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Annual Leave Policy

Page history last edited by Dolores L. Garcia 2 days, 7 hours ago

I. Background

In August 2015 the UNM resident union (CIR) negotiated a new vacation policy with UNM administration.  The policy states:

 

  1. Residents are entitled to 3 weeks of vacation (21 days).  Typically the breakdown of days is 15 weekdays and 6 weekend days.
  2. Any vacation request for more than 7 consecutive days off requires program director approval.  Additionally, service, clinic and RRC requirements will be taken into account when those are requested (i.e. for Family Medicine meeting the FM RRC “weeks in clinic” yearly clinic requirement will need to be taken into account). 
  3. Vacation does not carry forward from one academic year to another.

 

The UNM FM residency has traditionally allowed some vacation to be taken in less than one-week increments, and would like to preserve some flexibility while also understanding that having residents take 21 weekdays of vacation is not the intent of the new collectively bargained policy. 

 

Additional important concepts:

 

  •  Many rotations have the potential need for residents to work on weekend days, and to guarantee that the weekend is off residents need to request those days off.
  • We have had a continued challenge of our upper-level residents not submitting vacation requests until very late in the year when options were limited.
  • Rotations are only required to grant a total amount of vacation days to a resident cohort commensurate with the amount of time residents from the program work on the rotation.  For example, a rotation must grant 21 days’ vacation per year if they have the equivalent of one full FTE of resident time, or 1 resident rotating through at all times.  An example is that the Santa Rosa rural rotation will only grant an amount of vacation total per year commensurate with the amount of people rotating there that year. (i.e. they won't grant 3 total weeks if they only have rotators 8 of 13 blocks).
  • There are, at times, limitations on when vacation can be taken due to either RRC requirements or rotation staffing needs that supersede vacation requests.

 

The following will be the UNM FM residency policy and procedure, which fits within the guidelines of the negotiated UNM GME policy but offers 4 additional days of vacation if the resident so chooses, and is able to get vacation requests to the residency office in a timely manner.  This policy creates a potential total of 25 days of annual leave, which puts our program in a very favorable position nationally[1].

 

II. Vacation Request Procedure

  1. All UNM FM residents will be entitled to a minimum of 21 days of vacation, levels PGY1 through PGY3
  2. 2 of the 3 weeks must be taken in 1 week (consecutive 7 day) increments, not more or less.
  3. 1 of the 3 weeks may be broken into 4/3 day increments, or 5/2 day increments (but no other manner).  If a resident chose to do this, it would in effect give them 4 more days than the previous rules, since they could choose weekdays as "days off" and pair them with a weekend they might otherwise have been scheduled for call. 
  4. In order to qualify to break the 3rd week into the 4/3 or 5/2 increments as per above, the resident must have vacation requests finalized by the following dates:
    • PGY1: May 1 prior to starting intern year
    • PGY2/3: July 1 of the new academic year.  Calls for vacation requests will begin May 1 for current PGY1's and PGY2's.

        5. Since some vacation requests occasionally do not work (i.e. the rotation has given all the FTE's of vacation they are required to allow), we recommend submitting vacation requests 4-6 weeks prior to the final deadline, i.e. as soon as you can after you are first notified by the residency office that vacation             requests are being collected.  That will give you the best chance at getting the specific days off you are hoping for.

         6. If a resident fails to meet these deadlines, they will need to take all of their required vacation in 1 week (consecutive 7 day) increments.  If residents do not submit vacation requests, the residency office will work with the resident as possible to help schedule the vacation time.  This may lead to                choices that are more limited than if the resident is prompt with requests.

 

III. Specific Concerns by Year

 

PGY1

The PGY1 schedule is significantly more challenging to arrange vacation given the higher amount of inpatient rotations which would face undue burden if residents were to take leave.  As such, the program will work closely with the intern to try to accommodate their requests as much as possible but due to undue burden, some requests may not be granted.

  • The residency office will try to arrange the master PGY1 schedule templates to accommodate vacation requests prior to the start of intern year. 
  • 1 of the PGY1 weeks of vacation must occur during the 6 week ER block.  The office will work with the intern to choose the preferred week during that block.
  • PGY1's rotate on many off-service rotations who still have the ability to deny vacation requests depending on their own safe coverage needs (see problematic rotations list).
  • Some off-service rotations (such as pediatrics) require vacation be taken in 1 week/consecutive 7 day blocks.  An exception is the Christmas and New Year holiday rotations: residents will only be allowed to take 5 days of leave during that time, as is also the case for pediatrics residents.
  • During block 9-11 on pediatric ward, patient volume increases associated with RSV season.  Because of this, any vacation requests during this time will likely not be granted because it would place undue burden on the service.

 

PGY2

  • 1 week of vacation will be the first week of PGY2.  While we recognize that this limits flexibility, we have put in a lot of effort to the Population Health and Scholarly Activity schedule and curriculum, and it would be problematic if some took vacation during the block and others didn't. 

