or excessive stress to the supervising attending or program director.
• Appropriate relief or backup support will be provided when patient care responsibilities are especially difficult or prolonged.

Residents who are having issues with fatigue, stress, or work/life balance should be aware of the services available through the Employee Assistance Program.

Fatigue mitigation

In the event a Resident is required to work unexpectedly (i.e. was not scheduled) past 11:00 pm, or is called into work or leaving work between the hours of 11:00 pm and 5:00 am, or after completing a shift of sixteen hours or more in length the Resident may be reimbursed the cost of transportation for a round trip to the Resident's residence or to the hospital, up to thirty-five dollars ($35) each leg of the trip.

UBER/LYFT

If a trainee prefers to use the services of Uber or Lyft they should submit the receipt to their coordinator for reimbursement.

This benefit is for fatigue use only.

Fatigue ride home policy For surgical housestaff

The Division of Surgery Education will subsidize transportation for residents who are too fatigued to travel home safely. The cab service will drive home a fatigued resident (and drive the resident back to work the following day if necessary).

Company Contact: 215-GET-A-CAB

Procedure: Vouchers will be available in the resident lounge on 4 Maloney in the cupboard above the computer desk (or you may contact your coordinator.)

Housestaff should call 215-GET-A-CAB (215-438-2222) and tell the dispatcher the pick-up location and destination. Housestaff should tell the dispatcher that they are using a voucher if they are not asked.

The voucher must be completed in full (the Client/Firm Charge No. Box does not need to be filled out as the vouchers are pre-printed with our account code). The trainee must retain the TOP WHITE copy of the voucher and return it to your coordinator office as soon as possible. Used vouchers will be reconciled on a monthly basis with the cab company.

Attending surgeons should be informed promptly (usually within one hour) of certain changes in the patient’s condition through ongoing communication with the hospital team, which includes residents, PAs, NPs, fellows, and ICU physicians. The team should notify the attending surgeon or his/her designee of significant changes when they occur, regardless of the time of day or day of week. Conditions requiring immediate notification include, but are not limited to, the following:

1. Unscheduled return to the OR
2. Transfer to ICU
3. New Admission
4. Rapid Response (RRT)
5. Emergency Airway Response
6. Code
7. Death

Other conditions requiring timely notification: 

1. Unplanned intubation or ventilator support
2. Development of significant neurologic changes
3. Development of wound complications
4. Medication or treatment errors requiring clinical intervention
5. Visit to the Emergency Department (ED)
6. Development of any concern by a trainee that a situation is more complicated than he or she can manage
7. Discharge from the hospital or ED
8. Transfer out of ICU

In the event that a resident is expecting the addition of a child to their family during their residency, up to 12 weeks in a rolling 12-month period will be allowed off following the delivery in accordance with the Family Leave Act of 1993 (FMLA) as maternity or paternity leave. FMLA leave is also available for the placement of adoption, or placement of foster care child, or for the house officer’s own serious health condition or the serious health condition of a family member. Time off will be broken down in the following manner:

• House officers may receive up to six weeks of paid FMLA leave (of the 12 total weeks available) in any rolling 12-month period, when the leave is taken for their own serious health conditions, or for the birth, placement for adoption or placement for foster care of a child. Consistent with Employer GME policy, Residents shall be eligible for FMLA leave upon the commencement of training (i.e. on the first day of employment) and may receive up to six (6) weeks of paid FMLA leave (of the 12 weeks available) in any rolling 12-month period, plus two (2) additional paid weeks for new child leave (birth of adoption). Residents may use additional paid time banks concurrent with FMLA to receive up to an additional four (4) weeks of paid time. The maintenance and administration of FMLA policy shall be left to the Employer's discretion, subject to the terms of this subsection and applicable law. In the event there are two Residents who are parents of a child, then both Residents will be entitled to leave under this section, provided however that if such parents are Residents in training in the same program, they shall not be approved for concurrent paid leave, except at the discretion of the Program Director, approval not to be unreasonably withheld.
• Once such paid leave is exhausted, the house officer must use any available vacation (as approved by the Program Director) for the remainder of his or her FMLA leave. House officers may also receive short-term disability benefits if enrolled in the short-term disability plan and eligible under the terms of the plan.
• FMLA will be unpaid for house officers not receiving short-term disability benefits or who have exhausted all vacation time.

