How does your program decide vacation schedules?

[epsilonprodigy]

I'm curious about how other programs go about this. I am in a large to medium sized and very busy program. In the past, certain attendings (predictably, the ones nobody likes) have been able to declare a moratorium on vacation for their particular rotation. This makes it tricky, because if you have a wedding or something, you pretty much can't make it work if it falls during such a rotation. Conversely, there were certain rotations which contained suggested/forced vacation weeks. This lead to too many people trying to rejigger their rotation order.

This year, for the first time, vacation may be taken during ANY rotation. I think this is much better, because a) hells to the NO do I want to deal with my least favorite people/subspecialty any more than necessary b) my two favorite subspecialties with my mentors were both said "suggested vacation rotations." However, many of my co-residents are up in arms, because now some of our busiest rotations have new potential to be understaffed.

What has worked for others? What hasn't?

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[bannie22]

1 week vacation every 4 months based off seniority.

 

[mvenus929]

We have certain rotations that you can take vacation in-- no inpatient months except newborn nursery, and mostly electives. We have to have a certain number of core electives of 16 full days each, so we try to avoid scheduling vacation during months when those rotations are occurring unless someone has enough of them already.

Otherwise, we assign those vacation months based on preferences and availability.

 

[Raryn]

Both my residency and fellowship did things pretty similarly:

Vacations cannot be taken on various inpatient/call coverage months. Period. These inpatient months would cover at least half the year, so to make things simple, those in charge of the schedule took vacation requests first (with an emphasis on flexibility if possible), then built the rotation schedule around the vacation requests. If there was a conflict between multiple peoples vacation requests and neither put in flexibility, names got picked out of a hat. The full years rotation schedule including vacations would be determined by July 1 (in both cases, typically not till mid-June. Sucks if you want to plan stuff for July).

Both my programs gave us four weeks, typically with 2 one week vacations and 1 two week vacation during the course of a year, though I know a few people that took a four week block or that were extremely flexible and got four single week vacations.

All efforts were made to not schedule call the weekend before or after a vacation (though too many vacations around the holidays made that one hard to promise 100%). That means a one week vacation would typically be 9 consecutive days free from the hospital (and 2 week would be 16), but would mean you'd otherwise be busier that month (because your call weekends would be shifted as needed).

 

[clausewitz2]

We have a few particular rotations where vacation is a no go and on our consults months we are only allowed to take it in five day blocks. We get a number of days that seems on the small side (18 base in PGY-2), but luckily we get comp days anytime we work a holiday, and our system has some weird nonstandard holidays that no one minds working (Great Americans Day, anyone?)

Edit: oh yeah, and anyone who volunteers to work Thanksgiving or Xmas basically gets their pick of other holidays off. Which works out nicely when the system observes Xmas on a Monday because it happened on a Saturday or when you pull the Friday after Thanksgiving instead of Turkey Day.

 

[operaman]

Ours is three weeks vacay with a few restrictions that make sense. Nothing during June, limited during July especially for juniors. Seniority rules if there's an conflict.

There are definitely rotations where taking time away is frowned upon and others where you wouldn't want to be away and miss valuable learning time.

Ours is essentially managed by the residents and seems to work pretty well. By and large we all try to take time when it least impacts others and least impacts our own experience.

 

[gutonc]

Both my residency and fellowship did things pretty similarly:

Vacations cannot be taken on various inpatient/call coverage months. Period. These inpatient months would cover at least half the year, so to make things simple, those in charge of the schedule took vacation requests first (with an emphasis on flexibility if possible), then built the rotation schedule around the vacation requests. If there was a conflict between multiple peoples vacation requests and neither put in flexibility, names got picked out of a hat. The full years rotation schedule including vacations would be determined by July 1 (in both cases, typically not till mid-June. Sucks if you want to plan stuff for July).

This was how both my residency and fellowship did it as well. No vacation on ward/ICU/ED months. Schedule then built around requests at the beginning of the year. Seniors got preference if there were conflicts that made it an issue. Relatively big program though, so that likely made it easier.

 

[Perrotfish]

I'm curious about how other programs go about this. I am in a large to medium sized and very busy program. In the past, certain attendings (predictably, the ones nobody likes) have been able to declare a moratorium on vacation for their particular rotation. This makes it tricky, because if you have a wedding or something, you pretty much can't make it work if it falls during such a rotation. Conversely, there were certain rotations which contained suggested/forced vacation weeks. This lead to too many people trying to rejigger their rotation order.

This year, for the first time, vacation may be taken during ANY rotation. I think this is much better, because a) hells to the NO do I want to deal with my least favorite people/subspecialty any more than necessary b) my two favorite subspecialties with my mentors were both said "suggested vacation rotations." However, many of my co-residents are up in arms, because now some of our busiest rotations have new potential to be understaffed.

What has worked for others? What hasn't?

Intern year:. 2 one week vacation blocks which are assigned. They will not take requests. No other holidays, 2 total additional golden weekends during the year.

R2/R32:. One two week vacation block that is assigned, they do take requests as to the timing. Two one week blocks that can only be taking during electives, not during inpatient blocks. One 96 hour holiday: Christmas vs New year's vs Thanksgiving, they take requests but since everyone wants Christmas it's basically a lottery.

Bonus Rule:. You must be on vacation if you wish to leave the area , even if you have one of your rare golden weekends. In the area meant withing 90 minutes if the hospital.

Personal and family emergencies were in addition to the vacation. Non emergency events like weddings were basically a no go if they didn't fall on an elective.