 

PGY3

  • PGY3 has fewer restrictions, other than specific rotations that are problematic (see below list)

 

IV. Problematic Rotations for Vacation

For many years, the resident CIR Union contract has stated that "No rotation should be off limits for vacation."  And the Houseofficers manual adds "Leave requests may be denied if it places undue burden on the service." 

 

The program tries to carefully accommodate resident needs.  For interns, your schedule is built around vacation requests (as is possible to accommodate).  For upper-levels you are able to pick templates that you can tailor vacation timing preferences. We work very hard to accommodate your vacation needs, however this has created a challenging potential for conflict, since for many rotations one resident leaving necessitates calling in another for adequate coverage and safe patient care. 

 

As a result, some rotations can be very problematic if people request vacation as that would cause a undue burden on the service and may require getting coverage from another resident. 

 

Another variable is that coverage for major holidays needs to be equitable.

 

Below lists the rotations where vacation requests will be difficult to get coverage for:

  • Inpatient Wards: vacation would be problematic given requirement to have another resident cover, potential to cause lack of adequate patient care, and may affect your ACGME required hours/numbers of patients seen in certain settings
  • MCH: vacation would be problematic (see above) except in unusual circumstances
  • Night float rotations (including MCH Junior Night Float): would be problematic except in unusual circumstances
  • ICN3: vacation during ICN is also problematic since it by default creates difficult work schedules for the pediatrics residents.
  • Newborn Nursery: vacation would be problematic on this important but only 2-week experience.
  • Inpatient Pediatrics: vacation must be in 7 consecutive days.  Block 7 has built in holiday compensation during which you will get either 5 days around Christmas or around New Year’s Eve that will not be taken out of your leave.  Therefore, they will likely not be able to grant leave during this time to make sure that everyone gets these extra days off.
  • Cardiology: Upper-level residents are discouraged from taking vacation on cardiology.  This was the negotiation made by our department with Cardiology so that our residents would not need to work weekends on the rotation and thus would be available for call on our own services.
  • 2-week rotations not on this list: please be mindful of taking vacation on Sports Medicine, it is a high quality experience desired by many students and residents of other departments. Additionally, the available time is limited.  When our residents take vacation on the rotation it prohibits others from using that time that then is unused.  Also, it’s perceived as a high-value experience and a clinical area of weakness for many of our residents. 
  • Pediatric ER: vacation is problematic.  The rationale is that if a resident takes vacation, they will not obtain the required RRC number of Peds ER patients and there is no time that could be made up due to amount of learners on that rotation.
  • Cardiology/ED3:  see above- in terms of numbers that ACGME requires for all residents and these are both areas that our residents struggle to meet ACGME required numbers in.

 

V. Wellness Leave

 

Starting July 2017 UNM will provide a ½ day of paid wellness every 3 months to every resident, for the purpose of attending to personal health and well-being.  Some examples of such activities include medical and dental appointments, physical therapy and counseling.  A quarter’s accrual may be saved up to an additional quarter, to use in conjunction with the next quarter’s accrual for a total of 1 full day every 6 months.  The idea is that this is additional time during the week for residents to get things done, especially beneficial for residencies that don’t allow for vacation to be taken in increments less than 7 days.

 

We treat wellness half days like vacation, with limitations about when they can be taken being the same as in section IV.  We ask for 90 days lead time to cancel clinic, 30 days for other rotation experiences. If an appointment needs to be made within 7 days, we ask sick leave be taken.  These days will be tracked by the residency office.

 

VI. Educational Leave

 

GME policy of the Educational Leave Policy is that educational leave time to study for exams is not permitted,  you can take in person study courses but not on-line courses.  Below is text from the Houseofficer’s Manual Policy:

 

“Educational activities including but not limited to presenting papers, taking state and national examinations, or attending educational seminars may be allowed, with pay, with advance approval of a Houseofficer’s Program Director. The annual educational leave allowance shall be five (5) days. At the discretion of the Program Director, Houseofficers shall be permitted to split educational leave time or use it as a whole unit. Educational leave cannot be carried over from one academic year to another. Educational leave should not be used for conducting CIR business.”

 

We ask for 90 days lead time to cancel clinic as it causes undue burden on the clinics and the patients to re-schedule prior to that, 30 days for other rotation experiences.

 

VIII. Holiday Comp Leave

Holiday Comp Time is earned when you work a holiday and are not given time off during the rotation.   Holidays include 4th of July, Labor Day, Thanksgiving Day, Christmas Day, New Year’s Eve, New Year’s Day and Memorial Day (7 total).  During your OB, Pediatric Rotations and Emergency Medicine you are given additional time off during that rotation when it happens during the Christmas/NY holiday so you do not earn holiday time off.  The residency office tracks this time off from the duty hours that you log into New Innovations.  If it is not logged in New Innovations, you will not receive credit.  Holiday time carries over from year to year and you must follow the same guidelines as Annual Leave when requesting the time off.

 

VIII. Conclusion

The vacation policy is always dynamic and a work in progress. We will continue to iron out concerns that arise in a way that is equitable and fair to all, our ultimate goal.

 


[1] table 31, https://www.aamc.org/download/412558/data/2014stipendsurveyreportfinal.pdf

 

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