On Call

he acting chief resident is responsible for developing the call schedule.  Due to the 80 hour work week, the brunt of in house call is covered by the “night float” resident (PGY 2 or 3).  Night float is set up as its own rotation so that the affected resident is free of all other responsibilities.  They are responsible for one 24-hour shift on Sunday as well as four 12-hour shifts (Monday through Thursday) over the course of the week.  Friday and Saturday night call is covered by the remaining PGY 2 or 3 residents.  Night float starts around 4:30pm and ends after conference in the morning.  Due to our “Ortho Call Pager” system, the night float resident is free of all responsibilities once the pager is passed off to a daytime resident.  The length of the “night float” rotation is currently one month.

PGY 4 and 5 residents will be available on a nightly basis as out of house back-up.  While on back-up call, each resident will be available to answer routine questions, evaluate difficult patients, or operate as necessary (typically when two rooms are running simultaneously).  In general, when the back-up is called in, the back-up resident will take over the ED responsibilities of the on-call resident while the on-call resident goes to the operating room.  On rare occasions, an emergent case is felt to be “upper level” in nature.  In these instances, the senior resident will take the junior through the case as time and incoming consults allow. 

Saturday and Sunday morning rounds are the responsibility of the on call residents and their back-up.  On Saturday and Sunday any cases on the schedule by 7:30am will be the responsibility of the ACE resident.  The ACE is solely responsible for the operating room, but, their responsibility expires at 4:00pm.  Any case that is added-on after 7:30am or starts after 4:00pm will be covered by the resident on call or the back-up as necessary.  The general role of the back-up resident is not affected by the ACE in any way. 

Typically, each PGY 2 resident is responsible for 3 months of night float as well as one Saturday call and one ACE weekend each month when they are off night float.  PGY 3 residents are responsible for 1 month of night float each, in addition to one Friday call and one ACE weekend per month while off night float.  PGY 4 and 5 call is all out of house back-up.