Child fellowship with no call

[Aardvark01]

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I opened a new account to post this as I feel a bit lazy/embarrassed to ask this question! Does anyone know if there is a child fellowship with no call or basically really easy call? I'm too burned out to think about doing 2 more years of call and I need to enjoy life. I have looked into various programs but so far all have call. I really don't trust them when they say something like "fellows typically are called in once per week" as I figure they are probably making it seem a bit easier than it is in reality.

 

[rtennis18]

I interviewed at many of the child psychiatry programs on the East coast and California this past fall. The only program I came across that had no call was the Harvard/Cambridge Health Alliance program. They rotate through the Psych ER as one of their 1st year rotations, so I guess that is their substitute.

There are programs that pay you for taking the call such as the Yale Child Study Center program in New Haven, since you may have to go into the unit at night for seclusions.

 

[Aardvark01]

Thank you very much for your helpful reply. Anyone else?

 

[Chimed]

Thank you very much for your helpful reply. Anyone else?

I can't answer your question directly as I only looked at a few programs for child. Sorry to state the obvious, but you really just need to contact the programs directly to find out what their call is. I don't think you're going to get much info on this forum as there are only a few people in child here and most of us have probably stayed close to or within our adult program.

In general, however, most programs are not going to have that much call; so I wouldn't get too excited about it. Where I am we do 2 6PM to 10PM shift in our psych ER per month during the first year and 1 of those shift per month in our second year. It's pretty benign, and I would guess most places are like that.

 

[Technotronic]

🙂

 

[OldPsychDoc]

I can't answer your question directly as I only looked at a few programs for child. Sorry to state the obvious, but you really just need to contact the programs directly to find out what their call is. I don't think you're going to get much info on this forum as there are only a few people in child here and most of us have probably stayed close to or within our adult program.

In general, however, most programs are not going to have that much call; so I wouldn't get too excited about it. Where I am we do 2 6PM to 10PM shift in our psych ER per month during the first year and 1 of those shift per month in our second year. It's pretty benign, and I would guess most places are like that.

Yeah I remember coming on for night float there at 10pm, and almost getting run over by the child fellows signing out their initial assessments to me so they could beat it home... 🙄
Benign for them, maybe! 😉

 

[ssrnh]

I would check Maine Med 🙂

 

[Chimed]

Yeah I remember coming on for night float there at 10pm, and almost getting run over by the child fellows signing out their initial assessments to me so they could beat it home... 🙄
Benign for them, maybe! 😉

LOL...Well, we can't break work hour rules (must be out of hospital over 12 hours between shifts), now can we? 😉

BTW, since you've been there, the child cases have easily doubled. 😱

 

[OldPsychDoc]

LOL...Well, we can't break work hour rules (must be out of hospital over 12 hours between shifts), now can we? 😉

BTW, since you've been there, the child cases have easily doubled. 😱

Those were the days before work rules...

I can believe your volume's up...a FB friend who works PES occasionally made the remark that there were no child beds to be had anywhere in the entire state.

 

[billypilgrim37]

Those were the days before work rules...

I can believe your volume's up...a FB friend who works PES occasionally made the remark that there were no child beds to be had anywhere in the entire state.

You guys could use some more volume! I remember my month on the child floor, with two attendings, two child fellows, a pgy4, a pgy2, and an m4... to cover 14 beds!

(And since it was near the Halloween mass-discharge, there was a single day where there were more MDs on the floor than patients...)

Ah, those were the days, the halcyon days...

 

[Chimed]

You guys could use some more volume! I remember my month on the child floor, with two attendings, two child fellows, a pgy4, a pgy2, and an m4... to cover 14 beds!

(And since it was near the Halloween mass-discharge, there was a single day where there were more MDs on the floor than patients...)

Ah, those were the days, the halcyon days...

Easy there. I'm sensing some envy. 😉
1) This is not always the case as we typically don't have that many fellows and/or residents. I usually averaged 5 patients.
2) You could have stayed! 😛

 

[billypilgrim37]

Will move this to PM, lest the world continue to suffer our playful pokes 😀

 

[alina_s]

I did some research into call burden in 2009; I don't know of any programs that don't have call at all, but they do vary WILDLY about the nature of call. Actually, Hopkins may have stopped call or stopped working in the ER at night. Frequency doesn't matter nearly so much as the quality of call and what happens the day after. Ask lots of questions about what happens with admissions on the call shift- do you have to do the insurance authorization in the middle of the night (potential to be vastly more time consuming than the rest of the admission)? Is there a social worker on duty to help arrange alternatives to admission and deal with insurance? And how are admissions handled in the day time; is there potential that the work on the inpatient unit that isn't finished on day shift will become your problem at night? What are the ER staff's attitudes towards psych and are they going to call you with CC: "psych patient?" It also matters a lot whether the fellowship is on the same site as the general residency; if they share sites, odds are good that general psych residents will handle most of the call burden and fellows really will be specialty consultants for child cases, but call has potential to be a lot heavier if you're at a separate children's hospital.

 

[Aardvark01]

Thank you everyone for the helpful feedback!

Alina_s do you remember, in a general sense at least, which programs seemed to have friendlier call? Or those that had horrendous call?

 

[beezley]

Check out UW Madison. Call is only from July-December and it is only from home consulting with the PG2 who is actually doing all the work (seeing the patient in the ER, calling for placement, etc.). Pretty cake call. There is an opening for July 2011.

 

[alina_s]

Check out UW Madison. Call is only from July-December and it is only from home consulting with the PG2 who is actually doing all the work (seeing the patient in the ER, calling for placement, etc.). Pretty cake call. There is an opening for July 2011.

This is exactly what I meant about the quality, not the quantity of call mattering. I went to UW and call was very hard core my first year, but we made lots of changes in the second year and worked really hard to get some buy-in from the ER and general administration. I've been gone for nearly a year now. When we surveyed programs, we divided a up a list and I can't remember a lot of specific details, except that our program at the time was one of the most intense. University of Cincinnati was similar to UW and had the same problem, that child fellows covered psych issues in a separate children's ER and didn't get help from the general residents. UC had better social work support than we did at the time, though. I was impressed with the program director from Hopkins, who I think had withdrawn the fellows from the ER. At UW, we got a lot of push back from the ER staff when we were trying to appropriately delegate, and I expect that would happen most places. University of New Mexico had greater call frequency than UW, but they share a psych ER with the general residents and there was a protocol about the number to total patients and number of child patients in the ER before the fellows had to come in, and it seemed like it was quite rare for fellows to come in.