Residents Like the Call Program They Are Using
Hannah Kavookjian, MD, is a PGY4 resident at the University of Kansas in Kansas City, which utilizes at-home call.
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February 2020“I don’t think I have missed anything from an educational standpoint [from at-home call],” she said. “As a resident, my goal is to see as many patients and cases as I can. Sometimes there are no calls overnight and other times very interesting ones come through. I don’t miss good operative cases having to sit out a post-call day.”
Dr. Cabrera-Muffly said that there was some concern that at-home call might mean residents miss out on educational opportunities as others cover emergency interventions. One example is transfer of emergency airway management to trauma or other services that are immediately available. But she says her experience suggests this is not much of an issue because the residents have been able to gain experiences over-night while still being able to take part in educational activities during the day.
David Lee, MD,’s experience with call as chief resident at the University of Cincinnati has been a positive. The Cincinnati program has a month of weekday night call in the hospital starting at 5:30 pm. For those four to five weeks, the resident is off during the day.
“We do one month of night float a year for our second, third, and fourth years, so in a three-year span, we spend three months on nights,” he said. “I think people generally feel that their operative skills may be a little ‘rusty’ coming off of nights. But we do get three to four operative cases a week on call.”
In addition, the experience is very challenging, with a heavy workload. Dr. Lee said he believes residents come out of the call rotation more confident in their decision making.
Lessen Burnout?
The ACGME guidelines were also put in place to lessen burnout and address quality of life issues. Some suggest that in-home call is better because residents can go out and do things as long as they realize they may be called in. Others note that in-hospital call means having the next day to attend to personal business, and fewer days on call.
“Home call definitely gives me more flexibility, as I can go home for a bit and structure my evenings to the best of my ability, granted that some emergent problems can arise,” Dr. Kavookjian said. “Even then, you can go in, see a few patients at once, and go home again.”
Dr. Lee finds it is easy to plan around the night float month-long call, especially since it happens only once a year. He knows when he will be responsible for nighttime coverage a few months out, which can help him schedule family outings and activities. In addition, during the month, he knows he will have the entire weekend off.