Interpretation
Article 12 must be interpreted in light of the definitions provided in Articles 1.09 (weekend), 1.12 (call period in an establishment), 1.13 (night call in an establishment), and 1.14 (shift).
General
Basic regular schedule
The resident is subject to the schedule imposed on him by his responsibilities. Nevertheless, his basic regular schedule, during the day from Monday to Friday, shall not extend over a time slot in excess of twelve (12) hours. With the exception of call duty, the resident cannot be required to work more than the number of hours mentioned above.
Interpretation
The work day, excluding call periods, may therefore be no more than 12 hours long. This work day must be during the daytime, from Monday to Friday, and begin in the morning between 06:00 and 09:00, depending on the department. So if the establishment asks you to work during a weekend day, that day must be considered a call period.
Immediate superior
The resident shall be answerable for his medical activities to the head of his department and, for his other hospital activities, to the competent authorities.
Call duty
In addition to the basic regular timetable, the resident may be asked to perform call duty, either in the establishment or at home.
Interpretation
The basic regular schedule is the schedule normally worked by a resident in his department, for a schedule which, remember, must not exceed 12 hours in length. For instance, if all residents work from 07:30 to 18:00 from Monday to Friday, that schedule will become the basic regular schedule. Thus, if the department asks a resident to stay at work after 18:00 until he is relieved by the resident performing the night shift, he will be deemed to be performing call duty.
Pedagogical goals
Call duty shall meet the pedagogical goals of the program in which the resident is registered and correspond to his level of training.
Interpretation
Call duty sites
The resident shall not perform call duty in an establishment whose name is not recorded, for a given period, on his training card issued by the Collège.
Interpretation
The training card allows the resident to perform medical acts. It stipulates that the resident: “may perform professional activities corresponding to his/her level of training in the following sites” (indicated on the training card) “or in all other sites accredited by the CMQ [Collège] and required for the achievement of the objectives of the rotations by the training program.” Thus, a resident may not perform call duty in an establishment where he is not on rotation, except as provided for in Article 12.06 (multi-site call duty at home).
Also, residents may sometimes be asked to perform call duty paid over and above the salary they receive on their paycheque. These call periods would then be paid by departments or from sources other than the paying establishment. But Collège regulations stipulate that a medical resident can perform only such medical acts as correspond to his level of competency, within the framework of the postgraduate education program in which he is registered. Residents therefore cannot agree to perform such call duty, since it could be deemed to be unlawful.
It is also important to emphasize that any medical act performed outside the rotation sites approved by the Collège or outside what is required by the training program, even if it is requested as a result of the shortage of physicians, is likely not to be covered by the malpractice insurance provided for in the collective agreement.
Moreover, a resident performing call periods in addition to those stipulated in the Agreement and being paid additionally for this work could have his registration revoked by the Collège. In that context, the Federation discourages any medical resident from taking this route.
Finally, a resident may, on certain conditions, perform medical acts and be paid by the provincial health insurance board (RAMQ) if he holds a regular permit from the Collège that allows him to perform moonlighting. In that case, though, the resident will have to ensure that he has personal malpractice insurance coverage. This could be the case with a resident holding a permit in a specialty while pursuing residency in another specialty. In all cases, it is advisable to confirm the lawfulness of the moonlighting proposal before agreeing to it, since the rules have been considerably tightened in the past few years.
Multi site call duty
The resident shall not, at any time, perform call duty in more than one facility; when call duty is carried out at home, however, it may be performed in more than one facility, on the conditions determined by the Collège, notably:
a) the call duty shall meet needs of a pedagogical nature;
b) the call duty shall correspond to the method of practice of other doctors in the establishment;
c) the call duty shall be restricted to a limited number of training levels within the same university program.
Interpretation
You cannot be on call in an establishment or on night call in an establishment in more than one facility during the same period. But the rule is more flexible for call duty at home. In fact, it is possible to perform call duty in more than one facility of the same establishment (e.g., Royal Victoria Hospital and Montreal General Hospital—MUHC), if certain conditions are met.
Plurality of call duty
The establishment may establish the plurality of the two (2) call systems provided that, for the totality of call duty, the standards and restrictions provided for in Articles 12.09 and 12.10 of this Agreement are complied with.
