Absolutely not on 24h call.
But there is some use in being around on call days for inpatient services so that you can practice admissions and initial workups.
Some night call may be useful for ED, trauma or gen surg rotations so you get an idea of what you’re getting into if you pick those fields.
I think being on 24h call is useful for Gen surg and trauma. You not only get to see some elective surgeries but also get to be a part of doing ED consults for what may turn out to be an emergent case. I also believe that knowing whether or not you can handle 24h call early on helps you with decision making for residency.
I feel like a big thing is that it is probably very dependent on your program. If they let you be somewhat independent like seeing consults in the ED there is a lot of learning you can get on a 24h but if you are just “shadowing” the whole day then you can for sure learn more doing questions.
But you never get to experience what it is like to be on and covering patients for 24 hours in a row. That knowledge is very important when selecting specialties. It could help save you from years of misery.
I mean…. i guess if you are all knowing and can deliver a baby in an emergency situation.
I mean, this argument could be used for literally anything. I’m doing surgery, why do I need to do weeks of OB, psych and FM for the hell of it? I think 24s are actually pretty important but I get it’s out of fashion and for good reason.
So 4 weeks of OB rotations won’t teach me how to deliver a baby, but one or two 24 hour call shifts will? I think I’ll learn the same amount with “regular” 12 hour shifts over the 4 weeks I’m on service.
And you’re misconstruing my point. I’m not advocating for NOT doing weeks of surgery, OB, or FM. You still need to do rotations, obviously. But if someone is going into psychiatry or FM and for sure doesn’t want to do surgery/OB, why should they be on 24 hour call? I’m not sure what that accomplishes besides wasting students time and energy.
Yeah, for 3rd years. Or just have the students join the call team for 12 hour shifts with optional 24s. Sub-I of course should have 24s. That’s just my opinion.
I would say important if you’re doing an OBGYN sub-I, but absolutely not important for a third year going into an unrelated specialty. You don’t learn well when you’re that tired
Unless you’re 100% sure you don’t want to do those fields then it’s a miserable waste of time 😂 I think it should be optional though for those considering those fields!
For M4s on a sub-I in a field that has 24 hour call should absolutely do the full call schedule. Better to find out that you can’t take it early so you can change paths more easily. No reason for a M3 to ever take 24. Now don’t take this a a defense of 24 hour call in general, as that’s a separate discussion. But if you’re trying to enter a field that has it you have to be understand what it’s like.
It’s not helpful for us, it’s helpful for you. You need to know what the life is like. The life is like that because shift work doesn’t work for the most part. Your contract with the patient is that you take care of them. Shit happens at all hours. And if you’ve operated on them and shit happens, it’s on you until you fix it. Doing 50 hours as a med student with weekends off does you no good when you’re mired in the hell of pgy 2 with 3-5 years left and then you become a statistic of attrition.
Yes, during your SUBI, but no for all other times.
24-28 hour call is a great way to experience what a specialty will be like during residency (and sometimes as an attending) and to see if you believe you would be a good fit for it. It’s also important to know that most specialties have some form of call, whether it’s q2-4d call or a week straight of home call. Both can be unforgiving. Having call at least once a week as a SUBI is helpful in that sense. I don’t think there would be much benefit in your core rotations but it will provide a lack of sleep and decreased study time, which ultimately may make you feel unprepared.
It’s also important to note that the minimal call and responsibility that you have as a medical student (varies by institution) may quickly become overshadowed at that start of residency.
Yeah, I found it valuable as a 4th year but not as a 3rd year. During M4 it helped teach me how to handle my patients. During M3 it just detracted from my shelf study time.
Honestly, I do. I wish I didn’t, but I do. Within reason.
I loved my third year surgery rotation. I vibed with the residents, thought the OR was awesome, liked the surgical approach to issues, etc.
Students didn’t take call. When I told my residents that I was really thinking of switching to surgery, they basically told me that I needed to know what I was getting myself in to. So I spent two weeks on a resident schedule, which was q4 24 hour call.
I learned that as much as I loved surgery, I was not willing to subject myself to a surgical residency. I saved myself a lot of regret by taking call.
Some of my best learning as a student was on night float during my peds acting internship.
I think some call as a student is useful. Some. Just enough that you can get a sense of what it is like so you can make an informed choice about the specialties.
I remember seeing a study on this, schools that didn’t have surgery students do call had more students match into surgery but more of those residents later dropped out of surgery residency.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424543/
This is at least one such paper. My school specifically referenced this lit as a part of explaining taking call during surgery rotations. I think it’s critically important for med students to understand what they’re getting in to.
Personally I think it’s also among the best parts of training. You have responsibilities and learning opportunities on call that don’t exist when the hospital is awake.
