Night float v in-house call v home call - A resident's take?

Last I checked 6-6 is a pretty standard day in any surgical field- even in practice.

It depends what you think is most painful. I've had experience with in house call and home call, but not night float.

I would think night float would be the worst, as you would have to take care of all the ER consults and the scut, but your operative experience wouldn't be great, which at this point should be more important than splinting someone's ankle.

In house call is obviously painful, but it's a known entity. You're in house, you know you're going to get lit up, but you also know that the cavalry is coming in at 6 am, and with the 80 hour work week, you're leaving at noon.

Home call, personally, is the most painful. You're at home, comfortable, but then you have to leave the comfort of your sofa, bed, girlfriend, etc to go take care of things. Also, it's kind of a way to get around the 80 hour work week, because even if you get smoked and are at the hospital all night long, you're still on the hook all the next day, which can be painful depending on what you have to do.

Hope that helps. Obviously, this is only my opinion. I know alot of people who prefer home call to in house call, so it just depends on what you hate most.

Later players

I think Jeff Smoker raises some valid points on the pros/cons of various call systems.

I personally think that a night float system is not as great as cracked up for several reasons.
1. You do not have much supervision/education...you are basically working like a PA temporozing all the ER crap.
2. The hospital cafeteria is usually closed and you wont have anything good to eat.
3. Everyone in the hospital thinks you work as a painter because your scrubs are covered in plaster, unless you are a weiner and use OCL splints.

I have personally worked with Jeff Smoker and I know he is baised toward in house call because of his personal style.

1. The home call system allows him to "be a radiologist from home" when the ER cannot read an x-ray expect to be called to do their job for them.
2. There is a magic phrase that will force you to come in from home to see any consult no matter how lame..." I dont feel comfortable handling this" This is code for come see this as I work in an ER and have ceased to be a real doctor.
3. Any laceration that cannot be superglued back togther will require you to come in and evaluate for a suspicious tendon or nerve injury.
4. The work "kiddo" will be used ad nauseum at 3 am in phone consults.
5. In the middle of the summer you will find yourself living in the ER then doing a ten hour day in clinic....its quite fun.....

All in all call sucks and we must do it.....I wouldnt worry to much about it and just take it in stride.

I have noticed in my own program that med school is being made increasing more user friendly....creating weak med students that want to leave early and study for their OBGYN shelf exam.....the last refuge for the true bad a$$ is ortho.....so if you are that worried about call...you may consider being a sausage doctor....AKA joining the stream team...so I can call you with all the wicked pelvis fractures I need your help on.

Keep smokin on my brother Jeff......but be careful JAHCO may be testing you soon.......

Agree 100%.

Night float, in-house call, and home call each present unique challenges for residents. Night float allows for focused patient care overnight but disrupts sleep schedules. In-house call offers familiarity with the hospital environment but can lead to prolonged periods away from home. Home call provides comfort but requires quick response times when called in. Each has its pros and cons, shaping residents experiences and perspectives.