call schedules

I'll start with the one I know:



PGY1 - Q3 w/ Gen Surg dept.
PGY2 - Q2 home x 10 wks, then Q4-6
PGY3 - Q5-7 x 25 wks, Q14 x 5 wks, Q4 home x 15 wks, nights x 5 wks
PGY4/5 - home call only

Don't know how busy those calls are though.

b

Having just gone through the match process and interviewed at 15 different programs across the country, I can tell you that with the 80-hour work-week, call schedules do not vary that much. All of the programs have better months and worse months, with more better months as you move up the ladder. The only time I really paid attention to the call schedule was:

1) when I learned that one program had their chiefs taking in-house call (this was a little unusual)

2) when it seemed that residents took a lot of trauma call while on other services (spine, hand etc...)

I guess if a program is really small (2-3 people) the call schedule might be worse but otherwise they really did not seem that different to me.

When considering a program, I would focus on many of the other qualities of the program and not get too hung up about the call schedule - you can't really tell on paper how busy your calls will be anyway.

Hope this helps.

I agree with you in principle, but at the same time, it does play an important role. Ultimately, you better like the program itself. But I think call schedule is still important. I never paid attention to talk of call schedules until I realized that some specialties (like gen surg) do 5 straight years of Q4 call without a break from that. That's a far cry from, say, Harvard ortho's schedule, and if I had to choose between those 2 schedules, I would have to really hate Harvard not to choose them.

I'm not necessarily looking for intricate details, and I'm not trying to split hairs. But those 2 call schedules really are night and day, so I would want to know generally how a program's call schedule is. I've heard from some that Tufts is Q4 for 4 or 5 years also, and that BU may be worse in that the calls are actually extremely busy. I would say that makes a difference ... not the ultimate difference, but a significant difference.

b

100% agree with this. If anything, you simply want to know where call really tends to suck ass, not what the q# is.

No offense to the OP, but I seriously doubt that after you do aways and interview that you will think of the call schedule as making a "significant difference" in choosing programs. A buddy of mine went into EM....he had call schedules as the top criteria in the programs he applied to...I've met no surgeon-types who felt the same way. Maybe I need to get out more, but I doubt it.

I have to agree with bonetrauma on this one. Ranking residency programs based on difficulty of call schedules just doesn't make sense to me. I understand why it matters, as lifestyle and work hours can be widely different even among orthopedic programs. And yes, call can be painful. However I would equate this with ranking programs based on salary or other factors that are really not related to the quality of training you will get. You will only get 5 years to see and learn everything there is to know about orthopedics, and in many programs taking call is the only exposure you will get to evaluating patients in the ER, casting and doing formal reductions, or doing V-Y plasties during hand call, etc. These are valuable skills to learn and it would be a mistake to think that the best program is the one where you take Q15 call from home as a PGY-2, as enticing as that sounds. Just my 2 cents.

Do you guys all really think this is black and white? It seems like you all are saying "you can't choose a residency based only on call hours." That's like saying "you can't choose a residency based only on location, or only on [fill in blank]." First of all, of course not, because there are a lot of criteria to consider and this is just one of many data points. Secondly, you can't tell anyone else what criteria are "stupid" -- everyone has their own reasons for what is important to them, and I'm just asking for help with something that is a significant, if not primarily important, data point. Lastly, I didn't say originally that Harvard's schedule was so great because there's Q14 call. I only posted it because it's the only one I could find. Your comments only help to point out why it IS important to have an idea of what call schedules are like, because now I realize I might want to avoid programs that trade solid call experience for a posh lifestyle (again, one data point).

The reason I ask is because I am at the point where I need to start thinking about family. Considering how competitive the field is, I may well end up in a different city from my wife. And like you said, I can't choose just based on location, so maybe the programs near me won't be the ones I like. With that, being on Q3 or Q4 call means it will be extremely difficult to ever find time to see my wife. Is it not a good reason to know call schedules, if it means you may only get to see your wife once every month or two?

And again, is it not a good reason to want to know that Q14 call may not give you the experience you need, especially if you're interested in trauma?

Anyway, again, it isn't the only data point, it's just one of many. If I'm stupid enough to need people to tell me that, then don't worry, I doubt I would match anyway.

b

The subtle issue that appears to be missed here is again that there is not a direct correlation between ?q? number an ability to have a life and/or quality time with a SO.

A given program might be q6 but they might work your ass to death on regular days such that you simply don?t often have the energy or interest to spend quality time with your wife. Another program might be q3, but your regular duty days might be lighter such that you can have some resemblance of a normal life.

While addressing your methodology seems to be a sore spot, I might suggest simply asking ?what programs have the best resident quality of life? instead of trying to derive this from the call schedule. On that note, from word of mouth on this forum, Kalamazoo in Michigan seems to be one suggestion.

I agree with Bonetrauma's post. We take quite a bit of call, especially 2nd and 3rd year but our normal workday is rarely past 5 or 6pm.
Our schedule is
PGY 2 - 9 or 10 calls per month (depending on if its a 30 or 31 day month)
PGY 3 - 9 calls a month
PGY 4 - 7 calls a month
PGY 5 - 5 calls a month.

All are home call and you are the only one on call. Sometimes you never go home and sometimes you go home at 5 or so and dont come back.

Quite often even if I am on call I have time to run home and eat dinner with my wife before getting called back in.

Ah, there we go. Excellent advice. So in that vein then, anyone have comments on Northeast programs in terms of carrying on a life outside of the hospital?

Thanks
b