Call frequency is dependent on whether the rotation is in-house call, home call, or ICU/CCU call.
Any of the 8 types of leave must be subtracted from the total days available for call (days in the rotation) before calculating the maximum number of call periods for that rotation; you prorate the number of call periods to the number of days actually worked. You don't do extra call elsewhere because you used leave days.
Example: You have 3 days of education leave and 1 day of vacation leave in a 28 day rotation, so you have 24 days available for call. If you're on in-house call, your maximum is 6 call that rotation. If you're on home-call, the maximum is 8. If you're on ICU/CCU call, the maximum is once in every 3 days that you're available for call (don't count leave days).
If you have questions, feel free to contact us.
1 in 4 averaged over the rotation is the maximum in-house call frequency
Days in Rotation Max Call Periods
1 in 3 averaged over the rotation is the maximum home call frequency
Days in Rotation Max Call Periods
1 in every 3 days (not averaged over the rotation) is the maximum ICU/CCU call frequency
Clinical Teaching Unit (CTU) Senior Night Float
PGY3 residents on CTU call are considered CTU Senior Night Float.
The night float periods will be as follows:
(See full details in the Collective Bargaining Agreement section below)
Both parties hereto accept that, in order to provide adequate service and care to patients and to enhance the medical education of Residents and so facilitate the realization of their educational objectives, that duty hours be limited to provide a balance of patient care, clinical experience and academics. No Resident will be required to do more than 1 in 4 in-house call averaged over an academic rotation. The duty period referred to is from 1700 - 0800 hours Monday through Friday, and 0800 - 0800 hours Saturday, Sunday and statutory holidays. This duty period shall be referred to as “in-house-on-call” duty. Stipends will be pro-rated where call periods worked are less than provided herein.
Exceptions, based on academic need or exceptional situations, will be monitored by PAIRS (RDoS) and the College of Medicine. Where concerns arise, discussion will be held at a Joint Consultative Committee meeting.
In the event that a Resident performs In-House call duty in excess of 1 in 4 by assignment, such work will be paid at the rate of $178 (Effective January 1, 2014 increase to $182) for periods from 1700 to 0800 hours on weekdays, and $229 (Effective January 1, 2014 increase to $234) for periods from 0800 to 0800 hours on
There will be no prorating of these amounts for partial duty periods, and partial periods of In-House call shall not be considered in calculating the number of duty periods. Extension of hours pertaining to a critical medical situation or completion of training or service requirements will also not be considered. In-House-on-call duty periods that result from any leave of absence granted to any Resident pursuant to this Collective Agreement will also not be considered.
Notwithstanding any other provision of this Collective Agreement, where a Resident is scheduled for 24 hours on/24 hours off in an ICU/CCU, the maximum scheduled duty shall be one (1) rotation in every three (3) days, recognizing that this may be in addition to one (1) day of regular scheduled work.
In the event that a Resident works 24 hours on/24 hours off ICU/CCU, rotations in excess of the principle of one (1) occasion in three (3) days, he/she will be paid a stipend of $178 (Effective January 1, 2014 increase to $182) per occasion. There will be no prorating of this stipend, and partial duty periods will not be considered. Extended hours resulting from a critical medical situation or completion of training or service requirements will not apply.
For the purposes of determining the remuneration for rotations in excess of the principle of one (1) in three (3), the calculation will not include rotations that result from the granting of education leave, examination leave, compassionate leave, paternity leave, and the six (6)days off during the Christmas/New Year’s period to other residents on the service. With the agreement of the Program Director or the Administrative Resident where this duty has been delegated by the Program Director, the existing practice whereby residents may interchange duty hours amongst themselves is recognized, provided that adequate patient care is provided. Additional remuneration will not be provided in such cases. Permission for such interchange will not be unreasonably withheld, but consecutive twenty-four (24) hour shifts will never be considered. The reason for the rotation in excess of the principle of one (1) in three (3) must be clearly defined so as to be able to determine that the Resident doing the excess rotation is to be remunerated.
Extra rotations in excess of the principle of one (1) in three (3) will be voluntary and must have the mutual consent of the Resident and the Program Director.
