What is the call schedule like?
Call during the clinical anesthesiology years is dependent on the rotation and year of training. Regardless of the rotation, call is no more frequent than every third night. In general, the operating room call team is made up of four residents. One CA-3 resident who is the “Team Captain (TC), ” a junior or senior resident acting as the Assistant Team Captain (ATC), and two other residents (junior or senior). The Short Call system is comprised of seven residents who along with CRNAs relieve all non-call residents starting at 3:30-4pm
. As the OR activity slows, the TC and overnight attending will send short call residents home (starting with “short 7”). Depending on the staffing needs, short call residents who are designated 7 to 3 leave as early as 5pm to as late as 7-8pm
. Short 1 and 2 are considered “late residents” and will stay until 8 to 9pm
or until all of the cases can be covered by the overnight team. Short 1 and 2 residents are not expected to return to work until 9AM the next morning. In compliance with ACGME rules, residents are given a full 10 hours off between leaving the hospital and when they are expected to return to clinical duties. These rules are strictly enforced by the residency program. For example, a resident staying until 9pm
is not expected to return to the hospital until after 7AM
the next morning. Similarly, a short 1 or 2 resident staying until midnight
is not expected to return to the hospital until after 10AM
that day. In general, short call residents numbered 7 through 5 leave between 4-6pm
, short 4-3 leaving between 6-7pm
, and short 1-2 leave before 9pm.
The role of the TC is to manage the operating room board and coordinate anesthesia coverage for ongoing, urgent and emergent cases. As a TC, senior residents will gain vital experience in leadership and management of all perioperative services. The TC is responsible for all stat intubations and airway management during arrests in both Milstein hospital and at the Children’s hospital. The TC is also responsible for managing all patients in the post anesthesia care unit. The ATC resident is a CA-2 or CA-3 resident who aids the TC in managing all stat intubations and arrests as well as the PACU. The primary role of the ATC resident is to cover all liver transplants as well as any difficult or complex adult or pediatric case that is not suitable for a CA 1 resident.
For the main “Milstein Hospital” blocks, including neurosurgical anesthesia, regional anesthesia, Post-Anesthesia Care Unit (PACU) and Pre- Admission Unit(PAU) Clinic, call is as follows: (average hours per week: 55-60hrs)
CA-1: Normally 1-2 CA-1 residents are assigned to overnight call. Total number of overnight calls per month are 3-4. CA-1 residents also take 3-4 short calls every month.
CA-2: Normally 3-4 ATC overnight shifts and 3-4 short calls every month
CA-3: Normally 2 TC calls per month in addition to 3-4 short call every month.
For cardiothoracic anesthesia, obstetric anesthesia, cardiothoracic ICU and surgical ICU, calls are dependent on the number of residents, fellows and off service residents (for ICU only) assigned to the blocks. In general, the average number of hours spent in the hospital while on these rotations is 65-70 hrs per week.
For rotations in pediatric anesthesia, the fellows take overnight call. In general, CA1 and CA2 residents have 1-2 short calls per week including late short call and 1 overnight Saturday call in the main Milstein ORs or 1 in-house 7 am-7am Milstein backup Saturday call. CA3 residents have 1-2 short call including late short call and 1 Saturday in-house 7am-5pm Pediatric backup call per rotation. Emergency pediatric cases are covered by the Milstein call team until the at-home call Pediatric fellow and attending can arrive in the hospital.