New IM programs with no night call ever

[dggopal]

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Got interviewed at 2 progs with no night call at all and was wondering if the esteemed people of SDN had any opinions on if and how it may affect training?

 

[meliora27]

When you say "not night call at all" does that mean there is no Qx call schedule, or no night float, or just that there is never any housestaff overnight in the hospital?

What field was this?

 

[dggopal]

They said we may have a long call up until 10 PM, but will sign over to the hospitalist team after that, and go home. They have told us that we will never spend a night at the hospital during residency.

The program director justifies this by saying that they would rather have us rested and fresh for the next day, than hang around waiting for something to happen. Both the programs are internal medicine, community based, and university affiliated.

 

[rokshana]

i learned the most on night float....think you are missing something without that experience.

 

[NotAProgDirector]

It depends. Working lots of nights is just painful. Working some nights may be helpful for your education. The most important thing you learn at night is independence -- how to trust your own instincts and skills. There's less people around at night, so you get to call the shots more often. That situation can be created during the day also, but it can be difficult.

Another thing to think about is what you plan to do afterwards. If you plan a career in outpatient GIM, no one will care if you've done no nights. But if you want to get a nocturnist job, people may wonder. Or if a regular hospitalist position includes nights. Or if you want to be a Cardiology/GI fellow. Etc.

And remember that these programs have no required nights. If you get to your PGY-3 and you're interested in HM, I'm sure you could arrange some night rotation work. So it could be the best of both worlds -- nights if you want them, and only days if you don't.

 

[Law2Doc]

I would go a bit further than aPD in terms if the value of nights. you don't just learn independence. You learn "to be a doctor" when you are there by yourself, calling all the shots. the hardest thing in medicine isn't having the knowledge base, the procedural skillsets. Everybody can master those over time. It's being able to make good decisions, often without perfect information, when you are the guy where the buck stops. The most value you get during intern year is being alone with the pager, putting out fires. You learn to make good decisions. You gain confidence. You experience being in charge. Before that you are a student. After a year of that you are a doctor. You still have things to learn, but that the real value you need to come out if residency with. I don't think you ever can duplicate this during the day. too many people around. Nurses are never going to call the intern if a senior they trust more is in the building. Patients not sundowning and trying to die on you. Not being woken in the middle of the night to run and fix a crashing patient.etc. So no, if you want the skills necessary to be a good doctor, don't choose a Program with no nights. That doesn't mean you have to be Masochistic and choose the worst call schedule possible, but you'll actully go further looking at these things as a learning opportunity rather than lifestyle impediments.

Of course if we are talking about TY where you just want to get through to do your advanced residency in something else, then sure, pick the cushiest schedule you can find.

 

[dggopal]

Appreciate the prompt response from everyone... I had my own reservations when I heard these things from the programs but thought perhaps someone may expose benefits of no nights that I may have overlooked. Guess I was right....

 

[Siggy]

Was one of these programs in Florida near Tampa? I interviewed at a new IM program and what we were told was that our first year there would be no nights, but once the teaching teams get fully established with seniors, then we would be doing nights.

 

[dggopal]

nope... I think its as APD suggested and these programs just want emphasis on training future private practitioners rather than hospitalists....

 

[colbgw02]

or there's is something wrong with the programs and this is their way of attracting applicants, sort of like the programs that have an unusually high salary. i obviously don't know this to be true, but i am skeptical of their motivations based on the information provided.

 

[dggopal]

well these are both new programs and both are university affiliated and everything else about the program seems great... One of the program directors is very well respected and has been directing for a long time.... I dunno....

 

[colbgw02]

yeah, i mean, i don't want to discredit a program about which i know nothing. i would just keep a skeptical, or maybe even cynical, approach whenever something is unusual. why, exactly, are these program structured the way they are? is it really because of the reasons they're espousing? or because they're trying to sell themselves? could totally be the fomer, but be aware of the latter.