Scheduling

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Scheduling Chief Responsibilities

  1. Creates the annual rotation block schedule
  2. Processes all vacation requests
  3. Creates the monthly inpatient schedule
  4. Ensures appropriate back-up and cross-cover scheduling
  5. Processes schedule change requests
  6. Helps develop and enforce program policy for scheduling
  7. Verifies compliance during time off:
    1. Ensures completion of absence request forms
    2. Ensures cross-coverage of Epic in-baskets
  8. Communicates with the Program Coordinator and Program Director
  • Note that the outpatient schedule is primarily the responsibility of the Program Coordinator and individual Rotation Preceptor.
  • Note that didactic calendars/schedules are primarily the responsibility of the Academic Chief.
  • Note that despite scheduling most rotations, the Scheduling Chief may not know the details of a particular rotation.

Scheduling Requests

Submitting a Request

  • Residents will be required to complete the Scheduling Request form
  • Residents should carefully review their request and ensure compliance with program rules and policy
  • Residents should be aware of affected Rotations, Attendings, Preceptors, and Residents

Inpatient Schedule

  1. The Scheduling Chief will publish and share the preliminary inpatient call schedule by the 15th of each month.
  2. Residents are welcome and encouraged to submit Early/Advanced Accommodations before the preliminary schedule is released.
  3. Once the preliminary schedule is released, residents will have until the 20th to request any additional changes or accommodations to the scheduling chief.
  4. If the 20th is a weekend day or holiday, this will default to the next regular business day.
  5. Up to this date, the scheduling chief will have the primary responsibility and discretion to approve and process appropriately submitted requests.
  6. After this date, any further requests will require the approval of the IM Program Director.

General Guidelines

  • Ideally, schedule changes should be arranged early, preferably 1 month in advance.
  • Advanced approval of the Scheduling Chief, Program Director, and Program Coordinator is required.
  • Advanced notification or approval of affected Attending(s) and/or Rotation Preceptor, if applicable, is required.
  • All involved parties must consent and agree with proposed changes.
  • Proposed changes must not result in duty hours violation(s) for any residents involved.
  • When applicable, proposed changes MUST NOT interfere with continuity clinic scheduling.
  • Creation of "difficult call situations”, e.g., call on clinic day, should be avoided.
  • Schedule changes should be uncommon practice.
  • Remember, schedule changes are a privilege. Abuse or misuse of scheduling changes may result in loss of this privilege.
  • Trading of WEEKEND inpatient days between inpatient residents is NOT PERMITTED.

Early/Advanced Accommodation

  • Special consideration for specific day(s), requested in advance, before completion of the monthly schedule
  • Best and recommended method for all scheduling requests
  • Generally makes things much easier for the Scheduling Chief and Program Coordinator
  • Generally will be honored in a first come, first served basis.
  • Please note that early submission does not guarantee approval or feasibility of any request
  • Please note that these requests CANNOT be used to create inpatient "golden weekends"
  • Please note that these changes generally do not result in an increase in totals days off during a rotation
  • Guidelines:
  1. Should be submitted 1 month prior to the affected rotation, by the 20th of that month, before release of the final schedule
  2. Follows the rules outlined under Inpatient Schedule
  3. Requires advanced approval of the Scheduling Chief, Program Director, and Program Coordinator
  4. May require advanced notification or approval of affected Attending(s) and/or Preceptor, if submitted late

Call Schedule Change

  • Trading 1:1 of a WEEKDAY call period, 5:00 – 7:30 pm
  • Guidelines:
  1. Can be done to allow attendance of external commitments, or to avoid “difficult call situations”, e.g., call on clinic day
  2. Should not create new “difficult call situations”, e.g., call on clinic day
  3. Should be arranged as quickly as possible, preferably 1 month in advance
  4. Requires advanced approval of the Scheduling chief, Program Director, and Program Coordinator
  5. Requires advanced notification of the affected Attending who will be on call

Appointments & Same Day Time-off

  • Internal or external appointments, about 1 hour in expected duration
  • Includes doctor visits, dental visits, mental health visits,
  • May include committee meetings, QI meetings, community engagement, etc.
  • Guidelines:
  1. Should be arranged as soon as known, preferably 1 month in advance
  2. Requires advanced approval of the Scheduling Chief, Program Director, and Program Coordinator
  3. Requires advanced approval of the Rotation Preceptor and/or affected Attending(s)
  4. Appointments should preferably be scheduled towards the beginning or the end of the day
  5. Morning appointments should be avoided if on inpatient
  6. Cross-cover should be arranged if necessary
  7. Avoid “difficult call situations”, i.e., do not schedule on a call day
  8. MUST NOT schedule during continuity clinic

Vacation Change

  • Changing vacation week from one M-F period to a different M-F period
  • Guidelines:
  1. Should be arranged as soon as known, and preferably at least 1 month prior to the affected rotation(s)
  2. Ideally should trade 2 different weeks within the same month
  3. Requires advanced approval of the Scheduling Chief, Program Director, and Program coordinator
  4. May require advanced notification or approval of the Rotation Preceptor
  5. May require advanced notification of affected Attending(s)
  6. If affecting multiple months, the new month must be a vacation eligible rotation

Substitution

  • Resident on an off-service or elective rotation agrees to work an inpatient day or shift for an inpatient resident
  • Should only occur in rare and extenuating circumstances
  • This is the approved method for urgent and necessary changes of the inpatient weekend schedule
  • May require additional make-up shifts or weekend days during a future rotation
  • Guidelines:
  1. Should be arranged as soon as known, preferably 1 month in advance
  2. Requires advanced approval of the Scheduling Chief, Program Director, and Program Coordinator
  3. Substitute must have previously completed the rotation at the same PGY level for PGY1 and PGY2 residents
  4. Requires advanced notification of affected Attending(s)

Weekend Schedule Change

  • Trading of a WEEKEND inpatient day, e.g., Saturday for Sunday, between residents on inpatient
  • These changes are incredibly disruptive to the schedule and generally require at least 4 people
  • Program policy DOES NOT PERMIT these changes
  • Practice was heavily abused in the past:
    • Program and attendings were not informed
    • Resulted in days without resident coverage or with wrong resident coverage on some teams

Suggested Solutions

  • Early/Advanced Accommodation: Specific Weekend days should be requested 1 month in advance, preferably before the affected schedule is published
  • Substitution with a resident who is off-service or on elective can be permitted

Holidays

  • Expectations of the medical profession generally include working on holidays
  • Residents on inpatient rotations are expected to work on holidays
  • Residents on call will work a normal full call day
  • Residents not on call will generally work a short call day, Attending and Upper-Level permitting
  • Residents on outpatient rotations will generally be off on holidays, but should confirm with Rotation Preceptor
  • Continuity clinic will generally be closed on holidays
  • Some holidays, like Christmas and New Year’s Day, may be subject to special schedules

Vacation

  • Month before you go on vacation—ensure the following:
  1. Completion of Absence Request Form
  2. Cross-cover for your in-basket
    1. Clinic upper-level should have consistent access to your in-basket
    2. Generally your clinic day “buddies” should cover your in-basket
    3. Scheduling Chief may also need access to in-basket