Call Structure
In order to adhere to the ACGME work hour guidelines, a night float rotation system has been put in place. The night
float team consists of one PGY-1 intern and a PGY-2 or PGY-3 senior resident and is responsible for admissions to resident covered services and floor calls. Team members meet one morning during the block for a small group morning report for review of an evidency based review of a clinical question in addition to a chart stimulated recall (CSR) session. The CSR is a opportunity to review a random history and physical performed by the intern and review it from both a clinical and a billing perspective. The general night call works as follows:
float team consists of one PGY-1 intern and a PGY-2 or PGY-3 senior resident and is responsible for admissions to resident covered services and floor calls. Team members meet one morning during the block for a small group morning report for review of an evidency based review of a clinical question in addition to a chart stimulated recall (CSR) session. The CSR is a opportunity to review a random history and physical performed by the intern and review it from both a clinical and a billing perspective. The general night call works as follows:PGY-1 Night Call
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A night float system is in place from 8p-7a that allows a team of residents to cover the admissions and floor calls during the evening hours. The first four weeks of the year the team consists of two interns and one senior resident, for the remainder of the year the team is one intern and one senior resident.
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A short call system covers patient care from 5p-8p during the weekdays and is covered by interns on ECLS and GIMS. ECLS and GIMS interns cover weekend medicine call as well with one weekend call shift only.
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Interns are assigned to 1-2 weeks of Medical ICU-NF (6 days per week, 6p-6a) per year. Cardiac ICU is only day shifts for interns.
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During ambulatory weeks, if an intern is assigned as the "Lead Ambulatory Resident" they will cover clinic calls from home. This will occur no more than one week per year.
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During electives, intern may have three to four calls throughout the year on Saturday night shifts to cover if needed. Otherwise, interns usually don't have call during their electives or selectives.
PGY-2 and PGY-3 Night Call
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While on ECLS and GIMS, Senior residents take call once during each weekend covering medicine and unit call. In addition, they are assigned to short call from 5p-8p five times / month overseeing the interns.
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Each senior resident participates in the night float system. Each night float block is two weeks in duration and allows for coverage of the units or medicine admissions and floor calls.
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During critical care blocks, MICU and CICU have a night float system that the senior residents cover from 7p-7a.
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During ambulatory weeks, if a resident is assigned as the "Lead Ambulatory Resident" they will cover clinic calls from home. This will occur no more than one week per year.
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During electives, senior residents may be pulled for two or three calls throughout the year on Saturday night shifts to cover if needed. Otherwise, seniors usually don't have call during their electives or selectives.
A Typical Day on General Medicine at LVH
6am: Work Rounds
The typical day starts at 6am with the interns writing notes on each of the patients on service. Senior residents take the role of team manager and oversee the interns and medical students performance. The senior resident guides patient management and is a key player in creating the team approach to patient care. GIMS teams are composed of one senior resident, two interns, and one or two third year medical students.
The typical day starts at 6am with the interns writing notes on each of the patients on service. Senior residents take the role of team manager and oversee the interns and medical students performance. The senior resident guides patient management and is a key player in creating the team approach to patient care. GIMS teams are composed of one senior resident, two interns, and one or two third year medical students.
9am: Teaching Rounds
Each day teaching rounds are lead by one of our core GIMS faculty members. ECLS A and ECLS B are overseen by our core LVPG teaching faculty. GIMS C and GIMS D is overseen by the core teaching Hospitalist faculty. The General Medicine Junior attending block is overseen by a Private group (Lehigh Area Medical Associates - LAMA/CMA) or by separate Hospitalist faculty. Teaching attendings use a variety of teaching skills to enable resident growth, including bedside teaching, didactic teaching and case-based sessions.
Each day teaching rounds are lead by one of our core GIMS faculty members. ECLS A and ECLS B are overseen by our core LVPG teaching faculty. GIMS C and GIMS D is overseen by the core teaching Hospitalist faculty. The General Medicine Junior attending block is overseen by a Private group (Lehigh Area Medical Associates - LAMA/CMA) or by separate Hospitalist faculty. Teaching attendings use a variety of teaching skills to enable resident growth, including bedside teaching, didactic teaching and case-based sessions.
12 Noon: Didactic Conference Series
Noon lectures are held daily and follow a rotating subspecialty topic each month. In addition, residents are assigned various conferences to present throughout their residency that are held during our noon conference series. Wednesday afternoons are dedicated education time for all residents on non-primary services, allowing for focus on education and learning. See the section on conferences for more information.
Noon lectures are held daily and follow a rotating subspecialty topic each month. In addition, residents are assigned various conferences to present throughout their residency that are held during our noon conference series. Wednesday afternoons are dedicated education time for all residents on non-primary services, allowing for focus on education and learning. See the section on conferences for more information.
1pm-5pm: Discharge patients, follow-up on morning activities, admissions (if service allows)
Afternoons entail time for tidying up the morning responsibilities, including discharging patients, conferring with consultants, following up on studies, re-evaluating patients, and sometimes admitting another one to two patients. The afternoons are also the time for more directed didactic teaching, either by the senior resident or teaching attending.
Afternoons entail time for tidying up the morning responsibilities, including discharging patients, conferring with consultants, following up on studies, re-evaluating patients, and sometimes admitting another one to two patients. The afternoons are also the time for more directed didactic teaching, either by the senior resident or teaching attending.
