What are pros/cons to daily admissions without call for residency?

[Please_Stand_By]

I've noticed a select handful of programs not follow the traditional long call days with admission for med rotations. Is this generally a pro? Possibly more intense days but shorter hours? Well-received?

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[whoknows2012]

I've noticed a select handful of programs not follow the traditional long call days with admission for med rotations. Is this generally a pro? Possibly more intense days but shorter hours? Well-received?

My program has something similar (no "call"). There are short days until 5 and long days until 8, alternating, with either Saturday or Sunday off. Admissions any day whether you're on a short day or long day. Your co residents and co interns are very forgiving though and usually the person on a short day won't admit after 1-2pm. The big pro is that no one day is necessarily particularly bad, and there is no guarantee a long day will be worse than a short day (although more likely to get admissions given that you're there for an extra 3 hours). The big con is that there are no golden wknds and after a bad day you may only have a single short day before you're on again until 8. Some people would call this q2 call but that's a little disingenuous given the general definition of a "call day."

Personally this worked out really nicely for me but there are people in my program who'd prefer another system. Not sure one is better than the other each have their strengths and weaknesses.

 

[ShuperNewbie]

My program has pretty consistent days from 7-6pm regardless of long/short. Came from a program with traditional q4 call. I like this system better. I can make plans with friends without worrying too much about call holding me back. I was just long call today. Got out at 6:30 instead of 6pm . Tough day.

 

[portal2]

My school had "drip admissions." Now I am on call q4-q5. I like call days better. If you get a few quick admits, you'll be cruising for a few days if you can discharge them quickly. I like signing out at noon so I prefer this.

 

[Lccjblu]

I went to a Med school with drip system and am at a program now with call days. For me, I hated the drip system we would always get buzzer beaters and we ended up staying an hour past sign out, then another 30min to track down the night float residents who were busy running around doing admissions. Furthermore, we were persistently capped.

With the call system now, sure call days are busy, but on your pre and post call days your census can get down to single digits so rounds are fast and you have lots of time in the afternoon to catch up on reading and teaching. As an added plus at my program the precall days are half days.

 

[Please_Stand_By]

I went to a Med school with drip system and am at a program now with call days. For me, I hated the drip system we would always get buzzer beaters and we ended up staying an hour past sign out, then another 30min to track down the night float residents who were busy running around doing admissions. Furthermore, we were persistently capped.

With the call system now, sure call days are busy, but on your pre and post call days your census can get down to single digits so rounds are fast and you have lots of time in the afternoon to catch up on reading and teaching. As an added plus at my program the precall days are half days.

Were there any benefits though?

 

[gutonc]

Were there any benefits though?

Generally fewer admissions at any one time.

 

[Please_Stand_By]

Generally fewer admissions at any one time.

Hypothetically does that mean your admission cases could be more educationally beneficial? Some places I've interviewed at don't screen through the hospitalist which cases go on the teaching service so in theory you could be getting 3+ straight AMS or chest pain. Perhaps with daily admission your selected patients will have more unique presentations?

 

[whoknows2012]

Hypothetically does that mean your admission cases could be more educationally beneficial? Some places I've interviewed at don't screen through the hospitalist which cases go on the teaching service so in theory you could be getting 3+ straight AMS or chest pain. Perhaps with daily admission your selected patients will have more unique presentations?

Not necessarily. It may have more educational value for a different reason though. If you only get 1-2 admissions if that per day then you have more time per case to learn. As people have stated above, some find it beneficial to have one really bad day and 3 really easy days. I see the benefit of both systems.

 

[gutonc]

Not necessarily. It may have more educational value for a different reason though. If you only get 1-2 admissions if that per day then you have more time per case to learn. As people have stated above, some find it beneficial to have one really bad day and 3 really easy days. I see the benefit of both systems.

What he said. If the program doesn't have a non-teaching service, or admissions are distributed at random, it doesn't matter whether you get 2 or 8 admissions. But if you're only getting 1 or 2 a day, you'll definitely have more time to think about the ones you do get while babysitting your other placement rocks.