Resident Call

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  • Four types of residency call
    • University of Texas Health Science Center [UT] intern call
    • University of Texas Health Science Center [UT] upper level call
    • OB call
    • Pediatric call
  • "Night float" system established to reduce intern call fatigue. Basically an ER rotation that takes place at night.
  • UT Intern call
    • Unique call structure allowing steep learning curve for the intern
    • Will see over 600 emergent patients: assessing, ordering labs, and treating chest pain, CHF, respiratory distress, sepsis, stroke, abdominal pain, etc
    • Expect to become highly proficient in the treatment of the emergent patient
    • Responsible for in-hospital patient to manage and treat chest pain, respiratory distress, A-fib, sepsis, pain, etc
    • Respond to all codes and expect to be involved directly in over 15 codes and perform approximately 10 emergent intubations
  • UT upper-level call
    • Responsible for managing and treating the ICU patient
  • OB call
    • Triage, manage, deliver, and perform laceration repair on numerous OB patients
    • Expect on average per call one to two deliveries, and managing three to five laboring patients
    • Expect over 120 vaginal deliveries as a resident
  • Pediatric call
    • Assess and manage all Family Care Center newborns that are delivered
    • Assess ER pediatric patients and admit and manage hospitalized pediatric patients
  • Number of Traditional Calls per resident year: [approximate]
    • 1st year: 50 calls
    • 2nd year: 40 calls
    • 3rd year: 23 calls

There are four types of residency call. As an intern the resident has intern call at UT Health Northeast, and OB and pediatric call at Mother Frances Hospital. As an upper level resident there is upper level call at UT Health Northeast, and OB and pediatric call at Mother Frances Hospital.

In order to retain the experience obtained from UT intern call but relieve the fatigue of numerous calls the residency has implemented a "night-float" system. Because of the unique nature of UT intern call the resident is permitted to accomplish the call as part of an ER rotation. The ER rotation will start the second half of the year. When on rotation the intern is scheduled for four shifts per week for four weeks. The shifts are Sunday night through Wednesday night and then the intern is off Thursday morning until Sunday night. This significantly reduces call for the remaining interns the second half of the year.

Intern call
UT Health center intern call is unique. The intern can expect a steep learning curve for treating emergent pathology. The program has established an environment where the intern works in our ER seeing all patients with an attending. The intern will see patients as they walk in the door and quickly assess them, order labs, and treat with medications – stabilizing and developing a differential. With the history, physical and labs the intern will establish a diagnosis and definitively treat the patient. If admission is necessary then admission orders will be written on all admitted patients. This learning environment develops and hones the intern’s history, physical, assessment, and treatment skills to an exceptionally high level. The intern can expect to see and individually treat over 600 emergent patients. The intern will become highly efficient in treating pathologies like chest pain, CHF, COPD, pneumonia, sepsis, stroke, abdominal pain, etc. Because our residency has the intern working in the ER on call a deeper understanding of emergent pathology and what it takes to stabilize the emergent patient is developed.

When on-call in the ER the intern is also the first line physician for handling all floor problems. The nurses will page the intern for all problems arising on the floor from new chest pain, respiratory distress, fever, A-fib, etc. The intern will assess the patient, order labs, and treat the problem. If the intern needs help an upper-level may be called, the ER attending can be consulted, or the patient’s physician at home may be called.

While on-call the only three physicians are in-house; the ER attending, upper-level, and you. All three physicians respond to codes. The intern can expect to respond to over 15 codes throughout the year with approximately 10 emergent intubations performed by the intern. At the end of your intern year you should be proficient at managing codes.

Upper-level UT call
As an upper-level the responsibilities shift to the ICU. The resident will typically help in the ER until 900 pm and then shift all responsibilities to managing ICU patients. The resident will be available to answer question or help the intern with floor patient problems.

OB call
There are approximately 16 OB calls as an intern, 28 OB calls as a second year, and 12 OB calls as a third year. The resident can expect over 120 vaginal deliveries during the residency. While on OB call all Family Care Center OB patients coming to the hospital are triaged and treated by the on-call resident. A resident can expect on average to deliver one to two patients per call and manage three to five laboring patients. An OB attending will be in-house at all times and present for all deliveries. The resident can expect to become highly proficient in triaging, managing, delivering and the laceration repair of low-to-moderate risk L & D patients during the intern year.

Pediatric call
During pediatric call the resident will manage all Family Care Center (FCC) newborns that are delivered. The resident will work in the ER seeing pediatric patients and admit and manage all FCC pediatric patients needing hospitalization. Pediatric call is accomplished when on pediatric rotation.

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