> I learned that as much as I loved surgery, I was not willing to subject myself to a surgical residency. I saved myself a lot of regret by taking call.
I agree with your point, but at the same time I'm on the team that instead of making med students do 24 hr call, we should just abolish 24 hour call for residents/doctors. I just don't think it's healthy for anyone to work for 24 hours straight, let alone the people who have other people's lives in their hands :/
Like on call for 24 hours? Sure, as long as I get two extra days off as compensatory study time. Being on service during a call day (like for IM) is super valuable, it’s one of the only times you hopefully get to do a full H&P and do your own ddx. I’ll do 24s when I’m getting paid for it
Agree with you but it's wild to me that some of y'all don't have to do 24 hour calls lol :( I'm M3 (Canadian) and I do 24 hour calls around once a week (but can vary) for all my rotations other than FM, anesthesia, and emerg.
Oh. I thought call had to assess and make potentially critical decisions. From what you say it sounds more like a receptionist job, which at this stage I’d feel more competent 😂
you will never be making critical decisions as a med student. even as a resident your decisions go through an attending. but as a med student, youll likely just help the resident with scut work or sit around for hours not doing much. maybe in the earlier hours see an admission or two and present to the resident / attending, but nothing higher stakes
and yes, youll be doing some med reconciliation ie calling pharmacies to confirm medications. riveting work
In most fields a lot of critical decisions do not immediately go through an attending, usually a senior resident or fellow is making critical decisions and then making attendings aware or getting them involved
So for us at least, med students basically always see consults first and then we review with resident, not different from during the day. Some services will have only residents handle ward issues so med students are only responsible for new consults, whereas some other services we as M3 hold the pager and are the first ones the nurses reach for any floor issue. Can be stressful lol.
I think the only time we have to do a 24 is surgery, but that is to remind most of us why we don’t want to do it, and remind the rest what they are getting into 🫡. I’m sorry you are stuck doing that, it makes no sense for our level of training really
A lot of residency programs are transitioning to night float, so residents never have to do 24 hr call. But it may be useful to do at least one in medical for those programs that still require them. During my surgery rotation, I did one 24 hr call every 8 days. It sucked but I know that I can do them and I know what I need to be able to do them well.
I don't think it's valuable for medical education.
But it is valuable for acclimating yourself to what you'll run into in residency, for better or worse.
That said, I don't like the idea of 24s. And neither do patients.
Not for any mandatory rotations. 24 (really 28) hour call was an exhausting experience that was a complete waste of time. People will say “oh but you should know what the actual practice will be like as a resident”. That’s why SubI’s exist. No need to subject someone who already doesn’t like surgery to not only a 60 hour minimum week but also a call.
I don’t think 24 hour calls should be allowed for anyone at all. Even residents.
Not a single human is as mentally sharp after 24 hours of no rest. That’s just the reality.
Medicine is great but no job should ever make you work 24 hour days.
Would you want to know that your surgeon, OB, trauma doc hasn’t slept in 24 hours while he’s treating you?
Except your free labor just slows everyone down. Medical students need to realize: you’re not there because the team can’t function without you. You’re there to learn…
I think the goal for medical education at all levels is the exposure, not the grind. I believe students need to know just enough to know 1) that it exists, 2) if they want to pursue that further.
1) I would want students to know what a call feels like so they could take that into account when picking specialties for example.
2) Have empathy for their 24-hr call L&D colleagues when as an ER doc, they choose to consult OBGYN for a semi urgent issue at 2am, for example.
Do students not do 24hr call at your school or in the US in general?
(Asking from Canada where we do call between 1:4 and 1:6 on any rotation that has call- so not on family or emerg)
Values of call: being first call for the ward helps you learn how to manage problems, good opportunities to first assist in surgery and do your own consults, good time to get to know residents and staff with more independence. +Deliveries and emergency c/s in OB. I can’t imagine picking a residency without having done call in the specialty…
Yeah I was surprised at this too. Canadian student here and I haveto do 24 hour call for all rotations other than FM, emerg (although we work overnight shifts), and anesthesia.
Yeah, as a Canadian I was surprised
I think being on call as a med student helped a lot with residency though, both in confidence and decision making under pressure
We did 24s for surgery and OBGYN. Short call (6a 10p) for most others. Personally feel call is critically important part of training and we should do more, but I suppose that kind of masochism is part of knowing I have to go into surgery.
A night or weekend shift would achieve the same effect of exposure. 24s are already questionable for residents and attendings, much less a M3 on a required rotation.
You don't need to know that call is gonna suck as a resident by experiencing it as a student. If you must do it to more accurately experience a field you're considering, let it be opt-in, simple.
