Bumping an old thread with updates from my program. Good news, I think maybe our new schedule will work, and we'll overall do less call than people did before.
Big changes for us:
- no longer doing admissions on the VA side from the ED. The ED attendings will decide who to admit. We'll enter orders. Still consulting, though, so the question is if they'll consult us on everyone. Or just admit everyone until we're full.
Positives from this, though -- I think we were overburdened in our call duties by covering two different hospitals with only 12 residents doing all the call. Offloading some burdens is a win. Downside, we're losing our one site where we make decisions about admissions, so that will have to be considered somewhere.
- Night float will cover both the university and the VA. See above about the VA changes that will make this flexible. All 2nd years do 6 to 7 weeks of nightfloat (5 nights/12 hour shifts). With above changes, hopefully doable.
- streamlining of work flow for weekends/overnight. Based on night float covering so much, the NF resident will be encouraged to be brief with admits. Developmental history can wait for the morning.
- Based on night float taking over VA coverage, no more overnight weekday call. In the past, residents averaged q5 call when on VA services (3 months of first year, 4.5 months of 2nd year)
- call shifts will be weekday 3 hour short calls from 5 pm to 8 pm, overnight Friday, 24 hour Saturday and 12 hour 8 am to 8 pm on Sundays/holidays.
- interns will cover almost all the short calls and the 12 hour Sunday shifts
- 2nd years will do NF and most of the weekend calls, which works out to working about 2 out of 4 weekends (one Saturday and one Friday). 2nd years will also do backup calls for a few Sundays at the start of each rotation. 2nd years will also be in the call pool for the whole year. Up until now, our 3 months at the state hospital in 2nd year were call free.
- 3rd years average out to about 1 overnight call/six weeks (I think).
- attendings will be inhouse with interns for their first several shorts calls
- adding an inhouse all day attending at our university site. In the past, the attendings on the university side did supervised in the morning and saw their own clinic patients in the afternoon.
So overall, lots of changes, and maybe a pretty miserable night float experience. Less overnight call, though, and 3rd and 4th years are still kept largely out of the primary call pool. Downsides/upsides -- interns get less early autonomy and more direct supervision. Wards might be busier, too, since NF will be doing a less thorough admission than previously. I got to say, though, my call schedule doesn't look too bad, so I think I'm OK with it.
How about everyone else? Things working out OK or are 2nd years still getting screwed elsewhere?