During the adult neurology year, residents take call in adult neurology. The adult neurology program has fully eliminated in-house, 24-hour calls. Nights are covered 365 days a year by a night float system at Zuckerberg San Francisco General and UCSF Medical Center. Resident night float blocks are 4-5 days in length and are spread evenly through the second half of the R2 year, the R3 year, and R4 year. To allow for adequate transitions from day to night sleep cycles and back, we ensure residents have 1 post-call day and 3 days off during the 14-day period in which a night float block occurs.
Nights at the VA are covered by a home call system, shared between inpatient and outpatient rotators. No resident takes more than 2 nights per week, and outpatient rotators are given either a half-day or full day off after home call to allow adequate rest.
During the child neurology residency years, residents do not take in-house call. Advice and transfer calls are covered by faculty during the day. Residents take home-call split between the 6 trainees, as well as home call every 5th to 6th weekends. We have recently revised weekend call schedules so that no one resident takes more than 2 call nights in a row. We arrange call nights to minimize overnight duties or weekend call for the resident on the main consultation service, which allows them to focus on running the team, and education for themselves and their team members without fatigue. Residents do not participate in outpatient clinic post-call and are able to leave inpatient services after rounds on post-call days if they are fatigued.