Residents rotating on Night Float provide overnight coverage 6 nights per week. The 7th night (Saturdays) is covered by an off-service resident. This coverage is scheduled by the Administrative Chief Resident. PGY2 - PGY4 residents are scheduled for 5-7 Saturday night call shifts per year between HCMC and UMMC. Residents wishing to swap call shifts must make arrangements and communicate these changes to the chief residents.
VA home call residents do not respond to stroke codes, which are covered by the VA's telestroke system. Home call must satisfy the requirement for one-day in-seven free of duty, when averaged over four weeks. Residents are expected to be within a 30 minute drive while they are on call. Neurology Patient care episodes during home call that require in-house presence between 10 PM and 5 AM will trigger an “off duty period” of 10 hours as required by the training program (not required by ACGME), with the following three exceptions:
1. The residents are expected to attend their own continuity clinic and be in clinic in time for the start of the clinic, even if this means less than a 10 hour off duty period.
2. The residents are expected to allow for team members to attend their continuity clinic and be at their assigned hospital in time for a hand-off of the inpatients and consults, even if this means less than a 10 hour off duty period.
3. The residents are expected to attend Friday school from Noon to 4 PM.
A backup jeopardy call schedule will be created on a yearly basis to provide coverage of inpatient services in case of emergencies at UMMC, HCMC, and VAMC. Residents are assigned to the jeopardy call schedule when scheduled for an outpatient or elective month. Vacations are not allowed during the time that you are scheduled for jeopardy call. Residents may swap jeopardy call with another resident. Notify the chief resident(s) and program coordinator when a switch is made.
Primary and secondary jeopardy schedules are created. Residents scheduled for backup may be called in to cover G2 - G4 inpatient responsibilities. Backup does not cover continuity clinic. Residents will be provided with emergency back up coverage when they are ill, have emergent court assignment or have a death/serious illness in their immediate family requiring emergent absence from inpatient duties . If an emergent situation arises and you need backup coverage, you must alert the administrative chief (via phone or pager) immediately, so that arrangements for coverage can be made. You must also notify the program coordinator of your absence.
The backup resident (whether primary jeopardy or secondary backup) must be available to respond to their pager or cell phone within 15 minutes of receiving a call. This is true 24/7 for the entire period the resident is on backup. Residents should be prepared to report for duty within 2 hours (ideally less) of notification during their backup call period, 24 hours a day. Jeopardy shifts start/end on Sundays at 7pm.
Primary backup will be used first for coverage. Primary can cover up to 24 consecutive hours in the event of a night shift following a day-shift. Duty hour regulations still apply, including 12 hrs off after a 24-hr shift. Secondary backup will be used if: 1) primary backup is already in use, 2) it would violate duty hours for primary to cover, 3) primary jeopardy has an emergency or is unavailable, or 4) rare situations up to the discretion of the administrative chief.
The backup resident should still attend their continuity clinic even when filling in for an inpatient service. If continuity clinic would cause a critically low number of residents on the inpatient service, the administrative chief should be contacted.