Periods of Duty
17.00 (a) The usual hours of work do not normally exceed twelve (12) hours per day Monday to Friday inclusive. The usual workday ends at 1800 hours. Further, a resident will be scheduled to work a reasonable number of hours and the employer will undertake to limit the average number of hours with due regard to sound patient care and the educational requirements of the program.
17.00 (b) No resident shall be scheduled to work more than an average of 90 hours per week and not more than 360 hours in any 28-day rotation period.
17.00 (c) For the purposes of this article a Rotation Unit is either a 28-day block or a calendar month. A Rotation may be made up of one or multiple Rotation Units. In no case shall a Resident work more than two consecutive weekends. In no case shall a Resident work more than two weekends per Rotation Unit. On a scheduled weekend off, a Resident shall not be required to provide any services for the Employer including but not limited to rounds, or on-call duties. A scheduled weekend off is not considered vacation leave. (A weekend begins at 1700 on Friday and ends at 0600 on Monday. Where Monday is a statutory holiday as outlined in Article 19.05 the weekend ends on 0600 Tuesday).
17.00 (d) (i) Handover of patient care responsibilities and pertinent information must begin no later than a resident’s 24th consecutive hour on duty. Apart from this handover, no resident will be required to assume new responsibilities following the 24th hour of duty. The handover must be completed no later than two hours following the 24th hour of duty, or by 0900 hours, whichever is earlier. No Resident shall be required to work after this handover is completed. Other Residents on that service shall not be responsible for the extra workload that may result when a Resident exercises this right.
(ii) Departments or programs may request an extension from Maritime Resident Doctors beyond 0900 when the regular workday commences after 0700. Such requests will not be unreasonably refused.
(iii) Consecutive hours on duty, for the purposes of this article, shall include home call if the Resident’s home call has required him/her to be up most of the night and/or be present in the hospital between the hours of 12:00 a.m. and 6:00 a.m.
17.00 (e) The provisions of this Article do not prevent the Resident from remaining in a hospital or similar clinical setting to participate in exceptional educational experiences. This Article shall not be used to circumvent the rest of the provisions of Article 17.
17.01 (a) The Employer shall not schedule any Resident for in-hospital call more often that a ratio of one (1) night in a four (4) day period, spread pro-rata over the length of the rotation of PGY-1 Residents or over the length of a one-month, two-month or three- month schedule for Residents in other years. However, the assignment of in-hospital call for any Resident shall not exceed five (5) nights in a two (2) week period.
The number of days on service is specific to any individual Resident, and reflects the number of working days subtracting any time the Resident is away from the workplace for any reason including vacation and leaves. The total number of in hospital or home call shifts assigned to the Resident during any twenty-eight (28) day period shall be prorated downward to reflect the number of days’ present. For example, for a one month rotation, or any part, the following chart applies:
- 11-14 days on service — 3 calls
- 15-18 days on service — 4 calls
- 19-22 days on service — 5 calls
- 23-26 days on service — 6 calls
- 27-30 days on service — 7 calls
- 31-34 days on service — 8 calls
- 35-38 days on service — 9 calls
For rotations greater than one month, follow the 1:4 rule. If the total number of days on service divided by four includes a decimal value of greater than 0.5, then round up the total number of days on call. If the total number of days on service divided by four includes a decimal value of less than or equal to 0.5, then round down the total number of days on call.
17.01 (b) A Resident may be required to work nine (9) nights in twenty-eight (28), if needed to replace a Resident who is forced to miss scheduled call days due to sickness or other circumstances beyond his/her control or due to emergency. The Employer shall make every reasonable effort to limit such required increased call responsibilities for any one (1) Resident to no more than one (1) twenty-eight (28) day rotation in any six (6) month period.
17.01 (c) With respect to Emergency Room rotations:
- (1) no shift shall be longer than ten (10) hours;
- (2) a maximum of forty (40) hours shall be scheduled in consecutive days;
- (3) a maximum of one-hundred and seventy (170) working hours shall be scheduled in a twenty-eight (28) day period;
- (4) Residents shall have a minimum of ten (10) hours off between shifts; and
- (5) Residents shall have a minimum of one (1) weekend off in three (3).
17.01 (d) A Resident who becomes pregnant shall not be required to do overnight call after twenty-eight (28) weeks gestation or earlier if recommended by her physician. If the Resident is able to complete all her clinical and academic duties other than overnight call, she shall not be refused the right to work during the day.
17.01 (e) A Resident shall not be scheduled for overnight call the night before travelling to another location for a rotation change.
17.02 The Employer shall not schedule any Resident for home call more often than a ratio of one (1) night in a four day period, spread pro-rata over the length of rotation of the Resident. However, the assignment of home call for any Resident shall not exceed five (5) nights in a two (2) week period.
17.03 The Employer shall not schedule any Resident for a combination of in-hospital call and home call more often than a ratio of one (1) night in a four day period, spread pro- rata over the length of the rotation of the Resident.
17.04 The Employer shall publish duty schedules on a monthly basis at least two (2) weeks prior to their effective date. Copies of all duty schedules shall be made available upon request to the CEO of Maritime Resident Doctors. There shall be no changes to a Resident’s duty schedule within at least 48 hours of the date scheduled to be worked, without express consent of the Resident.
Chief Residents or other authorized persons responsible for preparing the call schedules will forward the following information to Maritime Resident Doctors:
- hospital name
- call period
- resident names
- type of call (at home or in-house)
- resident vacation and other scheduled leaves
- weekends clearly identified
- a contact name and telephone/pager number
- the date and time the schedule is made
17.05 Expedited Arbitration
If the Employer violates any of the provisions in Article 17, the CEO of Maritime Resident Doctors has the right, with or without the consent of any Resident involved, to engage the following expedited grievance procedure:
a) The CEO of Maritime Resident Doctors may advise the Program Director in writing of the alleged violation of Article 17.
b) Within seven (7) days notification of the alleged violation of Article 17, the Program Director shall investigate the allegation and consult with the Associate Dean or Academic Head and provide the CEO of Maritime Resident Doctors with a written response.
c) If the CEO of Maritime Resident Doctors is not satisfied with the written response provided under Article 17.06(b) above, she may refer the matter to expedited arbitration by providing written notice to the Director of Human Resources at the Nova Scotia Health Authority.
d) Within fourteen (14) days of the written notice of arbitration in Article 17.06(e) above, a hearing of the matter will take place before Arbitrator Susan Ashley, or William Kydd if Susan Ashley is not available, who shall render a decision within five (5) days of the hearing.
e) The arbitrator under this clause shall have the full range of remedies available to remedy any violation of the “Call Schedule” clause to ensure compliance and ongoing compliance with the provisions.
17.06 Rotation Change: Number of Moves
No Resident shall be required to relocate between communities more than three times during any one academic year as a result of rotation changes. For the purposes of this Article, a Resident who is required to change to a hospital that is less than 60 km from the Resident’s present hospital is not deemed to have relocated.