Night float vs overnight call.

[Voxel]

What are your thoughts on the pros and cons of overnight call vs nightfloat for a residency program? What's the lowest number of residents (per program or per year) that makes this possible without an overkill in the number of weeks of night float?

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[Voxel]

Any thoughts about being on night float (for radiology) the same time of the year and missing exposure to "seasonal" findings or related trauma?

 

[bat21]

I have seen both systems and was screwed by both. I started my training when we rotated calls. Although our program had 11 residents a year, we rotated through four hospitals and not counting AFIP. At two of the hospitals the on call junior resident stays in house. And a senior resident is back up and does interventional work. The first years don't take call until the last six months of their first year. The last years don't take call the last six months to study for Board. That leaves a small pool of residents to take call, so it comes out to every fourth or so. Being on call for a 1000 bed hospital with a level 1 Trauma Center is tough. Although we got the next day off, after rounding with the ER radiology attending and correcting reports and tidying up loose ends, it was often past noon. With this system, I missed all the conferences and work every fourth day.

We switched to the night float system my third year. Senior level residents must take two rotations of night float duty while a junior level covers the regular ER radiology rotation. The sleep cycle isn't screwed and you get the calls out of the way. With this system, the third year residents bear the brunt of after hour work. I didn't enjoy getting screwed as a junior level resident in the beginning of my training, and having paid my dues, getting screwed again as a senior level.

But given the choice between the two systems, I favor the night float.

 

[volvulus]

what are the hours per week like as a junior resident and a senior resident?

 

[bat21]

In my program, we had didactic lectures at 7 am Mon/Wed/Fri and 5 pm Tue/Thu where all the residents not on call must attend. Every hospital where we rotated had noon conferences which can be hot seats when the residents get grilled. Each subspecialty may have their own conferences and there were also physics lectures during certain times of the year. There were also monthly meetings at the city wide radiological society and visiting professors. The first years also had core lecture series.

Radiology training, unlike other specialties, does not have a lot of hierarchy. In large enough programs, the rotations are split into organ systems or by modalities such as Chest, GI, GU, Neuro, Pedi, Nuclear, US, CT, MRI, IR etc. Mostly only one resident was assigned to each monthly rotation. Each resident would eventually have rotated through each section several times, building on what had been learned. A junior level resident may have taken a rotation that a more senior level resident has not taken. In this way, the hours of the residents are very similar. The difference was what rotation that they are assigned to. IR hours are longer because the patients had to be worked and followed.