PARIM is the Professional Association of Residents and Interns of Manitoba

14.01 Both parties hereto accept that, in order to provide adequate service and care to patients and to enhance the medical education of Residents, duty hours must be scheduled to provide a balance of clinical experience, patient service and academics.  Duty Hours shall consist of both Regular Duty Hours and On-Call Duty Hours.

On-Call Duty Hours refer to those times the Resident carries clinical responsibilities beyond the Regular Duty Hours.  This usually includes evenings, overnight, weekends and designated recognized holidays.  A weekend will encompass the period from 1700 hours on Friday to 0700 hours on Monday. Two types of On-Call Duty Hours are recognized as set out in 14.01(a) and (b).  The determination of the type and frequency of on-call as well as increases or decreases to On-Call Duty Hours shall be made by the Departmental Residency Program Committee responsible for the rotation, or its equivalent, subject to consultation with and approval from the Office of the Associate Dean of Medicine in charge of the Division of Postgraduate Medical Education and the WRHA Chief Medical Officer.

• (a) In-Hospital Call
  In-Hospital call refers to clinical service, or immediate availability for such service, provided by the Resident beyond the regular duty hours, where the Resident is required to remain in the hospital for that time period.  A Resident shall not be scheduled for in-hospital call more than seven (7) times in averaged over a four (4) week period.
• (b) Home Call
  Home call refers to clinical service, or immediate availability for such service, provided by the Resident beyond the regular duty hours, where the Resident is not required to remain in the hospital.  Home call may result in a Resident returning to the hospital.  A Resident shall not be scheduled for home call or a combination of home call and in-hospital call more than ten (10) times in averaged over a four (4) week period.  As the parties have agreed to an objective that home call or a combination of in-hospital call and home call to be limited to “one in three,” a Resident will not be scheduled for call more than nine (9) times during a rotation of twenty eight (28) days when that Resident was on call ten (10) times during the immediately preceding rotation.  Limitations for home call or a combination of home call and in-hospital call will be pro-rated for rotation periods that are other than twenty-eight (28) days long.

14.02  In addition to the foregoing and subject to the exceptions provided in sub-articles 14.03, a Resident shall not be required to work On-Call Duty Hours inconsistent with the following provisions:

• (a) In-Hospital Call of one (1) night in four (4), such averaged over a four (4) week period;
• (b) Call of two (2) weekends off in four (4), (a weekend shall commence no later than 1700 hours on Friday and end no later than 0700 hours on Monday), such averaged over a four (4) week period except by mutual agreement between the Employer and the Association.
• (c) The scheduled work week including first call shall not exceed an average of eighty-nine (89) hours per seven (7) day week over a four (4) week period;
• (d) There shall be not less than fourteen (14) consecutive non-working hours (i.e., no home call) once every three (3) days, except in circumstances where it becomes necessary to accommodate the implementation of sub-article 14.02(b);
• (e) Other than to handle unforeseen exigencies, a Resident shall not be required to work more than twenty-six (26) consecutive hours (twenty-four (24) hours on duty and/or in-hospital call plus two (2) hours for transfer of care). However this shall not preclude a Resident from electing to attend seminars relating to his/her studies immediately following an on-call period. Scheduled home call shall not be included in calculating consecutive hours of work except where a Resident works a home call shift which is scheduled to end on a weekday morning and where the Resident was required to work in the hospital during the call shift for more than four (4) hours, of which more than one (1) full hour is after midnight and before 0600 hours, in which case the entire home call shift shall be included in calculating consecutive hours worked. Where home call is included in calculating consecutive hours worked the Resident may, at their option, elect to work on the post-call day.
• (f)  A Resident shall not be required to take call to make up for vacation time.

