Cardiology Fellowship Program Policies
Policy on Duty Hours for Trainees
The Cardiology Section recognizes that the physical and emotional well being of
trainees dramatically affects their ability to provide quality care for patients and to
assimilate the complex medical knowledge essential to developing competence
as a subspecialist. As such, the Cardiology Section complies with the LSUHSC-
New Orleans Institutional Policy on Duty Hours.
• Fellows will work no more than 80 hours/week of work when averaged over 4
• Fellows will have one 24-hour day out of seven free of Program duties when
averaged over 4 weeks.
• Fellows will have in-house call no more frequently than every third night when
averaged over 4 weeks.
• Continuous in-house duty is limited to 24 hours with up to 6 additional hours for
transition of patient care post-call.
• Fellows will have 10 hours between daily duty periods and following in-house
To assure compliance, regular self-reporting of duty hours is supervised by the
Program Director. These guidelines for duty hours apply to all institutions where
Cardiology fellows rotate. The Program Director and Section faculty members will
monitor fellows for signs of fatigue and sleep deprivation. Specific feedback related
to duty hours and impairment secondary to fatigue will be discussed with each
trainee at least semi-annually during performance reviews.
Along with this commitment to limited regular duty hours, the Cardiology Section
monitors moonlighting activities by fellows. All extracurricular medical practice by
trainees of the Section conforms to institutional policies at LSUHSC-New Orleans
and must be approved by the Program Director and/or Section Head. Fellows are
required to obtain this approval and independent medical malpractice insurance prior
to participating in any moonlighting activities. Moonlighting by fellows should not
exceed 72 hours per month and should be recorded as clinical service when
reporting duty hours.
Non-Teaching Patients Policy
Residents/Fellows evaluate and provide care to patients only under the supervision of
teaching faculty. Residents/Fellows may attend to non-teaching patients only when
rendering immediate care is required as a matter of professional conduct (e.g.
• Fellows are supervised by teaching faculty in all their activities commensurate
with the complexity of care being given and the ability and experience of the
• Fellows are supervised by teaching faculty in such a way that the fellows
assume progressively increasing responsibility according to their level of
education, ability, and experience.
• Schedules for teaching faculty are structured to ensure that supervision is
readily available to fellows on duty.
• Teaching faculty determine the level of responsibility accorded to each fellow.
• Procedures requiring moderate sedation are directly supervised by qualified
teaching faculty unless these procedures are emergent.
Order Writing Policy
Residents/Fellows will write all orders for patients under their care while rotating on the
service. To assure proper communication and management, any order that may have a significant impact on patient care will be discussed with the attending physician before
being written. If the primary resident/fellow is unavailable, a resident/fellow or attending
physician covering for the primary resident/fellow may write orders. The physician
writing these orders will notify the primary resident/fellow of these actions as soon as
possible. During medical emergencies when the primary resident/fellow is unavailable,
the resident covering for them may write the appropriate order.
Fellows must make a request to, and receive the explicit permission of, the
Department Head at the School of Medicine before engaging in any extracurricular
medical practice (see moonlighting application form). Further, fellows must receive
such permission for any additional extracurricular medical practice which differs in
location or nature from that which may have originally been approved, or for any
substantive change (increase in frequency or duration) from that which may have been
originally approved. Foreign Medical Graduates sponsored for clinical training as a J-1
by ECFMG are not allowed to moonlight or perform activities outside of the clinical
For purposes of this policy, "extracurricular medical practice" activity is medical
practice which is not an official part of the undergraduate medical education program,
or any post-graduate training medical education program of the School, or any of the
School's free-standing affiliated post-graduate medical education programs.
School, by its approval of permission to participated in extracurricular medical
practice, is not a party to any such arrangement, nor will the School furnish medical
malpractice insurance for extracurricular medical practice, nor defend any claim made
against me (malpractice or otherwise) that arises out of, or is in connection with, any extracurricular medical practice.
Adverse actions that could significantly jeopardize a Fellow's intended career
development are subject to appeal. The process is found the yearly House Officer Manual
Counseling and Support
The Campus and Employee Assistance Program is a free service provided by LSU Health Sciences Center New Orleans to assist employees, faculty, staff, residents, and students in resolving personal or work-related problems. Information about this service is found at http://www.lsuhsc.edu/orgs/campushealth/cap.aspx