OB/GYN RESIDENT CALL SYSTEMS ACROSS CANADA
Updated March 2014
Dalhousie University
Number of residents: 24
Number of sites covered: 3 sites (IWK Health Centre, and Queen Elizabeth has two
sites: Victoria General and Halifax Infirmary where the adult ER is)
Call system:
- There are two separate calls for gynecology and obstetrics.
- Gynecology is home call (our emergency department isn't in our women's hospital, so
we have to go between both). During the week we do night float system, the same
resident works 5pm until 8am Monday - Thursday. They also cover the Saturday.
Weekend calls Saturday/Sunday are 24 hour call. We do night float once every 3
months. On Tuesdays and Saturdays we cross cover General Gynecology and
Gynecology Oncology (which is at a different site).
- Obstetrics Call remains standard during the week, however we aim to schedule those
on-call for obstetrics at night to anything other than birth unit, so that you are only on BU
from 5pm until 8am. On the weekends we do 12 hour shifts. 1 person covers Friday
night and Sunday (8-7:00pm); second person - Saturday 8am to 7pm and Sunday 7pmMonday 8am; A third person covers Saturday 7pm - 8am.
Has it been successful?
It works really well.
Université de Montréal
Number of residents: Approximately 40
Number of sites covered: 4 in addition to rural sites where individual residents may be
on rotation.
Call system:
For seniors (PGY 3-5)  Officially, 24h home call. In practice, 24h in-house call except
for the gynecologic oncology rotation where 24 hour calls do happen at home.
For juniors (PGY 1-2)  12-16h days. Night shift week (Sunday-Thursday) 8pm-8am. 57 weeks/year.
What has been proposed:
Changing 16h calls to 24h calls to reduce number of calls and to be able to profit from
post-call days.
Has it been successful?
Lots of difficulties for junior residents to do numerous 12h shifts in a row as opposed to
24h call and benefit from post-call days.
Quebec government’s recent ruling has prohibited the 24h shift system, which has
benefited non-surgical specialties more.
Université de Laval
Number of residents: 34
Number of sites covered: 3
Call system:
- During the week: 17h-23h (a different resident for each day, they also work 8h-17h the
same day and the next day), 23h-8h (same resident from Monday to Thursday, only
work during nights)
- Week-ends: 8-20h (same resident for Saturday and Sunday, work from Monday to
Friday week before and after), 20-8h (work from Friday to Sunday, do not work on
Friday and Monday 8-17h)
Has it been successful?
Would you change it at all? There was a unanimous vote among resident for keeping
this system instead of the 24h call system.
When on call at home we still use the 24h system. We do not work the next day if we
leave the hospital after midnight.
Université de Sherbrooke
Number of residents: 4-5 per year (currently 25)
Number of sites covered: one main site; as well as our community hospitals
Call system:
Day time from 7 am to 5 pm
- Evening shift from 5 pm to 10 pm – 2 residents (junior + senior)
- Night shift from 10 pm to 7 am
o Included in our night week
o We have approximately 3 of them per year
o Either 2 residents (R1 + senior) or 1 resident (R2 - R5)
o From Sunday night to Friday am
- Weekend :
o Day shift : from 8 am to 8 pm (2 residents)
 Saturday and Sunday with Monday off
o Night shift : from 8 pm to 8 am (1 resident – R2-R5)
 Friday night and Saturday night - Friday off before the shift
- In community hospitals: Home call (9 per month) including one weekend
Has it been successful?
It works well. We’re overall satisfied. We don’t miss exposure during the day since we
finish our shift at 10 pm. We get more exposure during our night shift than if we were 2
residents.
McGill University
Number of residents: 46
Number of sites covered: 3
Call system:
NIGHT FLOAT
R1-R3, 4 weeks at a time, twice a year. R4 has 1 block of 4 week night float. R5 does
not do any night float. It starts from Sunday to Thursday from 5pm to next day 7am.
Night float has no weekend calls (so 4 full weekends off!)