Interpretation
It is possible to perform both call systems—call duty at home and call duty in an establishment— if the rules for call periods in an establishment (Art. 12.09) and night call in an establishment (Art. 12.10) are followed. The number of call periods in an establishment and at home taken together must then not exceed six per 28-day period. The call duty rate must be one call period every three days and, once per 28-day period, the resident may be required to perform one call period every two days.
It is also possible to perform night call in an establishment and call duty at home during the same period. In that case, a resident will be able to perform a maximum of six call periods at home, on top of his night calls in an establishment. But it is not possible, within the same day, to perform call duty at home (24 hours) and night call in an establishment.
Finally, the establishment may ask a resident to perform both call duty in an establishment and night call in an establishment, in addition to performing call duty at home. In that case, the combined number of call periods at home and call periods in an establishment must be no more than six, on top of the night calls in an establishment. But the rates of call duty in an establishment, i.e., one call period every three days, must be complied with, and it is not possible to perform, within the same day, one call duty at home and one night call in an establishment.
Resident coverage
When call duty is performed in an establishment, the resident, in the six (6) months following the start of his residency, shall be able to count at all times on the presence, on-site, of a physician who is a member of the Council of Physicians, Dentists and Pharmacists or of a resident other than a Resident 1.
Interpretation
The establishment has to set up a procedure, with which everyone is familiar, that identifies the physician or senior resident present in the hospital who has to go to the patient’s bedside in case of any problems, to help a resident on call duty in the first six months of his residency. Also, Article 10.04 stipulates that if you work in Emergency, a staff physician must always be present.
Note that Article 10.04 also stipulates that a resident must never be responsible for a resuscitation team before having completed six months’ training in a medical or surgical discipline and having obtained ACLS or APLS certification, depending on whether he is treating adults or children.
For instance, a resident registered in a psychiatry program who performs rotations in his discipline during the first six months of his residency does not meet the conditions whereby he can be responsible for a resuscitation team. He must wait until he has passed his six months of medical or surgical rotation before doing so.
Call period in an establishment and night call in an establishment
Call period in an establisment
The resident shall not be required to work more than six (6) call periods in an establishment in each twenty-eight (28) calendar-day period. A minimum interval of forty-eight (48) hours must elapse between the end of one call period and the beginning of the next. Two (2) of these call periods may, however, be separated by a minimum interval of twenty-four (24) hours.
In addition, an interval of at least forty-eight (48) hours shall elapse between two (2) call periods performed in different twenty-eight (28) day periods.
Notwithstanding the foregoing, two (2) of these call periods may be performed during the same weekend, provided they do not exceed twelve (12) hours on Saturday and fourteen (14) hours on Sunday and are separated by a mandatory rest period of eight (8) hours.
Interpretation
Note first of all that it is necessary to refer to the definition of “call period in an establishment” to differentiate it from “night call in an establishment” governed by Article 12.10 of the Agreement. Indeed, Article 1.12 defining “call period in an establishment” stipulates that:
- during the week, the call period in an establishment begins after the regular work day, which is of no more than 12 hours’ duration, can vary from one department to another, and must end no later than midnight;
- on Saturday and statutory holidays, it takes place between 08:00 and 20:00;
- on Sunday, since the weekend ends at 22:00 (Art. 1.09), the call period in an establishment takes place between 08:00 and 22:00.
Thus, the limit of six call periods in an establishment per 28-day period does not apply to night call in an establishment. Under Article 12.09, call periods in an establishment may not be closer than one every three days. For instance, if you are on call on Monday, you may not be on call again until the following Thursday. But, only once per 28-day period, the establishment could ask you to perform one call period every two days.
In addition, during the weekend, it is possible to perform two consecutive call periods in an establishment and thus not comply with the rate of call duty (Friday and Saturday, or Saturday and Sunday). For the purpose of calculating the number of call periods, you will then have performed two call periods, but will have worked a single weekend. The establishment will then be able to ask you to work during another weekend in the same period.
The Saturday call period must be no more than 12 hours in length, while the Sunday call period may be no more than 14 hours long. So the Saturday and Sunday call periods cannot be of 16 hours’ duration. In addition, following each of the call periods in an establishment, it is necessary to have at least 8 hours’ rest.
Remember that if you take leave during a period, the maximum number of call periods must be reduced in proportion to the time actually worked, pursuant to Article 12.20.
