The on-call schedule for the University and VA Hospitals is decided upon yearly by both residents and faculty members. Call at the VA is always from home, and Night Float at the University is always in-house. Only neurology residents rotate on Night Float at University Hospital. Both neurology and non-neurology residents rotate on call at the VA Hospital.
Throughout the year at the VA, PGY-2 neurology and all non-neurology residents are directly supervised by both senior neurology residents and neurology attendings. At the University, as junior residents gain experience, they are given increasing amounts of autonomy, ultimately with only attending supervision while on-call.
VA On-Call Protocol
Junior Resident (PGY2 Neurology and all off-service residents)
- First call from home.
- Frequency and schedule arranged by senior on VA wards according to UUHC call schedule.
- Weekdays, from 7 a.m. to 7 a.m. (24 hours).
- Generally covers one weekend day at a time, though it can cover both weekend days depending on scheduling needs and preferences.
- Weekend days, from 7 a.m. to 7 a.m. (24 hours).
- Takes all cross-cover, inpatient and ER consults. The junior resident should evaluate patient prior to calling the senior (up to individual senior preference).
- Post-call day is a normal full work day. If the call night is busy, the resident can be assigned a post-call day.
Senior Ward Resident (PGY3 or PGY4)
- Second call from home. First call stroke with off-service residents, though off-service residents should still be present.
- Call hours: 24 hours every day, except when the PGY2 Neurology resident is on call.
- Exception being senior back-up period when the senior is backup for both neurology and off-service residents. Senior backup coverage to be arranged by chief.
- Staff junior and off-service residents by phone. You may use your discretion regarding whether you need to see the patient in person.
- Round with off-service residents on weekend days and neurology juniors during senior backup period. Does not need to round with neurology juniors on weekends after backup period.
- Post-call days are always normal full work days.
University Hospital Short-Call Protocol
- Weekdays: 4 p.m. to 7 p.m. (until nightfloat shift begins).
- Weekends: 7 a.m. to 7 p.m. (until nightfloat shift begins).
- Each junior resident on rotation for University Wards takes, on average, one to two weekdays and one weekend short-call shift per week. Senior residents cover one short-call shift per week.
Responsibilities:
- Admit new patients.
- Consult on ED and inpatient consults as requested.
- Cross-cover for all University ward patients.
- Staff with attending by phone.
- Pass-off patients to the nightfloat resident (new patients and cross-cover issues).
Backup: For the first 12 weeks of the year, senior residents will provide backup assistance to junior residents via Day Float. Please see backup responsibilities below.
University Hospital Night Float Protocol
Nightfloat is on a one to two week rotating schedule.
- Duty hours: 7 p.m. to 7 a.m. every day.
- Day off is Saturday night.
Responsibilities:
- Admit new patients to both University ward and NCCU service.
- Consult on ED and inpatient consults as requested.
- Cross-cover for all university ward and NCCU patients.
- Staff with attending by phone.
- Pass-off patients in the morning to the ward and NCCU teams (new patients and cross-cover issues).
No junior resident will rotate on nightfloat until they have completed six weeks of daytime University ward rotation. These prerequisite six weeks are considered critical to prepare the junior resident for handling night float responsibilities independently. The junior resident will be prepared to independently rotate on night float after this time, staffing directly with attending physicians.
Senior Resident Back-Up
Objective: To provide in-house backup assistance to junior residents on short-call (weekday and weekend) during the initial rotations of the academic year. Senior resident is expected to be in-house for this.
Responsibilities: Initially senior resident is expected to oversee the junior resident with all patient-related issues and encounters. This expectation specifically pertains to the senior resident overseeing the proper evaluation, assessment and formulation of a care plan by the junior resident for each patient. This also pertains to overseeing procedures performed by the junior.
- The junior resident is expected to staff with the attending, input all orders and complete all documentation related to the patient encounter.
- As the junior resident gains more experience, the senior resident may grant more autonomy to the junior resident, with progressively less direct oversight.
- Back-up to be provided by ward seniors and day float resident.
- Weekends — ward seniors decide weekend days off so that there is always a senior available during senior backup. Rounding and pager coverage are to be determined by the ward senior with attendings.
PLEASE NOTE: Call schedule is subject to change.