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Residency Call Schedule

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Cholinergic

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What is the typical residency call schedule? Thanks in advance.
 

chrisisinnocent

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Most places use a night float system. When not on night float you have to cover weekends so it ends up being roughly Q7 with one golden weekend a month. That seems to be the case most places. Where it gets hairy is when someone gets sick or pregnant then you end up on call more often because of a shortage of bodies.
Some places even have a night float cover system for non ob services too where you have a resident inhouse covering all they gyn and onc patients.
 

Cholinergic

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Thanks! Q7 doesn't sound too bad. . .I thought it would be Q3 or Q4. And I am definitely only interested in programs with night float.
 

pruritis_ani

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I would be very wary of being "only interested in programs with night float". We have tried both, and night float freaking sucked.

As an intern, we were aprox q4 throughout the year. But, as a second and third year, we are q 5-6. That means 5 or 6 calls a month, meaning often 2 golden weekends in a month, and little more than once a week. Additionally, the call is 24 hours on, then you have 24 hours off. So, you get 5 or 6 extra days a month off.

With night float, you worked 14 on then 10 off from Sun-Thur. Which really wore you out, given that you had to adjust to nights on, and sleeping days. Your 2 days off a week really didn't feel like a weekend, as you were typically recovering. Then, when you were not on night float you worked weekends to cover the night floats, which worked out to at least 2 and often 3 weekends a month.

I may be crazy, but I would much rather stay up all night 6 times a month, and still have most of my weekends, and have bonus days off after my call shifts during the week.

Night float sounds wonderful, but what it really does is have you work more days, less hours per day, at least at the smaller programs. So, be careful, and look at what the call schedule is where you are interviewing. Do NOT assume night float is good, as not all night floats are the same. And, consider whether days off or shorter, more frequent shift work are better for you. I think you will find about 60/40 in terms on night float vs traditional call out there.
 

Diane L. Evans

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Sorry to rain on your parade (itchy):

Ok I vote the q 3-4 calls really stink and if you have family forget it you'll never see them you will be pre post or on call. Although 18 weeks of nights split between 3 months (I agree with pruritis_ani (see I actually do agree with you sometimes!)) stinks. Night float does a toll on you-- but the trade off is that you have no call on the week days HAVE A NORMAL SCHEDULE and actually can get off 1 or 2 weekends a month as an intern more as an upper level.

As far as 1 in 7 call I am not sure if any programs do that.

At most night float institutions calls are Fridays/ Sunday (Sunday until 6pm then night float takes over) or all day Saturday 7am-8am Sunday.
 

pruritis_ani

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Sorry to rain on your parade (itchy):

Ok I vote the q 3-4 calls really stink and if you have family forget it you'll never see them you will be pre post or on call. Although 18 weeks of nights split between 3 months (I agree with pruritis_ani (see I actually do agree with you sometimes!)) stinks. Night float does a toll on you-- but the trade off is that you have no call on the week days HAVE A NORMAL SCHEDULE and actually can get off 1 or 2 weekends a month as an intern more as an upper level.

As far as 1 in 7 call I am not sure if any programs do that.

At most night float institutions calls are Fridays/ Sunday (Sunday until 6pm then night float takes over) or all day Saturday 7am-8am Sunday.

Actually, all of our interns get at least one and typically two weekends off per month...without night float. Q 3-4 call is not a picnic, for sure, but it lasts exactly one year. Really only the first 2 months here, then it is more q 4-5. As an upper year it is q 4-6, with q 5-6 being by far the more frequent. As a chief, you are home. Call me crazy, but q 5-6 equals 5 or so calls a month, with maybe one being a weekend. That is a piece of cake, especially since there is no "post call" problem. You go home, take a nap, have the rest of the day free and then get to bed after some family time!

As for the family situation...well, leaving for work at 530pm (when my family gets home and ready for dinner), then coming home at 730am (when my family is going to work) really sucked.

Our hours with night call....rounds at 0600-0630, clinic from 0900-1700, busywork til about 1800, latest. If you are on the floor, you sign out at about 1730. If you are on call, it is 24 hours, followed by 24 hours off. Weekends only if you were on call, which was about once a month.