14.03   Duty periods in excess of those prescribed in sub-articles 14.01 and 14.02 may be worked by an individual Resident only by reason of:

• (a) a Resident on the same service being ill, on maternity leave, declining over-night call after completion of thirty-one (31) weeks of gestation pursuant to sub-article 22.07 (ii), being on examination leave, educational leave or compassionate leave, provided however, that such excess duty period shall not exceed one (1) duty period per month; or
• (b) a Resident working in an established Night Float Rotation that has been established and agreed upon by the appropriate Program Director, the Office of the Associate Dean of Medicine in charge of the Division of Postgraduate Medical Education, and the Association.  A Resident working in an established Night Float Rotation shall, however, be eligible for On-Call Remuneration in accordance with Article 14.05 herein; or
• (c) a Resident working in a rotation where the number of Residents would cause the provision of adequate service and care to patients to be compromised as a result of the application of the limitations called for in those articles.  In that circumstance, the Association and the Departmental Residency Program Committee responsible for the rotation, or its equivalent, (subject to consultation with and approval from the Office of the Associate Dean of Medicine in charge of the Division of Postgraduate Medical Education and the WHRA Chief Medical Officer), will agree to appropriate revisions to the limitations called for in Article 14.01 and 14.02 to the extent necessary to provide adequate service and care to patients while respecting the intent of the limitations and the legitimate interests of Residents in the rotation.

14.04  The additional duty hours referred to in sub-article 14.03 (a) shall be by mutual agreement between the Resident and the appropriate Program Director.  Notification in writing of such additional duty periods must be submitted by the appropriate Program Director to the Office of the Associate Dean of Medicine in charge of Postgraduate Medical Education and to the Association.

14.05    On-Call Remuneration
Residents shall receive on-call remuneration for each scheduled period of in-hospital call and home call as follows:

    (a) In-Hospital Call:

•  i) Effective July 1, 2007, a Resident shall be paid $80.00 for each scheduled period of In-Hospital Call Duty fulfilled by the Resident in accordance with sub-article 14.01 (a).
• ii) Effective January 1, 2008, a Resident shall be paid $90.00 for each scheduled period of In-Hospital Call Duty fulfilled by the Resident in accordance with sub-article 14.01(a).
•  iii) Effective June 29, 2008, a Resident shall be paid $100.00 for each scheduled period of In-Hospital Call Duty fulfilled by a Resident in accordance with sub-article 14.01 (a).

    (b) Home Call

• i) Effective July 1, 2007, a Resident shall be paid $40.00 for each scheduled period of Home Call Duty fulfilled by the Resident in accordance with sub-article 14.01 (b).
•  ii) Effective January 1, 2008, a Resident shall be paid $45.00 for each scheduled period of Home Call Duty fulfilled by the Resident in accordance with sub-article 14.01 (b).
• iii) Effective June 29, 2008, a Resident shall be paid $50.00 for each scheduled period of Home Call Duty fulfilled by the Resident in accordance with sub-article 14.01 (b).

c)   A Resident who is scheduled for Home Call Duty but is required to work in the hospital during the call shift for more than four (4) hours, of which more than one (1) full hour is after midnight and before 0600 hours shall be remunerated at the rate applicable to In-Hospital Call Duty.  The Employer shall have the right to implement reasonable rules to verify that the Resident is entitled to be paid at the In-Hospital Call Duty rate for that shift.

14.06 Duty Schedules for each service and department shall be posted covering a one (1) month period, and shall be posted not less than one (1) week in advance of the beginning of the schedule period on appropriate departmental bulletin boards and copies of these published schedules shall be sent to the Association.  The existing practice whereby Residents may interchange duty hours among themselves is recognized provided the requested number of Residents of equal qualifications on a particular service remain on duty.

14.07 When a Resident is required to perform on call duties on a particular service, the Resident shall not be required to perform on call duties on another service, unless being on call on more than one service is a traditionally recognized combination of on call duty.

14.08 Where a schedule is not in compliance with the provisions of this Article or where a Resident is required to work duty hours in excess of those prescribed herein, either the Resident or the Association may submit a grievance in accordance with Article 6.

14.09 Without limiting the general remedial powers of an arbitrator, no provision in Article 6 shall be deemed to limit the remedial power of a board of arbitration or a sole arbitrator, as the case may be, to award a Resident compensation either in the form of money or compensatory time off where it finds there has been a violation or misapplication of the provisions of this Article.

14.10 For information purposes only, Appendix “E“ attached hereto sets out on-call coverage requirements as at July 1, 2007.  It is acknowledged that the Employer shall determine its coverage requirements from time to time.