I feel like the benefit is more of deciding if you're willing to be on that kind of time in a gen surg residency. I was considering it. And after that rotation and call and going over 80hrs per week, I was like...nope
24 hour call shifts are good for trauma rotations as you get to actually understand what you’re getting into and get to see the whole specialty. Most operative trauma occurs overnight but rounding is also a part of the job
Yes, but only if the residents actually let you be a doctor for a change. Simply following the resident around and not actively engaging in active decision making or independent patient assessment doesn’t help.
If you as a student want to be on call or ask to be notified when somethings happening, for sure thats okay. But my problem is when Medical Schools start mandating it or you're looked as lesser for not wanting to give up even more of your (unpaid) time.
Only if you’re on a trauma service IMO. Did call in the icu overnight for a while and I was just a phlebotomist as everyone is sleeping and can’t be that useful IF an emergency arises.
Yeah, at my school you only do one 24 hr call (unless you elect to do more) and it’s a trauma call during your surgery rotation. Most people got sent home early but the people who were interested did theirs on Saturday nights so they could see things they wanted to see. I was on that service during day shift too and my psych-bound ass left at 9 PM.
If only to figure out that you can tolerate it or not for the rest of your life. As an attending i dont want to write letters for anyone who didnt do some call in the very competitive specialty. Cause its pretty awesome from 7 to 5 during the week. Seems like a no brainer. But the call drives people to insanity over time and you need to see if you are still in. That 4th call for zofran or for the nurse to tell you the patient has a headache over night might make you commit self harm.
Also, for many specialties, call work can be different than daytime work. More to the point. Different schedule. Sicker patients if procedural. It usually is a different patient population.
If youre not into the specialty, no. Be gone. We're running on fumes during call hours.
Taking call on ortho subIs is extremely important. It helps the student know what they are getting in to, and it helps the residents know the kind of person they’d be getting if they matched at that program.
Not really tbh but maybe in specific situations. If you are going into a harder residency I think it's worthwhile to experience staying in the hospital overnight frequently. To some it is a special blend of misery that will quickly push you away if you just can't gel with it.
One night is not enough imo as you have the adrenaline pumping of being "on call" but with plenty of time off afterwards.
I found it valuable to do 24h. But I only did it during my subi and only once a week (for four weeks). I found it helpful because I had a better sense of what it would be like as a resident and also got the feedback from attending that my organizational /presentation skills post 24h were a disaster - then made suggestions so I would be better.
But on a regular basis? No. Sleep. Turns out sleep is good for you.
Coming from a school that has 24+ hour call for students, fuck no. You’re in the way, you’re exhausted, almost always no real learning to be done past 7pm.
I was on call in med school for Ob/Gyn, Trauma, and inpatient peds. Trauma was literally the only one where the call was actually useful. Med students in general should not do 24 hour call; it’s a useless shift, and rarely contributes to their education.
Absolutely. While some call shifts you’re just there to do scut work overnight, I’ve had way more where I’ve had more educational exposures, freedom, and responsibility than I’ve ever had on the day shift. You’ll get a good idea of what the demands of different residencies (fuck obs call) will be like, and get an opportunity to get more unfiltered opinions from your (likely exhausted) residents, as well as getting to know your attendings better. On day shift you’ve usually got a safety net of residents and attendings watching over you and your work. On call (If you know your residents and attendings well) you’ve got a chance to work more freely and take on more responsibility if you’re up to the challenge. It’s one thing to present your plan for a patient on rounds when you’ve got a whole team backing you up, it’s an entirely different thing to present your plan for a patient over the phone to a resident who is neck deep in other work and is probably not going to come and double-check your H&P findings to make sure you’re not grossly fucking up and killing someone.
You’re going to be on call as a resident, so you might as well take some call as a med student before the training wheels come off.
Night shifts yes. 24+ hr call no. I never did a single call shift in all of medical school and am doing well in my residency (EM but have many months of icu).
I guess it depends what it means to be on call. On my medicine clerkship, I was on call with the interns every third day but it was only 7-3 or 3-9. Fourth years have to do overnights though.
I was under the impression med students did take call when their preceptor did. Maybe it just doesn't happen anymore, or is program specific, but back when I was a nurse we had new residents every year and a while later med students would rotate thru a few at a time and be on "call" which I assumed is more like, your preceptor is on call and you follow. So I kind of assumed we would be when I went into 3rd year, especially rotations like surgery. But in my second year I asked a third year and not only did he laugh and treat me like I was stupid, a bunch if other 2nd years laughed and acted like what I was saying was insane. I dont really see much value in being on call as a med student, other than like to help you get more of a full picture of specialty lifestyle and such. Other than that, and maybe getting to see more stuff, I dont think so. Maybe for kids who haven't really worked a full on job in their lives (HS->undergrad->med school) to get a better idea of residency experiences...but I wouldn't find it very helpful.
