During business hours, senior residents (PGY 3-4) who are doing their clinic rotations cover call. After business hours and on weekends and holidays, two junior residents (PGY 1-2) are assigned to cover call. One junior resident is assigned to University hospital and one is assigned to the VA hospital. A senior resident is on back up call at home, and can help out at both the University and the VA if needed.

Call is assigned on a monthly basis. Typically, junior residents are assigned to either take call at the University or at the VA during a given month. Call shifts are each assigned a certain number of points and the total number of points is divided among the residents. This helps to ensure that time on call is distributed evenly.

During after hours call, the resident on call covers any psychiatric emergencies that present to the Emergency Room, any emergent consults that are requested, cross-cover calls from the inpatient psychiatric units, and outside phone calls.

Junior call at University Hospital is divided between a rotating schedule of residents and a night float resident. Residents cover call from 5pm to 10pm Monday through Friday and in 12-hour shifts (8 a.m. - 8 p.m. and 8 p.m. - 8 a.m.) on the weekends. Each month a PGY-2 resident or a PGY-1 resident with several months of call experience will be assigned to the night float rotation and will cover call from 10pm to 8 a.m. during the week (the Sunday night shift is 8 p.m. - 8 a.m.) Junior residents receive approximately $9 cafeteria credit for a weeknight shift and $15 for a weekend shift. They also get access to a call room with TV, private toilet and shower, and a computer.

New junior residents also have the benefit of four "training calls" at the University. During the first four calls a junior resident takes at the University, the senior resident is required to be in-house with the junior resident. The first night the junior resident just shadows the senior and by the fourth night the senior is simply available in the hospital to answer their questions. After the first four calls the senior resident is always available by phone and can come in if required. A staff physician is also available by phone to provide additional assistance if necessary.

At the VA hospital, the patient load is lower than at the University so a night float is not required and call is taken from home. Junior residents pick up the pager at 5pm and turn it over at 8 a.m. the next day. On weekends they pick up the pager at 5 p.m. on Friday and turn it over at 8 a.m. on Monday. They are required to go to the VA for urgent evaluations or acute issues on the inpatient units. As with University call, the senior back-up resident and VA physician are always available by phone and can come in if required.

Senior residents provide back-up support to their junior colleagues. They serve as back up from 5 p.m. - 8 a.m. on weekdays and 8 a.m. - 8 a.m. on weekends. They normally have call 1-2 weekdays and one weekend each month and provide support to both the VA and University Hospital. They have to be in-house for training calls when their junior has had less than four call nights, but otherwise they only come in if the junior resident needs a hand.