The educational goal of night and weekend duty is to provide residents with supervised experience seeing patients with the acute and emergent psychiatric issues that arise after hours, developing skills in independent clinical decision making and determining when to consult senior psychiatric colleagues and other providers, and (for senior residents) developing skills in teaching and clinical supervision of junior colleagues. Night and weekend duty provides an experience with progressively increasing responsibility over the course of the residency.
The University of Washington Psychiatry Residency adheres to all ACGME duty hour limits.
Definitions
Night float
At Harborview the resident works for 2 weeks at a time from Sunday through Friday and then Sunday though Thursday. At UWMC and the VA the resident works 6 nights per week (Sunday through Friday) for 2 weeks at a time. Harborview shifts are 12 hours long (8pm-8am) for in-house duty, 14 hours long for home call duty at the Seattle VA (6pm-8am), and 15 hours long for home call duty at UWMC (5pm-8am). The resident has no daytime duties.
Call
Call consists of 10-15 hour weekend shifts (Friday night, Saturday day, Saturday night, Sunday day, or Holidays) and weeknight “training call” by senior residents. Residents who are not assigned to a weekend call shift have the weekend off.
Training Call
Initially, junior residents are on duty with a senior resident who provides “training call”, modeling interviewing, assessment, clinical decision making, and acute treatment and disposition planning. After the PGY-2 year, once the resident has had experience being on duty independently (with attending backup), PGY-3 and PGY-4 residents serve as “training call” residents, spending part of their night and weekend duty training and teaching junior residents.
Backup Call
PGY-2 residents have one week of a RISK rotation that is paired with their 2 week nightfloat. During this 7 day period (Sunday-Saturday) the resident serves as the first backup for nightfloat and call shifts. The resident covers in the event of absence of an on-call colleague. PGY-3 or PGY-4 residents serve in one week blocks as 2nd and 3rd backup for shifts.
- As part of their psychiatry months, all PGY-1 residents complete 2 weeks of night float.
- Additionally, all residents take approximately 6-8 weekend shifts throughout the year, ranging from 10-15 hours, during the time they are on psychiatry rotations in their PGY-1 year.
- Residents have one 4-week block of Risk where they are available to cover absences from other psychiatry residents on off-psych services. During this block, they are assigned to a CL service when not called in to cover off-psych.
- All night float, night, and weekend shifts are supervised by a senior resident (i.e. training call) or attending physician who is in house with the PGY-1 resident.
- 4-6 weeks psychiatry night float, in 2 week blocks that is paired with a week of RISK and a week of Float (where the resident floats from M-F to a needed inpatient, consult or PES service).
- Approximately 16-20 weekend shifts, 10-15 hours each, during PGY-2 year
- Shifts are supervised by an attending physician available in-house (Harborview) or by phone (UW and VA).
- Shifts are in-house at Harborview, home call at UWMC or VAMC
- No night float.
- Approximately 16-18 weekend shifts over the course of the PGY-3 year.
- Combination of solo and training call.
- Approximately 4 weeks of backup call during the PGY-3 year.
- No night float.
- Approximately 4-8 weekend shifts over the course of the PGY-4 year.
- Mostly training calls.
- Approximately 4 weeks of backup call during the PGY-4 year.