|
Inpatient Service Structure
| Where Residents Spend Their Time |
| Name of Service |
No. of
Residents
|
No. of
Interns |
No. of
Medical Students |
| General Medicine |
1 |
2 |
1-2 |
| CCU |
3 |
0 |
0-1 |
| MICU |
3 |
2 |
0-1 |
| ER/Clinics |
0 |
1 |
n/a |
|
THIS SCHEDULE WILL CHANGE AS OF JULY 2011, BUT CURRENTLY:
When on a general medicine team, the team consists of an upper level resident, two interns, an attending and one to two medical students. The team takes overnight call on an every five-day cycle. Long call, or overnight call, lasts from 3 p.m. until 7 a.m. the next day, or 10 admissions (maximum five per intern) whichever comes first. There are no admitting responsibilities on the post call day. Short call is also every five days and lasts from 7 a.m. to 3 p.m. with a maximum of six admissions (no more than three per intern). Clinic days do not have scheduled admissions. All residents have continuity clinics, including preliminary year interns.
The overall cycle is Short Call - Clinic - Long Call - Post Call - Clinic
The MICU and CCU are every third night call for the upper level residents. There is a fixed day off as part of the cycle every week. Interns in the MICU have a more flexible role and take call no more frequently than every fourth night.
When working on the general medicine/preoperative rotation, the resident (upper levels only) will work two weekends a month along with an attending. That is the only consult month or elective with any weekend duty whatsoever. In general, interns will have four to five months during the year with no weekend duty, and upper level residents will have seven months a year with no weekend duty, allowing a great deal of free time for reading and relaxation.
FAQ - Have you investigated changing over to a float type schedule and eliminating overnight call?
Yes, we have discussed that issue frequently! In August 2009, we began a pilot study of shift work in the Medical ICU [eliminating traditional call and 30 hour shifts]. We have currently drawn up plans to expand that to the Medicine Ward Services and to the Coronary Care Unit, thus eliminating all 30 hours shifts and complying with all of the new ACGME regulatory requirements. Please be sure to ask about this on your interview day!!
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