Anesthesia Resident Call Systems Across Canada

[Cat_eyed]

Hi all!

I'm wondering if the residents in Anesthesia can share what kind of call system their program uses, as I know there is variety across Canada and controversy over which type works best for balancing learning, wellbeing and patient safety. The two I know of are:

U of S: 16-hour call (night float)
U of A: 24-hour call with post-call day

Please add to the list if you can!

Cheers

[TimmyMax]

Ottawa: 16-hour call
Queen's: 16-hour call
Western: 24-hour call (duh!)

[quackster]

silly question, but when does 16 hour call start and end? 8am-midnight? 4pm-8am? In the case of the latter, do you not come into the hospital until 4pm and are then post-call the following day?

[justletmein]

silly question, but when does 16 hour call start and end? 8am-midnight? 4pm-8am? In the case of the latter, do you not come into the hospital until 4pm and are then post-call the following day?

Normally 8-midnight with night float covering 12-8.

[quackster]

And then you're expected to be back in hospital at 8am the next day? Yowsa. I'd rather do a 24hr with a post-call day.

[NLengr]

And then you're expected to be back in hospital at 8am the next day? Yowsa. I'd rather do a 24hr with a post-call day.

Yeah 16 hour call sucks.

[justletmein]

And then you're expected to be back in hospital at 8am the next day? Yowsa. I'd rather do a 24hr with a post-call day.

some programs (i cant speak for anesthesiology specifically) are beginning night float at 10 or 11 pm so it's more reasonable for the residents who need to be back at 8.

[Cat_eyed]

Having done a large part of the Anesthesia CaRMS tour now I can come back and largely answer my own question for any med students who might be interested in the same question I had. So here's what I've found out from the schools I interviewed at:

16-hour call:
U of C
U of S
U of T*
U of O
Queens

24-hour call:
U of A
Western
MUN
Dalhousie**
Mac***

*Hospital dependent at U of T, but most of the hospitals have 16-hour call. Those that have 24-hour call give residents a 4-hour break in the afternoon (presumably, to sleep and get ready for the overnight). At these sites, they try to schedule residents in higher turnover rooms for the morning so they get the most bang for their buck.

**Dal is currently on 24-hour call but will shortly begin trialing 16-hour call at their trauma centre.

***Mac also currently has 24-hour call but will be trialing new call system alternatives this year (not necessarily 16-hour).

I don't know about UBC, but heard their call structure is quite different, with 12-hour shifts. McGill should have 16-hour call I'd imagine since they're in Quebec but I didn't interview there so don't know 100% how it works. Also not sure about Winnipeg and NOSM.

From the schools I do know about, those that have 16-hour call give you a pre-call day off AND a post-call day off. Yes. It's NOT night float. They start at 4-5pm and go until 7-8 the next morning. This generally works well because in these programs, while on-call you cover a lot: emergency OR cases, trauma team and code team for airway, and obstetrics after the emergent cases finish (around midnight-2am at most places); this means epidurals and C-sections, which is busy. So, you essentially DO NOT sleep at night. The programs that have 24-hour call largely do it because they have a pretty decent chance of sleeping at night; most of them, if not all of them, do not cover Obstetrics on-call, and in some programs you are not even on the code/trauma teams (eg. U of A, UBC).

In the end, it seems to just depend on what you want in your residency. Do you want to do Obstetrics longitudinally over the course of your residency, or would you prefer a consolidated block or two where you do nothing but Obs for a few months? Do you think trauma team and code team experience is valuable? Are you the type of person who would prefer 24-hour call with the chance of sleeping 2-6 hours at night or 16-hour call with virtually no sleep at night?

Anecdotally, the residents I talked to at schools with 24-hour call were generally opposed to changing it (strongly got this sense at U of A, Western and MUN). At MUN in particular, they were worried that it can already be quite slow at night, and strongly believed that bringing in 16-hour call would mean they really would not see enough. The residents who went to programs with 16-hour call were hugely in favour of it. I don't think I talked to a single resident at one of these programs who was opposed to 16-hours. Of note, I got the opportunity to talk with a senior resident who had recently transferred from a program with 16-hour call to one with 24-hour call because of a significant other, and he said he preferred the 16-hour system.

Hope this helps someone!
cheerio :)

[UBCmed09]

Just a quick note about call at UBC (and a slight correction to the last post). Our call structure varies from hospital to hospital. Here is a summary for the main sites that we rotate through:

VGH: 12 hour call (day call is 7am-7pm, night call 7pm-7am)
-you are part of code team and respond to all codes to manage airway, not part of trauma team
-you get a pre and post call day for night call
-no obstetrics but generally busy all night with emerg cases

St Paul's: 12 hour call (only night call, come in at 6pm I think, done at 7am)
-you are on code team here as well
-pre and post call day
-obstetrics

Royal Columbian Hospital: 24h call I think - recently changed and haven't been there in a while
-obstetrics

BC Children's: 24h call
-usually quiet by 11pm or so
-cover pain service
-post call day

BC Women's: all shift work (8h shifts)
-15-17 shifts per month

Hope that's helpful to someone!