Internal Medicine Residency Quality of Life

Over the past decade, we have designed our programs to respect the quality of life and concerns of our residents. Effective July 1, 2003, the RRC has mandated the resident's work hours not exceed 80 hours per week. Baystate's night float system and Q4 call schedule along with intricate scheduling has assured that the work hour rule will be enforced.

Night Call Schedule

Residents take in-house call less than four months during the year and approximately a total of six months their second and third years. For the first year medicine residents, call is every fourth night on the medical wards, the Intensive Care Unit, and the Cardiac Care Unit. For the second year class, call is every third night in the Cardiac Care Unit and every 4th on the medical ward. For the third year residents, call is every fourth night for the medical wards and every third night in the Intensive Care Unit. There are two night float systems which allow the on call R1 and R2 on the medical wards to leave at 10:00 p.m. Cross coverage is done by the R1 ward night float. All admissions after 10:00 p.m. are admitted by the R2 night float. With the institution of these systems, residents get an adequate amount of rest even when they are on call. We also try to avoid scheduling Continuity Clinic sessions post call, and clinic sessions are never scheduled on call days.

Night Float Systems

The admission night float, a second-year resident, comes in at 9:45 p.m. This allows the in-house second year resident an on-call interns to go home at 10:00 p.m. The float resident admits and covers the new patients until accepting teams come in at 7:30 the next morning to assume responsiblity for their care. Each second year resident is the float resident for one month. He/she is scheduled for no more than 21 nine hour shifts per month. Four days of each week the night float resident and the intern ward night float resident meet with a faculty member to discuss cases they have admitted or interesting cross-coverage issues. They are finished with their educational activities before 9:00 a.m., insuring time for adequate rest. The admission night float resident has his/her Continuity Clinic on Friday mornings. On Friday mornings there are no scheduled floats attending rounds. The night-float cross-coverage intern provides weekday cross-coverage for all interns froms 9:45 p.m. to 7:30 a.m. This allows all interns on the wards to go home.

Flexibility in Scheduling

Residents have a variety of expected and unexpected family and personal needs that arise during medical training. We have been able to meet those special scheduling needs that occur as a result of childbearing, health problems, spouse career obligations or changes, and family crises. We are proud that a resident has never had to leave medical residency at Baystate as a result of financial, personal, educational, or family needs.

Salary and Benefits

We have attempted to maintain salaries in the 75th and 85th percentile range in New England, and above the 85th percentile nationally. Few programs match our benefits. For a list of salaries and benefits, please refer to the education page.

Workload Limitation and Backup

We believe it is educationally and medically unsound to ask residents to care for more patients than they believe they can manage comfortably. We limit the number of admissions to interns (a maximum of seven over a four day period), the total number cared for, the frequency of night call, and the number of months on call by providing conscientious faculty and resident backup through the firm systems and subspecialty backup. We have graduated responsibilities for second and third year residents to allow them to learn supervisory and teaching skills.