E2167. Sunday-Thursday Work Week for Residents: A Pilot Study
  1. Ashley Mendez; University of California - San Diego
  2. Angela Chen; University of California - San Diego
  3. Julie Bykowski; University of California - San Diego
Resident weekend call is a balance between the educational experience of learning to triage and manage a service with higher work volume, and the staffing need of the institution for timely urgent imaging review, critical results communication, protocol support, and contrast response. As our program reviewed resident rotations, weekend and evening call volume, and projected staffing models, we decided to pilot a shifted Sunday - Thursday schedule for the neuroradiology resident on service covering inpatient/emergency room studies at one of our sites, incorporating one weekend call day into the rotation. If Residents had a conflict for the assigned Sundays, they could opt out and work Monday - Friday that week, and the weekend would revert to the general call pool.

Educational Goals / Teaching Points
Alternate staffing models may be considered to include resident call within service rotations, rather than having call as an additive requirement. Preserving alternative choices provided autonomy for residents to opt in/out based on other commitments. Creativity and compromise are essential for identifying balance between education, staffing needs and life beyond training.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A total of 18/50 radiology residents were involved in the shifted schedule module (PGY2/R1=8, PGY3/R2=2, PGY4/R3=3, PGY5/R4=5), removing 38 Sundays from the general call pool of 412 weekend/holiday call shifts (9% reduction). Of the 14 remaining Sundays, 9 of were part of holiday call coverage, and only 5 were due to residents opting out of the Sunday-Thursday schedule due to pre-existing conflicts prior to the call schedule being released. Additional logistic requirements included prospectively rotating faculty on Fridays to diffuse distribution of the altered coverage across the service, ensuring fellow coverage, and having site contrast coverage provided by the chest section on the affected Fridays without resident staffing. Residents were surveyed prior to and after the shifted week schedule for feedback. Positive points included call being inclusive in a rotation rather than additive to the service, continuity of call with current service rotation for consolidating knowledge; preserving a 2-day “weekend” (shifted to Friday-Saturday); ability to do other tasks during a routine business day; preserving protected education sessions on Monday and Thursday mornings as part of the rotation; and maintaining resident staffing on weekend call. Negative points included commitment of up to 4 sequential weekends if on a longer rotation block; requires faculty and fellow coordination for Fridays; introduces inconsistency for contrast coverage across site; and not scalable/translatable to all services beyond Neuroradiology.

Shifting a neuroradiology resident service week to Sunday- Thursday met the educational experience and staffing needs for weekend call, while reducing the overall call responsibilities for residents.