WEEKEND shifts
Friday night 5pm-8am (whoever does Friday night call will have Friday day off)
Saturday day 8am-7pm
Saturday night 7pm-8am
Sunday day 8am-5pm
Sunday night = night float starting again.
We do maximum 4 weekend shifts per month. It's maximum 2 weekends out of 4. R5
only has 1 weekend shift per month.
We have 2 tertiary care centers and 1 secondary care center (community hospital). We
always have a senior and a junior in tertiary care centers. Junior takes care of all low
risk pregnancies (including labor & delivery, post-partum). Senior takes care of gyne
ward, gyne onc ward, MFM, ER consults and supervises junior. In our community
hospital, only 1 resident at night (R2-R4) who covers all OB/GYN services in that
hospital; however, there is no gyne onc, low volume of MFM, but very large volume of
low risk pregnancies. Usually there is also a family medicine resident that is paired with
the OB/GYN resident to share workload in labor & delivery.
Is it successful?
This night float system has been in place since at least 8 years. It is actually one of the
great things about our residency program. although it is quite demanding for that month,
the continuity of care of patients are ensured at night and during daytime as it would be
the same teams and no one would be post call during a week day and the day teams
would leave anytime between 5-5:30pm every weekday.
The weekend call schedule is actually new for a little bit over a year now replacing the
24h calls over the weekend. It has been working well so far, and we don't foresee any
changes to that in the near future.
University of Ottawa
Number of residents: 35
Number of sites covered: 3 (2 tertiary centers, one community hospital)
Call System:
- 24hr on weekdays, 12hr on weekends. You rarely leave the hospital later then the 15
minutes it takes to handover.
- Weekdays - we cover the regular assigned service (L&D, Gyne, MFM or GyneOnc)
and we start call covering all other service from 5pm to 7am. There are always 2
residents at the centre with MFM and GyneOnc but only one resident at the other
tertiary and one resident at the community hospital. Total of 4 residents at any given
time and those numbers do not include PGY1’s.
- Weekends - Saturday and Sunday we do split 12h shifts 8am - 8pm (Sunday till 7pm) there is usually one team who does Friday night and Sunday day, and another who
does Sat. day, Sunday night, and then a senior will cover Sat. night
We have a graduated call system where juniors do b/n 6-8 calls per month and seniors
do about 3 calls per month. Our 5th year residents stop doing call after December to
allow them to study.
For the 24h call we are paid a full in-house call stipend (approx. $105). For the 12 hour
call, we are paid half of the in-house stipend, billed as "home call" (approx. $50)
Has it been successful?
The 12hr change has been going on for about a year and it has improved quality of life.
The coverage gets done.
We currently have a committee in place who will review with our program director to try
to have a maximum of 16hrs in the hospital. Night float has been suggested but rejected
by our RTT. We are now looking at not working pre-call nor post-call.
That being said, we currently have a working group in place looking at various call
schedule options, given the likely eventual adoption of a 16h max working day.
University of Western Ontario
Number of residents: Approximately 6 per year (currently 32 residents)
Number of sites covered: We amalgamated 2 hospitals to one main site (Victoria
Hospital) in 2011. Consultants are divided into 2 teams, Red and Blue, and residents
are assigned to either team. There are two consultants on every night, with one
covering New OB consults, and one covering New Gyn consults. Gyne consult
requests at other sites (University Hospital and St. Joes) must be transferred to Victoria
if they need assessment.
