Residency Policies & Procedures
V. CLINICAL ROTATIONS
Coverage During Absences (Vacation, Sick Leave,
A. Absence of the Attending
- A covering Attending will be designated.
- The covering Attending functions more in a consultant role; if the
regular Attending’s absence is of short duration (less than one week),
the covering Attending should see the new patients, review the treatment
plans, and be available for spot problem solving.
- For longer absences (in excess of two weeks), the covering Attending
should become more closely familiar with the patients and the unit,
and take on the full responsibilities described above.
B. Absence of the Resident
- No vacation can be taken in the last week of June or the first week
of July. Resident vacations may not overlap for residents on one
service. Residents may not take vacations during prolonged absence
of their Attendings.
- Vacations need to be arranged in advance with the Attending (to rule
out Attending absence), the Chief Resident (to rule out overlap), and
the Psychiatry Residency Program. Residents will arrange their
vacation plans as early as possible, and submit the proper form to the
residency office, no later than 30 days in advance of vacation leave.
- Residents will attempt to (a) schedule vacations after the medical
students have been on the service for a few weeks, (b) “load their teams
up” with patients before going on vacation, thus avoiding too many new
admissions during their absence, and (c) avoid “team-of-the-week” assignment
during the vacation time, etc.
- Within reason, Attendings can agree for the team of the absent Resident
to be smaller in size.
- New admissions: Day-time admissions should go to the non-vacationing
Resident’s teams. The absent Resident’s team should take admissions
at night-time, and on weekends, with work-ups provided by the on-call
Resident. In the unusual circumstance that a daytime admission
needs to go to the absent Resident’s team, the Attending should consider
letting the medical student work the patient up under his/her supervision.
- Day-to-day management of the absent Resident’s patients will be done
by the Attending. However, another Resident (called the “back-up
Resident”) will be available for emergency consultation to the medical
student, to answer general questions from the students, and the nursing
staff, to cosign non-critical orders, and to provide emergency care
(especially medical care). These activities are done in a spirit
of positive collaboration.
- The “back-up Resident”, and the Attending of the absent Resident,
are asked to communicate coverage problems to the Residency Training
Director. If an Attending feels that the back-up Resident is unresponsive
to reasonable requests, or if the Resident feels “dumped upon” by the
Attending, they should call the Training Director, and give a brief
description of the incident.
- The Attending will supervise the medical student, and give clear
guidelines with regard to daily orders and progress notes. The
medical student will report to the Attending.
- Who is the “back-up Resident”? The back-up Resident will be
the Resident of the “other” team on the unit; alternatively, a rotating
system of back-up Resident assignment is to be worked out by the Assistant
Training Director and the Chief Resident.
- If sick leave is anticipated to be more than two days, a “back-up
Resident” will be assigned to help out as in the case of vacation.
- Residents on non-inpatient assignments (E/R, consultation-liaison)
cannot be asked to function as back-up Resident
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Psychiatry Residency Training Program
1959 NE Pacific Street, Box 356560
Seattle, WA 98195-6560