Call

The call experience at UCSF provides the skills needed to manage patients overnight on the inpatient psychiatry units, as well as the skills needed to assess and manage behavioral emergencies. When starting call, interns have a tandem experience with a senior resident before progressing to indirect supervision with an attending psychiatrist. The philosophy of call is to promote independence and autonomy while maintaining educational excellence and supervision.

PGY-1

First-year residents take psychiatry call at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) when on their psychiatry months. Call is largely a night float system. The different shifts are as follows:

  • Short Call – Mondays through Fridays, 5:00 p.m.–8:30 p.m.
    • Evenly distributed between the eight residents rotating on ZSFG inpatient psychiatry and Clinical and Emergency Experience (CEE); typically, residents are scheduled for approximately one short call per week.
    • Our program’s culture appreciates the complexities of people’s schedules and lives, and trades of short call shifts between interns are welcomed.
    • Approximate short call frequency: 2.75 shifts per month
  • Night Float – Sundays through Fridays, 8:00 p.m.–8:00 a.m.
    • PGY-1s do three weeks of night float in total. Half the class does their three consecutive weeks while on their CEE rotation. The other half does two consecutive weeks during their CEE rotation and one week during their ZSFG inpatient psychiatry rotation.
  • Weekends:
    • Saturday, 8:00 a.m.–8:00 p.m.
    • Saturday, 8:00 p.m.–8:00 a.m.
    • Sunday, 8:00 a.m.–8:00 p.m.
    • Approximate weekend call frequency: 1.5 shifts per month
       

During orientation (the first couple of weeks on the ZSFG psychiatry inpatient service), PGY-1s do not have night float and are always on call (short call and/or weekend shifts) together with an upper-level resident. Indirect supervision—with direct supervision available—then becomes the model once each PGY-1 meets the required competencies as assessed by their supervisors and reviewed by the site and program directors.

At all times, faculty provide supervision as “faculty backups” for residents while they are on call at ZSFG. These supervising physicians are available by pager during the night and during the daytime on weekends and holidays. They come into the hospital on weekends and holidays to see all new patients and provide direct supervision to on-call residents. In addition to the faculty backup being available to the PGY-1 at all times, an attending psychiatrist is in house 24/7 in the ZSFG Psychiatric Emergency Service and is, therefore, always available to provide immediate direct supervision.

While on medicine and neurology rotations, psychiatry PGY-1s take call following the same schedule as interns on those services. ACGME duty hours regulations are followed across all services.

Upper-level residents

Residents in the PGY-2, PGY-3, and PGY-4 years take call at the Mount Zion campus (covering the inpatient psychiatry service) and the San Francisco VA Medical Center (SFVAMC), as described below. The amount of total call per year declines over time, with PGY-4s having the least amount. Faculty provide supervision as “faculty backups” for residents while they are on call at either Mount Zion or SFVAMC. These supervising physicians are available to the resident on call by pager at all times. The following are brief descriptions of the current frequency of call across the different residency years.

PGY-2

  • Three non-consecutive weeks of night float: two weeks at SFVAMC and one week at Mount Zion
  • Approximately 60% of weekend/non-night float call at SFVAMC, ZSFG, and Mount Zion, which includes: regular weekend call, three-day weekend call, Thanksgiving and Winter Holiday call, and occasional non-night float weeknight call.
  • One tandem shift at Mount Zion with a PGY-3, prior to first independent call at that site, on a Saturday or Sunday from 8:00 a.m.–5:00 p.m.
  • Approximate call requirements for the year (excluding night float):
    • 6 overnight shifts
    • 11.5 weekend day shifts
    • 3 24-hour weekend shifts
       

PGY-3

  • Two non-consecutive weeks of night float at Mount Zion
  • Approximately 40% of weekend/non-night float call at SFVAMC, ZSFG, and Mount Zion, which includes: regular weekend call, three-day weekend call, and occasional non-night float weeknight call.
  • Approximate call requirements for the year (excluding night float):
    • 5 overnight shifts
    • 5.5 weekend day shifts
    • 1.5 24-hour weekend shifts
       

PGY-4

  • Two non-consecutive weeks of night float at SFVAMC