Call system: Night Float
Approximately 1 NF week, and 1-2 weekends per 4-week block
3 residents (2 juniors, 1 senior) in house; PGY-1s are buddied to one the juniors:
o Red resident – covers Red delivery room/antenatal/triage, and either OB
consults/Criticall or Inpt Gyn/Gyn consults
o Blue resident – covers Blue delivery room/antenatal/triage, and either OB
consults/Criticall or Inpt Gyn/Gyn consults
o Senior is available for “chief” cases (i.e. gyne ORs, operative vaginal
deliveries, complicated C/S), and as back up if the juniors are swamped
Hours:
o Mon-Fri Days: 7am-5pm
o Sun-Thurs (NF week): 5pm-7am (except 6pm-7am on Sun)
o Weekend Days (Sat/Sun): 7am-6pm
o Weekend Nights (Fri/Sat): 5pm-8am (except 6pm-8am on Sat)
Gyne Onc is home call and is covered by the junior/senior on Gyne Onc. If
neither is on, Gyne Onc is covered by on call resident covering Gyne
Has it been successful?
Works extremely well – well-received by both senior and junior residents. A large part
of our success is probably because we are at a single site and have enough bodies to
fill the schedule. After some trialing, we have found the currently shift hours work the
best. There was some discussion about allowing the senior to be home call, however,
that was been turned down by consultants at our annual retreat.
McMaster University
Number of residents: 30 (PGY 1, 7 residents not on ob/gyn call sched)
Number of sites covered: 3
Call system:
- Site 1 low risk high volume, traditional 24hr call, covered by 5-6 pgy2's and 1-2 chief
residents at a time
- Site 2 high risk mod-high volume, covered by 8-10 PGY 3-5's at a time, traditional 24
hr call
- Site 3 gyn-onc home call 1 in 3 covered by 3-4 resident at a time
Has it been successful?
It has been successful. We are changing to a 24 hr on week days, split 12 hr shifts on
weekends. We just talked as a program about switching as well, but voted just to make
weekend into 12 hr shifts
Queen’s University
Number of residents: 3 per year
Number of sites covered: 1
Call system:
Weekdays: During the day we are all on our own current rotation's services-gyne, gyne
onc, MFM, urogyne, etc. That includes a day time OB team. Our day time OB team
comes in and has all of their rounding done by 7:00 so the person who worked the night
goes home right at 7:00. This always happens.
Nights: We have one night float person that works Mon-Thurs night. This person covers
all services (L &D, antepartum, postpartum, inpt gyne/gyne onc pts, emerg consults).
They start at 17:00 and work until 7:00 the next morning. As an R2 I only do this 2x
every 4 months. Frequency of night float is graduated as well. By fourth year you may
do one night float every 4 months. You have a pre call day on the Monday before night
float begins. Rarely will you work one (definitely not book end) weekends surrounding
your night float week.
Weekend: The weekends are covered by 3 people. One person works Friday night
from 17:00-08:00 and Sunday 08:00-18:00. One person works Sat 08:00-18:00
Saturday night and Sunday night 18:00-07:00. One person works Sat night 18:0008:00. If you work Friday night, you have a pre call day on Friday. Obviously if you work
Sunday night you have a post call day on Monday. There is a second resident (usually
R4/R5) who is on second call for the entire weekend (home call) and completes gyne
onc rounding in the morning. There is a graduated system where R4/R5 rarely work 2
weekends/block and if they do it's typically on second call/rounding or only Saturday
night call. This allows R4/R5s who are on senior rotations (senior OB, gyne onc, senior
Gyne) to miss minimal days being post or pre call.
We always have an R4 or R5 on second call (home call) in case the resident on in
hospital call (usually only relevant overnight) has to be in 2 places at once. I have had
to call someone in once. We had a torsion going to the OR and a C-section at the same
time. You may be called in on second call once a month - very rare. Second call
coverage receives a $50 call stipend per night.
Has it been successful? Yes. Quality of life is very good. Continuity on rotations is
significantly improved as you will not be post call throughout the weekdays. You do miss
one week at a time if you are doing a night float week. Part of the reason this works for
us is that we cover one hospital, however we are a small program, so perhaps it could
still work for larger programs covering more sites. Some of our staff are resistant to this
call system due to concerns regarding too much missed rotational time during our night
float week and precall days. One of our chiefs two years ago reviewed how many days
we missed post call when we did 24hr call and compared it to the current call system;
we actually miss less time with this schedule.