Note that if you change department or establishment, it is hard for the person drawing up the new call schedule to know the date of your most recent call duty in your previous department. So it is preferable for you to let him know before your rotation begins. That way, the establishment will be able to ensure a minimum interval of two days between your call periods in an establishment.
Note also that, under Article 12.18, you are entitled to two weekends off per 28-day period. The weekend starts at 17:00 on Friday and ends at 22:00 on Sunday. But if you are taking vacation time, the weekend ends at 08:00 on Monday.
Also, if you have unequivocally refused—orally or in writing—to work irregular call periods, the establishment may be liable to a $150 fine per violation of the call schedule. Furthermore, if a department regularly produces irregular call duty schedules, the Association may demand payment of such a penalty for each irregular call duty appearing on the call schedule (see Article 12.25), without the resident having to object formally, and even if he performs the call duty. This penalty will be paid to the Federation, and will be used to support higher education.
Night calls in an establisment
The resident shall never perform more than twenty (20) night calls in an establishment per twenty-eight (28) day period.
Also, the resident shall never perform more than five (5) consecutive night calls in an establishment, following which he shall benefit from forty-eight (48) hours’ mandatory leave.
The resident shall not alternate more than once per seven (7) day period between night call in an establishment and any other work schedule
Interpretation
Note first of all that it is necessary to refer to the definition of “night call in an establishment” to interpret this article correctly. Article 1.13 stipulates that night call in an establishment is: “the work period starting at or after 20:00, or at or after 22:00 on Sunday, and continuing beyond midnight; night call in an establishment cannot last longer than twelve (12) consecutive hours.”
A few conditions apply to night call in an establishment, namely, that the resident cannot work during the day of the night call, the call duty must begin after 20:00, and the call period may not be longer than 12 hours. So a resident could not be at work during the day or part of the day and then perform night call (or a shift in Emergency) at midnight.
For a full night-time rotation, the maximum number of night call periods in an establishment is 20. But if you are not performing a night-time rotation, the number of night call periods in an establishment may be anywhere from 0 to 20. Note that in that case, you may also have call periods in an establishment to perform (see Article 12.09).
You cannot be asked to perform more than five consecutive night call periods in an establishment. If you reach this maximum, the establishment must give you leave for the following 48 hours. Thus, this leave may be taken both during the week and on the weekend.
Furthermore, night call periods in an establishment performed during the weekend are considered weekend call duty, but are not deducted from the six call periods in an establishment provided for in Article 12.09.
Note that the establishment is required to give you two weekends off per 28-day period. For instance, if you perform two call periods in an establishment on the same weekend and night call in an establishment from Thursday to Sunday on another weekend, you will then have worked your maximum of two weekends for the 28-day period.
Also, the establishment cannot ask you to alternate between night call in an establishment and call duty in an establishment or the regular work day more than once per 7-day period. For instance, if you are asked to perform night call on Sunday and a regular work day the following Tuesday, the establishment cannot ask you to perform another night call in an establishment before the following Sunday. You must take a mandatory eight-hour rest period following night call in an establishment (see Article 12.11).
Rest period
Interpretation
You may not work more than 16 hours in a 24-hour period. Or, to put it another way, 24-hour call duty in an establishment is illegal. Note, moreover, that Article 1.13 stipulates that night call may not be more than 12 hours in length.
After each work period, regardless of that period’s duration, you must have a minimum rest period of 8 hours. The hospital may not impose any sanction or take reprisals against you if you avail yourself of this right by leaving the department after call duty in an establishment or night call in an establishment.
Nor should you be asked to attend an academic activity following call duty in an establishment or night call in an establishment (Articles 12.09 and 12.10).
Note that the rule of a maximum of 16 hours per 24-hour period stemmed from a court decision following a resident’s complaint that was supported by the FMRQ. The court ruled that going beyond that threshold was a violation of residents’ fundamental rights, including the right to fair and reasonable conditions of employment, a right protected by the Quebec Charter of Human Rights. This rule concerns work and call duty in an establishment, and not call duty at home.
Emergency room
Call duty in emergency room
When a call period is performed in the emergency room, the resident shall not be required to work there for a continuous period of more than twelve (12) hours.
When a call period in the emergency room immediately follows the resident’s basic regular timetable, he shall not be required to work for a continuous period of more than sixteen (16) hours.
Interpretation
This article concerns residents on rotation in another department who have to perform a shift in the emergency room, which, under this article, will be considered call duty in an establishment in the emergency room.