With night float:
Night float 1730-0730 Sun-Thur
(Night float stays friday for didactics until 1200)
Non night float: Rounds 0630, clinic 0900-1700, busywork til 1800 latest (same as night call)
Rotate weekends...which puts you on at least 2 weekends every month, unless you are on night float.

Your program may have a different night float system, but here those of us with families unanimously hated it, as we could not see our families, and our weekends off sucked because of your sleep cycle.

Again, night floats are not all created equal. And, the nonsense about spending more time with the family is just that...nonsense. My family time is after work and on weekends, and these are the exact hours that night float systems take away from you.

Don't be scared to stay the night in the hospital once in a while if it gives you many more days when you don't have to even come into the hospital.

The point of this lengthy post is to really make sure people look into the reality of the individual schedules, and not say something silly like "night float is better". Night float systems are almost never less hours, they are simply distributed differently. If you have a lot of residents, and don't lose all of your free weekends, it may be a better system. But, night call is not evil, and in many cases it actually is a LOT better in terms of free time away from the hospital. Almost to a person, the people I have worked with and spoken that have done both systems prefer the night call system. There are a few that like the night float as well (funny, though, in my program it is the single residents who want to go out and don't have family to think about). Just truly make up your own mind on a schedule by schedule basis after deciding what time is important for you to have free. It is a mistake to classify programs simply as "night float or regular call", and you may wind up misunderstanding a great schedule.
 

Flea girl

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I have posted before stating how I much I love night float! Every program is a little different in regards how their night float works. At my program interns start Mon -thurs night 6:30pm- 8:00am 2-4 th yrs start 8:30pm -8:00am ish everyone starts at 7 pm on sun. Morning rounds start @ 7am but interns are required to leave by 8am b/c of the 10 hr rule but for the most part we are out of rounds b/t 8- 8:30am,occ we have been done with rounds by 0730. only 3&4 yrs have clinic in fri morning but they only see pt that they personal book into their clinic. I have every weekend off and frankly love it! I feel that I get to see my 2 kids any husband quite a bit on Nights. We have 2 5 week block of nights for the year. Otherwise, we call call roughly every other weekend unless someone is on vacation. We also have a short-call for yrs 2-4 which is why we come in at 8:30pm for night float. Hope this is clear but if anyone have any q's just ask away. Sorry, having done q4 call on SICU as an intern, I would never consider a program without night float! But again, this is what I prefer. Happy New Year to all!
 

OB/GYN RNtoMD

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Oh I had to jump in this conversation. I thought I had to be at a program with night float. Now that I'm actually in it, it does suck. The first week is ok but once again when you have a family and you have to leave in the evenings and sleep all day it once again, sucks. And at our program night float starts Sunday @ 7AM, that's right AM. Now the schedule true is more complicated than Sun all day Mon-thurs nights, which is the case when we are at the main hospital but when we rotate to our county hospital its Sun all day, Mon-Wed nights then Friday AM clinic and didactics in the PM.
 

Flea girl

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I think every program has a little different take on night float, for us we only cover one hospital and are excused from diadiactics(?sp) and other daytime activities. I am usually home by 0830-0900 and in bed by 10 am and wake up b/t 4:30-5:00pm and out the door by 8:10-8:15pm. For me I love it! Five week blocks give me enough time to "flip" myself and I try to mostly keep on the same night schedule when i have the weekends off...Just means I go to bed later and sleep in later but not all day. In all seriousness, everyone has decide what works for them. If this is something important in deciding on a program, then I would ask the residents what they think. I would ask more than 1 person too. At our program, I love nights and one of the other residents in my class absolutely hates it. I think it also depends if you are a night person or not.
 

pruritis_ani

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Again, the point is that it is foolish to go into the interviews thinking that you have to have night float. All night floats are not created equal. People have been so brainwashed to think that you must have night float to have a life, and that is just not so. Call sucks, residency sucks. There is no magic trick that is going to make it better. So, really add up the hours, look at what times you will be free, look at what your weekends are like, all of that.
 

Flea girl

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Again, the point is that it is foolish to go into the interviews thinking that you have to have night float. All night floats are not created equal. People have been so brainwashed to think that you must have night float to have a life, and that is just not so. Call sucks, residency sucks. There is no magic trick that is going to make it better. So, really add up the hours, look at what times you will be free, look at what your weekends are like, all of that.

