Dallas Veterans Affairs Medical Center (VAMC)

The teaching ward service will be composed of 5 teams, each with one resident, one intern, a fourth year medical student, and 2 to 3 third year medical students.  Each team takes “long call” every fifth night.  On the day after the post-call day, the team assumes care of patients admitted by the night float resident (so-called “short call”).

PGY-1 Ward Schedule:

• Take overnight, in-hospital long-call every fifth day
• On weekday (Su-Th) call, admit patients with team resident (PGY-2 or PGY-3) from 7:00 am to 9:00 pm, then admit patients with night float resident (PGY-2 or PGY-3) from 9:00 pm to 12:00  midnight 
• On weekend (Fri-Sat) call, admit patients with team resident (PGY-2 or PGY-3) from 7:00 am to 4:00 am the following day
• PGY 1 stays overnight for cross-cover purposes
• Leave hospital by 1:00 pm on post-call day
• One half-day continuity clinic per week (always at same hospital as ward rotation)
• One day off per week

PGY-2 and PGY-3 Ward Schedule:

• Take “long call” every fifth night
• On weekday (Su-Th) call, admit patients with team PGY-1 from 7:00 am to 8:00 pm; sign out to night float resident at 8:00-8:30pm; go home; return to hospital post-call morning at 6:30 am and work full post-call day
• On weekend (Fri-Sat) call, admit patients with team PGY-1 from 7:00 am to 4:00 am the following day and spend night in hospital; leave by 1:00 pm on post-call day
• One half-day continuity clinic per week (alternates among PHHS, St. Paul, and DVAMC)
• One day off per week

Night Float Schedule:

• One night float resident (PGY-2 or PGY-3) each night Su-Th
• Take sign-out from on-call resident at 8:00-8:30 pm
• Admit patients to next day’s “short-call” team between 12:00 am and 4:00 am; sign these patients out to oncoming team at 7:00 am
• Present patients admitted with on-call team at post-call attending rounds at  7:30 am
• Leave hospital by  8:00 am
• Two days off per week

DVAMC Non-teaching Service (NTS)

• In response to increasing patient volume, a non-teaching service (NTS), run by hospitalists, has been instituted
• The NTS consists of board-certified/eligible internal medicine physicians
• The NTS admits 7 days a week
• The NTS will admit patients in rotation with the teaching service and then admit all patients once the teaching service reaches its “cap”.  Admissions deemed to have lower clinical education potential will be admitted preferentially to the NTS (typically patients admitted electively for procedures or infusions and not requiring a diagnostic work-up)
• The NTS service rounds on its patients, provides independent cross-cover, and writes progress notes and orders every day  

DVAMC MICU Service:

• The DVAMC MICU service consists of one attending, one pulmonary/critical care fellow, and four housestaff teams, each composed of one upper-level resident and one intern
• Teams take in-hospital overnight call every fourth night
• On-call days, teams admit patients from 7:00 am to 7:00 am the following day
• Post-call teams sign out remaining work to pre-call teams at  1:00 pm, then leave the hospital

DVAC CCU Service:

• The DVAMC CCU service consists of one attending, one cardiology fellow, and four housestaff teams, each composed of one upper-level resident and one intern
• Teams take in-hospital overnight call every fourth night
• On call days, teams admit patients from 7:00 am to 7:00 am the following day
• Post-call teams sign out remaining work to pre-call teams at  1:00 pm, then leave the hospital