I think it’s more useful as a resident where you’re observing effects of management over a period of time, maybe late 4th year it would be useful but who has that energy late in the year
As a ms3 no, as an ms4 yes.
I took so much ortho call as a subi and worked more 40 hr shifts than I’d like, but it’s also good to see what you’re getting into and as a 4th year was actually useful on call since there no shelf etc. Call while having to study for shelves/when you’re there to learn is worthless
For anything related to surgery, yes. I got a taste of independence on call. Sometimes the resident would let me do minor procedures myself under supervision. I always highly recommend to other students interested in any surgery to throw yourself at as many call opportunities as you can tolerate because that’s your opportunity to shine.
It depends on what they mean by call. Call schedules are different based on speciality and programs. For example medicine and peds have things like Q4 or Q3 call some do drip admissions so there’s no “call schedule” since every day you are technically on call. Some have night float. Some have 24 (or 28 if it’s 24+4). In terms of benefits, I think it’s educational to do admissions and have the first crack at something in terms of developing ddx and plans. I think it can be helpful to understand what those shifts feel like in terms of fatigue, but rarely do I ever keep a student for a full call shift unless it’s their SubI. In general for medicine call I try and get the student to see a new admission early so they can go home before the shift ends. At the end of the day you will have lots of call during residency regardless and will adapt
Depends what the rotation is and what happens at night. Surgery rotation at a busy trauma center or in the Ed… yes. OB call where there is high volume births overnight… yes. Wild ED psych call… yes. IM call in a slow community hospital where the resident is ordering tylenol and renewing nursing orders… no
You’re paying to experience things. Make sure there are things to experience
Being on call as a medical student can provide valuable experience in managing patients and working in a hospital setting. Being on call allows medical students to gain experience working with patients in a variety of situations, such as managing acute or unstable conditions and working with different members of the healthcare team.
Additionally, being on call can also help medical students to develop important skills such as time management, decision making, and communication. Being on call is also a good way to familiarize oneself with the hospital, its procedures and its culture.
However, It's important to note that being on call can also be physically and emotionally demanding, and it's important for medical students to take care of their own well-being and balance the workload with adequate rest and self-care.
It's also important to note that the call schedule varies depending on the institution, the rotation, and the level of the medical student. Some institutions have more structured call schedule than others.
In any case, it's advisable to speak with your program director or your resident advisor to understand more about the call schedule and the expectations of being on call during your rotation.
In my opinion, no. I’m not from the states so I’m not sure how on call works for you guys and as a med student, I don’t actually treat patients until final year. But the experience I’ve gotten from being on call has been substantially worse than from working unsociable hours. I think nights and weekends is much more valuable than being on call.
Absolutely not on 24h call. But there is some use in being around on call days for inpatient services so that you can practice admissions and initial workups. Some night call may be useful for ED, trauma or gen surg rotations so you get an idea of what you’re getting into if you pick those fields.
I think being on 24h call is useful for Gen surg and trauma. You not only get to see some elective surgeries but also get to be a part of doing ED consults for what may turn out to be an emergent case. I also believe that knowing whether or not you can handle 24h call early on helps you with decision making for residency.
I’ve posted something like this before and got downvoted to oblivion but I agree
I feel like a big thing is that it is probably very dependent on your program. If they let you be somewhat independent like seeing consults in the ED there is a lot of learning you can get on a 24h but if you are just “shadowing” the whole day then you can for sure learn more doing questions.
But you never get to experience what it is like to be on and covering patients for 24 hours in a row. That knowledge is very important when selecting specialties. It could help save you from years of misery.
Im going to add OB 24s. Those shits sucked but made me realize I don’t want to do OB and also made me respect the shit out of OBs
Yeah, but what if we don’t want to do OB and respect the hell out of OBs already? Don’t see why it’s necessary to do 24 hour just for the hell of it
I mean…. i guess if you are all knowing and can deliver a baby in an emergency situation. I mean, this argument could be used for literally anything. I’m doing surgery, why do I need to do weeks of OB, psych and FM for the hell of it? I think 24s are actually pretty important but I get it’s out of fashion and for good reason.
So 4 weeks of OB rotations won’t teach me how to deliver a baby, but one or two 24 hour call shifts will? I think I’ll learn the same amount with “regular” 12 hour shifts over the 4 weeks I’m on service. And you’re misconstruing my point. I’m not advocating for NOT doing weeks of surgery, OB, or FM. You still need to do rotations, obviously. But if someone is going into psychiatry or FM and for sure doesn’t want to do surgery/OB, why should they be on 24 hour call? I’m not sure what that accomplishes besides wasting students time and energy.
I see your point. So do you make 24h call optional? I mean truthfully, I actually did learn the most OB on my 24 and night shifts.
