How demanding are on-calls in gastroenterology?

[Doc mu]

As per an ER doc: "The top specialties I call at night are Cards, Cards and GI"

Do you get to sleep well during on calls? How often do you end up going to the hospital at night for an emergent procedure?

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[Elixir6]

I am at academic, so I don't get many calls except for transfer, since fellows take calls. There are very few reasons to go into the hospital at night, and except for ALF they are all due to endoscopy need. You may get called frequently depending on your institutional culture, but rarely have to go in. This was my personal experience at a huge institution as a fellow as well. Personally, I can go to sleep again quickly, so it's not really a big deal to say: "Great, we'll see in the morning."

 

[Suprep]

most night consults are so hey can put my name on the chart and pass liability to me while i decide if i wanted to go in or not

 

[1Cor1557]

highly dependent on the location. depending where you are and the facility and setting, you could reliably be up most nights, or asleep most nights, or anything in between. I'm in an "average" size community hospital in an mid size "average" metro, but majority of the nights overwhelmingly I dont have to go in, I may get a few secure texts or calls to answer if that, but more often than not dont have to go in, occasional bolus or volvulus or unstable hematemesis every now n then. Now back in fellowship when was at the state flagship university hospital that had triple the beds and got shipped every mess within a 3 hour radius, you got lit up big time! But my first love was cards but chose GI just to get away from the interventional call, glad I did, choose wisely and its nice. Choose reallllly well and you can sleep most/all of the nights depending were you are at

 

[AlteredScale]

As per an ER doc: "The top specialties I call at night are Cards, Cards and GI"

Do you get to sleep well during on calls? How often do you end up going to the hospital at night for an emergent procedure?

Really depends on the program and hospital size. My hospital is close to 1000 beds and is very busy but even with that, I have call weekends that are completely silent and others where I am paged every hour throughout the night. On average I go in every 2-3 call nights for an emergent procedure but the nice thing about GI patients we are called on overnight is that they are either too unstable to scope tonight, or too stable to scope tonight. what defines a stable patient or need to scope is also faculty dependent, but most faculty are not trying to come in at night (because they have been working all day)

 

[TexasMed22]

Really depends on the program and hospital size. My hospital is close to 1000 beds and is very busy but even with that, I have call weekends that are completely silent and others where I am paged every hour throughout the night. On average I go in every 2-3 call nights for an emergent procedure but the nice thing about GI patients we are called on overnight is that they are either too unstable to scope tonight, or too stable to scope tonight. what defines a stable patient or need to scope is also faculty dependent, but most faculty are not trying to come in at night (because they have been working all day)

How many times per year, on an average year, have you had to come in overnight to the hospital as an attending?

 

[sloh]

How many times per year, on an average year, have you had to come in overnight to the hospital as an attending?

Having to go in every 2-3 call nights seems hellish

 

[Elixir6]

When I was a fellow and covered greater than 1000 beds, at a quaternary academic center, which included a liver transplant program, I did not go in every 2-3 nights. So I think it depends on your comfort and local culture.

I would disagree that the reason attending doesn't go in at night is due to working all day. That would be true of any consultative subspecialty. The reason is it mostly doesn't change outcomes.

 

[gutonc]

most night consults are so hey can put my name on the chart and pass liability to me while i decide if i wanted to go in or not

I kind of feel like this is true of at least 80% of hospital consults across specialties.

I'm not GI (or procedural) but in my 12 years since completing fellowship, I can count on less than two hands the number of times that my presence at the bedside, or in the chart, had a meaningful impact on any patient's acute hospital outcome.

 

[1Cor1557]

I kind of feel like this is true of at least 80% of hospital consults across specialties.

I'm not GI (or procedural) but in my 12 years since completing fellowship, I can count on less than two hands the number of times that my presence at the bedside, or in the chart, had a meaningful impact on any patient's acute hospital outcome.

When In doubt, load the boat 🚢⛵. When it sinks we all go down together ⚓🔱. Nothing like community

 

[gutonc]

When In doubt, load the boat 🚢⛵. When it sinks we all go down together ⚓🔱. Nothing like community

Oh yeah...I hate that attitude. I had an attending in fellowship who would consult GI for every abnormal LFT, renal for a creatinine of 1.3, cards for an incomplete LBBB present for 15+ years and derm for dry skin...all on a patient admitted for neutropenic fever, so of course you know ID was there...also surgery because they had a port and had surgery at some time in the past.