The collective agreement sets out specific rules in this regard. First, Article 12.12 sets limits on the number of hours, at 12 hours for a resident doing only the shift in his day, and 16 hours for a resident working during the day in another department and performing the shift in the emergency room afterward. In both cases, it is necessary to have eight hours’ rest after working in the emergency room.
Aside from the limits on hours set out in this article, these medical residents are subject to the provisions concerning call periods in an establishment and night call in an establishment found in Articles 12.09 and 12.10. Thus the maximum number of call periods in the emergency room must be six, and the rate of call duty must be complied with (i.e., call periods every three days, and, once during the 28-day period, one call duty every two days).
Note that it is possible to perform two call periods during the same weekend, without complying with the above call duty rate. Note that, if you take leave during a period, the maximum number of call duty periods must be reduced in proportion to time actually worked, under Article 12.20.
Shifts in emergency room
When the resident works in the emergency room for a twenty-eight (28) day period, he shall never, during that period, perform more than eighteen (18) shifts of eight (8) hours.
Also, the resident shall never perform more than seven (7) consecutive shifts or, if he is performing night shifts, more than five (5) consecutive shifts, following which he shall benefit from forty-eight (48) hours’ mandatory leave.
Interpretation
This article governs the work conditions that must apply during a rotation in the emergency room. It limits the duration of the shift to eight hours. Shifts can be broken down, depending on the department’s needs, among day, evening and night shifts, but the total number of shifts must not exceed 18 in a 28- day period.
The establishment should provide you with your work schedule no less than five days before the time when you have to work, in accordance with section 59.0.1 of the Act respecting labour standards. After that deadline, you could contest this shift or change.
Note that, if you take leave during a period, the maximum number of shifts must be reduced in proportion to time actually worked, under Article 12.20.
In addition, other rules must be followed:
- after seven day or evening shifts, you must have 48 hours off;
- after five night shifts, you must have 48 hours off.
Note that the 48 hours off is not necessarily on a weekend.
Moreover, this does not remove the employer’s obligation to comply with the rule whereby each medical resident is entitled to two weekends off without any clinical activities. The weekend begins at 17:00 on Friday and ends at 22:00 on Sunday, except on returning from vacation, when it ends at 08:00 on Monday.
Also, you must have eight hours’ rest after each shift (Art. 12.14).
Rest period
A call period or a shift in the emergency room shall be followed by a mandatory rest period of eight (8) hours.
Call duty at home
Call duty at home
When call duty is carried out from home, the resident shall not be required to work more than nine (9) call periods in each twenty-eight (28) calendar- day period.
Interpretation
You may be on call at home a maximum of nine times per 28-day period. No interval has to be maintained between call duty periods at home. These may be consecutive, provided the two weekends off are respected (see Article 12.18).
Note that, if you take leave during a period, the maximum number of call periods at home must be reduced in proportion to time actually worked, under Article 12.20.
Post call
When the resident is performing call duty at home and has worked for eighteen (18) hours during a twenty-four (24) hour period, he shall be released from his basic regular schedule immediately following his call period, for a period of at least twenty-four (24) hours. In no case shall the resident work more than twenty-four (24) hours in a row.
Interpretation
If you have worked in the establishment for at least 18 hours while on call duty at home, not necessarily consecutively, you may have a 24-hour post-call day without any clinical activities. In such a case, you must notify your supervisor that you wish to avail yourself of your post-call day.
Présence fréquente à l’établissement
When call duty at home requires the frequent presence of the resident at the establishment, in the same twenty-eight (28) day period, the establishment shall comply, for this call duty at home, from the time the association so requests, with the standards and restrictions set out in Articles 12.09 to 12.11 of this Agreement.
Interpretation
Weekend
Weekend
Interpretation
The weekend, for the purposes of the collective agreement, is defined as: “The period of time extending from 17:00 on Friday until 22:00 on Sunday. For the purposes of Article 25.05, however, “weekend” means the period of time extending from 17:00 on Friday to 08:00 on Monday. Nevertheless, the resident whose daily work schedule ends no later than 20:00 on Friday is not thereby deemed to have worked that weekend.”
This definition of “weekend” never varies. So if a statutory holiday falls on a Monday, that day will not be considered a weekend day, since it does not meet the criteria set out in the definition of “weekend” in Article 1.09 of the Agreement. Therefore, if you return from vacation and the Monday is a statutory holiday, that day is not part of the weekend.
