How often do attendings have to go into the hospital when on-call?

[Cremaster reflex]

Hi,

I am currently applying to DR but am interested in potentially doing IR fellowship and being dual boarded in IR/DR or potentially doing ESIR. Out of curiosity I have been looking at jobs for attendings and is seems most have 12-13 weeks of call/year. I am assuming most of these practices have ~5 IR physicians who are taking call q5 nights (is this accurate?). For these practices, on average how often do you think the attending gets called in at an academic center vs. community place? Thanks

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[irwarrior]

Depends on a number of factors. How many beds and ICU beds in the hospital, how many hospitals you are covering and the services that the hospital covers ie Level 1 trauma, stroke thrombectomy center, transplant etc. The larger more tertiary a facility the more you will have to come in on the nights and weekends. There is an increasing role of IR in the emergent setting and so it has progressively gotten busier on call for many of us.

 

[Tiger100]

To be honest, if you ask this question, probably IR is not for you.

 

[Cremaster reflex]

To be honest, if you ask this question, probably IR is not for you.

I appreciate your reply.

I understand that IR doctors work hard, and that is totally fine with me. But your response doesn't answer my question.

Again, I completely understand the answer to this question is highly variable and depending on a plethora of variables. I guess I am more probing to see if there are jobs out there, and if so how common are they, in which you can do both IR/DR and not have to be coming into the hospital every fourth night (or whatever is the norm for IR).

 

[Tiger100]

I appreciate your reply.

I understand that IR doctors work hard, and that is totally fine with me. But your response doesn't answer my question.

Again, I completely understand the answer to this question is highly variable and depending on a plethora of variables. I guess I am more probing to see if there are jobs out there, and if so how common are they, in which you can do both IR/DR and not have to be coming into the hospital every fourth night (or whatever is the norm for IR).

If you want to do procedures, then you can do them even without IR fellowship.
But if you want to become an IR doctor, your lifestyle won't be good.

I still don't understand yoir question. It is like saying that I want to become a dermatologist but don't want to go to clinic. Call is a part of IR and there is a good chance that you will be paged.

There are very few outpatient IR jobs out there but not the norm. A Typical IR job has call.

 

[Cremaster reflex]

If you want to do procedures, then you can do them even without IR fellowship.
But if you want to become an IR doctor, your lifestyle won't be good.

I still don't understand yoir question. It is like saying that I want to become a dermatologist but don't want to go to clinic. Call is a part of IR and there is a good chance that you will be paged.

There are very few outpatient IR jobs out there but not the norm. A Typical IR job has call.

I appreciate you taking the time to answer this.

My question was how often does the average IR physician has to come into the hospital at night while on call. I understand call is an integral part of IR and that is totally fine with me, I was inquiring about how often, and for how long IR physicians end up coming into the hospital in the middle of the night while on call. For instance, if I was taking call every 5-6 days and getting called in every other call shift (every 10-12 days) I don't think I would mind that but coming in consistently every 4-5 nights for the entirety of the night may be too disruptive for my mental health and well being.]

Others have seemed to understand my question very clearly and have direct messaged me helpful responses without being condescending but again, I do appreciate your time.

 

[IJL]

I appreciate you taking the time to answer this.

My question was how often does the average IR physician has to come into the hospital at night while on call. I understand call is an integral part of IR and that is totally fine with me, I was inquiring about how often, and for how long IR physicians end up coming into the hospital in the middle of the night while on call. For instance, if I was taking call every 5-6 days and getting called in every other call shift (every 10-12 days) I don't think I would mind that but coming in consistently every 4-5 nights for the entirety of the night may be too disruptive for my mental health and well being.]

Others have seemed to understand my question very clearly and have direct messaged me helpful responses without being condescending but again, I do appreciate your time.

Really totally depends on what hospital you’re at. IR at a level 1 trauma center will get called in much more. Otherwise, at smaller, level 2 hospitals where a lot of ppl work, it’s not THAT common to get called in.

 

[CherryRedDracul]

I appreciate you taking the time to answer this.

My question was how often does the average IR physician has to come into the hospital at night while on call. I understand call is an integral part of IR and that is totally fine with me, I was inquiring about how often, and for how long IR physicians end up coming into the hospital in the middle of the night while on call. For instance, if I was taking call every 5-6 days and getting called in every other call shift (every 10-12 days) I don't think I would mind that but coming in consistently every 4-5 nights for the entirety of the night may be too disruptive for my mental health and well being.]

