Intern and Resident Policies
Trainees who are Midwestern University employees are protected against discrimination by the official policy of Midwestern University/OPTI to recruit, select, place, train, discipline, and promote employees and qualified applicants for employment without regard to race, religion, color, national origin, gender, age, marital status, veteran status, sexual preference, or disability unrelated to their ability to perform the essential functions of a job, with or without reasonable accommodation. Gender, age, or religion is considered and determinative only as bona fide occupational requirements.
The Midwestern University/OPTI ensures that all trainees employed by the Participating Partners are protected against discrimination by standards equal to those of the Midwestern University/ OPTI.
Oversight Policy of On-Call Schedules and Work Hours at Member Institutions
MWU/OPTI recognizes that excessive numbers of hours worked by trainees may lead to errors in judgment and clinical decision making. Excessive work hours may compromise both patient safety, through medical errors, and the safety of physician trainees, through increased motor vehicle accidents, stress, depression, and illness-related complications. MWU/OPTI training institutions, DMEs, and trainee Program Directors must maintain a high degree of sensitivity to the physical and mental well being of trainees and make every attempt to avoid scheduling excessive work hours that lead to sleep deprivation, fatigue, or the inability to conduct personal activities.
The MWU/OPTI adopts and enforces the Work Hour Policies as mandated by the AOA Basic Document for Postdoctoral Training Programs. The current rules include:
- Residents will not be assigned to work physically on duty in excess of 80 hours per week averaged over a four-week period, inclusive of in-house night call.
- Residents will not work in excess of 24 consecutive hours exclusive of morning and noon educational programs. Allowance may be made for, but may not exceed, up to 6 hours for inpatient and outpatient continuity, transfer of care, educational debriefings, and formal didactic activities. Residents may not assume responsibility for new patients after 24 hours.
- If moonlighting is permitted, all moonlighting will be inclusive of the 80 hours per week maximum work limit and must be reported to their respective training programs.
- Residents will receive alternate week, 48-hour period off, or at least one 24-hour period off each week.
- Upon conclusion of 24-hour duty shifts, residents will receive a minimum of 12 hours off before being required to be on duty again. Upon completing lesser-hour duty periods, adequate time for rest and personal activity must be provided.
- All off-duty time must be totally free from assignments to clinical or educational activity.
- For those rotations requiring resident assignments to Emergency Department duty, residents will not be assigned to duty shifts longer than 12 hours.
- Residents and training institutions must always remember that patient care responsibility is not precluded by this policy. In cases where residents are engaged in patient responsibilities that cannot be interrupted, additional coverage will be provided to relieve the involved residents as soon as possible.
- Residents may not be assigned to call more often than every third night, averaged over any consecutive four-week period.
- Training institutions must provide on-call rooms for residents and on-call rooms must be clean, quiet, safe, and comfortable, so as to permit rest during call. Telephones must be located in on-call rooms. Toilet and shower facilities must be present in, or convenient to, the on-call rooms. Nourishment must be available to residents during the on-call hours of the night.
Supervision of Work Hours Policy
Training programs are educational experiences and must be designed by training institutions to offer structured and supervised exposures that promote learning rather than service. Trainees must receive supervision and evaluation throughout their training with sufficient availability of scheduled training program teaching staff. During daytime hours, attending physicians assume responsibility for trainees and their assignments.
The MWU/OPTI monitors compliance with work hour policies at all Participating Partner institutions:
- The OGMECs ensure that all Participating Partner institutions pucblish clear work hour policies that comply with current AOA regulations related to work hour limitations.
- The OGMECs verify that all trainee attestations for work hour compliance have been completed at Participating Partner institutions.
- The OGMECs document that all Participating Partner training programs have disseminated the AOA Work Hours Violation Hotline information including website and telephone number. This information must include a statement that all reporting is immune from reprisal.
Trainees have four option levels for review without reprisal to report noncompliant duty hour scheduling:
- The institutional DME or regional Chairs of the OGMECs
- The AOA confidential e-mail line (firstname.lastname@example.org)
- The AOA Postdoctoral Program Violation Hotline (877-325-8197)
- Through their representatives on the institutional Graduate Medical Education Committees
Progress Toward Program Completion Policy
The MWU/OPTI maintains a complete lits of all trainees in its approved training programs and monitors their progress toward fulfillment of program requirements and graduation. The MWU/OPTI trainee evaluation process measures and documents prograss toward completion of the training program and ensures evaluation and completion of the AOA Core Competencies.
- To ensure that performance is evaluated based on the AOA Core Competencies, the regional OGMEC Program Offices maintain files for each Participating Partner training program's evaluation process that include, but are not limited to, descriptions of trainee evaluation tool(s).
- The regional OGMECs verify during on-site visits that trainee evaluations are based on the AOA Core Competencies.
- Each regional OGMEC Program Office maintains separate databases of trainees and tracks their advancement through the training programs:
- Databases track trainees by AOA number, start date, and expected completion date
- The MWU/OPTI requires all training programs to validate annually the accurace of the trainee database
- Directors of Medical Education report to their regional OGMEC Program Office any instances in which trainees are delayed for academic reasons in advancing to the next OGME level or to program completion, and they develop individual remediation plans for trainees who fail to meet performance expectations
Certificates of Completion Policy
Graduates of AOA-approved postdoctoral internship training programs participating in the Midwestern University/OPTI receive a Certificate of Completion from the MWU/OPTI or an OGME-1 Completion Letter from their Program Director.
Graduates of AOA-approved residency training programs participating in the Midwestern University/OPTI receive certificates of completion upon fulfillment of all program requirements.
Certificates must be signed by representatives of their training institutions and the MWU/OPTI. Each certificate includes:
- Midwestern University/OPTI
- American Osteopathic Association
- Name of member institution and training program number
- Name of graduating trainee
- Inclusive dates of the training program
- Signatures of
- Chair, MWU/OPTI Governing Board
- Executive Director/Chief Academic Officer, MWU/OPTI
- Director of Medical Education, member institution
- Program Director
- Other institutional officers as mandated by Participating Partner institutions
Confidentiality of Records Policy
The MWU/OPTI maintains permanent files in a secure location in OGMEC offices. Files may also be maintained, secured, and stores at Participating Partner institutions.