House staff taking FMLA (up to the full 12 week time period off from clinical duties) may be required to extend the date of their completion of the training program by the amount of additional time requested off in order to comply with the Residency Review Committee of the ACGME and American Board of Surgery requirements for clinical weeks spent as part of the surgical residency. Questions regarding board eligibility and RRC requirements can be answered at www.absurgery.org and www.acgme.org or with your specific specialty Board. All requests for FMLA or extended leave should be made to the Program Director, with notification to the Director, Surgery Education Administration.

GME Family Medical Leave Policy (intranet only).

All reimbursements require you to submit a copy of the receipt and your credit card statement that shows your name, at least the last four digits of the account number and the transaction.

MT Licensing

Will be paid directly by DSE.

MD Licensing

The renewal costs of an unrestricted medical license will be reimbursed by DSE.

DEA Licensing

DEA licensing costs will be reimbursed by DSE.

USMLE Step III

Examination fees for Step III will be reimbursed by DSE one time. The test must be taken and passed by February of the second clinical year.

In-service Training Exams

Will be paid directly by the DSE.

All Housestaff are eligible for meal benefits and will receive $500 per year to be used at their home institutions.

In addition, all housestaff will have unlimited access to vending services, at their own expense, 24 hours a day.

HUP cafeteria: Founders building – 2nd Floor

• Breakfast served 6:00 am to 10:30 am
• Lunch/Dinner served 10:30 am to 7:00 pm
• Grab ‘n Go items available until Midnight

A salad bar, short order grill and deli, as well as a variety of freshly baked cookies and desserts are featured daily. Takeout items are available throughout the day.

Starbucks - Founders Building - 2nd Floor - ORDER HERE for pick-up

• Open Monday - Friday 6:00 am to 7:00 pm
• Open Saturday - Sunday 7:00 am to 6:00 pm 

Wellness activities reimbursement

As part of our ongoing wellness initiatives, the Division of Surgery Education will reimburse clinical team meals. Please see the table below for specifics on the amount that can be reimbursed as well as the process for being reimbursed. If any questions, feel free to reach out to your program coordinator.

Mobile Device Options/Support

• All incoming housestaff and newly hired employees (who are being issued a smartphone), will be issued the current model free iPhone
• We are an iPhone only department
• Surgery IS will support the downloading of the Company Portal which will enable UPHS email on your device. They are not responsible for other apps or personal email accounts.
• Surgery IS is not responsible for the backing up and then reloading of iPhone content through iTunes in the event of a phone upgrade.

Mobile Device Problems

• Anyone experiencing problems with their cell phone must report the problem to SurgeryHD@pennmedicine.upenn.edu Please state in the email your cellphone number and make sure to give a contact number where you can be reached. You will be receiving a return email with your ticket number and a Surgery IS staff member will contact you for a resolution.
• Hardware issues related to damage (Ex. cracked glass, water damage, etc.) are NOT supported by Surgery IS but you will be directed to a 3rd party vendor who can assist (at cost of the user).

Lost/Stolen/Damaged Devices

• There are numerous protective cases that can be purchased that will help prevent damage to the phone if dropped.
• The Department of Surgery is not responsible for lost chargers or phones and must be replaced at the expense of the user.

Mobile Device Plan (per month)

• The current UPHS cell phone plan is 450 minutes per user.
• 2gb of data
• Unlimited texting

Transferring your personal number onto our account. NOT FOR INCOMING HOUSESTAFF!!

• If your personal number being moved onto the UPHS account is currently an AT&T number, the date you are eligible for a discounted new phone price will come over with your current plan (Bringing your phone number to UPHS does not guarantee you an immediate upgraded phone).
• If your personal number is with a carrier other than AT&T, you will either be issued the current free iPhone or pay out of pocket for an upgraded device.
• Please email SurgeryHD@pennmedicine.upenn.edu to begin this process

International Use

• Using your mobile devices outside the United States is Strictly Prohibited for anyone but Faculty. When traveling overseas, please set to airplane mode and only use Wi-Fi. Any incurred international charges will be dealt with on a case-by-case basis by the department heads.

Any questions pertaining to the above information please email SurgeryHD@pennmedicine.upenn.edu.

With the permission of their Program Director and Research Mentor, Residents in their unaccredited training years are eligible to moonlight. You must hold an unrestricted medical license (MD) and complete all appropriate credentialing with OMA. Please contact your coordinator for more information. Residents may moonlight up to 120 hours (10 shifts) per month.

This policy is a supplement to the CPUP Policy on Professionally Related Expenses (PRE) for Housestaff employed by the University of Pennsylvania Health System and sets forth the program specific policy governing department/division/program support for Personal Protective equipment, Specialized Training Equipment, Required Licenses and Certifications, and Conference Travel and Reimbursement for Housestaff in the above referenced program. Housestaff Reimbursement Policy (intranet only).

