Attending Double Coverage

[RadOncMegatron]

I just wanted to know how many residents out there are at programs where you have to double cover services when someone is on an elective. This is quickly becoming an issue in our dept, especially, when we have more attendings then residents in the first place.

We have almost always have someone on elective and this gets worse when one of us goes on vacation or uses a sick day.

I really just wanted to get an idea if this is what is going on at other departments and advice on how to deal with it.

Thx.

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[Gfunk6]

In our department we had about 10 "clinical slots" every month and 3 "elective slots." Since we have 13 residents, it worked out well. Those who were are on elective did not have to cover except for urgent situations like an unplanned resident leave.

 

[Neuronix]

I just wanted to know how many residents out there are at programs where you have to double cover services when someone is on an elective.

Our department never has double coverage, and most attendings are used to not having residents much of the time. I think it's a big positive for our program.

 

[medgator]

I just wanted to know how many residents out there are at programs where you have to double cover services when someone is on an elective. This is quickly becoming an issue in our dept, especially, when we have more attendings then residents in the first place.

We have almost always have someone on elective and this gets worse when one of us goes on vacation or uses a sick day.

I really just wanted to get an idea if this is what is going on at other departments and advice on how to deal with it.

Thx.

Our department never has double coverage, and most attendings are used to not having residents much of the time. I think it's a big positive for our program.

Yup. It's very program-specific.

 

[brendav]

we had this at my program and it was a HUGE problem, especially when senior residents were spending months in the lab or away rotations. for some reason, the program wanted all attendings covered even though there were more faculty than residents.

we would often have to cover 2 attendings who treated completely different sites. it was very overwhelming, both the clinical load and having to study so many disease sites in a 3 month period. residents complained daily. no one listened.

finally, after 1.5 years of pain, our PD scrapped this once it became a big issue for visting rotators / residency applicants who asked questions about the double coverage during interviews (ACGME also flagged us for a related issue). now attendings go uncovered on a rotating basis. even two "light" attendings (e.g. <20 sims in 3 month period each) can unexpectedly get very busy and, when their schedules overlap, you miss out on clinical experiences (but we were still responsible for all the scut work for both faculty --- painful when you don't know all their patients!!).

as an applicant, avoid programs that insist on all attendings being covered. that is telling that faculty comfort is prioritized over resident learning.

 

[RadOncDoc21]

Yeah, this became an issue in our department especially as a pgy-2 with 2 attendings with extremely high expectations. I felt like a half resident with double the load.

I rather be on one extremely busy service than having to cover 2 attendings any day. Glad things have changed and I totally agree with the posts above.

 

[Neuronix]

as an applicant, avoid programs that insist on all attendings being covered. that is telling that faculty comfort is prioritized over resident learning.

As much as I agree, applicants have to be aware that this applies to a lot of programs, especially many of the big names. While some of them don't strictly have 100% attending coverage, the double (and even triple!) coverage issues are quite common.

 

[medgator]

As much as I agree, applicants have to be aware that this applies to a lot of programs, especially many of the big names. While some of them don't strictly have 100% attending coverage, the double (and even triple!) coverage issues are quite common.

Correct, and in the current environment you can't be too choosy about which programs you apply to

 

[Neuronix]

Correct, and in the current environment you can't be too choosy about which programs you apply to

Apply to all, adjust rank list accordingly, roll 1d12 and the result is which program you get

 

[deleted4401]

Yeah, very few students will truly "pick" what program they go to.
Double coverage sounds horrible, UPMC didn't do it, but there were times when it was super light. Balance is good. I think a few of the private practice programs (Kaiser, Cal Pacific, maybe Mayo Jax) were fairly big on the double coverage and the only advantage/benefit is that you can get used to being overloaded and it makes it easier when you experience it during your career.

Funny though, the most consults I've seen in a week in private practice is about half what I saw in the busiest week of residency.

S

 

[TarHeelRadOnc]

Yeah, very few students will truly "pick" what program they go to.
Double coverage sounds horrible, UPMC didn't do it, but there were times when it was super light. Balance is good. I think a few of the private practice programs (Kaiser, Cal Pacific, maybe Mayo Jax) were fairly big on the double coverage and the only advantage/benefit is that you can get used to being overloaded and it makes it easier when you experience it during your career.

Funny though, the most consults I've seen in a week in private practice is about half what I saw in the busiest week of residency.

S

Agree with most of the above posts. Unfortunately, Rad Onc is competitive enough that there will always be more "beggers" than "choosers"... and the former cannot rule out programs on the basis of occasional double attending coverage.

The program where I trained implemented double services for a period of time, such that all attendings were covered. Was painful at times, but in aggregate I feel it was beneficial in that you were covering multiple disease sites at the same time and managing a busy combined service. This experience was helpful in preparing me for a busy community practice. I think that a double service is an innapropriate burden for most first and second year residents, but should be manageable for a more efficient and knowledgeable senior resident.

Unlike SimulD, my busiest week is residency is slower than my average week in private practice.... so I am thankful for the experience in retrospect.

 

[medgator]

The program where I trained implemented double services for a period of time, such that all attendings were covered. Was painful at times, but in aggregate I feel it was beneficial in that you were covering multiple disease sites at the same time and managing a busy combined service. This experience was helpful in preparing me for a busy community practice. I think that a double service is an innapropriate burden for most first and second year residents, but should be manageable for a more efficient and knowledgeable senior resident.

Coming from a program that also did this, you 100% nailed it. Probably not the best resident-experience if you are planning a research-oriented academic career, but great if you are planning to join a busy community private-practice where multiple disease sites and heavier volume are the norm.

 

[RadOncDoc21]

Coming from a program that also did this, you 100% nailed it. Probably not the best resident-experience if you are planning a research-oriented academic career, but great if you are planning to join a busy community private-practice where multiple disease sites and heavier volume are the norm.

I can see how this can be a good thing for a more seasoned resident but jumping from various organ systems without a good foundation in one did not help me at all. Especially when both attendings had multiple organ systems on their own. In one day I would see a prostate, lung, breast and base of tongue