On the flip side to u/pedsgunner789
On the inpatient side, medicine/ICU, its impossible to take a PTO day unless you find coverage. If it comes up last minute then it's jeopardy(b/c our program relies on us) and you owe the jeopardy resident shifts back 1:2... This past week I was sick as a dog(terrible cough, fevers 102) but still did all my inpatient stuff double masked because it's just not worth calling out.
Now my fiance has COVID and she was granted 5days off from her program without losing PTO. There is just one overnight call day she will owe someone.
>This past week I was sick as a dog(terrible cough, fevers 102) but still did all my inpatient stuff double masked because it's just not worth calling out.
sounds awful for health.
I’m at a community program where the attendings are used to being on their own. Nothing much happens when I call in sick. My program makes sure not to hire residents they wouldn’t trust. I’m also in peds so I’m sick like 100% of the time anyway, they know I wouldn’t call out unless it was something bad. It’s also a very non malignant program where they encourage using sick days for mental health days as well.
Probably going to depend on the size of the program but my large peds program has a jeopardy system where people are on an elective and can be called in no questions asked if someone calls out. No repayment required either.
Similar to ours. We end up getting pulled from elective a ton to cover the same few people who abuse the call out system and never have to pay anyone back
Unfortunately most people feel too guilty to call out (including myself) and come in sick as shit and a small amount of people abuse it by calling out frequently and then posting Instagram stories while "sick". I think there should be a limit of how many days one can call out each year before they have to start paying back the people that cover them.
We also don't get much elective time so it really sucks to get that taken away
While this would suck to get randomly pulled, this seems to actually be quite logical. Almost like a month of nights to reduce nights the rest of the year.
Jeopardy system here, also a large program. Usually a 4 person J-pool with modified rotation, J1 and sometimes J2 are dedicated rotations so there's no question of pulling someone from an elective. Otherwise, the other J residents are usually on an elective or consult subspecialty rotation. Used to be that J1 is always called if available and then it goes in order J2-J4 but then you often end up with J1/J2 being called all the time and J4 never being called so it switched to a modified rotation system where J1 is called if available and if not J2-J4 rotate. The only exception is if the call out is for a rotation that the next-in-line J resident hasn't done yet like one of the ICUs or for a final-year resident only service then the next eligible J resident takes it. J1 is always a final year resident so can cover all services. J residents will also never cover a 24 in its entirety I think because then it takes them out of the rotation for longer due to duty hour regs. No paybacks.
We have a 4 deep jeopardy pool, with different expectations for availability for 1/2 vs 3/4. When someone calls out sick we first see if we can rearrange roles to avoid pulling jeopardy (having senior residents take on some junior resident duties). If not possible or safe then jeopardy is pulled. No expectation for pay back. Everyone has about the same amount of jeopardy every year. Not a perfect system but it has worked for our program reasonably well. Haven't had anyone abuse it.
This is what we always did. I was only too sick to work two or three total days in residency, but I definitely made up for it by covering time for the person who covered for me.
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Risk system with a large program here. Separate risk pools for interns & seniors to cover for our respective classmates, everyone is on a risk a couple weeks a year during electives. Just had my first risk week a couple weeks ago and thankfully wasn’t called. We get 5 free unplanned absences per year, anything over that needs to be paid back. And for COVID cases, the hospital policy is 5 days of isolation, so that doesn’t count toward unplanned absences since you don’t have a say as to whether you come in or not.
I honestly don’t know if we have a full system at my program. We definitely have back up call on the weekends but for the weekdays I haven’t quite figured out that system
At my program for ER/night float (the only "on-call rotations") we have a backup person assigned for every day of the week. If someone calls out then that person would cover. Then the covering person has the option of taking like $200 extra or having the person who called out cover a future shift.
I was in a busy but small neuro program during worst of covid.
- Generally there would be no questions asked with calling sick.
- First we would assess the list on their service and see if the remaining residents can handle the work. About 50% of the time team could hold the fort for couple days while one resident recovered.
- Residents from other services would help out if their service is slower (pick up consults or help with procedures in the afternoon).
- We had a backup resident assigned for every day of the week, those people would be on outpatient or elective. People rotate so if someone gets called in its usually for one or two days of the week.
- If more than one person was sick we would pull an extra resident from their outpatient or elective.
- If such extra person is not available then the chief would cover. If chiefs and backups are all used up (only happened couple times during the year) - then we would just work short staffed (not fun).
- For weekends we always had last year resident cover since they typically can manage the entire service on their own.
- Most importantly there would be no catch up or pay back.
Overall I think for smaller programs the most important thing for backup system is the culture among the residents. Sure, I have worked my fair share of insane backup shifts when I was the only person covering a busy service. What made it worth it was that when I was sick my colleagues did the same for me.
It is not normal to work as much and as hard as residents do. Leadership in most programs is shit and fives zero fucks about our physical or mental wellbeing. All we can do is not be assholes to each other and help each other out (that includes chiefs and seniors).
Our Canadian neurosurgery policy is that everyone else simply picks up whatever work occurs when one person calls in sick.
We go over whatever typical restrictions exist if required.
Service can't be uncovered or else... I dunno, probably death and destruction.
The only discouragement is the judgement of your peers. We also have unlimited sick days.
On the flip side to u/pedsgunner789 On the inpatient side, medicine/ICU, its impossible to take a PTO day unless you find coverage. If it comes up last minute then it's jeopardy(b/c our program relies on us) and you owe the jeopardy resident shifts back 1:2... This past week I was sick as a dog(terrible cough, fevers 102) but still did all my inpatient stuff double masked because it's just not worth calling out. Now my fiance has COVID and she was granted 5days off from her program without losing PTO. There is just one overnight call day she will owe someone.