You are entitled to two weekends off per 28-day period. This leave means you are exempted from any clinical activities, including weekend rounds. In addition, you may not work more than two weekends running, both within one period and between two periods. You must therefore advise the person drawing up your call schedule, in order to ensure conformity of the schedules during period changes.
Miscellaneous
Release from call prior to examination
Interpretation
The resident shall be released from his call duty or any performance of work in the evening, at night and on weekends, during the seven (7) days preceding examinations of the Collège des médecins du Québec, the Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada or the Medical Council of Canada with a view to obtaining a licence or specialist certification.
Leave
When, pursuant to the Agreement, the resident benefits from leave, the total number of call periods and shifts performed by the resident during the same twenty-eight (28) day period shall be prorated downward to reflect the number of days’ leave during the said period.
Interpretation
The number of call periods must be proportional to the number of days worked in a 28-day period. If you work in a department that asks you to perform call duty in an establishment and night call in an establishment during the same period, the total number of call periods you will have to perform if you take leave during that period will have to be calculated for each type of call duty, prorated to the number of days worked during the said 28-day period. None the less, the collective agreement does not stipulate that the number of weekends worked must be proportional to time worked, so it remains a maximum of two.
Leave other than vacation
If you take a week’s leave other than vacation, notably a week’s conference or study leave in a 28-day period, you must not perform more than five call periods in an establishment in addition to the night calls in an establishment or seven call periods at home.
You are therefore available to perform call duty for 23 days, or 28 days – 5 days’ leave = 23 days.
The calculation method for determining the number of call periods you can be assigned if you take a week’s (five days’) leave other than vacation is as follows:
- X call periods in an establishment = (23 days available to perform call duty X 6 call periods in an establishment) / 28 days = 5 call periods in an establishment
- X night calls in an establishment = (23 days available to perform call duty X 20 days’ call duty normally assigned to residents employed in the establishment) / 28 days = 16 night calls in an establishment
- X call periods at home = (23 days available to perform call duty X 9 call periods at home) / 28 days = 7 call periods at home
- X shifts = (23 days available to perform shifts X 18 shifts) / 28 days = 15 shifts
Vacation
Furthermore, if you take a week’s vacation, you must not perform more than four call periods in an establishment or six call periods at home, because you have to be released from your call duty on the weekend preceding and the weekend following your vacation. This means the number of days available for performing call duty is 19, or 28 days minus the 5 days’ vacation and the 4 weekend days, and not 23 as in the previous example. The calculation method for determining the number of call periods you can be assigned is as follows:
- X call periods in an establishment = (19 days available to perform call duty X 6 call periods in an establishment) / 28 days = 4 call periods in an establishment
- X night calls in an establishment = (19 days available to perform call duty X 20 days’ call duty normally assigned to residents employed by the establishment) / 28 days = 14 night calls in an establishment
- X call periods at home = (19 days available to perform call duty X 9 call periods at home) / 28 days = 6 call periods at home
- X shifts = (19 days available to perform shifts X 18 shifts) / 28 days = 12 shifts
Call schedule
The call schedule shall be prepared by the establishment, through the chief resident; the schedule shall account only for residents employed in the establishment who are normally assigned to this duty, and shall comply with the standards and limitations stipulated in this article for such call duty.
The chief resident or assistant chief resident shall ensure that work hours are distributed as fairly as possible among the residents available.
If the schedule meets these conditions, it shall be signed by the chief resident and the Director of Professional Services or his duly designated representative, other than a resident.
The establishment shall convey the call schedule to the resident concerned and the association no less than five (5) working days before it becomes effective.
Interpretation
The schedule must be drawn up so as to distribute call duty as fairly as possible among all the residents subject to the call schedule.
The call schedule must take into account residents on rotation normally assigned to this duty. In other words, if the norm is that a resident assigned to a specific rotation does not normally perform call duty, it cannot suddenly be decided to impose call duty on him. Similarly, the establishment should not ask a resident to perform call duty in a department other than his own, unless all residents from different departments have always been grouped together to perform call duty.
In addition, the call schedule must be conveyed to the residents concerned and the Association on the Monday prior to the beginning of each period. In order for you to receive your schedule, it is important to make sure that the department in which you are performing your rotation has your email address.