University of Toronto
Number of residents (PGY2 – 5): 47
Number of sites covered: 7
3 “academic” centers – night float (new as of July 2013; covered by PGY2-5)
4 “community” centers – 24 hour call (not all nights covered by ObGyn residents)
Call system:
Night float (per 3 month block):
Core residents do 4 nights (Mon-Thurs) x 3 weeks in a row. Outside osf these
weeks they do 2 weekend days or nights q2wks. Nights are 12-14h long
(depends on hospital).
Relief residents (ie those on subspecialty rotations) do one week of night float (4
nights), plus occasional weekends (depending on PGY level/rotation)
Night resident covers BOTH Obs & Gyn, except at Mount Sinai where there are
two teams (two residents on call, one covers Low Risk Ob + Gyne, other covers
High Risk Ob + MFM inpatients)
This excludes gyne onc and PGY1 call (separate call schedules)
Chief residents are not part of night float (chief home call)
24 hr call
In community sites (approx. 1:4 depending on site)
Has it been successful?
Surveys regarding Night Float are ongoing and the system remains under development
Initial survey results suggest:
1. Overall preference for night float over 24hr call among both relief and core
residents.
2. Optimal number of nights was 4.
3. Strengths – 1/2 of residents felt less fatigued, 1/3 felt no difference
4. Weaknesses – some expressed concern that nights were felt to be an isolating
experience, and although fatigue was less, core residents felt that morale and
quality of life were overall worse. Sleep aids were used more often.
University of Manitoba
Number of residents: 33 residents
Number of sites covered: 2 tertiary centres: St Boniface Hospital and Health Sciences
Centre. There are some off service rotations that involve clinics and ORs at community
sites
At one site we have the gyne and obs services separate (i.e. - one resident for each)
because it is busier. At the other site the two are combined. We have one resident
(pgy2- after their three month backup period- to pgy5) on for each service.
Call system:
Call works differently for the two sites:
At St Boniface, the obs and gyne services are sort of split. Mon-Fri one resident
covers both the Obs and Gyne services. On weekends there is one resident who
covers Gyne both Saturday and Sunday (24hr). Obs is covered by a different
resident.
At HSC, the services are completely split and there are always two residents on
call, one for obs and one for gyne.
Has it been successful?
At HSC the system works well. At St Boniface, during the week (Mon-Fri) it can get
hectic if both the obs and gyne services are busy i.e. a busy labor floor + lots of consults
for gyne in the ER. Having a dedicated resident on gyne over the weekend has
alleviated this a little.
University of Saskatchewan
Number of residents: Currently there are a total of 20 residents - 2nd to 5th years are
eligible for call therefore in total 16. First years are eligible BUT they are buddy shifts.
Number of sites: 1
Call System:
- We do 24 hour call. During daytime hours people are on their regular services, and
there are also residents on L&D. People running L and D work from 0700-1700. They
hand over all at 1700. The night call person works from 1700-0800.
- Weekends i.e. sat/ sun are 24 hr so the time is 0730-0730.
- We get a post call day off
-We currently have graduated call, so R2s do the bulk of the call (6-7 calls/4 weeks) and
R5s do the least (2 calls/4 weeks)
Has it been successful?
There is no government legislature to change our call but rather someone has stated we
need a change. We have voted on this issue multiple times and on the 5th vote it was
voted to change the call schedule. The proposal is under way to the College of
medicine but we don't know if it will get approved. As of right now, the call schedule will
remain as is.
University of Calgary
Number of residents: 30
Number of sites covered: 3
- Site one is the high risk center and there is always one or two PGY2-5 resident(s) or
an OB resident and an off-service resident covering ob and gyne together
- Site two has recently become covered by a PGY2-5 resident every night with a
second off service resident
- Site three is at a primarily PGY-1 run site, most coverage is by PGY-1 OB
residents/off service PGY-1 residents (PGY2-5 cover if they are doing an elective
there or if the coverage is needed)
Call system:
We have just started a new "nap" model since Dec 2012 for PGY 2-5s (PGY 1s and offservice residents follow the traditional 24h call). Weekday call is from 5pm-8am.