Could not agree w/ you more about residency sucking, call sucking, and not all night floats are created equal but in my humble opinion, at my program, after experiencing Q4 call on SICU, I would not go to a program without night float. But like I have said, everyone is going to have to decide what works for them. I think the original poster of this thread was just wondering about typical call schedules and look what what is has turned into..I love night float... you hate night float..I hate q 4 call...you do not mind it. Let it be known to all applicants out there trying to figure out what their rank list ... Find what works for you whether it be night float or q4 call. Above all don't be afraid to ask residents at the programs you are interested in ranking how their call/ night float works. Happy New Year to all!!
 

Wednesday

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Need to look into if the program lets you off in am or waits until noon post call to release you. Sounds like Pruitis Ani's program does, but that's not a given. I had night float at my program too, and it was all day Sunday (24hrs) then Mon-Thurs nights (6:30pm-8am) with didactics until 11am on Friday. I found it hard on my family (hard to explain to my 1 year old daughter why I had to leave every night after dinner) but I did see her more in afternoons than I did the other days of the week, since she went to bed early and when I was working during the days I often got home after she was asleep and I always left in the morning before she was awake.

For call schedules considerations, I would look at how many residents are in the program and how many sites you cover, that makes a huge difference in the frequency of call. The other thing to consider is when they sign out. We signed out at 6:30, which means we sometimes didn't get out until 7 or 7:30 (not always, but often), which was rough on the family.
 

pruritis_ani

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Need to look into if the program lets you off in am or waits until noon post call to release you. Sounds like Pruitis Ani's program does, but that's not a given. I had night float at my program too, and it was all day Sunday (24hrs) then Mon-Thurs nights (6:30pm-8am) with didactics until 11am on Friday. I found it hard on my family (hard to explain to my 1 year old daughter why I had to leave every night after dinner) but I did see her more in afternoons than I did the other days of the week, since she went to bed early and when I was working during the days I often got home after she was asleep and I always left in the morning before she was awake.

For call schedules considerations, I would look at how many residents are in the program and how many sites you cover, that makes a huge difference in the frequency of call. The other thing to consider is when they sign out. We signed out at 6:30, which means we sometimes didn't get out until 7 or 7:30 (not always, but often), which was rough on the family.

Strong agreement on the release time. 24 hours of call is an entirely different beast than 30 hours. I would rather do night float than the 30 hour shifts we did my intern year.
 

SippiGirl08

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i think one point that the rest of you guys have slightly glossed over is that with night float, you're not on call for the rest of the year except on weekends. i don't know about you, but i'm willing to suck it up for 5-7 weeks of the year if i don't have to pull any 30 hour shifts on call for the other 45-47. at my program, night float works sun-thurs, 1700-0700, with other residents covering friday night (1700-0700)/sunday morning (0700-1700) or 24 hour saturday call. with seven residents per year, this comes out to about two 24-hour calls per month when not on the night float rotation.


so to the original poster, i think you will see the major differences (and major complaints) by comparing how long each rotation lasts at each institution, how many residents are in the program to split the remaining weekend calls, and time of check-out. 10 weeks of night float is more of a pain than 7 or 5. if i'm not mistaken, pruritus ani is at a program with only three residents, so of course s/he will have many more weekend days on call than someone at a program with 7-10. and lastly, having check-out at 8pm (after dinner with the family) is a very different from check-out at 5pm (you leave for work before your family gets home).
 

pruritis_ani

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i think one point that the rest of you guys have slightly glossed over is that with night float, you're not on call for the rest of the year except on weekends. i don't know about you, but i'm willing to suck it up for 5-7 weeks of the year if i don't have to pull any 30 hour shifts on call for the other 45-47. at my program, night float works sun-thurs, 1700-0700, with other residents covering friday night (1700-0700)/sunday morning (0700-1700) or 24 hour saturday call. with seven residents per year, this comes out to about two 24-hour calls per month when not on the night float rotation.


so to the original poster, i think you will see the major differences (and major complaints) by comparing how long each rotation lasts at each institution, how many residents are in the program to split the remaining weekend calls, and time of check-out. 10 weeks of night float is more of a pain than 7 or 5. if i'm not mistaken, pruritus ani is at a program with only three residents, so of course s/he will have many more weekend days on call than someone at a program with 7-10. and lastly, having check-out at 8pm (after dinner with the family) is a very different from check-out at 5pm (you leave for work before your family gets home).