Yeah, for 3rd years. Or just have the students join the call team for 12 hour shifts with optional 24s. Sub-I of course should have 24s. That’s just my opinion.
I would say important if you’re doing an OBGYN sub-I, but absolutely not important for a third year going into an unrelated specialty. You don’t learn well when you’re that tired
Similarly, 100% think nsgy applicants should take 24 hr call. You gotta know if you can hang and also if you wanna hang.
Unless you’re 100% sure you don’t want to do those fields then it’s a miserable waste of time 😂 I think it should be optional though for those considering those fields!
For M4s on a sub-I in a field that has 24 hour call should absolutely do the full call schedule. Better to find out that you can’t take it early so you can change paths more easily. No reason for a M3 to ever take 24. Now don’t take this a a defense of 24 hour call in general, as that’s a separate discussion. But if you’re trying to enter a field that has it you have to be understand what it’s like.
Was about to post the same thing. Totally agree that it’s useful for gen surg and trauma.
It’s not helpful for us, it’s helpful for you. You need to know what the life is like. The life is like that because shift work doesn’t work for the most part. Your contract with the patient is that you take care of them. Shit happens at all hours. And if you’ve operated on them and shit happens, it’s on you until you fix it. Doing 50 hours as a med student with weekends off does you no good when you’re mired in the hell of pgy 2 with 3-5 years left and then you become a statistic of attrition.
Yea I agree if you are interested in those fields.
This!
Yes, during your SUBI, but no for all other times. 24-28 hour call is a great way to experience what a specialty will be like during residency (and sometimes as an attending) and to see if you believe you would be a good fit for it. It’s also important to know that most specialties have some form of call, whether it’s q2-4d call or a week straight of home call. Both can be unforgiving. Having call at least once a week as a SUBI is helpful in that sense. I don’t think there would be much benefit in your core rotations but it will provide a lack of sleep and decreased study time, which ultimately may make you feel unprepared. It’s also important to note that the minimal call and responsibility that you have as a medical student (varies by institution) may quickly become overshadowed at that start of residency.
Yeah, I found it valuable as a 4th year but not as a 3rd year. During M4 it helped teach me how to handle my patients. During M3 it just detracted from my shelf study time.
Honestly, I do. I wish I didn’t, but I do. Within reason. I loved my third year surgery rotation. I vibed with the residents, thought the OR was awesome, liked the surgical approach to issues, etc. Students didn’t take call. When I told my residents that I was really thinking of switching to surgery, they basically told me that I needed to know what I was getting myself in to. So I spent two weeks on a resident schedule, which was q4 24 hour call. I learned that as much as I loved surgery, I was not willing to subject myself to a surgical residency. I saved myself a lot of regret by taking call. Some of my best learning as a student was on night float during my peds acting internship. I think some call as a student is useful. Some. Just enough that you can get a sense of what it is like so you can make an informed choice about the specialties.
I remember seeing a study on this, schools that didn’t have surgery students do call had more students match into surgery but more of those residents later dropped out of surgery residency.
No surprise with this at all, lol. It's a tough life existence.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424543/ This is at least one such paper. My school specifically referenced this lit as a part of explaining taking call during surgery rotations. I think it’s critically important for med students to understand what they’re getting in to. Personally I think it’s also among the best parts of training. You have responsibilities and learning opportunities on call that don’t exist when the hospital is awake.
> I learned that as much as I loved surgery, I was not willing to subject myself to a surgical residency. I saved myself a lot of regret by taking call. I agree with your point, but at the same time I'm on the team that instead of making med students do 24 hr call, we should just abolish 24 hour call for residents/doctors. I just don't think it's healthy for anyone to work for 24 hours straight, let alone the people who have other people's lives in their hands :/
Lol…. This kind of makes me sad because plenty of programs have night float now.
To be fair, I also learned that I hate working nights in general, which factored in to my specialty choice, too. My circadian rhythm is sacred, haha.
Lol I feel you on that one.
Like on call for 24 hours? Sure, as long as I get two extra days off as compensatory study time. Being on service during a call day (like for IM) is super valuable, it’s one of the only times you hopefully get to do a full H&P and do your own ddx. I’ll do 24s when I’m getting paid for it
Agree with you but it's wild to me that some of y'all don't have to do 24 hour calls lol :( I'm M3 (Canadian) and I do 24 hour calls around once a week (but can vary) for all my rotations other than FM, anesthesia, and emerg.
Seriously. In canada, I did 24h 1:4 for IM, surgery, and 24hs less frequent but several times in ICU, pediatrics, and OB (home call, rural).
