On this beautiful sunny Sunday in Chicago, I sit in my resident workroom on a call shift. C-c-c-all. So boring and unfortunate, you couldn’t even make a Tik Tok about it. And although I don’t particularly like call shifts, I must admit that I have it pretty good for a resident.
What is “call” exactly? Well, it means something different for different people. In my case, I am a Family Medicine resident. Although much of my work is in the outpatient setting, we have our fair share of inpatient work. I am a senior resident in my inpatient Family Medicine service. I help run a team of other residents as we admit patients to the hospital, round on newborn babies, respond to Rapid Response activations, call back pages, discuss cases with specialists, and coordinate discharge plans with social workers. I work around four months in this senior role throughout residency, and on average, I get four days off each month. When my co-residents have their days off from this service, I am scheduled on a rotational basis with others to sub in for them in a 24-hour slot. That is my “call.” It thankfully doesn’t happen too often.
Some other programs and specialties are more demanding. When I rotated through Surgery in my intern year, the senior Surgery residents worked a 24-hour call shift about once every 3-4 days. That is crazy, but it happens a lot.
Those call shifts are pretty much just…shifts. Oftentimes when you think of call, it actually means that you are out in the community. You at da crib. But you can be called by the hospital at any time. You’re the GI doctor getting that REM cycle sleep, and I’m the resident waking you up about a scary GI bleed that is drowning someone’s hemoglobin to 5.2. Just today I heard an overhead page about a heart attack in the Emergency Room. The cardiologist on STEMI call was called in. It’s the way the medicine world works.
So you’re probably thinking, well…that kind of sucks…why take call? Great question. First of all, if you’re employed, call might just be part of the job. I will likely be employed by a medical group for my first Attending job. Part of my job might be to take telephone call for my practice once every ?? days. As someone being recruited, you might be able to negotiate less call, but it will come at a cost. Now if you’re in private practice, you eat what you kill. So let’s say you take call at a hospital: not only are you getting paid by the hour for call, but you are getting business for what you are being consulted for. Even if you aren’t actively being placed on consult, an ER physician may look at the call board and put your name in the discharge paperwork when he/she thinks the patient needs an outpatient referral to your specialty. Thus, it is a great way to build a busy practice.
I really have to pour one out for the call-heavy specialties. It has to be tough, especially throughout the span of a career. It’s not even as simple as taking call for the hospital you work out of. Your group can technically not be on hospital call, but if the referring doctor wants you or one of your partners, whoever is taking call for your group is getting a call. If you’re a general surgeon, that abdomen you operated on a week ago is your work. If that patient goes to an outside ER 30 minutes away, you very well might be getting a call.
Many medical students in recent years have grimaced towards the thought of a call-heavy specialty. This has sparked popularity for shift work specialties, such has Emergency Medicine, Radiology, Anesthesiology, and even Hospital Medicine. There are burdensome features in all specialties, but you can work to ensure call isn’t one of them.
These views are of my own.
Comments