Department of Internal Medicine - Allergy-Immunology Training Program
Policies on Supervision & Assignment of Duty Hours
All fellows in the Division of Allergy-Immunology at the University of Iowa Hospitals and Clinics are supervised by faculty. Fellows are assigned to clinics that are staffed by a faculty member dedicated to that clinic. In addition, fellows have their own Continuity of Care (COC) Clinic that is staffed by a faculty member. There are no fellow-directed unsupervised clinics. Fellows are given increasing responsibility for patient care as they progress through the training program. Every patient seen by a fellow at the University of Iowa Hospitals and Clinics is also seen by a faculty physician in the division. In the Allergy Clinic at the VA Medical Center in Iowa City, all patients seen by a 1st year fellow must also be seen by the faculty member staffing that clinic. Patients seen by a 2nd or 3rd year fellow at the VA Medical Center are discussed with the faculty member staffing that clinic and in some instances will also be seen by the faculty member depending on the nature of the clinical problem.
The inpatient consultation service is run by Division of Allergy-Immunology faculty. All inpatient consultations during regular working hours are first seen by the fellow and then staffed by faculty members. Weekend and on-call consultations are first seen by the fellow and then staffed within 24 hours by the faculty on-call. A faculty member is always available for fellow supervision.
Fellows are given these guidelines for supervision and are expected to discuss this with the program director at any time there is a need to deviate from these policies. The program director has a meeting with each fellow every six months that provides an opportunity to address problems with supervision.
Policy on Duty Hours
The Division of Allergy-Immunology policy regarding fellow work hours follows the guidelines set by UIHC and by ACGME. This policy applies to all Allergy-Immunology fellows. Work hours are not to exceed 80 hours per week, averaged over four weeks. Fellows have at least 10 hours of between all daily duty periods. Fellows have at least 1 full day out of 7 away from program duties, averaged over a month’s time. Fellows do not take in house call. Evening and weekend call responsibilities are rotated among the fellows, but in all circumstances are structured to assure 1 full day out of 7 free from program duties, averaged over a month’s time.
Fellows are actively involved in preparing the on call schedule, which is reviewed by the training program director. Conflicts with this call schedule are directed to the program director for resolution. Note that the on-call fellow covers the University of Iowa Hospitals and Clinics as well as the VA Medical Center in Iowa City.
This policy sheet on “Duty Hours” is given to each A-I applicant (by e-mail), is attached to each fellow’s contract, is explained to the fellows during orientation, and reiterated at the time of each semi-annual review. This information is given to the fellows assigned to planning the call schedule; monitoring compliance is the responsibility of the program director. The call schedule is sent out monthly for departmental distribution and program director review. On a semi-annual basis, the fellows will be asked to complete a random duty hour survey sent by the Graduate Medical Education Office.