Policy Statement
Trainees are required to report to work physically and mentally capable of safely performing the functions of their job. Trainees must not report to work if they are impaired for any reason. Trainees must not consume alcohol, cannabis or any federally prohibited controlled substance while on call, including “at home call.” Trainees must self-regulate their use of prescribed or over the counter medications to ensure these medications do not cause impairment. Trainees must manage their sleep to avoid excessive fatigue. Programs have a responsibility to remove trainees from patient care activities if the trainee’s impairment poses a threat to patient safety.
Reason for Policy
The purpose of this policy is to define expected trainee conduct as it relates to fitness for duty, to provide guidance and direction on how to proceed when confronted with a potentially impaired trainee, and to help trainees in obtaining assistance when needed.
The purpose of this policy is to define expected trainee conduct as it relates to fitness for duty, to provide guidance and direction on how to proceed when confronted with a potentially impaired trainee, and to help trainees in obtaining assistance when needed.
We are committed to providing healthy, safe, and supportive training environments for all trainees, as well as safe, high-quality care for patients. Trainees practicing while impaired can have serious adverse effects on patient safety, and negative impacts on their own performance and safety as well as that of others in the workplace.
Reporting
- Responsibility to Report: Anyone who is aware of signs of impairment displayed by a trainee has an obligation to make a report to the trainee’s Program Director or supervisor on duty.
- Self-Reporting: Any trainee who believes they themselves may be impaired is required to contact their Program Director or supervisor on duty to report the situation. If a trainee is approached by a co-worker or patient who is concerned the trainee may be impaired due to fatigue or any other reason, the trainee has a professional responsibility to contact their Program Director to inform them of the concern.
Guidelines
Due to the safety-sensitive nature of their work, trainees must manage their off-duty exposure to substances that may cause impairment, including prescription medications. Because these substances affect each person differently, there are no universally applicable standards. In the case of alcohol, we reference U.S. FAA regulations for airline pilots as a guideline. These regulations prohibit pilots from operating an aircraft within 8 hours of the consumption of any alcohol, or while having a blood alcohol content of 0.04% or greater regardless of length of time since last consumption [FAR 91.17]. The institution expects trainees to refrain from alcohol consumption within 8 hours of reporting for duty or being on call.
Definitions
An impaired resident/fellow (trainee) is defined as any trainee who is unable to safely care for patients, perform duties normally expected of a trainee physician, or engage in peer interaction necessary for patient care for any reason, including but not limited to: personal stress; fatigue; medical condition (including physical disability or mental illness); use of alcohol or controlled substances, including drugs prescribed by a physician; or use of over the counter medication.
Fit for duty is defined as being physically and mentally capable of safely performing the functions of one’s job. Fitness for duty includes being free of alcohol and drugs that have not been legitimately prescribed, and being free from impairment that affects job functioning for any reason, including but not limited to personal stress, fatigue, use of drugs prescribed by a physician, or use of over-the-counter medication.
Procedure:
Reach out the Office of Graduate Medical Education ([email protected]).