Home call burden

[dohgrl76]

Hey everyone,

I'm trying to get a sense for what home call is like at other programs. Many of the fellows at my program are unhappy with the home call expectations at our main hospital site and I want to know if we are being reasonable in advocating for ourselves, or if we are being whiny, ha.

Please let me know how frequent you take call (every how many nights) and approx how many pages you get a night and from where (ED, inpt consults, outpatient calls, etc). Obviously no need to get specific with details.

Thanks so much for your help!

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[dohgrl76]

To provide an example in fairness, our call is approx every 4th night when at our main hospital. We take calls for all outpatient oncology, benign heme, and BMT patients for the hospital and its satellite sites, as well as inpatient consults and admissions from the ED to our inpatient services (onc, heme and BMT). It averages to 15-20 calls a night and often the calls are every 15 minutes for a few hours in a row.

 

[gutonc]

Do you take call all 3 years, or just as a first year fellow? How many fellows total?

We had 2 physically connected sites (Univ and VA) so all call was for both. We had 3-5 fellows/year (4 the year before me, 5 my year, 4 the year after and 3 the next few years). Weeknight call was "Q Fellow" and we were in the call pool throughout the fellowship. Weekend call was pyramidal, first years did 5-6 and tapered down over time (we had research fellows who did a 4th year and they only had to do 2 weekends). We had a moonlighter in-house at the University to actually admit and X-cover all inpatients so we never got those calls, although we did get the initial ED or transfer call and had to go in for new acute leukemics or bleeding/clotting disasters.

Your nightly call volume sounds pretty typical. Even with the moonlighter covering all the inpatient calls, I would routinely get ~15 calls/night.

 

[dohgrl76]

Thanks gutonc. We take university call whenever we are rotating on a university block, there are 4 university fellows at a time, so the call for the month is divided every 4th night. Then when we are at other hospitals we take call the entire time we are on those rotations, just for that site. Though the call at the other sites is much less, it ends up being an overall large amount of time on call. Especially first year, where we only get 1 non-call block the entire year.

We have been advocating to spread the call across the whole year instead of just when at the university, in an effort to decrease burn out. That would have all the fellows (5 each class) in the pool but still have it be first year heavy.

 

[hemonc12345]

I am at a very large fellowship program, so we do home call maybe twice a month as a first year, and monthly thereafter. You cover all the hospitals when you are on, and it is really annoying, but it is infrequent enough that it works out just fine. I would agree that having a smaller number of busy calls is preferable to the converse.