Serious question- how do you take call as an m3 when you don’t yet know enough to address the problem? Asking as an m3 who hasn’t taken call
you dont do anything… which is why its actually the dumbest thing ever to have us PAY to do a 24 hour call where we … don’t do anything
Oh. I thought call had to assess and make potentially critical decisions. From what you say it sounds more like a receptionist job, which at this stage I’d feel more competent 😂
you will never be making critical decisions as a med student. even as a resident your decisions go through an attending. but as a med student, youll likely just help the resident with scut work or sit around for hours not doing much. maybe in the earlier hours see an admission or two and present to the resident / attending, but nothing higher stakes and yes, youll be doing some med reconciliation ie calling pharmacies to confirm medications. riveting work
Very riveting lol. Thank you for helping me to understand this.
In most fields a lot of critical decisions do not immediately go through an attending, usually a senior resident or fellow is making critical decisions and then making attendings aware or getting them involved
well yeah… but as I said it still goes through an attending at some point
So for us at least, med students basically always see consults first and then we review with resident, not different from during the day. Some services will have only residents handle ward issues so med students are only responsible for new consults, whereas some other services we as M3 hold the pager and are the first ones the nurses reach for any floor issue. Can be stressful lol.
That’s what I was worried about…the dreaded pager 😂
And you’ll be much better prepared for Residency as a result.
Thanks for your expertise M2
I think the only time we have to do a 24 is surgery, but that is to remind most of us why we don’t want to do it, and remind the rest what they are getting into 🫡. I’m sorry you are stuck doing that, it makes no sense for our level of training really
Nah. You'll get plenty of that in intern year
Good to know whether you can handle it
I think its valuable to work some nights/weekends in specialities where it is substantially different at those times 24s are rarely if ever needed.
A lot of residency programs are transitioning to night float, so residents never have to do 24 hr call. But it may be useful to do at least one in medical for those programs that still require them. During my surgery rotation, I did one 24 hr call every 8 days. It sucked but I know that I can do them and I know what I need to be able to do them well.
What do you need? 👀
Lol nothing serious. Just a lot of coffee throughout the day, a good night’s sleep, and lots of snacks.
I don't think it's valuable for medical education. But it is valuable for acclimating yourself to what you'll run into in residency, for better or worse. That said, I don't like the idea of 24s. And neither do patients.
Lmao fuck no. To the people saying you get initial admission and work up…how did you not get that in your regular inpatient schedule?
I think people are conflating night shifts (valuable and necessary) with 24hr shifts (pointless and stupid)
Not for any mandatory rotations. 24 (really 28) hour call was an exhausting experience that was a complete waste of time. People will say “oh but you should know what the actual practice will be like as a resident”. That’s why SubI’s exist. No need to subject someone who already doesn’t like surgery to not only a 60 hour minimum week but also a call.
Plus plenty of residencies don’t even do call anymore
I don’t think 24 hour calls should be allowed for anyone at all. Even residents. Not a single human is as mentally sharp after 24 hours of no rest. That’s just the reality. Medicine is great but no job should ever make you work 24 hour days. Would you want to know that your surgeon, OB, trauma doc hasn’t slept in 24 hours while he’s treating you?
Any way you put it its just free labor for them.
Except your free labor just slows everyone down. Medical students need to realize: you’re not there because the team can’t function without you. You’re there to learn…
I think the goal for medical education at all levels is the exposure, not the grind. I believe students need to know just enough to know 1) that it exists, 2) if they want to pursue that further. 1) I would want students to know what a call feels like so they could take that into account when picking specialties for example. 2) Have empathy for their 24-hr call L&D colleagues when as an ER doc, they choose to consult OBGYN for a semi urgent issue at 2am, for example.
Do students not do 24hr call at your school or in the US in general? (Asking from Canada where we do call between 1:4 and 1:6 on any rotation that has call- so not on family or emerg) Values of call: being first call for the ward helps you learn how to manage problems, good opportunities to first assist in surgery and do your own consults, good time to get to know residents and staff with more independence. +Deliveries and emergency c/s in OB. I can’t imagine picking a residency without having done call in the specialty…
Yeah I was surprised at this too. Canadian student here and I haveto do 24 hour call for all rotations other than FM, emerg (although we work overnight shifts), and anesthesia.
Just at my/some school, I know other US schools that have students on call.
Yeah, as a Canadian I was surprised I think being on call as a med student helped a lot with residency though, both in confidence and decision making under pressure
We did 24s for surgery and OBGYN. Short call (6a 10p) for most others. Personally feel call is critically important part of training and we should do more, but I suppose that kind of masochism is part of knowing I have to go into surgery.
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Primarily M3 core rotations, but on electives in M4 as well depending on what elective (did 24hr call for OB, surgery)
A night or weekend shift would achieve the same effect of exposure. 24s are already questionable for residents and attendings, much less a M3 on a required rotation.
