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Where Residents Spend Their Time (Month/Year)

  Medicine Wards MICU CCU Electives / Specialty Consults ER Night Float

PGY1

5

1

0

4.5

1

0.5

PGY2

3

1

1

6.5

0

0.5

PGY3

2

1

0

8.5

0

0.5

 

Inpatient Service Structure

For our inpatient Staff Medicine services, each team consists of an upper level resident, two interns, an attending and one to two medical students. In addition, there is typically a staff pharmacist and/or pharmacy resident that rounds with each medicine team daily.

Our inpatient services are all generalist admitting teams which provides outstanding case-mix diversity. All inpatient ward teams are led by an experienced clinician educator attending who is dedicated to resident teaching and mentorship.

Our residents are not scheduled for any continuity clinic sessions during their inpatient-based months. Furthermore, we believe that our inpatient call cycle and hybrid nightfloat schedule create an optimal environment for learning while maximizing patient safety, continuity of care and resident satisfaction. 


Team Structure

Name of Service
No. of Residents
No. of Interns
No. of Medical Students

General Medicine

1

2

1-2

CCU

3

0

0-1

MICU

3-4

2-4

1-2

ER/Clinics

0

1-2

Varies

 

For our inpatient General Medicine services, our five (5) day call cycle works as follows:

Short Call
  • Monday through Friday, 7 a.m. to 3 p.m.
  • Cap of four (4) new admissions for two interns, i.e., max two (2) admissions per intern
  • The upper-level resident and both interns on the team are present for short call
Rounding Day
  • The morning is spent rounding on the team’s inpatients
  • The team has no admitting duties
  • The afternoon is reserved for completing inpatient duties, teaching, and/or study time
  • One of the house staff may have the day off
Long Call
  • Long call Part A: [admitting done by one of the two interns on the inpatient team and the team upper-level resident]
    • Daily, 7 a.m. to 7 p.m.
    • Cap of five (5) new admissions
  • Long call Part B: [admitting done by the other of the two interns on the inpatient team and the "night float" admitting resident – both arrive at 7 p.m.]
    • Daily, 7 p.m. to 7 a.m.
    • Cap of five (5) new admissions
Post Call
  • Entire team meets at 7 a.m. to discuss the overnight admissions
  • Afterward, the overnight intern and night float resident leave by ~9 a.m.
  • The other intern and the team resident will round with the attending and complete patient care throughout the day
Rounding Day
  • The morning is spent rounding on the team’s inpatients
  • The team has no admitting duties
  • The afternoon is reserved for completing inpatient duties, teaching, and/or study time
  • One of the house staff may have the day off

 

Intern Night Float

  • All “cross-coverage” of patients is done by a separate night float intern from 5 p.m. to 7 a.m.
  • The night float intern does not admit patients but solely handles cross-cover issues and assists with codes
  • On average, CMC internal medicine categorical interns will have two 2-week blocks (Sunday through Thursday) plus an additional two weekends of this night float "cross-coverage" in the first year
  • Preliminary interns are not scheduled for a night float rotation but are scheduled for approximately 4 weekends / year of night float duties

Resident Night Float

  • On average, upper level residents will have two weeks (Sunday through Thursday; 7 p.m. to 8 a.m.) plus an additional two weekends of night float responsibilities per year
  • The night float rotation during the PGY-2 and 3 years consists mainly of supervising/assisting an intern as he/she admits patients from the emergency department
  • The night float resident also sees overnight medicine consults and serves as the team leader in code situations

         IM Resident Call Schedule            Call schedule           IM Resident Call Schedule 2

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