On-Call Schedules
On-call schedules are circulated on a monthly basis. All vacation and scheduling
requests are submitted in writing prior to the first of the month preceding the
scheduled request, (e.g., if a resident has a vacation request for September, this
request must be submitted before August 1st). Every attempt is made to comply with
vacation requests, but approval is not guaranteed, particularly during the months of
December and June. Any changes in the on-call schedule must be approved by the
Internal Medicine Department.
All residents are required to have one 24-hour period each week without patient care
responsibility. Therefore, weekend cross-coverage is shared between ward senior
residents, ICU senior residents, and ward and ICU/CCU interns.
Senior On-Call Schedule
Weekend on-call assignments for are divided among the senior residents who are on
electives; the ward and ICU/CCU senior residents share in this weekend call.
Medical Ward Intern On-Call Schedule
Each ward team comprise of one resident and two interns along with acting interns
and medical students. Each team is on long-call every 3rd day and accept admissions
form 7 am to 6 pm on weekdays,while on weekends admitting team is on call for 24
hours (8 am - 8 am) .Each new patient is evaluated by senior resident on call along
with one of the two interns on call. New admissions (up to 10) are distributed equally
between 2 interns. Any overflow patients admitted during the night before by night
float team are distributed to team not on call.
CCU/ICU Intern On-Call Schedule
Each intern is on call for 24 hours (7 am - 7 am) every fourth day . When
post-call, the intern is responsible for attending teaching round and
completing work rounds on his/her patients. The intern is then able to check out with
their team senior resident and the intern on-call for the team that day, after which time
he/she is free to leave the hospital. Patient care responsibility should be targeted to
end at 11:00 AM so that the post-call intern can leave no later than noontime.
Night Float
This year we have introduced night float system during wards rotation for the interns
as well during weekdays. Each night float team comprise of one resident (PGY-2 or 3)
and one intern . Night float team takes call from 6pm-7am ,Monday through Friday.
Intern does one week of night float in one month (when on elective) and on average
each intern does 3 weeks of night float rotation through out the year. Residents have
night float rotation for both wards and ICU and they do night float in 2 weeks block
(while off during weekends). Each resident ,on average, does 3 blocks of night float
rotation.
Jeopardy Policy
Patient care responsibilities must be covered at all times. Therefore, if a resident is
sick he/she must notify the Department of Medicine office as soon as possible so that
the resident on jeopardy call can be notified. At night and on weekends, the admitting
medical resident is notified, and he/she contacts the resident on jeopardy call. All
jeopardy calls must be paid back with a comparable call at the convenience of the
jeopardy resident.
When on jeopardy call, a resident must be reachable by pager at all times and be
available to relieve the ill resident on a timely basis. Responsibility for the sick intern's
patients is delegated to the intern’s team members by the team senior resident until
the jeopardy resident can get to the hospital. If possible, the team senior resident
assists in this coverage. It is imperative that those covering the sick intern's patients
remain in contact with the patient's attending physician(s).
Admissions
At the request of an attending physician, an admission to be covered by the internal
medicine residents is evaluated by a senior medical resident as well as an intern. The
senior resident is required to evaluate the patient, write a concise admitting note,
immediately write any urgent orders or those necessary to expedite the patient’s
transfer to a bed (if in the ED), and notify the intern of the admission. Following the
intern's history and physical examination, the senior resident reviews the differential
diagnoses and proposed treatment plan for the patient. The senior resident then
reviews the intern's notes and orders and ensure that the attending physician is
notified of the patient's condition as promptly as possible. In general, this process
should take no longer than 90 minutes.
After being notified of an admission, it is the intern's responsibility to complete the
orders and have them on the chart promptly, and to notify the attending physician
promptly of the therapeutic plan of action as well as of any significant changes in the
patient's status. The intern's admission history and physical is expected to be
thorough and include a review of the patient's past medical charts if available.
All direct admissions and requests for medical consults are discussed directly by the
attending physician with the senior resident on call to assure the appropriateness of
resident coverage and to ensure an optimal learning experience.
Only those attending physicians who play an active role in the teaching program and
are approved by the program director are eligible for resident coverage.
On-Call Limits
1. An intern is not assigned more than five patients requiring extensive workup plus
two patients requiring limited workup (e.g., most observation patients and some
consults), for a maximum total of seven patients in a 24-hour period.
2. After the limits have been reached, the senior resident in charge assesses each
patient and personally work out a disposition with the attending physician. Options
are as follows:
3. First year residents will not be assigned more than eight new patients in a 48-hour
period. Second and third year residents will manage no more than sixteen new
patients in a 48-hour period.
4. A first year resident is not be responsible for the ongoing care of more than twelve
patients at one time. A senior resident is not responsible for more than twenty-four
patients at one time. [This excludes cross-coverage patients.]
5. Team leaders should distribute assignment of admissions to interns in such a way
as to meet this requirement. If the above limits are exceeded for any reason, this
should be reported to the program director or associate program director or chief
resident immediately.
requests are submitted in writing prior to the first of the month preceding the
scheduled request, (e.g., if a resident has a vacation request for September, this
request must be submitted before August 1st). Every attempt is made to comply with
vacation requests, but approval is not guaranteed, particularly during the months of
December and June. Any changes in the on-call schedule must be approved by the
Internal Medicine Department.
All residents are required to have one 24-hour period each week without patient care
responsibility. Therefore, weekend cross-coverage is shared between ward senior
residents, ICU senior residents, and ward and ICU/CCU interns.
Senior On-Call Schedule
Weekend on-call assignments for are divided among the senior residents who are on
electives; the ward and ICU/CCU senior residents share in this weekend call.
Medical Ward Intern On-Call Schedule
Each ward team comprise of one resident and two interns along with acting interns
and medical students. Each team is on long-call every 3rd day and accept admissions
form 7 am to 6 pm on weekdays,while on weekends admitting team is on call for 24
hours (8 am - 8 am) .Each new patient is evaluated by senior resident on call along
with one of the two interns on call. New admissions (up to 10) are distributed equally
between 2 interns. Any overflow patients admitted during the night before by night
float team are distributed to team not on call.
CCU/ICU Intern On-Call Schedule
Each intern is on call for 24 hours (7 am - 7 am) every fourth day . When
post-call, the intern is responsible for attending teaching round and
completing work rounds on his/her patients. The intern is then able to check out with
their team senior resident and the intern on-call for the team that day, after which time
he/she is free to leave the hospital. Patient care responsibility should be targeted to
end at 11:00 AM so that the post-call intern can leave no later than noontime.
Night Float
This year we have introduced night float system during wards rotation for the interns
as well during weekdays. Each night float team comprise of one resident (PGY-2 or 3)
and one intern . Night float team takes call from 6pm-7am ,Monday through Friday.
Intern does one week of night float in one month (when on elective) and on average
each intern does 3 weeks of night float rotation through out the year. Residents have
night float rotation for both wards and ICU and they do night float in 2 weeks block
(while off during weekends). Each resident ,on average, does 3 blocks of night float
rotation.
Jeopardy Policy
Patient care responsibilities must be covered at all times. Therefore, if a resident is
sick he/she must notify the Department of Medicine office as soon as possible so that
the resident on jeopardy call can be notified. At night and on weekends, the admitting
medical resident is notified, and he/she contacts the resident on jeopardy call. All
jeopardy calls must be paid back with a comparable call at the convenience of the
jeopardy resident.
When on jeopardy call, a resident must be reachable by pager at all times and be
available to relieve the ill resident on a timely basis. Responsibility for the sick intern's
patients is delegated to the intern’s team members by the team senior resident until
the jeopardy resident can get to the hospital. If possible, the team senior resident
assists in this coverage. It is imperative that those covering the sick intern's patients
remain in contact with the patient's attending physician(s).
Admissions
At the request of an attending physician, an admission to be covered by the internal
medicine residents is evaluated by a senior medical resident as well as an intern. The
senior resident is required to evaluate the patient, write a concise admitting note,
immediately write any urgent orders or those necessary to expedite the patient’s
transfer to a bed (if in the ED), and notify the intern of the admission. Following the
intern's history and physical examination, the senior resident reviews the differential
diagnoses and proposed treatment plan for the patient. The senior resident then
reviews the intern's notes and orders and ensure that the attending physician is
notified of the patient's condition as promptly as possible. In general, this process
should take no longer than 90 minutes.
After being notified of an admission, it is the intern's responsibility to complete the
orders and have them on the chart promptly, and to notify the attending physician
promptly of the therapeutic plan of action as well as of any significant changes in the
patient's status. The intern's admission history and physical is expected to be
thorough and include a review of the patient's past medical charts if available.
All direct admissions and requests for medical consults are discussed directly by the
attending physician with the senior resident on call to assure the appropriateness of
resident coverage and to ensure an optimal learning experience.
Only those attending physicians who play an active role in the teaching program and
are approved by the program director are eligible for resident coverage.
On-Call Limits
1. An intern is not assigned more than five patients requiring extensive workup plus
two patients requiring limited workup (e.g., most observation patients and some
consults), for a maximum total of seven patients in a 24-hour period.
2. After the limits have been reached, the senior resident in charge assesses each
patient and personally work out a disposition with the attending physician. Options
are as follows:
- Follow the patient through the night. This may bring the senior resident’s
workload to ten patients. Patients not covered by interns overnight are turned
over to a ward team senior resident prior to morning report.
- Turn the management of a patient beyond the tenth patient over to the other
senior resident in-house. This senior may also manage up to ten new patients
on a shift. Again, those patients not covered by an intern at night are turned
over to a ward team senior resident prior to morning report.
- Consult with the attending physician on the initial orders and then turn all
responsibility for further care of the patient over to the attending physician,
making sure that he/she knows that the house physician can be called for a
history and physical examination and/or any problems or further orders.
3. First year residents will not be assigned more than eight new patients in a 48-hour
period. Second and third year residents will manage no more than sixteen new
patients in a 48-hour period.
4. A first year resident is not be responsible for the ongoing care of more than twelve
patients at one time. A senior resident is not responsible for more than twenty-four
patients at one time. [This excludes cross-coverage patients.]
5. Team leaders should distribute assignment of admissions to interns in such a way
as to meet this requirement. If the above limits are exceeded for any reason, this
should be reported to the program director or associate program director or chief
resident immediately.
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