on call again?

i am back... continuing the day in the life of a resident with photos of my outfit splattered throughout this post used as a "page break".

for part I, head here... I talked about my big program and what short and long calls mean and changes in the work-hour/week limit that occurred while I was in the middle of my training.

Next, I will outline the different resident roles when "on-call"where I trained.

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Here's the call structure.

There is a SENIOR-IN-HOUSE. This is an upper level resident who are post-graduate 2 all the way to 5. There are peds residents who signed up for the 5 year plan like the Triple board residents and Pediatrics/Emergency residents. {I signed up for the 5 year plan too as a Child Neuro resident.}

Next is SENIOR ASSIST. Like the term implies, this is an upper level resident who backs up the senior-in-house. "When I was a resident," the senior assist was the back-up for Heme/Onc. Heme-onc patients are on the sickest in the hospitals (besides those at the Peds ICU). I have had to call my senior assist twice when i was taking call for Heme Onc as an intern.

The other peds upper level who were on-call were at the ICU. We have two ICUs in our hospital. we called them PICUNorth and PICU South (they have changed their names now). PICUNorth admits were of general PICU cases. PICUSouth patients are the CV Surgery pts and  some general Peds ICU patients.

Besides Peds upper levels taking call at the Peds ICU, we also had Emergency medicine residents and Med/Peds residents who were part of the call pool. Peds ICU training is part of their training curriculum.


For the intern call structure, we used a color system to designate roles.
"when I was a resident," we had a GOLD intern, SILVER intern and PLATINUM intern.

You'd want to BE the platinum intern because cross coverage was not too bad for those interns... plus they are "back-up" interns doing admissions.

Gold interns covered: Developmental Pediatrics,  Cardiology, Metabolism and Genetics
Silver interns covered: Hospitalist, Infectious Disease, Pulmonary
Platinum interns covered:  Renal, Endocrinology

{I don't remember who covered Gastroenterology}

If a resident is on-service for a specific specialty,she will cross cover her own team and also the rest of the patients in that color grouping.

Heme onc interns covered just Heme-onc patients.
NICU residents just covered NICU patients.

{but as I have heard, the roles have been changed for the color groupings}

Neurology and surgical subspecialties were not included in the Peds call pool. Those specialties had their own coverage and resident call pool.

There's also residents in the "jeopardy call list". That's where the back-up residents are chosen from when a resident is sick, etc and a need /call night/ day-time coverage has to be filled. These residents in the "jeopardy call list" are usually on their electives or outpatient months or research months.

We had a sort of "graded" call system.
I was "q4" meaning every 4th night I was on call as an intern. My friend SP and I were the "lucky ones" (I'd remember this FOREVER!) but we would be the "lucky" ones to get 9 calls in one month! That was when the rotations were based on calendar months rather than 4 week blocks. My training program has now adopted the 4-week block. Therefore length of experience is similar with different rotations or subspecialties.

As I became a second year in peds, my calls went to "q5" meaning every 5th day I was on call for busy services -- which means peds Hospitalist, Peds ICU. The rest of the services were as great as q6 (every 6th night!).

ok.. I am stopping there for now. It's getting boring. You might find this interesting if you are thinking of going into medicine or looking into different pediatric residency programs.

For my other readers, this might be a total snoozefest! sorry!

stay tuned for more....
thanks for reading!

Linking up with SarahDorandaMorgan, LeanneElizabeth, Elena,  Madeline,  Jaymie,  SydneyDanielleGrace, Brooke.

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