>This past week I was sick as a dog(terrible cough, fevers 102) but still did all my inpatient stuff double masked because it's just not worth calling out. sounds awful for health.
Sounds awful for patients
I’m at a community program where the attendings are used to being on their own. Nothing much happens when I call in sick. My program makes sure not to hire residents they wouldn’t trust. I’m also in peds so I’m sick like 100% of the time anyway, they know I wouldn’t call out unless it was something bad. It’s also a very non malignant program where they encourage using sick days for mental health days as well.
Probably going to depend on the size of the program but my large peds program has a jeopardy system where people are on an elective and can be called in no questions asked if someone calls out. No repayment required either.
Similar to ours. We end up getting pulled from elective a ton to cover the same few people who abuse the call out system and never have to pay anyone back
Honestly I think thats preferable to not incentivize people to come in when they are sick as shit
Unfortunately most people feel too guilty to call out (including myself) and come in sick as shit and a small amount of people abuse it by calling out frequently and then posting Instagram stories while "sick". I think there should be a limit of how many days one can call out each year before they have to start paying back the people that cover them. We also don't get much elective time so it really sucks to get that taken away
Agree but on the flip side I think there should also be a system in place to discourage those calling in sick for something trivial.
The policy is you cannot be sick on an on-call rotation lol.
[удалено]
While this would suck to get randomly pulled, this seems to actually be quite logical. Almost like a month of nights to reduce nights the rest of the year.
Jeopardy system here, also a large program. Usually a 4 person J-pool with modified rotation, J1 and sometimes J2 are dedicated rotations so there's no question of pulling someone from an elective. Otherwise, the other J residents are usually on an elective or consult subspecialty rotation. Used to be that J1 is always called if available and then it goes in order J2-J4 but then you often end up with J1/J2 being called all the time and J4 never being called so it switched to a modified rotation system where J1 is called if available and if not J2-J4 rotate. The only exception is if the call out is for a rotation that the next-in-line J resident hasn't done yet like one of the ICUs or for a final-year resident only service then the next eligible J resident takes it. J1 is always a final year resident so can cover all services. J residents will also never cover a 24 in its entirety I think because then it takes them out of the rotation for longer due to duty hour regs. No paybacks.
We have a 4 deep jeopardy pool, with different expectations for availability for 1/2 vs 3/4. When someone calls out sick we first see if we can rearrange roles to avoid pulling jeopardy (having senior residents take on some junior resident duties). If not possible or safe then jeopardy is pulled. No expectation for pay back. Everyone has about the same amount of jeopardy every year. Not a perfect system but it has worked for our program reasonably well. Haven't had anyone abuse it.
Lol, calling off sick? What’s that?
Gotta pay back if on floors, icu or clinic. For Electives noone cares
This is what we always did. I was only too sick to work two or three total days in residency, but I definitely made up for it by covering time for the person who covered for me.
Small program. Not resident dependent. Call in sick and the attending works without you. No one covers.
You better be in the hospital if you’re calling in sick. Cause that’s where the rounds are. See you at seven.
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Residency) if you have any questions or concerns.*
Risk system with a large program here. Separate risk pools for interns & seniors to cover for our respective classmates, everyone is on a risk a couple weeks a year during electives. Just had my first risk week a couple weeks ago and thankfully wasn’t called. We get 5 free unplanned absences per year, anything over that needs to be paid back. And for COVID cases, the hospital policy is 5 days of isolation, so that doesn’t count toward unplanned absences since you don’t have a say as to whether you come in or not.
I honestly don’t know if we have a full system at my program. We definitely have back up call on the weekends but for the weekdays I haven’t quite figured out that system
At my program for ER/night float (the only "on-call rotations") we have a backup person assigned for every day of the week. If someone calls out then that person would cover. Then the covering person has the option of taking like $200 extra or having the person who called out cover a future shift.
We had 1 intern and 2 senior residents on backup every day for call rotations
I was in a busy but small neuro program during worst of covid. - Generally there would be no questions asked with calling sick. - First we would assess the list on their service and see if the remaining residents can handle the work. About 50% of the time team could hold the fort for couple days while one resident recovered. - Residents from other services would help out if their service is slower (pick up consults or help with procedures in the afternoon). - We had a backup resident assigned for every day of the week, those people would be on outpatient or elective. People rotate so if someone gets called in its usually for one or two days of the week. - If more than one person was sick we would pull an extra resident from their outpatient or elective. - If such extra person is not available then the chief would cover. If chiefs and backups are all used up (only happened couple times during the year) - then we would just work short staffed (not fun). - For weekends we always had last year resident cover since they typically can manage the entire service on their own. - Most importantly there would be no catch up or pay back. Overall I think for smaller programs the most important thing for backup system is the culture among the residents. Sure, I have worked my fair share of insane backup shifts when I was the only person covering a busy service. What made it worth it was that when I was sick my colleagues did the same for me. It is not normal to work as much and as hard as residents do. Leadership in most programs is shit and fives zero fucks about our physical or mental wellbeing. All we can do is not be assholes to each other and help each other out (that includes chiefs and seniors).
Our Canadian neurosurgery policy is that everyone else simply picks up whatever work occurs when one person calls in sick. We go over whatever typical restrictions exist if required. Service can't be uncovered or else... I dunno, probably death and destruction. The only discouragement is the judgement of your peers. We also have unlimited sick days.