With respect to House Officer work schedules and release time, the Employer is responsible for remaining in substantial compliance with Accreditation Council for Graduate Medical Education (ACGME) requirements.

Clinical and educational work hours are defined as all clinical and educational activities related to the residency/fellowship program; i.e., patient care (both inpatient and outpatient), administrative duties relative to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled activities such as conferences. Clinical work done from home, such as charting in the EMR and patient-related phone calls must count towards the clinical and educational work hour limit. Clinical and education work hours do not include reading, study, or preparation time spent away from the duty site. On-call responsibilities outside of the hospital ("home call") are not included in the clinical and educational work hour calculations except for time spent in active patient care responsibilities. Time spent on the hospital premises after arriving from "home call" are also included in the clinical and educational hour calculations.

Clinical and educational work hours must be limited to eighty (80) hours per week, averaged over a four (4)-week period, inclusive of all in-house call activities and designated off-premises activities. Residents must be provided with one (1) day in seven (7) free from all educational and clinical responsibilities, averaged over a four (4)-week period, inclusive of call. For purposes of this Article, one "day" or "release time" is defined as one (1) continuous twenty-four (24)-hour period, free from all clinical, educational, and administrative duties. Although the one (1) day free in seven (7) is averaged over a four-week period, the normal expectation and intent is that a House Officer would not work more than two (2)-weeks without a day off.

It is a responsibility of the House Officer to accurately report clinical and educational work hours to their Program Director by logging them in MedHub within the specified time frame and reporting any frequent or unusual violations directly to the Program Director. The Program Director, representing the Employer, is responsible for monitoring clinical and educational work hours for compliance with the above standard. In the event that a House Officer does not obtain release time in accordance with the standards set forth in paragraph 61, an alternative day off will be scheduled within the four (4)-week period. If alternative day(s) off cannot be scheduled then the House Officer will receive additional compensation equivalent to 1/365th of his/her annual base salary, for each day of release time that is not provided. Also, the Employer must immediately discontinue any work schedule practices that are not in compliance with these standards.

If a House Officer's schedule is inconsistent with the above, the House Officer or the House Officers Association may request the work schedule to be reviewed by the Program Director. If work schedule concerns are not resolved to the satisfaction of the House Officer, the House Officer or the House Officers Association may appeal any work schedule concerns to the Graduate Medical Education Committee, or their designee. In such a situation, the decision of the Graduate Medical Education Committee will be final. It is further agreed that there shall be no retaliation, in any form, towards any House Officer as result of requesting review of his/her work schedule.

It is further understood that days off taken as vacation days will not be counted as release time as defined in paragraph 61. For example, if a Resident works the first two (2) weeks in a month, and takes the latter two (2) weeks as vacation, the Resident shall still be entitled to two release days for the first two (2) weeks in that month.

If, during the term of this collective bargaining agreement, there is a change in the clinical and educational work hour standards specified by ACGME requirements, then those regulatory standards will take precedence over this language, and the parties will abide by any new standards promulgated by the ACGME. However, in no case will clinical and educational work hours exceed the limits set forth in paragraph 61. Prior to implementation of any change of practice due to a change in ACGME standards, the Employer and the House Officers Association will meet to review the revised standards, and discuss implementation plans.