Call Schedules for Psychiatry Residents
Residents work together across the four years of our program to provide 24 hour coverage seven days a week for the psychiatric services at OHSU and the Portland VA Hospital (PVAMC).
While on their psychiatry rotations, Interns are involved in providing coverage on the weekends at OHSU and the VA via a team call coverage model. The weekend team consists of 2 interns (one from the Unity hospital and one from the VA hospital) and a senior resident (a PGY3 or 4). Together this team provides coverage on Saturday and Sunday form 8am until 8pm. The interns work together to cover both sides of the bridge (VA and OHSU) and the senior resident works alongside the interns, assisting them with triage, workflow, assessment and treatment planning. The team call coverage model provides continuity of care to patients over the weekend, and has helped to lower the stress of call and decrease the sense of isolation that many residents felts when call was organized around individual shifts. It also decreases the need to call in back-up, as most times having three residents to cover two hospitals is more than adequate. Interns gain the benefit of working with a variety of upper level mentors, who have the opportunity to share tips and strategies related to assessment, treatment, documentation, and efficiency. As soon as the work of the day is done, interns (who work in a consistent pairing over the course of a 3 month rotation) decide together which one of them will go home early. The other intern, along with the PGY3 or 4, will stay and cover any new work that comes up at either OHSU or the VA.
During the weekday, the PGY2 class provides after hours coverage at both hospitals. From 4:00pm to 8:00pm, the resident on the acute psychiatry rotation covers the VA inpatient unit and consult services, while a second PGY2 covers any new consults that arise at OHSU. At 8pm on Sundays through Thursdays, the night float resident arrives and gets sign out from the people working the short call shifts. They then cover both OHSU and the VA from 8:00pm until 8:00am the following morning. Often times, the two residents working short call shifts will be able to spend time together if things are not busy, which helps minimize isolation and builds a sense of camaraderie within the class. From 4:00pm Friday until 8:00am on Saturday and then from 8:00pm Saturday until 8:00am on Sunday a PGY2 resident will cover both sides of the bridge similar to the night float rotation coverage during the rest of the week.
Back-up ("Jeopardy") coverage for residents on-call is provided by PGY3 and PGY4 classes. This jeopardy coverage is assigned one week at a time. These residents are available to come in during times when workload is heavy or in the case where an illness/emergency for the resident assigned to a primary call shift arises. They may also help out during the first month that interns are on psychiatry.
PGY2 residents assigned to a short call shift that falls on a federal holiday (e.g. labor day) cover the assigned unit from 8:00am until 8:00pm that day. Interns do not work federal holidays that fall on weekdays. However, if the holiday falls on a Saturday or Sunday, they will work that holiday with their weekend call team.
To help provide an idea of the number of call shifts a resident works during each of the four years of residency, here is a table that approximates the distribution of call shifts. Number of shifts sometimes varies in the PGY3 and 4 years as some residents fast-track into Child Psychiatry, which means they are no longer in our call pool. In years when this is the case, the PGY3 and PGY4 class work together to come up with a fair distribution of shifts. Lastly, the acute rotation (which covers short call 4:00pm-8:00pm at the VA) is not included in this table because their coverage is actually built into the hours of the rotation - they arrive to work at noon each day, covering the ED from noon to 4:00pm and then the VA inpatient unit and the consult service until 8:00pm. Thus, they work a 36-40 hour work week with no weekend call duties during that time.
Schedule for Non-Psychiatry Services
Interns on the General Medicine and Neurology services take call according to those department schedules. Currently, General Medicine has a nightfloat system, and therefore has no overnight call shifts, although residents on General Medicine do have long days and work 6 days per week. On Neurology, call consists of daytime rounding with the inpatient service one weekend per month. There are no overnight calls taken with the neurology service. The Emergency Medicine and Chronic Illness Management Clinic rotations do not have a call system, and therefore residents do not take call on these rotations