Finally, please note that the establishment could amend this list during the period, provided all the provisions set out in Article 12 are complied with, no more than five days before the time when you have to work, in accordance with section 59.0.1 of the Act respecting labour standards. After that deadline, you could contest this change.
Lack of ressources
When there are not enough residents to provide call service at all times, the establishment may, if it deems appropriate, ensure the provision of the said call service, but by a non-resident.
Interpretation
If the establishment imposes a tighter schedule for call duty in an establishment on you, that is, more than one call period every two days, claiming that there are not enough residents to comply with the call duty rate, it is in violation of Article 12.22 of the Agreement.
The establishment alone is responsible for filling gaps in the call schedule, with non-residents where necessary. Should the establishment decide not to fill these gaps, this must not lead to any extra workload for residents on call.
Lack of ressources: workload
In the event the establishment chooses not to provide the service, this shall not result in additional workload for the resident on duty.
Derogation and right of refusal
Penalty for derogation
When the resident who is subject to an irregularity in the schedule for call duty in an establishment is forced to comply despite his manifest refusal, the establishment concerned shall be required to pay a sum of one hundred and fifty dollars ($150) for each irregularity.
If an establishment repeatedly fails to send the association a call schedule within the timeframe provided for in Article 12.21, it shall be required to pay, from the time the association so requests, a sum of one hundred and fifty dollars ($150) for each such failure.
If the call schedule of a service or clinical department regularly violates the standards provided for in Articles 12.09, 12.10 and 12.18, the establishment concerned shall be required to pay, from the time the association so requests, a sum of one hundred and fifty dollars ($150) for each irregularity appearing on a subsequent call schedule.
The amounts provided for in this article shall be payable upon demand of the association and shall be paid into a fund to support higher education for the most deserving residents. This fund shall be administered by the Federation.
Interpretation
Penalties may be claimed in the following situations:
- If the establishment forces you, despite an unequivocal refusal on your part, to perform irregular call duty, the Association may require payment of a $150 penalty for each such call period;
- In the case of a service or clinical department which regularly, that is, in more than one consecutive call schedule, violates the provisions concerning call duty in an establishment, night call in an establishment or weekends off, the Association may request payment of a $150 penalty for each irregular call period appearing on the call schedules which follow;
- When the establishment repeatedly fails to send the Association the call schedules, the Association may request payment of a $150 penalty for each call duty schedule not received.
Note that the penalties are not given to the residents who performed irregular call duty, but are paid into a fund managed by the Federation.
Call responsibility premium
The establishment shall pay the resident called upon to perform call duty service, in the course of a year, in addition to his salary and at the end of each twenty-eight (28) day period, a call responsibility premium, the amount of which appears in Appendix I.
Interpretation
The call responsibility premium is payable to any resident likely to have to perform call duty during a year, i.e., to all residents. In other words, to receive the call responsibility premium, the Agreement provides for no minimum call duty to be performed per 28-day period.
The premium covers a 28-day period.
It has been $595 since April 1, 2018.
Also, residents receive the premium during all leave paid for by the employer and provided for in the Agreement. Moreover, pregnant residents relieved of their call duty have to receive the call responsibility premium. But medical residents do not receive the call premium while on sick leave of six days or more.
Information capsule
Call Duty Schedule: How to Tell if the Collective Agreement Is Respected
First, here are some definitions :
Call duty in an establishment (art. 12.09)
Corresponds to clinical work performed in the evening from Monday to Friday, after the regular work day, and during the day on weekends.
Night call duty in an establishment (art. 12.10)
It is performed from 20:00 onward, on weekdays and on weekends.
Then, here are some provisions of the collective agreement :
Limit of the number of calls
You may perform up to 6 calls in an establishment and up to 20-night calls during a 28-day period.
Limit of the number of weekends worked
You must have two weekends off for each 28-day period.
Alternate limit between night calls and any work schedule
It is forbidden to alternate more than once per 7-day period between night calls and any other work schedule.
These last three provisions limit the total number of call duties (see articles 12.09 to 12.11).
Thus, you will never be able to reach both call duty limits (6 calls in an establishment and up to 20-night calls) during a 28-day period.
It is still possible to perform a total of more than 6 calls in a 28-day period, since you can be asked to perform both types of call in the same 28-day period. However, the provisions mentioned above must always be respected.