Overnight call was q 5 in internal medicine, q 4 in peds, q 4 in OB ( for these, the whole team was on call, including all the students). Overnight call was q 4 on general surgery (there were 4 students, 1 stayed per night -with 1 resident per night- and we were allowed to work who stayed when amongst ourselves) and q 2 on trauma surgery (whole team on this schedule). No overnight call on psych or family.
I thought overnight call was fairly valuable. On medicine and surgery, the student often went to the ER first and got the chance to try to evaluate the patient for about 20 min before the resident showed up. We wrote the H&P, and then followed the pts we admitted. Peds usually was a bit busier, so we often went at the same time as the resident, but they would let you try to do all the workup first if you asked. Peds had the busiest call, and that was where I learned to write H&P on the fly (instead of writing stuff down on scrap paper and recopying)... a skill that proved to be very valuable on subsequent rotations. OB call was pretty busy, the students evaluated all patients first, and then presented them to the intern. We wrote the H&P on all pts admitted to L&D. We didn't get to spend much time in the labor hall, but we did get to do deliveries galore. (avg 15 unassisted per student). By the time I got to surgery, I could do H&P pretty quickly, and so I moved on to doing both H&P and sometimes admission orders. I also took initative to help the resident in the truama evaluation area keep track of what pts had their xrays and ct scans done, and who still needed evaluation, etc.
Students/interns here really don't draw blood or start IV's (in fact I was surprised when I did an elective away to learn that is common in some hospitals). I didn' t feel that what we did on call was just scut. I thought it was valuable. No, I didn't learn a lot of academic stuff, but I feel like I'm learning practical skills that will be very useful next year as an intern. And, at an away rotation (the one where interns do draw blood) I was treated as an intern, took intern call schedule, and even was allowed to carry the intern pager a few hours each call night. Yes, I did a lot of scut. I still thought it vaulable becuase I began to learn ways to organize the scut to get it done and get some sleep. The inern I took call with hadn't had a similar experience in school and told me he wished he had.
Plus, helping with some of the scut can produce rich rewards...my school is a procedure mecca for students, but if you don't help with some of the call stuff, you don't get the chance. Currently I'm in an ICU rotation, and I wrote notes on 18 pts (out of 23) on my last shift. I wrote more notes than I was expected to in order to help my resident, because he was running behind as we were slammed. In return, I got to do a bronchcoscopy and a central line (got that on my first stick, too!). Plus, the resident was called to go to the OR for an urgent splenectomy as the chief and fellow were already on another case. He acutally came and found me so that I could come, too. There's another student in the same rotation, but different team, who isn't doing much and the residents say they won't let this individual do anything in the way of lines, etc because of that. I've also gotten to do some small operations, some in the third year rotation and some as a 4th year. That's not something every student gets to do, only the ones who are willing to work hard and help the residents.
While I agree that drawing blood all night long won't help you on an exam, you will refine your skill at doing that..which could pay off nicely if you do your residency somewhere that the intern is expected to do all that. I plan on seeking out opportunites to draw blood and start IV's, though those aren't things that interns/students normally do here, so that I can practice if I wind up at a place where that is the expectation. The way I see it, the more time you can refine you skills as a student, the more efficient you can be as an intern and the more sleep you will get.
I see one more benefit of taking overnight call as a student... you get used to staying up! I can't imagine having my first overnight call be as an intern. It will be scary enough that first call with MD behind my name, being the one actually making the decisions, I don't want to worry about the fatigue of being up. I can do 36 hours without sleep pretty easily now, and I'm very glad to have that experience under my belt.
When I first started rotations, I didn't realize there were schools where students don't take overnight call. Now that I have learned that there are, I'm glad that we do. The experience I have had has been valuable for reasons cited above.
