JUNIOR RESIDENT AGREEMENT
DAVID GEFFEN SCHOOL OF MEDICINE at UCLA
2006-2007
This agreement establishes the conditions under which postgraduate training will be provided by the
David Geffen School of Medicine at UCLA and the Department of Surgery and the General Surgery
Residency Program to the resident named herein.
DAVID GEFFEN SCHOOL OF MEDICINE AT UCLA hereby offers Joe Bruin an appointment as a
postgraduate trainee in General Surgery Residency Program resident training year 1-2, postgraduate
training year 1-2. Subject to the following terms and conditions:
1. APPOINTMENT AND TERM
Appointment is for the period commencing June 23, 2006 and ending June 23, 2007. This
appointment is contingent upon the maintenance of academic good standing, satisfactory performance
on assigned rotations as determined by evaluations by the Program Director and faculty, and the
completion of stipulated responsibilities.
Further, the appointment above the PGY II level is contingent upon possession of a current and valid
license to practice medicine in the State of California, unless otherwise provided by law.
2. COMPENSATION
Your annual salary is to be paid in monthly increments on the first day of each month.
R1 - $40,500/year
R2 – $41,820/year
R3 – $43,504/year
R4 – $43,504/year
R5 – $45,300/year
3. ACADEMIC, LICENSURE AND CERTIFICATION REQUIREMENTS
A.
The resident must be a graduate of an institution accredited by the Liaison Committee of
Medical Education or otherwise must meet the eligibility requirements of Part 1, Section 3 of the
ACGME Essentials.
B. The resident must obtain, and subsequently maintain, a license to practice medicine from the
State of California prior to the commencement of any postgraduate year after the second year of
the resident's participation in graduate medical education. Graduates of foreign medical
schools, whether United States nationals or not, must meet the licensing requirements of the
State of California.
C. The resident must at all times maintain in effect and verify, upon request, all legally required
permits, licenses, and other relevant documents, including proof of citizenship, naturalization or
current and valid visas authorizing the resident to work in the United States.
D. All residents in first Board programs in the Family Medicine, Internal Medicine, Surgery,
OB/Gyn, Emergency Medicine, Pediatrics, and Anesthesia training programs will be offered
ACLS or PALS courses. They must present evidence of certification in ACLS or PALS
certification by the American Heart Association prior to the completion of their training
program.
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4. UCLA Medical Center will monitor the provision of each of the following:
A. On-Call Quarters: On-call quarters, serviced by Housekeeping on a daily basis, are
provided. A lounge with telephones, computers, TV and VCR is located within the on-call
area. Food service will be available 24 hours/day in the house staff lounge.
B. Meals: Meal Access Cards are issued to the resident at the beginning of their training. A
resident is eligible to receive credit for meals when he/she is scheduled and works 9 or more
consecutive hours in the Medical Center as part of their training. A resident is eligible to
receive credit for meals when he/she is engaged in patient care activities. An annual dollar limit
is determined by the reported on-call schedule. See Medical Center Policy 6001, Residents’
Meal Access Card Program.
C. Uniforms: One (1) long white coat will be issued to each resident. Ownership will remain with
the Medical Center. A one-for-one exchange program is provided for the laundering of white
coats. Scrub uniforms may be obtained from the Operating Room laundry facilities. Scrub
uniforms are not to be worn outside of the UCLA Medical Center.
D. Duty Hours: Program requirements relating to duty hours and on call schedules are based upon
educational rationale and patient care needs including prudent continuity of care. These
requirements comply with guidelines established by the Accreditation Council of Graduate
Medical Education (ACGME), the Residency Review Committee (RRC) for Surgery, and
University of California guidelines. The Program establishes on-call and duty schedules based
upon both educational goals and clinical responsibilities, and publishes such schedules. Back
up support will be provided when patient care responsibilities are especially difficult or
prolonged, or if unexpected circumstances create resident fatigue sufficient to jeopardize
patient care. The Program will endeavor to allow residents an average of one (1) day out of
seven (7) to be relieved of clinical responsibilities. However, the emphasis of the program
is the maintenance of the quality of patient care and prudent continuity of care.
