Hi everyone:
When I was a trainee, creating the schedule was easy. We had fewer residents, 36-hour call, only one specialty service (oncology), and no clinic blocks. For most of three years it was floors, ICU, emergency room, and a sprinkling of electives.
These days, our schedule has to accommodate the unique needs of multiple residencies and tracks: Traditional, YPC, Med-Peds, General Preliminary, Neurology Preliminary, Ophthalmology Preliminary, Anesthesiology, Psychiatry, OB-GYN, Emergency Medicine, Interventional Radiology, and PM&R. We have to staff multiple specialty services: Oncology, Duffy, Klatskin, Donaldson, Peters, Whitman, Yale Hospital Medicine, Goodyer, Cardiology Blue, Cooney, SLA Floors, DEFINE-HM, VA Hospitalist Intern, SDU, MICU, CICU, and multiple VA Floors. In the YNHH MICU we have team assignments, float positions, and a MARS role. PGY3s have capstone rotations: Whitman, VA MICU, Yale Hospital Medicine, and MICU MARS, while categorical interns have required rotations: VA Selectives, Cooney, and DEFINE-HM. We need to sort categorical trainees into color blocks, and we have to coordinate off-service rotations with Neurology, Ophthalmology, Anesthesiology, Psychiatry, and Surgery. Finally, we have to ensure we have enough residents on backup each block to cover illnesses and family emergencies.
We aim to meet residents’ preferences for specialty rotations while ensuring everyone can experience every specialty at least once during their three years of training. Because non-categorical interns don’t have ambulatory blocks, we need to distribute electives and vacations strategically to prevent exhaustion. We have to distribute nights fairly and prioritize vacation requests. And for residents applying to fellowship, we have to schedule non-backup rotations during interview season.
Someday, artificial intelligence will do this work for us, but for now we’ll rely on the brilliant human intelligence of our Rising Chiefs. We’ll try our best to release the schedules by mid-May. Until then, please join me in supporting and thanking the Rising Chiefs as they step up to this challenge.
Enjoy your Sunday, everyone. I’m thinking of heading to Hammonasset Beach to read and watch the waves.
Mark
P.S. What I’m reading:
- That Distant Land (Wendell Berry)
- The World: A Family History of Humanity (Simon Sebag Montefiore)
- The Graves Are Walking: The Great Famine and the Saga of the Irish People (John Kelly)
- The Quiet Magic of Middle Managers (David Brooks)
P.P.S. One last shot of totality, taken from a baseball field in Ayer’s Cliff, QC: