Call Schedule and Night Float, Department of Family Medicine in the Medical School at the University of Minnesota

Everything You Ever Wanted to Know About Our Call Schedule

This spells out how call works for St. Joseph’s residents. You will find that our call schedule process is well designed and resident-friendly. Call will never be painless, but this is probably as good as it gets.

Some Basic Math
There are eight residents in the first-year class. Call is divided among these people.

Types of Call
There are three types of call: 1) house call, 2) obstetrics call, and 3) peds call.  One first-year resident (FYR) is assigned to the obstetrics service, and another to the peds service. The remaining FYRs share house call responsibilities.

House Call Frequency and Duties
As you can probably surmise from the above, house call will average approximately once every six days. The word “approximately” was chosen deliberately. Sometimes (for whatever reason) you will be on call twice per week, but then have a long stretch off. 

Duties are a very key consideration. The house office is charged with the care of existing inpatients who experience acute status changes. These status changes range from life-threatening medical emergencies (myocardial infarction, respiratory failure, etc.) to extremely pedestrian stuff (insomnia, analgesic needs). Duties do not include admitting patients to the hospital or delivering babies. Other residents are charged with these responsibilities.

Obstetrics Call Frequency and Duties
Obstetrics call is once every three days. This sounds brutal at first but is actually tolerable to pleasant. The post call resident is done in the morning and can go home. The entire post call day is yours to sleep, run errands, or whatever. There are no rotation-related duties on your post call day.

Duties while on call are what you might expect:  you triage patients, manage labor, and deliver babies.

Pediatrics Call Frequency and Duties
Pediatrics call is once every four days. This rotation occurs at Children’s Hospital in St. Paul.

Duties include admitting patients to the hospital (including a few patients going to the intensive care unit) and “cross-cover.” The latter is the Children’s Hospital equivalent of house call at St. Joseph’s; you are called to deal with acute status changes such as fever, feeding difficulties, abnormal laboratory results, etc.

There are two FYRs per team at Children’s Hospital (either a peds resident or another family medicine resident from another program). Cross-cover duties are split (generally by floor) between these residents. You do not have to cover the entire house by yourself.

Special Features About Our Call Schedule
One of the chief residents creates the house call schedule. All special requests (vacation, CME, etc.) are forwarded to him/her. The schedule is then created and distributed. It is sometimes possible to switch call days after the schedule is prepared as long as clinic schedules aren’t impacted. 

Senior residents are always in house to bail you out. Always. You are never alone.

Night Float  (Second- and Third-Year Only)
Second- and third-year residents are scheduled for three separate weeks of night float (NF) each year and also will do an average of three weekends (Friday and Saturday) with the same responsibilities.

The NF week is a night shift from Sunday through Thursday, from 6 pm to 8 am Unlike being on call, this is a shift, and residents are awake at night, and sleep during the day. Residents on NF see their clinic patients on Friday mornings.

Responsibilities include new admissions, followup on labs and radiology, and assisting the house call resident as needed. This new system replaces the former senior call system, and it provides better continuity of patient care on the Family Medicine Teaching Service and increases available rotation time by eliminating numerous post call days.