Night and Weekend Duty

The educational goal of night and weekend duty is to provide residents with supervised experience seeing patients with the acute and emergent psychiatric issues that arise after hours, developing skills in independent clinical decision making and determining when to consult senior psychiatric colleagues and other providers, and (for senior residents) developing skills in teaching and clinical supervision of junior colleagues.

Night and weekend duty provides an experience with progressively increasing responsibility over the course of residency.  Initially, junior residents are on duty with a senior resident who provides “training call”, modeling interviewing, assessment, clinical decision making, and acute treatment and disposition planning.  After the PGY-2 year, once the resident has had experience being on duty independently (with attending backup), PGY-3 and PGY-4 residents serve as “training call” residents, spending the bulk of their night and weekend duty training and teaching junior residents.

Night and weekend duty in our program is done as night float rotations (with no daytime duties) and night/weekend call.  Night float rotations are 2-week rotations, 5 nights per week (Sunday-Thursday).  Night float shifts are 12 hours for in-house duty (Harborview; 8pm-8am) and 14 hours for home/pager duty sites (University of Washington Medical Center and the Seattle VA; 6pm-8am).  Call consists of weekend shifts (Friday night, Saturday day, Saturday night, Sunday day) and weeknight “training call” by senior residents.  Residents who are not assigned to a weekend call shift have the weekend off.

The University of Washington Psychiatry Residency adheres to all ACGME duty hour limits.  In addition, senior residents doing weeknight training call are off at 8am the following morning.

Night float and call assignments in each year of residency are as follows:

PGY-1
2 weeks night float at Harborview (HMC)
2 weeks night float at UW/VA

About 12 weekend call shifts per 6 months

PGY-2
4 weeks night float at UW/VA (two 2-week blocks; residents entering as PGY-2s have 6 weeks total, i.e. three 2-week night float blocks, including a night float rotation at HMC)

About 24 weekend call shifts for the year

PGY-3
No night float

10-15 (most training calls) per 6 months
2 weeks backup per 6 months (in case of illness of another resident; if called in on backup, this call is repaid by the ill resident at a later time of your choosing)

PGY-4
No night float

6-10 training calls per 6 months
2 weeks backup per 6 months