ACGME duty hours
ACGME duty hours are the work limits for residents and fellows in US accredited programs: 80 hours a week averaged over four weeks, plus rest rules.
ACGME duty hours are the limits the Accreditation Council for Graduate Medical Education sets on the work of residents and fellows in accredited US programs. The ACGME now calls them clinical and educational work hours. The Common Program Requirements (version effective July 1, 2026, requirements 6.20 to 6.28) set these core limits: at most 80 hours a week, averaged over four weeks, including in-house work, clinical work from home and all moonlighting; at most 24 hours of continuous scheduled clinical assignments, plus up to four hours for transitions of care and education with no new patients; one day in seven free, averaged over four weeks; in-house call no more often than every third night, averaged over four weeks; and at least 14 hours free after 24 hours of in-house call. Residents should also have eight hours off between scheduled work periods.
Averaging is done by rotation, never as a rolling average, and vacation or leave days are left out of the calculation. Specialty Review Committees can set further limits. The rules cover trainees only: federal law sets no general limit on attending physicians' hours.
Pitfalls: checking compliance only after the month is over, forgetting that home call activity and moonlighting count, and regularly placing the required day off on a post-call day. A major revision of the Common Program Requirements is under way, so check acgme.org for the version in force.
Common questions
What are the ACGME duty-hour limits?
For residents and fellows: at most 80 hours a week averaged over four weeks, including moonlighting and clinical work from home; at most 24 hours of continuous scheduled clinical work plus up to four hours for handoffs and education; one day in seven free; in-house call no more often than every third night; and at least 14 hours off after 24 hours of in-house call.
How is the 80-hour week averaged?
By rotation: over a four-week period, a one-month period, or the rotation itself if it is shorter than four weeks. The ACGME does not allow a rolling average, because it can hide heavy rotations behind light ones. Vacation and leave days are removed from both the numerator and the denominator of the calculation.
Do ACGME duty hours apply to attending physicians?
No. They apply to residents and fellows in ACGME-accredited programs. Federal law sets no general limit on the hours an employee aged 16 or older may work in a week, and physicians are exempt from federal overtime rules. Limits for attendings come from state rules, medical staff bylaws, group agreements and employment contracts.
How Momentum handles it
For residents and fellows, Momentum checks the maximum hours and minimum rest you set to match your program's limits and lists any breach before the schedule goes out; it does not log worked duty hours for ACGME reporting.