E. Communications: Pagers will be supplied for the year of appointment. The Medical Center
will provide email. House staff are provided access to the Internet in all areas of the Medical
Center and Clinics and at no cost from home, through UCLA Bruin On Line.
F. Libraries: All house staff have full access to the Biomedical Library at no cost. Computer
facilities are available, including word processing, spreadsheets, databases and presentation
software. Medical databases and reference searching is provided by both the Biomedical
Library and Medical Center Computing Services, 24 hours per day, seven days a week.
Additionally, the Program will provide an on-site library and access to reference searching
when the Biomedical Library is unavailable.
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G. OSHA and CDC Recommendations: Compliance is required with OSHA and CDC
recommendations are required:
A) Contact with a patient’s blood or other body substances are assumed to be infectious.
The use of protective equipment is required to prevent exposure of the health care provider
from parenteral, mucous membrane, and non-intact skin exposures. Protective equipment
including gloves, masks and goggles, and cover gowns are provided by the UCLA Medical
Center.
B) At the beginning of training, all residents must begin or have received the Hepatitis B
vaccination series, or sign an OSHA approved declination form. MMR vaccine is also
highly recommended. Annual TB skin tests are required.
5. RESIDENT RESPONSIBILITIES
The goal of the Program is to foster within the resident, the skills and habits necessary to
achieve excellence in the diagnosis, care, and treatment of patients. To achieve this goal, the
resident agrees to do the following:
A. Be cognizant and knowledgeable of the written goals and objectives of the program, and of
each rotation. These are provided in each resident’s manual and updated annually.
B. Participate in a personal program of self-study and professional growth with guidance from the
Program’s teaching staff.
C. Under the supervision of the School’s teaching staff, housestaff will participate in safe,
effective and compassionate patient care, consistent with the resident’s level of education and
experience.
D.
Participate fully in the educational activities of the residency program and assume
responsibility for participation in the teaching of more junior physicians and medical students.
E. Develop an understanding of ethical, socioeconomic and medical/legal issues that affect the
practice of medicine.
F. Apply cost containment measures in the provision of patient care.
G. Comply with all University, Medical Center, Department of Surgery, and Residency Program
rules, regulations, practices, procedures and policies.
H. Strictly adhere to the call schedule and schedule of assignment in a prompt and timely fashion.
I.
Participate in the standing committees of the Medical Staff, especially those that relate to
patient care review activities, as assigned by the program director or elected by your peers.
J. Maintain charts, records and reports in a complete and updated condition as per Medical Staff
policy. All notes and orders should be appropriately authenticated with a printed last name
and pager ID number.
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K. Consistently maintain an up to date log of surgical cases and invasive procedures utilizing the
ACGME Surgical Operative Log (SOL).
L. Comply with duty hour restrictions and maintain a record of duty hours in accordance with
Program policy.
M. Consistently participate in the evaluation of the training program and its faculty using the
mechanisms provided for by the Program.
N. Comply with Program, School and ACGME policies regarding moonlighting. A written letter
of the intent to moonlight must be submitted to the Program Director prior to participation.
Written permission must be obtained from the Program Director prior to beginning
moonlighting.
O. The special nature of residency programs requires ongoing communication between the
residents, the training programs, administrators and others at UCLA Medical Center, and
affiliated institutions. Residents are required to maintain an up to date address and home
telephone number with Surgery Education Office. In addition, all residents are required to be
available via email. Residents are required to have a UCLA Mednet account which is provided
without cost. Outside email accounts may be forwarded to the UCLA Mednet account.
Residents are expected to check their Mednet email at frequent intervals (not less than every
three days) unless they are on approved leave.
6.
EMPLOYMENT BENEFITS/LEAVE
A. Vacation: residents are entitled to twenty-eight (28) days of paid vacation time per year. The
scheduling of vacation time will be conducted by the Administrative Chief Residents
(ACR) and Program Director consistent with the policies of the Program. Vacation time
must be used within the year of appointment and no carryover to subsequent years will be
made. Changes in the posted vacation schedules must be requested by the resident in
writing, not less than four (4) weeks prior to the desired change. Such changes are subject
to staffing requirements of the Department and the approval of the Program Director,
Service Chief, and Administrative Chief Residents.
