Emergency Call Response

What happens when a resident has started their in-house call shift and finds it inappropriate to continue to work? (Example, personal health or other emergency)

Answer: Physicians have both an individual and collective duty of care to their patients.   The onus is on the resident physician on-call to exercise good judgment regarding their ability to work, and to reach out to other qualified physicians to assist.  Likewise, other resident physicians have a duty to assist to the extent that they are able.  The staff attending physician on-call has the ultimate duty of care and must ensure that all resident physicians are adequately supported and supervised. 

Back up call Rules and Policies: Backup Call Rules for Internal Medicine Clinical Rotations Policy 

Emergency Call Response

For the inpatient services covered by the Internal Medicine program, the following illustrates the natural sequence of responsibilities to guide all involved in this unusual situation (i.e., when a resident on-call is unexpectedly unable to continue to work).  This does not apply to absences anticipated during normal work days before the call shift begins.

Please remember that the care of patients is paramount, and residents should be generous in helping a colleague in need.  Likewise, all residents involved should recognize their own limitations while on call.  

Always contact the more senior in-house residents (Senior, Fellow) and/or the staff physician on call if there is an emergency that requires a change in the call coverage during a shift.  The rotation supervisor and/or program director should be notified immediately.

For UAH Cardiology, try to schedule two junior residents for call every weekday overnight (1700 - 0800 hrs) and weekends/holidays (0800 - 0800 hrs). They usually have one junior covering CCU, Ward 5A5, Ward 5A6, and Inpatient Consults (carrying the "Cardio Team 1 (CCU)" team pager) and the other junior covering ER Consults (carrying the "Cardio Team 2 (ER)" team pager). All call performed is in hospital; juniors do not do home call. 

In the event one of the junior residents is unable to perform call, it is your responsibility to find another resident to replace you (or as occurs more frequently, find another resident who is willing to swap call shifts). If there is an emergency where the junior cannot find another resident to replace them or swap call, then they simply go down to having only one junior resident scheduled for that call shift. They cover all services (CCU, Wards 5A5/5A6, Inpatient & ER Consults) and carry both team pagers.