In July, 1995 residents successfuly changed the psychiatry call system from a traditional and needlessly onerous 24 - 36 hour call to a more humane night float system.  Under this system there are two people on call each night at each location; an evening call person followed the "night float."  This effectively decreased evening call hours down to 5 hours on weekdays or 12 hours on weekends.  The night float shift is always 12 hours (see below). 

When on-call the resident has three clinical responsibilities:  1) To evaluate all psychiatric patients in the emergency room and if needed admit them to the inpatient units, 2) Respond to any urgent psychiatric consults called in by another medical service, and 3) respond to any medical or psychiatric urgencies on the inpatient units (i.e. the 80 beds at PAVA or 33 beds at Stanford).  Child psych issues are handled by the Child-Psych fellows. [NB: When residents are on either neurology or medicine services they take call with those services and are exempted from the psychiatry call pool.]

Float Call System

Interns are assigned two two-week night float rotations at the Palo Alto VA, each alternating with two weeks vacation. PGY2's are assigned to a single one month rotation at either Stanford or PAVA. PGY3's cover two one-week blocks of float at their choice of location PGYIVs do not take call or float!!! During this rotation interns/residents only work during the nights (10:00 PM - 8:00 AM). Sunday through Friday. Each morning the person on float reviews that night's activities with the Chief Resident in Morning Rounds. The person on float has Saturday off. There are noday-time duties except for attending Thursday afternoon classes.

 

Point Call System

PGY1's, 2's and 3's are assigned call based on point call system. Call occurs each week-night (5:00 PM - 10:00 PM) and week-ends (12 hour shifts). Each hour of call is worth roughly 1 point multiplied by your year.  Therefore, PGY-1’s, when on psychiatry rotations, will do a bit less than three hours of call for every two hours of call by a PGY-2 or one hour of call by a PGY-3.  This translates into approximately 40-45 hours of call per MONTH for PGY1’s and a bit more than a third of that by PGY3.