In September 2010, the ACGME Board of Directors voted to implement work rules which would among other things limit intern shifts to 16 hours effective July 2011. At Jefferson, our leadership team began working on our program’s process and specific plans in attempting to rapidly adapt to the new ACGME mandates even before they were formally adopted. Together with our Chief Residents, Drs. Doug Guggenheim, Dina Halegoua, and Emily Stewart, we planned a retreat for October 22, 2010. It was held at the Union League with assembled residents from all three levels, senior administrators, and faculty that we forged our plan and response. Our goal was not only to comply, but to enhance the educational environment at Jefferson at the same time.