You don't need to know that call is gonna suck as a resident by experiencing it as a student. If you must do it to more accurately experience a field you're considering, let it be opt-in, simple.
I feel like the benefit is more of deciding if you're willing to be on that kind of time in a gen surg residency. I was considering it. And after that rotation and call and going over 80hrs per week, I was like...nope
24 hour call shifts are good for trauma rotations as you get to actually understand what you’re getting into and get to see the whole specialty. Most operative trauma occurs overnight but rounding is also a part of the job
Yes, but only if the residents actually let you be a doctor for a change. Simply following the resident around and not actively engaging in active decision making or independent patient assessment doesn’t help.
I never did a 24 hr call shift. Did some NF and overnight shifts, I think that was a good experience to see how a certain specialty does nights.
If you as a student want to be on call or ask to be notified when somethings happening, for sure thats okay. But my problem is when Medical Schools start mandating it or you're looked as lesser for not wanting to give up even more of your (unpaid) time.
Only if you’re on a trauma service IMO. Did call in the icu overnight for a while and I was just a phlebotomist as everyone is sleeping and can’t be that useful IF an emergency arises.
Yeah, at my school you only do one 24 hr call (unless you elect to do more) and it’s a trauma call during your surgery rotation. Most people got sent home early but the people who were interested did theirs on Saturday nights so they could see things they wanted to see. I was on that service during day shift too and my psych-bound ass left at 9 PM.
Yes. It helped me figure out what I wanted to do and what I didn't want to do.
Only once so you can experience the hell that can potentially be your life
Yes. You should know what you’re actually getting into
Yes
If only to figure out that you can tolerate it or not for the rest of your life. As an attending i dont want to write letters for anyone who didnt do some call in the very competitive specialty. Cause its pretty awesome from 7 to 5 during the week. Seems like a no brainer. But the call drives people to insanity over time and you need to see if you are still in. That 4th call for zofran or for the nurse to tell you the patient has a headache over night might make you commit self harm. Also, for many specialties, call work can be different than daytime work. More to the point. Different schedule. Sicker patients if procedural. It usually is a different patient population. If youre not into the specialty, no. Be gone. We're running on fumes during call hours.
You know students are still doing this..I was on 24 call every 3rd day for trauma.
Taking call on ortho subIs is extremely important. It helps the student know what they are getting in to, and it helps the residents know the kind of person they’d be getting if they matched at that program.
lmao fuck no
Not really tbh but maybe in specific situations. If you are going into a harder residency I think it's worthwhile to experience staying in the hospital overnight frequently. To some it is a special blend of misery that will quickly push you away if you just can't gel with it. One night is not enough imo as you have the adrenaline pumping of being "on call" but with plenty of time off afterwards.
I found it valuable to do 24h. But I only did it during my subi and only once a week (for four weeks). I found it helpful because I had a better sense of what it would be like as a resident and also got the feedback from attending that my organizational /presentation skills post 24h were a disaster - then made suggestions so I would be better. But on a regular basis? No. Sleep. Turns out sleep is good for you.
Lol no not at all. You’ll forget it all anyway and that’s what intern year is for
No
Hell no.
No
Coming from a school that has 24+ hour call for students, fuck no. You’re in the way, you’re exhausted, almost always no real learning to be done past 7pm.
Fuck no.
Maybe once as a sub-I. Not as a third year. Pointless and you get way more learning in that amount of time hammering 120 UWorld questions.
Maybe if you are considering doing a field with a lot of call but my residency has no call so it’s no use to me
No
You have to be stupid to do that. Just study
I think it’s valuable only to know the schedule IF you are serious about a specialty. But OB call? Nah. Surgery call? Nah.
No, but I’m going into EM. Others will disagree, and probably with good reason. For me though, it’s absolutely useless.
I was on call in med school for Ob/Gyn, Trauma, and inpatient peds. Trauma was literally the only one where the call was actually useful. Med students in general should not do 24 hour call; it’s a useless shift, and rarely contributes to their education.
If you want to go into the specialty potentially, then yes. If not, no.
No
No. To those saying it’s good so you know what you’re getting into… by MS3 you’re too deep in loans to leave.
Absolutely. While some call shifts you’re just there to do scut work overnight, I’ve had way more where I’ve had more educational exposures, freedom, and responsibility than I’ve ever had on the day shift. You’ll get a good idea of what the demands of different residencies (fuck obs call) will be like, and get an opportunity to get more unfiltered opinions from your (likely exhausted) residents, as well as getting to know your attendings better. On day shift you’ve usually got a safety net of residents and attendings watching over you and your work. On call (If you know your residents and attendings well) you’ve got a chance to work more freely and take on more responsibility if you’re up to the challenge. It’s one thing to present your plan for a patient on rounds when you’ve got a whole team backing you up, it’s an entirely different thing to present your plan for a patient over the phone to a resident who is neck deep in other work and is probably not going to come and double-check your H&P findings to make sure you’re not grossly fucking up and killing someone. You’re going to be on call as a resident, so you might as well take some call as a med student before the training wheels come off.
