Supervision and Duty Hour Policy Department of Pediatrics

UI Graduate Medical Education
Medical Genetics Residency Program

Supervision and Assignment

The Medical Genetics resident will have an attending Medical Geneticist assigned who is responsible to assure the excellence of medical care and to supervise and teach the medical genetics resident involved in the care of that patient. All medical genetics services will be continuously covered by a faculty member who is accessible at any time by means of the pager system. The assignment of the Medical Genetics Resident working hours is according to the requirements of the Pediatric RRC and the ACGME for Pediatric subspecialty residents. Call-free months and days per week are built into the program.

The following guidelines have been established to assure the appropriate supervision of Medical Genetics Resident:

Inpatient Consultation Service

Patients seen through the Medical Genetics Inpatient Consultation Service are assigned to the Medical Geneticist on-call.

The Medical Genetics resident is instructed to notify the attending Medical Geneticist on-call of every inpatient consult to the service. The Medical Genetics Resident will initially evaluate the patient - developing a working diagnosis, evaluation and treatment plan to encourage the resident's independent diagnostic and management plans. The Medical Genetics Resident will notify the attending Medical Geneticist faculty on-call after the resident completes his/her work-up of the patient.  The attending Medical Geneticist faculty will be notified promptly of intensive care admissions or other urgent consults.  Daily attending rounds are made by the faculty who remain actively involved in directing patient care. The Medical Genetics Resident is given progressively increasing responsibility, while continuously maintained under faculty supervision. The first­year Medical Genetics Resident typically spends 9 months of the each year in clinical activities with only 3 months in research. There is an attending physician available 24 hours a day for consultation and is physically present when required. The residents in General Pediatrics first call the Medical Genetics Resident via the pager system.

Outpatient Medical Genetic Service

The faculty from the Division of Medical Genetics are assigned to staff all the Medical Genetics outpatient clinics. Scheduled patients seen in the Medical Genetics clinics are evaluated initially by the Medical Genetics Resident, and then are staffed by the faculty. The Medical Genetics Resident is assigned patients that he or she follows.  Faculty will supervise the care of every one of these patients as well. The program and the Medical Genetics Resident are keeping records of the number and diagnoses of patients that they evaluate in the inpatient and outpatient settings.

Conferences

Medical Genetics Residents attend the following Conferences and/or meetings:

  • Genetics Journal Club weekly on Tuesday mornings, where they present an article 2-3 times a year for all 2 years of training.
  • Medical Genetics Residents attend the Clinical & Molecular Genetics Case Review Conference and In-Service presentations weekly, where patients seen during the week in outpatient clinics and inpatient consultations are discussed with faculty and other staff.  Also presented during this conference are patients with abnormal newborn screens and patients with abnormal cytogenetic/molecular screens.  The residents will present the patient cases that they are directly involved with each week of the clinical rotation training months.
  • Medical Genetic Residents attend a Core Curriculum lecture series presented by Department of Pediatrics faculty.
  • Medical Genetics Residents attend a Medical Genetics Division meeting once every other month to discuss all issue of the division.

Research

This 2-year Medical Genetics Residency Program will be comprised of 18 months of broad-based general clinical genetics training and 6 months of clinical or laboratory-based research activity.  There will be an option for a 3rd year that can be spent primarily in clinical or laboratory-based research activity.

The first 2 months of the first year will be designated as orientation months during which the residents will be oriented to clinical and research aspects of our program.  During this period, the resident will attend 6-8 half-day UIHC Genetics Dlinics, 1 full day RGCS clinic, and 2-3 inpatient consults per month. First-year residents will also be encouraged to spend 3-5 one or two-week periods in a funded laboratory or clinical research setting of their interest to choose a research mentor. These first 2 months will be part of the three month period designated as elective months; therefore, the resident will have 1 additional month in the first year for elective clinical or laboratory-based research time.

During the second year of the Medical Genetics Residency, a three-month block will be devoted to clinical or laboratory-based research activity.  The Medical Genetics Resident is encouraged to participate in an ongoing project, or under direct guidance, to establish a project related to the ongoing studies. Once a laboratory or clinical research mentor and project have been identified, the Medical Genetics Resident is directly under the supervision of the investigator involved and reports progress to the program director and a 3 member mentoring committee that includes the research mentor but not the program director, as needed.

Work Hours of Medical Genetics Resident

Medical Genetics Resident work hours will be monitored by the Program Director, by means of a work hour record on MedHub that the Medical Genetics Resident will be expected to keep updated. The Medical Genetics Resident will need to monitor their duty hours via the calendar provided on MedHub. The work hours for day and night duty are designed such that hours worked will fall within the ACGME rules for a Medical Genetics Resident work hours: no more than 80 hours per week when averaged over 4 weeks; one day off in seven when averaged over 4 weeks.  Adequate time for rest and personal activities will be provided.  A minimum of a 10-hour time period between all daily duty periods and after call will be provided.

All trainees will report any concerns about trainee hours directly to Dr. Keppler-Noreuil or via evaluations solicited at the end of every 6 month period.

Call:
Call in the Division of Medical Genetics is on a 24 hour calendar, starting at 0800 each day.  Day call is from 0800 to 1600.  Evening/Night call is from 1601 to 0800 the next morning. The evening and night call are from home and the Medical Genetics Resident has a pager on during that entire time. Call on Saturdays and Sundays is from home.  In the event the Medical Genetics Resident is unable to perform their duties either during the day or at night, the faculty will take over the duties required.
Moonlighting:
The Program Director must ensure that moonlighting does not interfere with the ability of the resident to achieve the goals and objectives of the educational program.  The director will comply with the institution's written policies and procedures regarding moonlighting.  Moonlighting that occurs within the residency program and/or the sponsoring institution is internal moonlighting and must be counted toward the 80-hour weekly limit on duty hours.

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