In accordance with our fellowship’s graduated autonomy approach, each fellowship class has a different on-call schedule with different responsibilities appropriate for their level of skill and experience. Within each class, the call is rotated among the fellows in the class (currently 6/year). The call responsibilities of each class year are listed below:
- First year fellows are the “front line” of our division, and take call for the inpatient general cardiology unit, as well as all consults from any inpatient units, NICU, PICU, emergency room, and referring hospitals/cardiologists. They also field phone calls from patients and parents. The first year fellow performs all admissions, whether to the general floor or cardiac ICU, and may go on transport if a physician is needed. Once patients are admitted to the cardiac ICU, the first year fellow hands off care to the second year in the ICU. Coverage is through a night float system for Sunday-Thursday, with weekends covered by a rotating schedule. Fellows go home post call after sign out in the morning.
- Second year fellows take call exclusively in the Pediatric Cardiothoracic Intensive Care Unit (PCTU), which is in-house call. The second-year fellows rotate coverage through a night float system for Monday-Thursday coverage, with weekends covered by a rotating schedule. During the week, fellows go home post call after signing out in the morning. On weekends, the on-call fellow stays to round on their team before going home by 10 AM. Cardiac surgery nurse practitioners provide assistance to patient care coverage on most night/weekend shifts.
- Third year fellows rotate call as the “backup fellow”. They perform any echocardiograms and catheterizations that happen at night and weekends, and go on any transports that are determined to need a more experienced physician. They also serve as backup to the other 2 fellows on call. In the beginning of the year, they are a welcome resource for the first year fellow with regards to logistical and other more general questions. The third year fellow may also be called in to assist the first or second year as needed for urgent coverage for illness/emergency and in particularly busy or high acuity times. When not called in, the third-year fellow on call is not required to stay in the hospital.
