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Randy_nelson (Randy_nelson)
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Username: Randy_nelson

Post Number: 82
Registered: 09-2005
Posted on Monday, July 20, 2009 - 12:57 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Our TY program recently received the following citation from the RRC:
"A resident should not be reqired to take in-house call on another service without a sound educational rationale for this assignment (Program Req VI.E.1.a). The program has not provided a sound educational rationale for scheduling TY residents to take call during elective rotations."

Do other programs have this call coverage requirement and if so what is their educational rationales. Any info would be appreciated!
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Charlie_daschbach (Charlie_daschbach)
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Username: Charlie_daschbach

Post Number: 228
Registered: 07-2005


Posted on Monday, July 20, 2009 - 01:37 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Many residencies have residents on one service cross-cover call on another service...but this usually occurs WITHIN that residency...for example a Pediatrics resident on Endocrinology elective may have to take call in the Peds ICU on a weekend...

When this occurs within the same program there is an “assumption” that the educational learning experience on the cross-covering assignment is part of the overall curriculum...

Well, it’s a stretch...often these assignments are purely because there is a coverage gap...and it cannot be filled with only people on that rotation. This seems acceptable to Medical Educators TO A POINT...as long as it does not detract educationally from the main rotation that a resident is on...as long as it is fully supervised and has all the elements of patient care and team interaction that the (covered) rotation has, i.e. it is not “above and beyond” the normal expectations on that rotation...

But outside of that specialty it becomes very PROBLEMATIC TO EDUCATIONALLY JUSTIFY. For example a Family Medicine resident on Cardiology covering the Peds Ward, a Surgery resident on ENT covering a call on Neurosurgery service, or a Transitional Year Resident on Neurology covering OB/Gyn call. I’m not sure I can easily come up with theoretical reasons why this should exist within a curriculum...

It’s a s-t-r-e-t-c-h to have a Transitional resident covering a service when they are on another rotation. If you were to justify this, it would seem that the only acceptable rationale would be that the TY Resident is deficient in that covering patient carte experience (Ob/Gyn, ER, Cardiac ICU etc.) and that this covering augments the TY curriculum for educational purposes...and that the TY Director has it designed for that purpose...and gets an evaluation that is added to the resident’s file and portfolio...

I have to side with the sheriffs on this one...

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