Not really glossing over the no call thing. Just in my program, you lose half you weekends when you are not on night float. So, you either work every night or every other weekend. Not a great schedule, IMHO.

Truly, with or without night float, you spend the same amount of nights in the hospital. It is simply a matter if you want them all at once, and then to have all your weekends after that, or if you want them mixed up a bit. To me, (at our small program), the night float system took away any chance of having a realistic life. It ruined all my nights and weekends during night float, and then ruind half my weekends when I was off night float. No night float meant a crappy night once a week or so, with a reward of one day off. Every time they hurt me, they gave me a day off. That makes it a no brainer.
 

goodsamob

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I thought I would really love night float for a lot of the reasons noted above. Turns out, I hated night float with a passion. Loved the work, hated the hours. I adjusted ok, but really didn't enjoy never seeing my husband. I am eternally grateful that I had my daughter after I finished night float.

I have experienced both types of call. Night float existed in my 1st and 2nd year, but as a senior (yrs 3 and 4) we take traditional call. For my program this equates to 1 in 8. I really look forward to the days off post call. This is extra time for family and for doing those things you can only do weekdays 9-5.

The point is, you likely won't know what it's really like (and what type of call you will like) until you live it. Just like the rest of residency. So don't write a program off based solely on the type of call. The call system should merely be one of a thousand factors weighing into your decision.
 

Cholinergic

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After looking at programs of FRIEDA, I wanted to know how accurate the section is on the hardest call schedule during each of the PGY years? At some placs, it's q3 for 1-2 months. At other places, it's q3 for 52 weeks all four years! :scared: How is that possible? Can the human body even sustain all that call? The call schedule is probably going to be one of the biggest factors that goes into where I apply and rank.
 

Wednesday

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i think one point that the rest of you guys have slightly glossed over is that with night float, you're not on call for the rest of the year except on weekends.

Too bad those weekends come every week. :D

To the most recent poster: I wouldn't use call schedule as the top thing determining your rank list. It's only four years after all and if the whole place is full of unhappy malignancy, it's not going to matter what the call schedule is, you are going to be miserable. Remember, even on non call days you are there for many, many hours. Just like a lot of people have said, it seems that a lot of people are surprised by what they like and don't like in regards to call schedule.
 

pruritis_ani

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After looking at programs of FRIEDA, I wanted to know how accurate the section is on the hardest call schedule during each of the PGY years? At some placs, it's q3 for 1-2 months. At other places, it's q3 for 52 weeks all four years! :scared: How is that possible? Can the human body even sustain all that call? The call schedule is probably going to be one of the biggest factors that goes into where I apply and rank.


Freida is not to be relied upon. Get the call schedule from your interviews.

Call sucks, sure. But, keep in mind that wherever you work, you will be working 80 hours a week, for the most part. How much call is really just a matter of how each program divides up the hours. There truly is not a magic system that lets us all work less hours....
 

Cholinergic

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Bumping this salient topic now that I'm interviewing and understand a bit more about call schedules. Having worked night shift before in hospitals I still think I would prefer night float for a specified block of time.

I think most of the programs I'm interviewing at have approximately 2 months of night float per year. One program has 4 months during PGY1-PGY3 years. :mad: I think one program may not have night float at all and there are only 3 residents per class.

Just curious how the new interns are doing with their call schedules.
 

whoops00

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I'm in a program that doesn't have night float because there were only 3 residents per class (now they're up to 4).

I personally really like the call schedule that we have. We've worked it out so that all residents, regardless of year (which the seniors kind of hate) take 7-8 calls a month, averaging out to q4. Now that we have 4 residents per class, they're trying to work it out so that when the 4 residents become seniors, we work q6. Regardless, everyone still gets a completely golden weekend for the month (no work Sat/Sun) and at least a half-golden (work Friday night, get Sat/Sun off).

All in all, I think that both ways work. I think night float is nice, depending on the situation. I think taking regular call is nice as well because we get our entire post call day off, which a lot of people use for doing regular, normal life things.
 
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