No Resident will be required to provide more than one (1) in three (3) call averaged over an academic rotation.
Definition of the regular work week is Monday to Friday, inclusive.
A Resident will be scheduled to work a reasonable number of hours. The training/employing organizations will undertake to limit the average number of hours, having due regard for sound patient care and treatment, and the educational requirements of the Resident’s program.
Residents who are not on call may be contacted and invited to participate in a case. However, except in the event of an emergency of qualified medical personnel not being available, all residents will be free to decline such invitations.
Residents who are not scheduled to be on call will not be expected to attend rounds on Saturdays and Sundays that are for service purposes only. However, this does not preclude the scheduling of teaching sessions on weekends, which Residents will be expected to attend.
Article 9.9.1 Home Call
Residents are to be relieved of clinical responsibilities after twenty-six (26) hours from the previous day’s start time on the first post-call day at the Resident’s professional discretion at such point as they feel their ability to safely care for patients may be compromised.
Article 9.9.2 In-House Call
A Resident who is required to provide care of a continuing or intensive nature shall be relieved after patient care handover. Patient care handover shall commence at the 24th hour and not exceed two (2) hours. No new clinical duties shall be assigned or undertaken after twenty-four (24) hours barring emergent circumstances. The Resident shall resume work on regularly scheduled hours the subsequent work day.
In the event that a particular service or elective period does not have on-call duty periods, the Resident shall not be re-allocated to do on-call duty periods on another duty service unless a traditional combination of more than one (1) service on-call block applies. The foregoing shall not mean that the Postgraduate Program shall be precluded from the implementation of new call arrangements in the furtherance of educational objectives to meet changing needs or new programs.
Persons on a service with on-call duties will not be available for on-call duties on another service (be the call in-house or out-of-house on either service).
Program Directors will make copies of all duty schedules available to PAIRS through the secretarial staff with the assistance of the Administrative Resident.
Vacation time, sick leave and leave of absence for any purpose shall not be regarded as time available for on-call duty periods; rather, the number of duty periods shall be prorated to the number of days actually worked.
Other than in exceptional circumstances, no Resident shall be selected to be on call for more than two (2) out of three (3) consecutive weekends. The onus is on the Resident to notify the upcoming rotation coordinator at least four (4) weeks in advance in order to accommodate scheduling, so that the Resident will not be required to work more than two (2) out of three (3) consecutive weekends when changing rotations. If the Resident does not have his/her upcoming schedule at least four (4) weeks in advance, the Resident should immediately notify the relevant schedulers who will then be responsible for aligning the two (2) call schedules so that they do not violate the two (2) out of three (3) rule.
Once in every three (3) week cycle, a Resident must have from the end of the regular working day on Friday until the start of the working day on Monday morning free from clinical responsibilities.
In the interest of patient safety and Resident well-being, neither party encourages consecutive twenty-four (24) hour call. However, it is recognized that residents may on occasion choose to do consecutive twenty-four (24) hour call on certain services. With the approval of the appropriate program committee(s), Residents assigned to those services may opt to accept sequential twenty-four (24) hour call periods. This option must be exercised prior to preparation of call schedules.
1. Effective July 4, 2011, PGY3 residents on CTU call will now be considered CTU Senior Night Float.
The night float periods will be as follows:
Senior residents will come to work at 7:30 p.m. to perform bedside teaching with two junior residents on-call, will stay in-house until at least 11:30 p.m., and will then be on home-call until 7:30 a.m. for CTU senior consults;
Senior residents will do one or two weeks of nights consecutively for two to four weeks during their senior year;
Senior residents are first call from Emergency and will distribute consults between two take residents;
Senior residents on-call during the day would cover on-call consults until 7:30 p.m. This would be twice a week for RED and BLUE seniors and once a week for SILVER seniors;
Seniors on subspecialty and CTU will cover Friday night call, Saturday call, and Sunday day call.
2. Residents will be paid the home-heavy stipend and will not be entitled to the excess of 1 in 4 call stipend.
3. The call stipend for Sunday will be prorated between the day and night resident.