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 their first night consult shift, as well as two ER consult shifts, supervised with a PGY-4 “buddy” who is present for the entirety of the shift to supervise them and provide guidance and training. 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. The Inpatient Night Float (INF) resident covers all of the inpatient Neurology services, sometimes including some Neuro-ICU patients, from 5:15PM-6:00AM on the weekdays, and from 8PM-7AM on weekends. The Consult Night Float (CNF) resident responds to all consults in the hospital, from 5:30PM-7:00AM on weekdays, and from 8PM-7AM on weekends. Most night float rotations are done in 2 week blocks, with one week as the INF resident and one week as the CNF resident.
The PGY4 residents are not in-house overnight, but the chief-on-call is available from home to discuss consults and admissions with the night-float residents. They 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.