B. Sick Leave is accrued at the rate of eight (8) hours per month of appointment completed
and is credited only to the current year of appointment. In the event of illness, the
resident will notify both the Chief Resident of the service to which the resident is assigned
and the Department of Surgery Education Office as soon as possible.
C. Leave of absence for jury duty will be granted with no loss in pay or benefits. Any jury
summons received by the resident should be immediately presented to the Department
Residency Coordinator.
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D. Maternity leave: two (2) weeks of paid leave per academic year. Written notice of the
intent to take maternity leave must be given to the Program Director at least thirty (30)
days prior to the expected date of birth or adoption. Leave in excess of this time, with the
exception of sick leave or vacation leave, will be leave without pay and may not be
credited for training requirements.
E. Paternity leave: one (1) week of paid leave per academic year. Written notice of the
intent to take paternity leave must be given to the Program Director at least thirty (30)
days prior to the expected date of birth or adoption. The paternity leave cannot be taken
later than thirty (30) days before the actual birth or adoption date, nor commenced prior
to thirty (30) days before the expected date of birth or adoption. Leave in excess of this
time, with the exception of sick leave or vacation time, will be leave without pay and may
not be credited for training requirements.
F. Family illness or bereavement leave: up to five (5) days of sick leave may be used if the
resident is required to be in attendance or provide care due to an illness in the family or
attendance is required due to the death of a relative.
G. Medical leave: may be requested if a medical condition affects a trainee’s ability to
continue in the Program, or to safely or adequately fulfill his/her patient care
responsibilities.
H. Liability Insurance: The Medical Center shall include house staff under the University’s selfinsurance program with limits of up to $7.5 million per occurrence for the liability of the
resident while acting in the performance of his/her duties or in the course and scope of his/her
assignment. Claims made after termination of training will be covered if based on acts or
omissions of the resident within the course and scope of his/her assignments during training.
Liability coverage will be provided for the resident on rotations outside UCLA Medical Center,
provided such rotation has been duly approved or mandated by the program. Liability
insurance or other indemnity does not cover a resident who participates in clinical
activities outside of the scope of the Program (“moonlighting”).
I.
Health Insurance: The resident and members of his/her immediate family are eligible for
enrollment in health, dental, life, and vision care insurance provided by the UCLA Medical
Center. Insurance premiums are not required from the resident, however, co-payments, if
applicable, will be the responsibility of the resident. Mental health services are part of the
health insurance plan. Information on these plans can be found in the House Staff Manual, or
on the GME website www.medsch.ucla.edu/residencies/. There is no charge to the resident for
these insurance premiums.
J. Life and Disability Insurance: is available for the resident without premium costs.
K. Psychological, Counseling, and Support Services: the UCLA Medical Center offers a
Mental Health Program for Physicians in Training. Impaired physician services and
evaluations are offered through the UCLA Medical Center Physician’s Health
Committee.
L. Parking: The School shall provide parking access. The University sets monthly parking fees.
If parking is purchased, pre-tax deductions may be made from the monthly stipend checks.
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7. PROFESSIONAL ACTIVITIES BEYOND THE SCOPE OF THE RESIDENCY
To comply with the tenets of the American Board of Surgery, and the RRC, residents are
forbidden from engaging in compensated professional activities beyond the scope of this
Agreement, unless expressed written approval has been obtained from the Program Director.
Participation in compensated professional activities beyond the scope of this Agreement
without prior written approval will result in dismissal from the Program without recourse or
appeal. University liability insurance or other indemnity does not cover a resident who
participates in clinical activities outside of the UCLA Training Program (moonlighting).
8. EVALUATION, COUNSELING AND ADVANCEMENT
A. A written evaluation of each house officer shall be made by the attending physician(s) on each
house officer’s rotation(s). A written composite of all evaluations shall be made and a copy of
the composite must be provided to the individual house officer. The house officer shall be
given the opportunity to discuss their performance and the written composite with the Program
Director two times per academic year or more often as necessary or requested. The house
officer shall be notified within a reasonable time if an evaluation for a given rotation indicates
unsatisfactory performance. Both annual and rotational evaluations shall be included in the
house officer’s records.
B. The records of each resident shall be maintained as confidential, and the consent of the
individual shall be required before access is allowed to such records except where permitted or
required by law, or where directly or routinely required in the administration of the Program.
Residents may review their composite evaluations and other administrative materials upon
request and in accordance with applicable University policy. Evaluations of individual
performance are part of the training evaluation and per Medical Staff policy, are maintained as
confidential.
C. Program appointment, advancement and completion are not assured or guaranteed to the
resident, but are contingent upon the resident’s satisfactory demonstration of progressive
advancement in scholarship, continued professional growth, and satisfactory completion of the
stated responsibilities. Unsatisfactory resident evaluation can result in required remedial
activities, temporary suspension from duties, or termination of appointment and residency
education.
9.
DUE PROCESS
Residents who dispute any disciplinary action have the right to appeal said action through the due
process policies, as found in the House Staff Manual, Section I, Operational House Staff Policies.
Residents initiate this process through contact with their program’s Clinical Competency
Committee. The House Staff Manual is distributed to all new residents at the House Staff
Orientation. Additional copies are available in the House Staff Office. The Manual is also
available on the GME web page at www.medsch.ucla.edu/residencies.
The Campus Ombuds Office (825-7627) is available to all house staff for consultation. In
addition, a local Ombudsperson can be contacted at 206-2427. All information is fully
confidential.
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10.
COMMITTEE PARTICIPATION
The following committees address house staff issues:
The Resident Action Committee is a resident organization created to communicate and exchange
information on the house staff working environment and educational programs. It is a
subcommittee of the GMEC and is open to house staff from all programs. The frequency of
meetings is set by the RAC, but is not less than quarterly. The meeting dates and agendas are
available on the GME web page.
The Graduate Medical Education Committee (GMEC) addresses specific issues related to the
academic training programs. The Committee meets under the authority of the School of
Medicine and is composed of Residency Program Directors, faculty, and housestaff. The
committee meets monthly and performs internal reviews of all UCLA residency programs as
mandated by the ACGME and assists Programs with their RRC site visits. All training programs
must be approved by the GMEC. Resident representation is voluntary and consists of four (4)
residents from larger Programs, two (2) residents elected from smaller programs, and two (2)
residents from very small programs (3 or less trainees). The Committee works closely with
individual programs to assist them with their RRC site visits.
11.
NONDISCRIMINATION
The University of California does not discriminate on the basis of race, color, national origin,
religion, sex, physical or mental disability, medical condition, ancestry, marital status, age, sexual
orientation, citizenship or status as a covered veteran. This policy applies to all employment
practices, including recruitment, selection, promotion, transfer, merit increase, salary, training
and development, demotion, separation. This policy is intended to be consistent with the
provisions of applicable State and Federal laws and University policies.
12.
SEXUAL HARASSMENT AND OTHER ABUSE
The University of California is committed to creating and maintaining a community in which
persons who participate in university programs and activities can work together in an atmosphere
free of all forms of harassment, exploitation or intimidation, including sexual. Specifically, every
member of the University community should be aware that the University is strongly opposed to
sexual harassment and such behavior is prohibited both by law and by University policy. It is the
intention of the University to take whatever actions may be needed to prevent, correct, and, if
necessary discipline, behavior which violates this policy. The University’s policy on sexual
harassment may be found in the House Staff Manual, Section IV, p. 9. The David Geffen School
of Medicine at UCLA Statement on Supporting an Abuse-Free Academic Community may be
found in Section IV, page 11, of the House Staff Manual. Appointments for consultations can be
made by contacting the Chair of the Gender and Power Abuse Committee.
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13.
DUTY HOURS
Duty hours are defined as all clinical and academic activities related to the residency program, ie,
patient care (both inpatient and outpatient), administrative duties related to patient care, the
provision for transfer of patient care, time spent in-house during call activities, and scheduled
academic activities such as conferences. Duty hours include all hours spent in moonlighting
activities. Duty hours do not include reading and preparation time spent away from the duty site.
Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of
all in-house call activities.
Residents must be provided with 1 day in 7 free from all educational and clinical responsibilities,
averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour
period free from all clinical, educational, and administrative activities.
Adequate time for rest and personal activities must be provided. This should consist of a 10 hour
time period provided between all daily duty periods and after in-house call.
It is everyone’s responsibility to abide and work within the duty hours policy. Programs must
develop realistic schedules and mechanisms for off time coverage and transfer of patient
responsibilities to others. Faculty must remain vigilant of the trainees under their supervision and
frequently monitor the residents’ activities. Residents must stay within the duty hours and notify
chief/senior residents, faculty, and / or the program director if they are having difficulties in
meeting daily or weekly duty hour requirements. Residents should notify their program
director and/or the Sr. Associate Dean for Graduate Medical Education if their assigned
hours are not in compliance with UCLA or ACGME duty hour policy.
The GMEC requires that all program directors monitor and assess compliance for their program
and residents. The GME Office distributes a yearly questionnaire on duty hours to resident each
spring, which is one part of assessing compliance. Additionally, the UCLA GMEC requires an
annual Program Director certification of compliance with duty hours.
Concerns of duty hour violations should be reported to the Senior Associate Dean for GME and
or the institutional Compliance Hotline at 800-296-7188.
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14.
ON CALL ACTIVITIES
The objective of on-call activities is to provide residents with continuity of patient care
experiences throughout a 24-hour period. In-house call is defined as those duty hours beyond the
normal work day when residents are required to be immediately available in the assigned
institution.
A.
In-house call must occur no more frequently than every third night, averaged over a fourweek period.
B.
Continuous on-site duty, (admitting, inpatient call, etc.), must not exceed 24 consecutive
hours. Residents may remain on duty for up to 6 additional hours to participate in didactic
activities, transfer care of patients, conduct outpatient clinics, and maintain continuity of
medical and surgical care as defined in Specialty and Subspecialty Program
Requirements. Therefore, the total day may be up to 30 hours.
C.
No new patients, as defined in Specialty and Subspecialty Program Requirements, may
be accepted after 24 hours of continuous in house duty.
D.
At-home call (pager call) is defined as call taken from outside the assigned institution.
i. The frequency of at-home call is not subject to the every third night limitation.
However, at-home call must not be so frequent as to preclude rest and reasonable
personal time for each resident. Residents taking at-home call must be provided
with 1 day in 7 completely free from all educational and clinical responsibilities,
averaged over a 4-week period.
ii. When residents are called into the hospital from home, the hours residents spend
in-house are counted toward the 80-hour limit, averaged over 4 weeks.
iii. The program director and the faculty must monitor the demands of at-home call
in their programs and make scheduling adjustments as necessary to mitigate
excessive service demands and/or fatigue.
15.
ACCREDITATION STATUS
David Geffen School of Medicine at UCLA will inform residents of adverse
accreditation actions taken by the ACGME in a reasonable period of time after the action is taken.
Should the School of Medicine and the Medical Center begin the process of closing a residency
training program for accreditation reasons or for other reasons, the resident will be continued in
the institution for the remainder of the academic year. The School and Program will do
everything within its power to assist house officers in finding a program to become eligible for
board certification.
16.
MISSION STATEMENT
The mission of the Graduate Medical Education Program is to maintain a
scholarly environment which is committed to excellence in education, medical care and
biomedical research to support the graduate medical education programs of the David Geffen
School of Medicine at UCLA.
.
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BY MY SIGNATURE, I HEREBY CONFIRM THAT I HAVE REVIEWED THE TERMS OF
THIS AGREEMENT AND AGREE TO ABIDE BY THE CONDITIONS AS STATED, AND
THAT I HAVE RECEIVED A COPY FOR MY PERSONAL RECORDS
__________________________________________
Resident
_________________
Date
___________________________________________
Program Director
__________________
Date
resident contract.doc
Revised 03/20/06
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