Best Psych Call Schedules

[TexPre-Med]

I'm an MS3 and wondering which psych programs have the best call schedule. I know that many people like call because they learn more, but I would prefer to moonlight (get paid) instead of call. Anybody know of programs with a great call schedule? Thanks

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[Doc Samson]

I'm an MS3 and wondering which psych programs have the best call schedule. I know that many people like call because they learn more, but I would prefer to moonlight (get paid) instead of call. Anybody know of programs with a great call schedule? Thanks

Even the most rigorous call-heavy programs taper off by PGY-3 year when you are typically allowed to moonlight.

 

[atsai3]

I'm an MS3 and wondering which psych programs have the best call schedule. I know that many people like call because they learn more, but I would prefer to moonlight (get paid) instead of call. Anybody know of programs with a great call schedule? Thanks

San Mateo. Per the FAQ posted on their Web site,

8) What is the on-call schedule?

We believe that exessive overnight call detracts from the ability of residents to devote full attention to their clinical and didactic experiences during the day and to enhance their education by continually reading on their own. Therefore, at this time our only formal call requirement is that PGY 1 residents take call in our Psychiatric Emergency Services one night each week during their six months of inpatient psychiatry and take one weekend day of call during one month of neurology. PGY 2-4 residents do not take evening or overnight call. As at all residencies, we cannot guarantee that the on-call schedule will not change, but this has been the typical schedule over the recent years at our program.

9) Are residents allowed to moonlight?

Yes. Once licensed, residents may moonlight as long as it does not interfere with their training or violate ACGME work hour restrictions or county policies. Many residents moonlight on weekends in Psychiatric Emergency Services and consider it a useful addition to their clinical training. Any moonlighting is considered work outside the residency, and residents must arrange their own pay and malpractice coverage with the employer of the moonlighting job.
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People talk about how Stanford also has a fairly light call schedule, but as far as I can tell from their Web site, the only distinguishing thing is that there is no call during the PGY-4 year.

Float Call System

Interns are assigned two two-week night float rotations at the Palo Alto VA, each alternating with two weeks vacation. PGY2's are assigned to a single one month rotation at either Stanford or PAVA. PGY3's cover two one-week blocks of float at their choice of location. PGYIVs do not take call or float!!! During this rotation interns/residents only work during the nights (10:00 PM - 8:00 AM) Sunday through Friday. Each morning the person on float reviews that night's activities with the Chief Resident in Morning Rounds. The person on float has Saturday off. There are no day-time duties except for attending Thursday afternoon classes.

Point Call System

PGY1's, 2's and 3's are assigned call based on point call system. Call occurs each week-night (5:00 PM - 10:00 PM) and week-ends (12 hour shifts). Each hour of call is worth roughly 1 point multiplied by your year. Therefore, PGY-1's, when on psychiatry rotations, will do a bit less than three hours of call for every two hours of call by a PGY-2 or one hour of call by a PGY-3. This translates into approximately 40-45 hours of call per MONTH for PGY1's and a bit more than a third of that by PGY3.​

Just as a point of comparison, here are the call schedules for two programs that are typically regarded as being more call-heavy.

University of Washington:

R-1s: 30 equivalents per 6 months
R-2s: 26 equivalents per 6 months
R-3s: 16 equivalents per 6 months
R-4s: 8 equivalents per 6 months

* Equivalents = one weeknight or a 12-hour weekend call is 1 equivalent; 24-hour weekend call is 2 equivalents
​

University of California at San Francisco is also known for being call-heavy (with residents taking call all 4 years, although the 4th year lightens up considerably -- just as with UW, see above), but I could not find the policies spelled out on their Web site.

 

[josehernandez94]

our call schedule at cambridge is pretty light. intern year there's no call for psych or neuro rotations.

pgy-2 and pgy-3, call is approximately q 12-14. opportunities for moonlighting abound and a number of residents do, in fact, moonlight (it's all within the institution as well).

i don't believe there's any call as pgy-4.

 

[masterofmonkeys]

our call schedule at cambridge is pretty light. intern year there's no call for psych or neuro rotations.

pgy-2 and pgy-3, call is approximately q 12-14. opportunities for moonlighting abound and a number of residents do, in fact, moonlight (it's all within the institution as well).

i don't believe there's any call as pgy-4.

Cambridge was the first program I thought of re: light call schedule.

 

[DebDynamite]

Univ of South Carolina SOM/ Palmetto Health

intern year:
Q4 medicine wards X 2 months
state hospital in house call, overnight X's 2 months
pager call with rounding X's 2 months

second- fourth year
approx 3 days in a row of home call (primarily pager) every 4-6 weeks

Also: fellowships, excellent attendings and wide range of pathology.