Departments/Divisions will provide $1,000 per year per Resident in reimbursement for approved educational and/or academic expenses.

Covered

• Non-credit education that is related to the house officer's current position (e.g. medical textbooks, journal subscriptions, in-training exam and board preparation materials)
• Job-related training programs
• Preparation seminars or online resources for certification exams required by program
• Conference registration fees
• Travel, meals, lodging costs incurred by attending or presenting at a conference
• Preparation of academic/scientific poster for presentation at a conference
• Medical equipment used during residency/fellowship training (Note that reimbursement for equipment may only be one time for specific item during training. (e.g. one loupe, headlamp, etc.)
• Memberships to professional organizations

Not covered

• Laptop computers or tablets
• Upgrades to phones or phone plans
• Other electronic devices such as smartwatches or headphones
• Monthly parking or public transportation costs
• Memberships to organizations, societies, groups, clubs, academies unrelated to house officer's current position
• Licensing fees or renewals not required by the program
• Fees for exams with no educational component
• Exams and prep materials for exams not required by program
• Books, magazines, DVD's, online training, etc. that DO NOT offer CMEs after completion or that are not related to house officer's current position.

A Prior Authorization for Travel Form (intranet only). (available electronically from the departmental/division) MUST be completed and submitted to the program coordinator when submitting an abstract for acceptance for approval by the Chair, Chief, Program Director, and/or Director of Division Administration. You MUST know your funding source at this time. Failure to submit pre-trip form is at risk for denial of reimbursement.

Housestaff PRE tipsheet

The Department of Surgery maintains an ongoing system of standardized evaluations of resident performance:

1. Monthly performance evaluations by all Faculty and Senior Residents from the residents' assigned service for the month are completed through our on-line evaluation system. These evaluations are available for the residents' review at any time online. Bi-Annual quantitative and comparative summaries are provided to the Education Committee, Program Directors, and Division Chiefs.
2. Annual In-Training Examinations. This national exam provides formative feedback to residents and Program Directors concerning fund of knowledge in surgical clinical and basic science. General surgery residents are required to pass the exam as the first step in the American Board of Surgery certification process. The Residency Review Committee for Surgery of the ACGME requires that scores on the exam be reported to them. Performance on the exam is reviewed in detail by the Education Committee. The Department has established minimum performance standards on the exam for general surgery residents: maintenance of a minimum total test score of 35th percentile every year in relation to the national peer reference group.
   1. Urology interns are required to take the ABSITE. All policy questions should be directed to Dr. Guzzo. All logistical questions regarding the exam are handled by the Division of Surgical Education.
   2. Preliminary residents may be exempt from taking the exam with prior approval from Dr. Williams and their PGY2 program director.
3. Bi-Annual review of each resident by the Program Director. A written summary of performance becomes part of the residents' permanent record.

The Residents' Executive Council is an open forum for all residents to discuss issues concerning the surgery residency training years. The Council meets on the last Friday of each month. Agenda items should be sent to the committee chair.

The vitality of the residency depends on active participation in this committee as an effort to provide input from the residents to the Department. It only works if the residents participate actively. 

Representatives

• 1 representative per training year in both categorical and preliminary programs.
• May self-nominate / elected by class members.
• Will act as a bidirectional liaison between their class and REC
• Representatives will be held accountable to:
  • Actively communicate with their group
  • Represent the interests of their training year and not personal interests

Residents' Executive Council

• Composed of 9 representatives including REC Chair, REC Chair elect
• Meets monthly and as needed; resident members and Program Director attend the meetings, non-members welcome to join.
• Meets monthly and as needed
  • Class Reps, Program Director, Associate Program Directors, Program Administrator expected to attend all meetings.
  • Meetings are open to all general surgery residents.
• Committee that formulates resident policies and schedules, including:
  • Service specific goals
  • Educational Programs
  • Yearly slotting – February
  • Provides official resident position on various issues

Chair and Chair-Elect - Selection

• Elected by majority vote based on an anonymous survey/election
• Must be a lab resident, given time constraints
• Must be nominated, self-nominations allowed
• First serves as REC Chair-elect, so as to allow a period of overlap and systems education with prior REC chair
• Elected in Spring, assumes position on July 1.