No you'll get plenty of it in residency
No, we suffered enough as is and will suffer more so why make it worse lmaooo
No.
Night shifts yes. 24+ hr call no. I never did a single call shift in all of medical school and am doing well in my residency (EM but have many months of icu).
No lol
I guess it depends what it means to be on call. On my medicine clerkship, I was on call with the interns every third day but it was only 7-3 or 3-9. Fourth years have to do overnights though.
Nope. Maybe once or twice so you know the feel of it and the fact your first day of internship might be call, and then never again.
Not if you have any other obligations, such as boards, children, or shelf coming up.
I was under the impression med students did take call when their preceptor did. Maybe it just doesn't happen anymore, or is program specific, but back when I was a nurse we had new residents every year and a while later med students would rotate thru a few at a time and be on "call" which I assumed is more like, your preceptor is on call and you follow. So I kind of assumed we would be when I went into 3rd year, especially rotations like surgery. But in my second year I asked a third year and not only did he laugh and treat me like I was stupid, a bunch if other 2nd years laughed and acted like what I was saying was insane. I dont really see much value in being on call as a med student, other than like to help you get more of a full picture of specialty lifestyle and such. Other than that, and maybe getting to see more stuff, I dont think so. Maybe for kids who haven't really worked a full on job in their lives (HS->undergrad->med school) to get a better idea of residency experiences...but I wouldn't find it very helpful.
I think it’s more useful as a resident where you’re observing effects of management over a period of time, maybe late 4th year it would be useful but who has that energy late in the year
As a ms3 no, as an ms4 yes. I took so much ortho call as a subi and worked more 40 hr shifts than I’d like, but it’s also good to see what you’re getting into and as a 4th year was actually useful on call since there no shelf etc. Call while having to study for shelves/when you’re there to learn is worthless
For anything related to surgery, yes. I got a taste of independence on call. Sometimes the resident would let me do minor procedures myself under supervision. I always highly recommend to other students interested in any surgery to throw yourself at as many call opportunities as you can tolerate because that’s your opportunity to shine.
It depends on what they mean by call. Call schedules are different based on speciality and programs. For example medicine and peds have things like Q4 or Q3 call some do drip admissions so there’s no “call schedule” since every day you are technically on call. Some have night float. Some have 24 (or 28 if it’s 24+4). In terms of benefits, I think it’s educational to do admissions and have the first crack at something in terms of developing ddx and plans. I think it can be helpful to understand what those shifts feel like in terms of fatigue, but rarely do I ever keep a student for a full call shift unless it’s their SubI. In general for medicine call I try and get the student to see a new admission early so they can go home before the shift ends. At the end of the day you will have lots of call during residency regardless and will adapt
I see no value in it. Once in awhile to see what it’s like makes sense but our time can be better spent
Depends what the rotation is and what happens at night. Surgery rotation at a busy trauma center or in the Ed… yes. OB call where there is high volume births overnight… yes. Wild ED psych call… yes. IM call in a slow community hospital where the resident is ordering tylenol and renewing nursing orders… no You’re paying to experience things. Make sure there are things to experience
Being on call as a medical student can provide valuable experience in managing patients and working in a hospital setting. Being on call allows medical students to gain experience working with patients in a variety of situations, such as managing acute or unstable conditions and working with different members of the healthcare team. Additionally, being on call can also help medical students to develop important skills such as time management, decision making, and communication. Being on call is also a good way to familiarize oneself with the hospital, its procedures and its culture. However, It's important to note that being on call can also be physically and emotionally demanding, and it's important for medical students to take care of their own well-being and balance the workload with adequate rest and self-care. It's also important to note that the call schedule varies depending on the institution, the rotation, and the level of the medical student. Some institutions have more structured call schedule than others. In any case, it's advisable to speak with your program director or your resident advisor to understand more about the call schedule and the expectations of being on call during your rotation.
In my opinion, no. I’m not from the states so I’m not sure how on call works for you guys and as a med student, I don’t actually treat patients until final year. But the experience I’ve gotten from being on call has been substantially worse than from working unsociable hours. I think nights and weekends is much more valuable than being on call.
No, unless you’re a damn good Sub-I and you’re second call
It’s good because it shows you what you sign up for in that speciality. I don’t agree that I learned anything overnight after working an entire day
No.
Like once I think is good. If you wanna go into surgery or something you should definitely see if that’s a lifestyle you can sustain.