 

[wolfvgang22]

As I interview for the Match I also find it important to know not only how often you are on call, but how busy that call is, where that call is, are standing PRN orders allowed so you don't get paged for a tylenol at 3am, do you basically belong to IM on medicine months for call or do psych only call, and so forth. One of my favored programs has a med/psych unit, so interns never even have to rotate on regular IM patients. Another program that I really like is less attractive in that residents cover 3 hospitals psych wards at the same time on call night.

 

[whopper]

Repeating what Samson said.

Most programs & states won't let residents moonlight by PGY II or III year, and most programs taper off calls by then anyways.

 

[chameleonknight]

Call at LSU-New Orleans is pretty light and residents moonlight extensively from PGY II and thereafter.

 

[TexPre-Med]

So far: Cambridge, San Mateo, South Carolina, and LSU-New Orleans.

Chameleon: Could you elaborate on your call schedule at LSU?

Any others?

 

[chameleonknight]

NOAH/DePaul: PGY 1, averages to every 7th night

Ochsner: PGY 2, every 9th night

MHERE: Moonlighter (PGY 3 or 4), most people take 4-6 per month (keep in mind this is moonlighting, so you are getting paid!)

PGY 3 and 4 no mandatory call

 

[wolfvgang22]

Also it depends on if you like night float or not, as some programs reduce actual "call" with a night float system.

 

[OldPsychDoc]

Also it depends on if you like night float or not, as some programs reduce actual "call" with a night float system.

Night float done right can be fabulous training, though. You are "The Doctor", but you have phone back up if you need it. You work hard, but you get to go home in the morning and sleep. It was one of the best "seasoning" experiences in my training.

 

[wolfvgang22]

Sorry if I came across as anti-night float, I'm not, in fact I favor it personally, but I recognize that not everyone likes night float.

 

[WnderWmn10]

When you are talking moonlighting, is it moonlighting in psychiatry or general medicine moonlighting. For some reason I thought moonlighting was mostly for medicine and FP residents. ARe there a lot of opportunities to moonlight in psych?

 

[josehernandez94]

When you are talking moonlighting, is it moonlighting in psychiatry or general medicine moonlighting. For some reason I thought moonlighting was mostly for medicine and FP residents. ARe there a lot of opportunities to moonlight in psych?

i'm specifically talking about moonlighting in psychiatry. i'm not sure about opportunities at other programs (well, actually if i remember correctly, a number of brown residents moonlight), but moonlighthing is quite prevalent at my current program. basically, if the on call psych resident gets overwhelmed with consults/admissions etc, they can call in the moonlighter to help them do an admission or consult or what have you.

 

[CarleneM]

(well, actually if i remember correctly, a number of brown residents moonlight)

Yes, just interviewed at Brown and learned they moonlight quite extensively and earlier than most places (first half of PGY2!). One resident said she gets paid by the hour to carry a moonlighting pager and got paged 1-2 times/wk, making more if she has to go in to evaluate a patient. They emphasized there is still an attending supervising them and they are learning a lot while they are moonlighting.

 

[Doc Samson]

Yes, just interviewed at Brown and learned they moonlight quite extensively and earlier than most places (first half of PGY2!). One resident said she gets paid by the hour to carry a moonlighting pager and got paged 1-2 times/wk, making more if she has to go in to evaluate a patient. They emphasized there is still an attending supervising them and they are learning a lot while they are moonlighting.

This runs very close to the ACGME rules on in-house moonlighting. The ACGME stipulates that you can't be paid extra for training experiences (and the having an attending back-up sure makes it sound like a regular call situation). Don't know how they're negotiating this, but I'm not sure how the ACGME would take to it.

 

[Chimed]

Night float done right can be fabulous training, though. You are "The Doctor", but you have phone back up if you need it. You work hard, but you get to go home in the morning and sleep. It was one of the best "seasoning" experiences in my training.

And it's even better now that they've added an attending until 2AM!

 

[CarleneM]

This runs very close to the ACGME rules on in-house moonlighting. The ACGME stipulates that you can't be paid extra for training experiences (and the having an attending back-up sure makes it sound like a regular call situation). Don't know how they're negotiating this, but I'm not sure how the ACGME would take to it.

Interesting. To clarify, they made it sound like the 2 moonlighting sites were not "in-house" and are certainly not an expected part of training. I'm not sure of further details. I think they were half-joking when talking about the continued learning (ie "we are not just moonlighting for $$$"). ...