Chair and Chair-Elect Responsibilities

• Attends weekly DSE meetings
• Chairs REC and Surgery Resident Council Meetings, including dissemination of meeting minutes
• Maintains active role in Housestaff Committee/GMEC
• Monitors and manages scheduling issues with program director’s assistance

Goals

• Insure adequate patient care.
• Full unequivocal compliance with all resident work rules – all SURGERY housestaff will comply regardless of clinical rotation or hospital.
• Open, fair, and equitable system to respond to personal and academic conflicts. Ensure all residents involved with switches agree to schedule changes.
• Systematic approach with clear rules and expectations.

Process

• MASTER ROTATION ASSIGNMENTS are posted on the Medhub and kept current. Day to day schedules are posted on the department web site.
• The email request should be sent to the administrative residents.
• The email request is required to include:
  1. Purpose of the change, specifics in detail of the change and solution to assure coverage.
  2. Work rule compliance.
  3. Concurrence of ALL stakeholders.
• Requests without any of the above will automatically be denied.
• Emergency requests should be sent directly to the administrative residents (i.e. personal and family health issues, interviews, etc.)

SOD call coverage by residents performing research outside of Philadelphia.

Principles

1. Away residents must take SOD call 10 times per year of away research with a maximum of 20 times total. Those residents who entered the lab prior to July 1, 2008 must take SOD call 10 times in total.
2. Away residents can take SOD call via multiple methods, and can choose whichever method(s) are most appealing to them.
3. An away resident will cover consult pager call when they have not yet finished the CY-3 year. Once they finish the CY-3 year, they will cover SOD call.
4. If the away resident is covering call during their clinical duty years, they may make up calls at PAH or HUP.
5. Making up the required number of calls is the responsibility of the resident.

Methods of Covering SOD Call

1. Return to HUP to cover SOD call during the research year(s). The away resident may choose which dates are most convenient to facilitate travel. (each call=1)
2. Cover extra SOD call during the CY 4/5 years:
   1. Take 12 extra hours of SOD call during one of their “on” weekends. One of the other residents in that SOD rotation will have no SOD responsibilities that weekend, but will still cover their service.
3. Cover SOD call for fellow CY-4 residents on interviews. (each call=1)
4. Cover SOD call on holidays during CY 4/5 years (each 12hr holiday call=1). Cover SOD call on holidays during research years (each 12hr call=2).
   1. If holiday falls on a weekday, away resident is in-house senior resident 12 hours during day (6a-6p=1).
   2. If holiday falls on weekend, away resident covers a SOD shift that weekend (New Year’s Eve, New Year’s day, Easter Saturday or Sunday, Memorial Day Saturday/Sunday, July 3, 4, or 5 if on weekend, Saturday/Sunday of Labor day weekend, Saturday/Sunday of Thanksgiving weekend, Dec 24/25 if on weekend). (each 12hr call=1)
5. Do a nightfloat SOD rotation during CY 4 or CY 5 year (only eligible if slotting allows).

The Attending Physician has both an ethical and legal responsibility for the overall care of the individual patient in the supervision of the housestaff involved in the care of that patient. Each Division within the Department of Surgery has a team of housestaff involved in the care of all patients on the service with different levels of housestaff subordinate to those involved in a normal chain of command to the more senior housestaff, who are ultimately responsible for the junior resident activities. All major clinical decisions are discussed with the Faculty, all missions and plans are reviewed with the faculty, and all cases in the operating room are supervised by the physical presence of the Attending Surgeon. Although they require less direction than junior residents, even the most senior housestaff are supervised. Judgment of delegation of responsibility is made by the Attending Surgeon based on their assessment of each housestaff’s skills, knowledge, and ability. The Teaching Staff is always immediately available for consultation and support to all housestaff. All office visits, operative cases, and admissions are personally supervised by an identifiable Faculty member.

All Surgery Training Programs follow the guidelines outlined in the UPHS Housestaff Supervision Policy. (GME Policy #1-1 intranet only).

All housestaff in Department of Surgery training programs must receive a minimum of 4 weeks’ vacation, as assigned and approved at the sole discretion of the Program Director.

GME Vacation and Leave Policy (intranet only).

The Department of Surgery is committed to providing an educational and work environment in which housestaff may raise and resolve issues without fear of intimidation or retaliation. Program Directors and the Vice Chair of Education maintain an open door policy to address any complaints from housestaff in a confidential and protected manner. The Department encourages housestaff to participate in the housestaff committee in an effort to improve communication among programs within UPHS and effect changes in their work environment at an institutional level.

All Surgery Training Programs follow the guidelines outlined in the UPHS Housestaff Work Environment Policy. (GME Policy #11-K intranet only).