Call schedule?

[abefromann]

Hi,

Besides intern year, what is the typical call schedule like for Neuro residencies? Is it comparable to a primary care field, or less call like PMR? I will be doing my 4th year clerkship soon but would like some input earlier if possible.

Thank y'all

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[typhoonegator]

I can tell you what I did, but I think there is a fair amount of variability from program to program, particularly as some programs have a traditional call schedule and others have nightfloat.

I was q4 call for about 10 months of my PGY-2 year. When on neurosurgery, it was q2/q3. A two week period was call free. Vacation was call free. PGY-3 and 4 are significantly better.

 

[islander]

There is tremendous call variability among programs. At the worst end of the spectrum, some are short call q3 for much of PGY-2 and 3 (short call w/ nightfloat, meaning you're at the hospital admitting late every 3rd day w/o even having a post-call day), while some are q7 overnight w/ the post-call day off. Night float programs are generally a bad deal for the residents - they're sold as lifestyle friendly (ie, "no overnights!") but at a busy hospital you'll be there so late the night is shot anyway and you'll never have the joy of a post-call day off...

 

[Yoyomama88]

So is it possible than that a neurology residency can have an equally bad call schedule as being a neurosurgical resident? Or as a generalization is the call experienced as a neurosurgical resident > neurology resident?

 

[Thama]

Most residencies are either nightfloat or q4 overnight call. A few are more like q5 or q6. This often is different between wards and consults at the same institution. It's a matter of preference at this point- I've seen NF schedules that are incredibly sweet for everyone involved, and ones that are awful, and vice-versa for q4. In general inpatient neurology is similar to inpatient internal medicine from a workflow and schedule perpective.

I've never seen a neurology schedule that compares to a neurosurgery schedule in terms of hours. The average PGY-2/PGY-3 neuro resident that I've asked about hours tends to quote in the 60-70 hour range as an average, with a week pushing or exceeding 80 being pretty uncommon. The neurosurg residents I know would chuckle at the mention of working only 88 hours (many NS residencies have authorization to do that).

 

[NRC Advisors Program]

Varies by institution, the range usually q3-5. My particular program was q3 in the ICU and q5 on the floor. Night float was a separate rotation. Also consider how busy the call is, in addition to frequency, when evaluating potential pain.

 

[oopsy]

Hi,

Besides intern year, what is the typical call schedule like for Neuro residencies? Is it comparable to a primary care field, or less call like PMR? I will be doing my 4th year clerkship soon but would like some input earlier if possible.

Thank y'all

From interviewing, I've gathered that there are a certain number of inpatient months on a variety of services mandated by the ACGME to graduate residency. Different programs split them up different ways, and more "front-loaded" programs hammer you in PGY2 (ie 10 months, q4), and then you live a much more reasonable life PGY3-4, with residents taking 1 to 2 overnight calls a month PGY3 and none PGY4. Less "front-loaded" programs spread the call burden over all 3 neurology years and structure the program differently, although in general, PGY2 seems to be the most demanding neurology year regardless. There are advantages to both systems, but there are plenty of programs that do and don't front-load.

So is it possible than that a neurology residency can have an equally bad call schedule as being a neurosurgical resident? Or as a generalization is the call experienced as a neurosurgical resident > neurology resident?

Based on my limited experience as a sub-intern on both the neurosurgery and neurology services, I agree with Thama above: there is no comparison between the call schedules. They are by no means comparable. Call can be absurd for both, but is almost always so for the surgeons. Also, there are no outpatient months to break up the grind. It's OR, floor, and neuro-ICU. Repeat.

 

[neuro_nandri]

Could someone post a list of their school and if they have q4 vs night float? This would be extremely helpful for applications! Thank you!

 

[kchan99]

My program was front-loaded, and I was glad that I went to a front-loaded program. It was easier for me to do research in a front-loaded program because I had more time in the last half of residency for finishing research. Please keep in mind that for in some programs, senior residents have home call but in busier programs, senior call can be in-house. I've had both home call and in-house call.

 

[deathmerchant]

the other factor to keep in mind is , some programs have 1 person on call , some have 2. The former is obviously more difficult. Also depends on the workload. I mean , if u are doing even q3-4(long) call in a place where u can get 4-5 hrs of sleep at night, that might be better than q5 in a place with no chance of sleep. My program used to be like the latter, but it was mostly front loaded and after PG3 you barely do few inpatient months and rare calls. Its now changed to even calls(q7-8) in pg2 and pg3, with rare calls in pg4. I personally think night float makes everyone work more, but obviously in super busy places u might not have other options.

 

[deathmerchant]

Most residencies are either nightfloat or q4 overnight call. A few are more like q5 or q6. This often is different between wards and consults at the same institution. It's a matter of preference at this point- I've seen NF schedules that are incredibly sweet for everyone involved, and ones that are awful, and vice-versa for q4. In general inpatient neurology is similar to inpatient internal medicine from a workflow and schedule perpective.

I've never seen a neurology schedule that compares to a neurosurgery schedule in terms of hours. The average PGY-2/PGY-3 neuro resident that I've asked about hours tends to quote in the 60-70 hour range as an average, with a week pushing or exceeding 80 being pretty uncommon. The neurosurg residents I know would chuckle at the mention of working only 88 hours (many NS residencies have authorization to do that).

Our program's PG2 hrs were far more than average NES hrs, like mentioned above, esp on stroke months. Although Neuro residents do get other elective and outpatient months which are not even half of what NES does, and it calms down fast as u go up. NES also have bad hrs pretty much 1st 3-4 yrs and relatively more all through their career.