I remember when I was interviewing, I noticed that residents always seemed to talk about call schedules and what their call was like…when I hadn’t asked.  My thoughts were that I would pick the program that would best educate me to be a competent psychiatrist and if that program had an unfavorable call schedule, then so be it.  This…is the wrong approach. Even with the best of call schedules, call can be a frustrating experience. At some point in your not-too-distant future you will be called at 3AM by an E.R. doctor asking you to crawl out of your warm bed, trot on up to the E.R. and determine if a patient, brought in by police, is “Fit to stand trial,” or some such.  Call, whether you realize it at this point or not, is an important consideration.

We have three types of call at UAMS: “Beeper Call”, Arkansas State Hospital (ASH) call, and Arkansas Children's Hospital (ACH) call.

Beeper call

The only type of call which is required or feared: Beeper call. Residents are available by pager and cover two hospitals (UAMS and the adjacent VA hospital) starting at 4:30PM. Once you finish your normal work day, you go home with the call pager and go about your business hoping….praying that it won’t go off (it likely will). During beeper call, residents are not taking calls from any inpatient psychiatric facilities, as the inpatients are covered by faculty.

On average, you will receive 0-1 calls from the UAMS E.R., and on average 1-2 calls from the VA E.R. The good news is that many times you will receive no calls whatsoever. Sometimes one will receive a call through the switchboard regarding a suicidal clinic patient easily directed to the ER and even more rarely there will be a capacity evaluation on the floor. Upon arrival to the ER, one’s job is to perform a safety assessment, not to explore defense mechanisms and childhood relationships. You can expect to spend about an hour per call and all patients are checked out over the phone with attending physicians who are very supportive and known to drive up to the ER themselves in the middle of the night and troubleshoot if we run into problems.
Call on the weekends is very similar although weekends are split into two shifts: 8AM to 8PM and 8PM to 8AM. This is a new development and is highly regarded as, even if you do have to work a weekend in our program, it’s only a half day.

Interns currently take 30 beeper calls per year total, Second year residents have 20, third year residents work 10, and fourth year residents do not take call. I will let you do the math but I can tell you that in my experience you will be hard-pressed to find anything approximating this elsewhere.

State Hospital and Children's Hospital call

Now for the good news…

There are two other types of call within our program: The Arkansas State Hospital and Arkansas Children’s Hospital. We are actually PAID for working these shifts and they are assigned on a voluntary basis. Moreover, even though this is technically “moonlighting”, it does not require a medical license or malpractice insurance. All residents, PGY I-IV are eligible to moonlight at the Arkansas State Hospital and years II-IV are eligible to work at Arkansas Children’s Hospital.

Arkansas State Hospital

Weekday shifts are from 5PM-7AM. Saturday, Sunday, Monday, and Friday are In-house call and Tuesday, Wednesday, and Thursday are part In-house, part beeper. Residents are responsible for taking calls for general nursing concerns (PRNs, Seclusion, Restraints etc) as well as up to 4 new admissions (the average number of admissions on a weeknight is one to two). There is a very nice call room that has a private bathroom, TV, DVD, VCR, computer with internet connection, and video game system along with a very comfortable recliner. Residents are also permitted to have visitors, spouses, partners, friends while on call. Tuesday- Thursday residents work from 5PM-10PM in-house and then are permitted to leave the hospital and finish their shift from home, available by beeper.  Weeknight shifts are paid $300 and Saturdays are paid $600 (Sundays are split into two $300 shifts 8AM-8PM and 8PM-7AM). This is a great gig.

Arkansas Children’s Hospital

Residents are paid $50 on weekdays and $100 on weekends to carry the pager and make themselves available at home.  Consults are placed primarily from the ER, but also from the floor and are paid $125 per consult. At times, we are asked to follow up on patients that have already been evaluated by the day consult team and for follow up notes we are paid $75. Consults take about an hour and, again, are primarily safety assessments. Each consult is staffed over the phone with an attending physician.

Never in your career as a resident will you be so happy for your pager to go off.  This is also a great gig and many times residents have made over $1000 on a weekend shift while still being able to spend much of the day and night at home.

When I was interviewing at UAMS, an upper level resident summed up call in this way: “Its enough money to buy a ski-boat…and enough time off to use it.” There are many residents in our program that are interested not in the extra money they might make, but in the extra time that they are able to spend with their families given the favorability of our required call schedule. There are others that also choose not to work extra shifts at the State or Children’s Hospital because they have received their state medical license and make significantly more money moonlighting at psychiatric facilities in the community.

Call schedules and moonlighting opportunities are not the reason to choose UAMS…but they definitely aren’t reasons NOT to choose UAMS.

Brian Hyatt, PGY-4

July Call Schedule: Click here (pdf)