 

[PTPoeny]

My program is similar to several above where we can only take vacation on electives so the rotation schedule is built around vacation requests. It makes June weddings hard but we are allowed to trade shifts with other residents on any rotation and can usually put together a three day weekend for stuff like that.

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[LucidSplash]

We get 2 weeks for vacation PGY 1-4 and 3 weeks as PGY 5-6 (have a year of research built in so all chiefs are PGY-6). We need to use vacation time for interviews for fellowship or jobs which is why there is an extra week for 5&6. We all get an additional 5 days off at Christmas or New Years which is granted by our department, not the GME. The rule is that you can't take all your vacation in the same 6-month block (unless its for interviews which typically occur over a 3-4 month period).

Like others, vacation can't be taken while on certain rotations like ICU or trauma, or at the end of June or during July. From a chief standpoint, it can't be taken while rotating on the chief service. We also had to put a moratorium on our FP rotators from taking vacation during their month with us because every single one of them was trying to take it then and that was consistently leaving the same service down a person for a week every month. We get that they're not interested in surgery but its their program requirements that make them rotate with us, not us, and having the same service down a week every month was very frustrating. They are already essentially absent one day a week for their continuity clinic. (/rant)

Otherwise typically we try to make vacation requests as close to the beginning of each 6-month period as possible. For Christmas/New Years there's a request sheet every year and it usually comes out about even. But sometimes someone doesn't get their request and that's just the way the cookie crumbles. Same for regular vacation; the earlier you put in the request, the more likely you'll get it. But if a bunch of people are already on vacation or gone for conferences or whatever during that time, you might not get it so it is best to plan ahead.

Also @Perrotfish that "no out of town trips on weekends off" rule is whack. With a rule like that I wouldn't have been able to go out of town to my cousin's bridal shower this past weekend even though it was all on my own time. Not sure how they can make a rule like that and enforce it.

 

[Raryn]

Like others, vacation can't be taken while on certain rotations like ICU or trauma, or at the end of June or during July. From a chief standpoint, it can't be taken while rotating on the chief service. We also had to put a moratorium on our FP rotators from taking vacation during their month with us because every single one of them was trying to take it then and that was consistently leaving the same service down a person for a week every month. We get that they're not interested in surgery but its their program requirements that make them rotate with us, not us, and having the same service down a week every month was very frustrating. They are already essentially absent one day a week for their continuity clinic. (/rant)

Our program came to an agreement with our rotators (EM/FM on ICU/cardiology) where they could take vacation on an inpatient rotation in a pro-rated manner.

That is, we got 4 weeks/calendar year. So if there was 12 months of coverage from the EM on the ICU service, the EM folks were allowed to have a maximum of 4 weeks off between all of them. Their department could figure out which of their interns were the ones who could take advantage of those 4 weeks. If there was 9 months of coverage on the cardi0logy service between all the FM interns, they could have a total of 3 weeks vacation during the course of the year between all of them. Let their department figure out the rest.

Seemed fair enough to us, though we weren't allowed to take vacation on those services.

 

[WantToBeFamMed]

We divide the year into thirteen 4-week blocks. We get 4 weeks (20 days) of vacation.

We have about 5 of our 13 blocks per year when we're on a rotation where the assigned resident(s) are critical to the running of the service, or at least an important piece, so those have limited vacation days you can take in the block: night float (avg 1 block of this per year, no vacation), inpatient service (avg 2 blocks per year, 1 day max vacation per block), inpatient peds or ICU (avg 1 block per year of one or the other, 1 day max vacation), Labor & Delivery (avg 1 block per year, 2 days max vacation). Other than that we can take the remainder of our vacation days divided over whatever of the remaining 8 or so blocks in the year that we want, no more than 5 vacation days in any 1 block.

We signup for our rotation order in the spring for the whole year. Will-be 3rd years go first, choosing in a snake-style order (fantasy football draft style), when they're done the will-be 2nd years go. So if there is a big event planned you can just make sure you put one of your 8 lighter rotations with unrestricted vacation during that time. Then the incoming 1st years are just assigned a rotation order, though if they have a known major event planned like a wedding they have to be at or due date of their child or something they're encouraged to just let the program coordinator know at match time so they get a vacation-friendly block assigned for that time period. There is no limit on how many residents can be on vacation at a time, since the majority at any given time are on rotations where they are like working with a specialist or on electives and are non-crucial to the service. The vacation limitations on rotations where residents are critical are enough to ensure that there are always enough residents on those services to keep them running.

Weekend call schedule is usually made out in advance about 6 months at a time give or take, so you just have to turn in weekend off requests (not vacation days) before the chief residents plan to meet up to put together another large block of call schedule. Holiday call is assigned randomly on a yearly basis by drawing from a hat. Whatever holidays you received prior years you are ineligible to get assigned to you again in subsequent years.

Schedules for our continuity clinics are kept scheduled out 3 months in advance, which weekdays they land on and whether morning or afternoon varies for each resident week to week, with clinic days occurring every week on every rotation anywhere from 1-5 half-days weekly depending on the rotation and the PGY of the resident. Once scheduled for a clinic day you can not get that approved to take off for vacation, so if having specific days off is important you're encouraged to request at least 3 months in advance.

It works pretty well for us residents and I tend to hear minimal to no complaints.

 

[Mass Effect]

We can take vacation anytime we want (and multiple people can take vacation at the same time) except during night float. If you're on vacation, attending will run the service.