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Clinical Training: Night and Weekend Call |
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Back to main Clinical Training page
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Normally there are six fellows per year. Occasionally, a fellow starts in January, providing an extra half fellow in each of two successive years. And occasionally, we accept seven fellows.
Beginning in 2005, the call schedule had a new format compared to previous years, with the goals of maximizing fellow education and quality of life, resident education, and patient care.
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Overnight, on weekdays, the hematology and oncology services are covered by one fellow. During weekends, the services are separated and covered by two fellows. First-year fellows take 1-2 weekend calls per month on the service associated with their currrent rotation. Weekday and weekend hematology/oncology call is also covered by second-year fellows. The hematology/oncology fellow on-call provides supervision of overnight care for patients on the hematology and/or oncology services. He/she also triages outpatients from the Hematology and Jimmy Fund Clinics and provides hematology and oncology consults for the emergency room and inpatient services at Children's Hospital. In addition, he/she may be contacted by outside hospitals and primary care physicians with pediatric hematology/oncology-related questions. One the weekends, the on-calloncology fellow rounds on oncology and oncology consult service patients and the on-call hematology fellow rounds on hematology service patients with the respective attendings, residents, and nurses.
Overnight, most issues can be managed by the fellow from home. However, there are times when a fellow may need to be present in the hospital to help manage a patient, perform a consult, review a blood smear, perform an urgent procedure, or discuss a new diagnosis with a family. While, this role is covered by the hematology/oncology fellow on-call in the early evening (and during the day on weekends), the hematology/oncology fellows does not return to the hospital overnight, rather this coverage is arranged via the stem cell transplant fellow who is in house for the night.
First year fellows take approximately 70% of the call for the hematology and oncology serivices, while second year fellows take approximately 30%. Third year fellows have only stem cell transplant call and no hematology/oncology call so they can focus on their research.
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Stem Cell Transplant Call: Overnight, fellows provide direct in-house care for patients on the stem cell transplant unit. First-, second-, and third-year fellows cover this call. The fellow on call also provides coverage for outpatient phone calls from active or former stem cell transplant patients. In addition, the in-house transplant fellow addresses urgent or emergent inpatient issues on hematology and/or oncology services overnight as needed.
This call is spread relatively evenly across the three years, with first-year fellows performing this call only while there are on the stem cell transplant rotation. In addition, many weekday nights are offered to upper-year fellows as moonlighting shifts.
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