SAVMA Duty Hours Guidelines

SAVMA Duty Hours Guidelines

  1. On call activities:
    1. Continuous on-site duty, including in-house call, must not exceed twenty-four consecutive hours. Students 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.
    2. No new patients may be accepted after twenty-four hours of continuous duty.
    3. A thirty-minute break for meals for every six hours of work will be provided.
    4. In-house call must occur no more frequently than every third night, averaged over the course of the length of the rotation.
  2. Regularly Scheduled Hours:
    1. Adequate time for rest and personal activities must be provided. This should consist of a ten-hour time period provided between all daily duty periods and after in-house call.
    2. A thirty-minute break for meals for every six hours of work will be provided.
    3. Students must be provided with one day in seven free from all clinical responsibilities, averaged over the course of the length of the rotation. This shall include call duties and mandatory in-class time.
    4. Duty hours should be limited to eighty hours per week, averaged over the course of the length of the rotation, inclusive of all in-house call activities.

History of guideline development

At SAVMA Symposium 2010 in Madison, Wisconsin, the SAVMA House of Delegates reviewed and began drafting a motion regarding the endorsement of Duty Hours Guidelines for students participating in clinical rotations. The motion was extensively debated among the HOD, resulting in several revisions over the following year. SAVMA proudly announces that as of SAVMA Symposium 2011 in Davis, California, the motion has passed. SAVMA now officially endorses the Duty Hours Guidelines as outlined above.

The motivation behind the Guidelines came from within the student body itself, in combination with a precedent set by the Accreditation Council for Graduate Medical Education (ACGME). The ACGME introduced duty hour standards in 2003 to control work hours for human medical residents and interns. Since then, the ACGME has continued to review the guidelines, and recently have passed more restrictive guidelines to continue to protect residents and interns. In addition, at least four medical schools, including Johns Hopkins, voluntarily adhere to the ACGME guidelines for their medical students. The council, and the schools that adopt the guidelines, believe that the health, safety, and mental well being of students, interns, and residents need not be jeopardized in the name of education.

As in the human medical field, veterinary students, residents, and interns in Veterinary Teaching Hospitals are often called upon to work long hours, sometimes without sufficient time to rest before their next shift. Excessively long hours are neither healthy for the student nor conducive to learning. Tired individuals may be hesitant to ask for much needed sleep in the fear of being seen as weak or unmotivated. Limiting duty hours and allowing these dedicated individuals an opportunity to rest and eat will improve their overall health, performance, and ability to learn, as well as decrease the rate of medical errors during shifts at the veterinary teaching hospital and traffic accidents while commuting between work and other commitments. Therefore, the duty hours guidelines serve to not only protect students, interns, and residents, but also safeguard the welfare of the patients in their care.

To gather additional support for the motion, a survey was conducted by Colorado State University of senior veterinary students, interns, and residents at eleven veterinary schools. The resulting data showed that not only do students, interns, and residents feel that protective guidelines would be well received, but they support the idea of having external guidelines to cite when they are overwhelmed beyond reasonable limits. Placing limits on duty hours also encourages a more streamlined and efficient teaching schedule within senior year rotations, and increases the instruction potential for rotations.

SAVMA endorses these guidelines for veterinary students under our area of responsibility and encourages the veterinary community to stand behind them as well. Since the AAVMC is regarded as the leader within veterinary medical education, we ask for your support in our endorsement. The endorsed standards are a guideline that is meant to serve as a loose starting point, and allow for significant flexibility within each school's own clinical duty schedule. Protecting the interest of veterinary students within veterinary teaching hospitals is a major responsibility of SAVMA.

Additionally, SAVMA is looking to the academic leaders of the profession to take up the charge in protecting interns and residents. Veterinary interns and residents at academic institutions are no longer students, but continue to work through long hours and challenging schedules within veterinary teaching hospitals. These guidelines could easily be adapted for interns and residents; all that is lacking is a coordinated effort among the national organizations.