Covering the ER during didactics

[Quimby2]

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Just curious how other EM programs deal with their didactics. At our program (King/Drew), during scheduled didactics the residents are not excused from any portion of their ER shift. At other programs I have rotated through, attendings cover the floor during lecture (not possible at our program, but that is an entirely different post).

Thanks for the input!

 

[Sheerstress]

I think most programs allow the residents to attend conference while attendings cover the ED. A few old school programs make the residents go back to the ED to work if they are late for conference.

 

[DrQuinn]

Most programs it is "protected time." Our program has 5 hours of Grand Rounds on Wednesday, 7a-12p... if you are in the ED that month, your shifts automatically end at 10p on Tuesday, so you get a full night's rest for the next day. Attendings cover the ED during Tuesday night and Wednesday morning.

Q

 

[Seaglass]

In fact I believe that according to the RRC residents are required to be released to be able to attend. I may be wrong about that

 

[southerndoc]

In fact I believe that according to the RRC residents are required to be released to be able to attend. I may be wrong about that

We are usually released, but there are occasional shifts that are scheduled to start at 11am. Those are not excused, and the resident must leave at 11 to staff the ED (and miss 3 hours of lecture). It's a gripe I have about the program.

Also, here recently, I've been scheduled with a couple Tue-Wed overnight shifts. I've been excused from lecture, but I feel like I'm missing out. I end up attending anyway and usually I'm exhausted Wednesday night. You know what though? I'm still attending lecture when that happens again.

 

[PhantomShadow]

It is absolutely an RRC requirement that residents be excused for conference. It is obligatory that didiactic time be available to ALL residents without repercussion. In fact, the RRC would cite this program and suggest probation if this cam to light.

 

[bulgethetwine]

It is absolutely an RRC requirement that residents be excused for conference. It is obligatory that didiactic time be available to ALL residents without repercussion. In fact, the RRC would cite this program and suggest probation if this cam to light.

I was also under the impression that it is a violation if your program doesn't release you... at our program, every resident is released with the exception of one rotation during the three year residency including off-service rotations.

The ED is covered by attendings and whatever off-service rotators we have that month (IM, anesthesia, etc.)

 

[southerndoc]

It is absolutely an RRC requirement that residents be excused for conference. It is obligatory that didiactic time be available to ALL residents without repercussion. In fact, the RRC would cite this program and suggest probation if this cam to light.

Who knows, we might have been cited for it. We just went through the review process. Haven't heard what the results were, other than we received full accreditation again. Haven't heard of any citations (yet).

 

[GeneralVeers]

It is absolutely an RRC requirement that residents be excused for conference. It is obligatory that didiactic time be available to ALL residents without repercussion. In fact, the RRC would cite this program and suggest probation if this cam to light.

RRC requirements don't mean too much at King/Drew. The people who run the academic portion of the program are more concerned with getting us to sign in even while working in the ED, regardless of whether or not we actually attended lecture.

 

[Jeff698]

Our conferences are all protected time. Each Thursday from 11a to 4p. We get protected time even on off-service months. I'm on medicine now and it's my one weekly break.

We will, however, get scheduled overnight prior to the conference. In that case, we are not expected to attend. Actually, we're told not to if it would otherwise get us into work hours trouble.

Take care,
Jeff

 

[GeneralVeers]

Our conferences are all protected time. Each Thursday from 11a to 4p. We get protected time even on off-service months. I'm on medicine now and it's my one weekly break.

We will, however, get scheduled overnight prior to the conference. In that case, we are not expected to attend. Actually, we're told not to if it would otherwise get us into work hours trouble.

Take care,
Jeff

After overnight ED shifts, or off-service overnight call we are told to come to lecture regardless. In theory we are allowed to leave conference early, at 10:30. That may be fine in theory, but sucks if you have to come back in at 7 PM that night for a shift.

Our program has become extremely punitive when it comes to conference. Numerous residents have been docked a day's pay when they miss conference.

 

[roja]

protected. covered by attendings and pa's

 

[Seaglass]

Our conference enforcement is really very generous. You have to maintain greater than 70% attendance which is tracked by the chiefs. If you are below you may not moonlight or do other fun things. There are more than the required number of hours of conference so it is easy to keep your numbers up. Generally we have very good compliance.

 

[anonymousEM]

the rrc requirement is that everyone needs to attend 70% of conferences. Thus your program doesn't have to protect your time as long as you're able to make 70%. RRC also states that conference is not part of the max 12 consecutive hours. It can be added on after a shift but then your time off doesn't start until the time you leave conference. IE if you worked 7p-7a you could go to conf from 7-12n but then couldn't be asked to work again until midnight or later. That being said it is up to the residency if they want to enfore a more strict attendence requirement. UF protects conference for residents in the ED and several off service rotations but the ICU rotations we don't go to our conferences.

 

[Quimby2]

From the ACGME EM program requirements(http://www.acgme.org/acWebsite/RRC_110/110_prIndex.asp[/url])
Bold type included by me:

"E. Planned Educational Experiences
...2. The program should ensure that residents are relieved of clinical duties to attend these planned educational experiences. Although release from some off-service rotations may not be possible, the program should require that residents participate, on average, in at least 70% of the planned emergency medicine educational experiences offered (excluding vacations). Attendance should be monitored and documented."

It sounds like the ACGME considers release from OFF service rotations , on occasion, to be understandably prohibitive; however, conference time should be protected when on-service.

On an additional note, we are required to attend the first few hours of conference even if we are between 2 night 7p-7a shifts (plus one hour of group rounding after). Uggg!!! Therefore, of course we do not have 12 hours off between 12-hour shifts.Those sneaky little #$^@$^#s!!! (please excuse my expression of frustration there).

 

[Seaglass]

Thanks for the quote. I'm not an RRC reviewer but I think that "Should" is a bit different than "must." It seems that relief from the ED is recommended but maybe not necessarily required.

 

[GeneralVeers]

Thanks for the quote. I'm not an RRC reviewer but I think that "Should" is a bit different than "must." It seems that relief from the ED is recommended but maybe not necessarily required.

It seems to me that the language is intended to be unambigous. If something isn't a requirement of a program, then it should not be included in the official guidelines.

 

[Seaglass]

I can see how that makes sense. I think I need to shrink my avatar.

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[southerndoc]

I can see how that makes sense. I think I need to shrink my avatar.

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Ha, I love the space intentionally left blank comment.

OK, back to the thread (attempt hijacking is over)...