Inpatient Service Structure
When on a general medicine team, the team assignment consists of an upper level resident, two interns, an attending and one to two medical students. All residents have continuity clinics, including preliminary year interns.
For our inpatient General Medicine services, our five (5) day call cycle works as follows:
- Short Call:
- Monday-Friday, 7 a.m. – 1:30 p.m.
- Cap of six (6) new admissions for two interns, i.e., max three (3) admissions per intern
- The upper level resident and both interns on the team are present for short call
- Clinic Day:
- The morning is spent rounding on the team’s inpatients. Either the upper level or the interns are in clinic in the afternoon. The team has no admitting duties unless there is patient overflow to the team. One of the house staff may have the day off.
- Long Call Day:
- Long call Part 1: [consists of one of the two interns on the inpatient team and the team upper level resident]
- Monday-Friday, 1:30 p.m. – 7 p.m. / Saturday-Sunday, 7 a.m. – 7 p.m.
- Cap of five (5) new admissions for one intern
- Long call Part 2: [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.]
- Monday-Sunday, 7 p.m. - 7 a.m., Cap of five (5) new admissions
- "Post" call day
- Entire team meets 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 any needed patient care throughout the day.
- Clinic Day
- Similar to the other clinic day.
All “cross coverage” of patients is done by a separate night float intern from 5 p.m. – 7 a.m. The night float intern does not admit patients, but solely handles cross-cover issues and assists with codes and other overnight emergencies.
Our house officers care for a vast variety of medical illnesses; including not only the diagnostic dilemmas, but a large amount of “bread and butter” medicine. It is rare that you would have a patient admitted with the diagnosis already made. Our inpatient services are all generalist admitting teams, and we have no subspecialty inpatient admitting services. Thus, when on an inpatient service, you will admit an exciting variety of neurology patients, cardiology patients, heme-onc patients, etc. all on the same night. It is up to your team to decide if you want a subspecialty consultant to assist you with patient management.