Others have seemed to understand my question very clearly and have direct messaged me helpful responses without being condescending but again, I do appreciate your time.

Depends on your luck.

At our shop, it can get quite busy. I remember one holiday weekend where our IR PD spent much of it in-hospital. He got, at most, 10 hours of sleep out of all 3 days. It was a busy diagnostic call for me, too, so we enjoyed co-ranting.

 

[Cremaster reflex]

At our shop, it can get quite busy. I remember one holiday weekend where our IR PD spent much of it in-hospital. He got, at most, 10 hours of sleep out of all 3 days. It was a busy diagnostic call for me, too, so we enjoyed co-ranting.

Thank you so much. Sounds like there is considerable variability depending on what setting you work in which is what I was hoping to hear. I appreciate everyone's time and insight

 

[Dave1980]

Depends on your luck.

At our shop, it can get quite busy. I remember one holiday weekend where our IR PD spent much of it in-hospital. He got, at most, 10 hours of sleep out of all 3 days. It was a busy diagnostic call for me, too, so we enjoyed co-ranting.

Totally off topic but why do you call your institution/department/group a "shop"? I hear that occasionally and have always found it slightly off-putting for a reason I can't quite put my finger on.

 

[CherryRedDracul]

Totally off topic but why do you call your institution/department/group a "shop"? I hear that occasionally and have always found it slightly off-putting for a reason I can't quite put my finger on.

To be quite honest, I never use that terminology either until that post. I hear it mostly from critical care people, and I agree it is slightly off-putting.

I think the only reason I even said that was because it is slightly off-putting.

 

[Dave1980]

To be quite honest, I never use that terminology either until that post. I hear it mostly from critical care people, and I agree it is slightly off-putting.

I think the only reason I even said that was because it is slightly off-putting.

lol I like your style!

 

[Smoking Jay Cutler]

Some jobs you don't get called in most nights or weekend days that you're on call.
Other jobs you expect to be called at night and have multiple cases per weekend day that you will try and cluster into a sequential group, but it's not always possible.

Higher end clinical IR in a busy tertiary center with level 1 trauma, transplant, and involvement with aorta and PAD will be busy.
Hybrid IR/DR practice where you might do 50% IR will generally do less complex IR and is more likely to staff community hospitals where complex patients are routed to the tertiary hospital.

There are plenty of in between situations.

Thank you for your question.

 

[Derv]

So I am on call this weekend as a resident for IR. We handle all consults, inpatient rounds, primary patients (had 3 this weekend), and are expected to scrub into as many procedures as possible. We take call at home during the night as well. I was in house till about 9pm Friday, 14 hours Saturday, and about 10 hours Sunday. Think we ended up doing like 6 cases Saturday and 4 Sunday. This was my lightest IR weekend ever. Last year I had one long weekend where the attending and I were up for about 36 hours straight before he sent me home, and he continued with cases. This is at a level 1 trauma, transplant, and cancer academic hospital.

 

[IJL]

So I am on call this weekend as a resident for IR. We handle all consults, inpatient rounds, primary patients (had 3 this weekend), and are expected to scrub into as many procedures as possible. We take call at home during the night as well. I was in house till about 9pm Friday, 14 hours Saturday, and about 10 hours Sunday. Think we ended up doing like 6 cases Saturday and 4 Sunday. This was my lightest IR weekend ever. Last year I had one long weekend where the attending and I were up for about 36 hours straight before he sent me home, and he continued with cases. This is at a level 1 trauma, transplant, and cancer academic hospital.

Exactly what kind of cases are you doing over the weekend?

At most places, academic centers included, you don’t routinely work like that.

 

[irwarrior]

Level 1 trauma centers, transplant centers and the more number of beds (particularly ICU beds) a hospital has the more busy the after hours and weekends will be for the interventional services. Also, comprehensive stroke centers and stroke thrombectomy centers are becoming busier as peripheral IR are helping cover these at some facilities. Depending on how frequent the IR team has to come in, the groups will have to make sure they have adequate number of physicians to enable sustainable coverage including potentially evening shifts and weekend coverages. The goal would be to grow the elective service lines (pain, veins, fibroids, pad, oncology, prostates) as much as feasible to increase the number of interventional physicians in each group and potentially decrease frequency of call.