Taking Internal Medicine hospital call as an ENT PGY-1 off service?

[Whodey22]

Hello,

I am trying to get some clarification on something. Currently, I am a PGY-1 rotating through the 6 months of "non-otolaryngology" approved rotations. A few of the rotations do not have built in call schedules for us, so, the internal medicine team is making my co-residents and I take medicine hospital call during these months even though we are surgical residents.

We are trying to figure out if this is allowed by the ACGME or not. The other questionable thing is the new implication that ENT interns do not take "night float" but we are scheduled for night shift IM call?

Is all of this "legal" or within their scope to do so? or is something not right here?

Looking forward to comments. Thanks everyone.

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[Pir8DeacDoc]

Talk to your oto program director. With the new intern year they are in charge of you and where you go from day 1. They may have arranged some sort of weird deal with the IM folks. My first instinct is that sounds crazy.

 

[Whodey22]

Yea it doesn't make any sense. We have actually just spoke to him and he mentioned he's thinking it over and said he needs to look more into it. I have been attempting to do some of the leg work but they are so busy, this has fallen through the cracks a few times already. Were trying to not be a burden to our program too, so its been an interesting balance.

I wondered if someone may know this off the top of their heads or have a resource that outlines the inter-specialty call rules. The most we have found is the "no night float" policy.

 

[Wordead]

Wait so you're not on any medicine rotations but expected to take medicine call? That sounds bizarre and dangerous.

 

[Whodey22]

Yes, that is correct. The only medicine service we will ever be on is ICU in a few months but have been doing this call stuff since July. None of our residents are on a medicine service of any kind.

 

[OtoHNS]

Yes, that is correct. The only medicine service we will ever be on is ICU in a few months but have been doing this call stuff since July. None of our residents are on a medicine service of any kind.

What are your responsibilities while on call for IM? Is this in house or home call? How often?

If you're just cross-covering IM floor patients for acute issues overnight, it's not really that different in principle than cross-covering urology or some other surgical service which is commonplace for surgical interns. I've never heard of any surgical service taking call for medicine though, that is weird.

If you're admitting patients from the ED or seeing consults, that would be especially weird.

If your department wants you to take call, I'm surprised they're not just adding you into the ENT call rotation.

 

[Whodey22]

What are your responsibilities while on call for IM? Is this in house or home call? How often?

If you're just cross-covering IM floor patients for acute issues overnight, it's not really that different in principle than cross-covering urology or some other surgical service which is commonplace for surgical interns. I've never heard of any surgical service taking call for medicine though, that is weird.

If you're admitting patients from the ED or seeing consults, that would be especially weird.

If your department wants you to take call, I'm surprised they're not just adding you into the ENT call rotation.

Thanks for your response. crazy enough, we are not just cross covering IM call for patients with acute issues. We are the primary person for IM call and as you mention admit patients to the IM service from the ED and consults. I agree 100% it is crazy what is happening. These call shifts do not cross cover or have any involvement with surgery. They are 100% medicine patients, and staffing them with medical attendings. Several have even said " why are you on medicine call, when you're an ENT resident"? ........ to which, they receive my dumbfounded look and response of " I dont know'.

You make an excellent point about adding us to our services ENT call now if they really want us to take call. I am going to propose this. As for the number of days, we still have our "non-otolaryngology" approved services outlined by the ACGME but this medicine call typically occurs on the weekend. This month, I'm on medicine call 3 of 4 saturdays with one 24 hr medicine shift.

Any additional comments or thoughts are appreciated.

 

[OtoHNS]

That's really weird, I've never heard of this before. It also sounds like it totally sucks. Hope you can find a way to get out of it, but if not, at least it's only temporary...

 

[Wordead]

True that it's temporary but **** dude, people would actually die if I admitted medicine patients.

 

[JKL22]

Per the ACGME---- This is not permitted

 

[neutropeniaboy]

Very odd requirement.

It's common for surgical interns to cover other surgical (within the department of surgery) specialties. It's even common for some related specialties to hold the pager during inservice exams.

I've never encountered a program that required a surgical intern to take call for a medical (or any other non-surgical) residency or program. It seems highly unusual and potentially very dangerous. I would work with your program director and chair to understand the rationale for doing this. Numerous chains above your chair before filing with ACGME.

 

[Whodey22]

Very odd requirement.

It's common for surgical interns to cover other surgical (within the department of surgery) specialties. It's even common for some related specialties to hold the pager during inservice exams.

I've never encountered a program that required a surgical intern to take call for a medical (or any other non-surgical) residency or program. It seems highly unusual and potentially very dangerous. I would work with your program director and chair to understand the rationale for doing this. Numerous chains above your chair before filing with ACGME.

Thank you for your response. I have been in the process of setting a meeting up with my program director this week . I also anonymously spoke with the Otolaryngology director for the ACGME and she stated this was not permitted. So I will relay that communication to my program director also and hopefully this will be resolved.