Shifts with Residents in Academics?

[KarlPilkington]

For those of you in academics, how often are you working with residents? Do any of you have a significant portion of your clinical hours working shifts at your institution where you don't supervise residents?

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[Daiphon]

Our department has a resident on at all times; but sometimes just an intern.

Only exception is conference day - protected time for residents = released from clinical duties.

I only work nights, so never have an uncover shift but at night only 1 pgy2/3 after midnight. Depending on volume & quality of the resident these sometimes feel like 2 shifts - my solo patients & my teaching patients.

-d

 

[dotcb]

Full-time academic job at a county hospital w/ EM residency. I work without any trainees ~ 20% of the time. It's good & bad. I prefer teaching, but working independently can be fun and prevents me from becoming a total gomer attending.

 

[Hair Police]

I work in a "community" affiliate of a large medical center with multiple residency programs. We have a resident about 30-50% of the time. Teaching is fun, but as a new attending, I rather prefer the other doc take the resident (we're double-coverage), mainly because I want more experience on my own.

The Mecca down the street has 2 residents, 2 interns, and 2 academic attendings on at all times.

 

[DocEspana]

I'm on the other side of the line, but our acedmic center has three attendings splitting the day (so double coverage most of the day) and a solo coverage night attending. But every day shift is 2 residents and 2 interns (except Wednesday day. No residents/interns) and every night shift is 1-2 residents and 2 interns.

I'd say our attendings have pretty good resident support (or dead weight. Opinions on residents could vary)

Edit: we work at another facility which is part of our academic center, but has a more "non-teaching" ER. Major major academic center, but in a month they will have 2 non-ER interns doing 15 or so shifts each and one of our residents doing 20 shifts. There are probably 120 shifts needing coverage (60 shifts and two sides) and only 50 of them have any resident coverage and its mostly IM interns. So experience at academic centers can vary even at major academic centers.

 

[xaelia]

Excepting resident conference days, 100% of my shifts have enough resident + mid-level coverage that I could coast by never seeing patients on my own. On a minority of shifts, where the coverage talent is poor, or the department is overburdened, I'll see a few unexciting non-educational cases on the side for the purposes of throughput – but it's usually not necessary.

 

[Mighty Mouse]

I am full time at a level 1 trauma center in Detroit, 100,000 annual patient census. 50 residents in our program (have combined programs too). My main department is essentially completely resident driven. There are some attendings who do not pick up a chart, ever. Residents pick up charts, get the workup going, and staff with the attending who then sees the patient. I personally like to pick up charts, and will do so in our lower acuity areas to help flow and prevent the resident(s) from drowning. In the high acuity area I rarely do. We do have a few shifts during peak volume times where the attending staff works independently to off load some of the charts. I also moonlight at our satellites where I fly solo. I find the combination to be nice. Staffing residents is a whole different kind of challenge -- making sure the department is flowing, making sure details aren't missed, and of course, teaching. As soon as you start picking up your own charts, it becomes very difficult to supervise too.

I also like the opportunity to pick up on my own, either in our main trauma center or at the satellites. I'm 4 years out of residency. I still have the hustle in me. I like doing things on my own sometimes without having to discuss with a resident why our workup plans or disposition plans are different. I think this gives me the best of both worlds, keeps me fresh, and honestly, I feel no fears about burnout.

 

[Birdstrike]

I am full time at a level 1 trauma center in Detroit, 100,000 annual patient census. 50 residents in our program (have combined programs too). My main department is essentially completely resident driven. There are some attendings who do not pick up a chart, ever. Residents pick up charts, get the workup going, and staff with the attending who then sees the patient. I personally like to pick up charts, and will do so in our lower acuity areas to help flow and prevent the resident(s) from drowning. In the high acuity area I rarely do. We do have a few shifts during peak volume times where the attending staff works independently to off load some of the charts. I also moonlight at our satellites where I fly solo. I find the combination to be nice. Staffing residents is a whole different kind of challenge -- making sure the department is flowing, making sure details aren't missed, and of course, teaching. As soon as you start picking up your own charts, it becomes very difficult to supervise too.

I also like the opportunity to pick up on my own, either in our main trauma center or at the satellites. I'm 4 years out of residency. I still have the hustle in me. I like doing things on my own sometimes without having to discuss with a resident why our workup plans or disposition plans are different. I think this gives me the best of both worlds, keeps me fresh, and honestly, I feel no fears about burnout.

The Mighty D-Town: Not for ----ies.

 

[GoBuckeyes913]

I am full time at a level 1 trauma center in Detroit, 100,000 annual patient census. 50 residents in our program (have combined programs too). My main department is essentially completely resident driven. There are some attendings who do not pick up a chart, ever. Residents pick up charts, get the workup going, and staff with the attending who then sees the patient. I personally like to pick up charts, and will do so in our lower acuity areas to help flow and prevent the resident(s) from drowning. In the high acuity area I rarely do. We do have a few shifts during peak volume times where the attending staff works independently to off load some of the charts. I also moonlight at our satellites where I fly solo. I find the combination to be nice. Staffing residents is a whole different kind of challenge -- making sure the department is flowing, making sure details aren't missed, and of course, teaching. As soon as you start picking up your own charts, it becomes very difficult to supervise too.

I also like the opportunity to pick up on my own, either in our main trauma center or at the satellites. I'm 4 years out of residency. I still have the hustle in me. I like doing things on my own sometimes without having to discuss with a resident why our workup plans or disposition plans are different. I think this gives me the best of both worlds, keeps me fresh, and honestly, I feel no fears about burnout.

Literally same exact scenario here, different city. We have 3 community free standing satellite EDs that my group covers. At 2 of them there is resident coverage from noon-10p when they are doing their "community ED" month. I work nights, so when I'm out there it's mostly just me aside from a few hrs with a resident. I think it's a good mix right now, and it's a nice break to be alone sometimes. Our mothership is solely resident powered. It's so true what you said about difficult to pick up your own charts ...when you get 8 patients presented to you in 10 minutes. I try to pick up a few quickies to keeps the rooms flowing but sometimes that even gets tricky!