In-hospital Call

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.

Neurology residents take in-house call at Yale-New Haven Hospital as well as the VA Medical Center. Residents also take "short-call" from 4pm-8pm at Yale, Monday thru Friday. Our program was an early adopter of the night-float system, and for that reason the number of overnight calls each resident has each month is greatly reduced.

In order for new residents to become familiar with on-call responsibilities, and to be comfortable with managing neurologic emergencies, the first two months of the year have traditional call schedules, without nightfloat. The sudden transition from internship to neurology can be challenging, and for that reason the first five calls are personally supervised in-house by senior neurology residents, so that this transition is as smooth as possible. During the first two months, call is from 4:00 PM to 8:00 AM on weekdays, and 8:00 AM to 8:00 AM on weekends and holidays.

In September, when nightfloat begins, residents in the call pool (PGY2s and PGY3s) cover Yale Saturdays from 8:00 AM to 8:00 PM as well as Sundays during the day from 8:00 AM to 8:00 PM . As VA call is much lighter than Yale, a nightfloat system has not implemented there, and there is resident call there 7 days per week. Short Call at Yale is from 4:00 PM-8:00 PM, Monday thru Friday. The evening hours for this short call resident overlap the hours of the night float resident and the ED resident, so that during the busy evening hours they are able to help each other distribute the often heavy workload.

Residents on call at Yale are responsible for covering the inpatients on the neurology ward and NICU, consults and admissions in the adult ED, consults in the pediatric ED, and consults on all the adult and pediatric non-neurology services in the hospital. The on-call resident also covers the answering service for the Department of Neurology.

Residents on call at the VA are responsible for adult ED consults and admissions, as well as all floor consults.

All consults and admissions are discussed with the senior resident on call. The senior 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.

On average, PGY2 and PGY3 residents take one full call, and one short-call per week, with 1-2 weekends off per month. This number will vary depending on the number of residents in the call pool.


Last modified: August 2006





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