In-hospital call is a valuable experience in the professional development of resident physicians, and is one mechanism for placing the resident in a position of increased responsibility for patients. On-call duty in the hospital is one of the requirements of the ACGME for an accredited neurology residency. Our program was an early adopter of the night-float system, and as of July 2017, there are no in-house 24 hour call shifts. There is a home call system at the VA.
Supervised Call Shifts
Each new PGY-2 resident will have at least 3 supervised call shifts in July and August, during which they are paired one-on-one with a PGY-4 resident or fellow. During these shifts, new residents learn the hospital system, participate in stroke codes, and develop their consultation skills, so that they will be better prepared to take overnight calls later in the year.
There are 2 night-float residents at YNHH. There is a dedicated resident that covers all of the inpatient Neurology services, including the Neuro-ICU, at 5:30PM on the weekdays. The second night-float resident responds to all consults in the hospital. The resident arrives at 7:30PM on the weekdays and Sunday and receives sign-out from the Second Consult Resident (evaluated all inpatient and pediatric consults on Weekdays) and the Emergency Room Consult Resident (evaluates all consults and stroke codes in the adult ER). The three consult residents help each other distribute the sometimes heavy workload during the busy evening hours.
During the first-half of the year PG2s are assigned to the Inpatient Night-Float block and PG3s the Consult Night-Float block. During the second-half of the year the responsibilities are switched and the PGY2s discuss all consults with the in-house PGY3 resident. For more information about the night-float system please refer to Description of Rotations.
On the weekends, there are 3 separate call shifts: Saturday 8 AM to 8 PM, Saturday 8 PM to Sunday 8 AM, and Sunday 8 AM to 8 PM. There are 2 residents on-call at Yale on the weekends and they cover the inpatient neurology services (ward and NICU), all inpatient adult and pediatric consults, and consults in the Emergency Rooms (adult and pediatrics). These shifts are part of the Consult, Swing and Stroke Service Rotations: residents on these services work 6 days per week, including one weekend 12-hour shift.
The PGY4 residents are not in-house after the first five calls of the year, but are expected to come to the hospital to assist the junior residents when the workload is heavy or when patients are seen whose care is difficult for the senior resident to supervise from home. All discharges from the ED, as well as all ICU admissions must also be discussed with the on-call attending.