Residents on call during the weekdays start work at the normal time and complete all
morning duties until 12 noon the day they are on call. At noon we are excused from
duties and have 12-5pm off. We return 5pm-8am. We still get our post-call day.
We round on our own patients post-call on weekdays, and, depending on the site, on all
post-partum or all gyne patients on weekends, so often we don't leave the hospital until
9 or 10 if it's been busy.
The weekend call is split into 12 hour shifts (Friday night/Sunday day), (Saturday night),
(Saturday day/Sunday night).
The call system is graduated with PGY-2’s doing about 7 calls and PGY-5 doing 3-4
calls per month.PGY 1-3 work two weekends per months and PGY 4-5 work 1 weekend
a month.
Has it been successful?
Yes, definitely. As for the nap weekday model, it is universally well-liked by residents
and supported by most staff, as many of them have a similar practice in taking the
afternoon off the night before call. Having normal mornings means that minimal time is
missed in the OR. We initially had the evening hand-over time at 6pm, but that did not
work well as often the PGY 2s covering L+D during the day would not end up leaving
the hospital until 7pm on a daily basis. The 12 hour weekend shifts are also well-liked.
University of Alberta
Number of residents: 35
Number of sites covered: 2
Call system:
Weekday 1700-0630 - 2 residents on at LHH and 1 at GNH; chief on home call
weekends split shifts 0800-1800 and then 1800-0800 - 2 residents on at LHH and 1 at
GNH; chief on home call - no night float system
Has it been successful?
It has worked well. We have recently switched to the split shifts on the weekends
because of the increase in resident size and we are much happier. If the numbers stay
high we can continue with the split shifts. We do 24hr shifts over the long weekends
though.
University of British Columbia
Number of residents: 34
Number of sites covered: 4
Call system:
Weekdays 5:30 PM to 7:30 AM at 2 residents at BCWH, 1 at RCH, 1 at VGH and 1 at
SPH
Weekends 7:30 AM to 7:30 AM 2 residents at BCWH, 1 at RCH, 1 at VGH and 1 at
SPH
The call system is graduated with PGY-2’s doing about 7 calls and PGY-5 doing 3-4
calls per month.
Has it been successful?
Yes. This has been our call schedule for a very long time. It can be essentially 24
hours on weekdays if you are covering day call.
Memorial University
Number of residents: We have currently 20 residents (usually we alternate with
CaRMS ➔3-4 candidates each year)
Number of sites covered: We only cover Health Science Centre (in St.John’s) but we
do have other residents in Rotation at our community sites (Corner Brooke (1), Grand
Fall Windsor (1 or 2), Fredericton (1) Clarenville (1))
Call system: 24 hour call.
There is a Caseroom (L&D) resident that does Monday to Friday 7AM to 5 PM
(doesn’t do call that month)
The resident on call starts at 5PM in the caseroom and covers labour & delivery,
obs floor, gyne floor, gyne onc and Emergency consult (if it’s super busy and in
ER it’s a rupture ectopic that will most likely go to OR, the chief will go do the
consult). We also, always have 2 medical students on-call.
The resident is relieved at 7 AM (so he/she can go round on their patient before
their post-call day and get out in a decent time).
So you are in hospital for 24h but during the day you do your regular rotation and
call starts at 5. You aren’t allowed to operate on post-call day and aren’t
expected of any clinical duty.
Weekend call
We do split call, so overall you work on more weekend, but smaller shift and still get to
enjoy most of your weekend.
Friday night resident (regular call) 5 PM starts…but we switch at 9 AM
Saturday is split in 2 :
o Saturday day (9AM till 6PM) Resident A
o Saturday night (6PM till 9AM) Resident B
Sunday is split in 2:
o Sunday day (9AM till 6PM) Resident C
o Sunday night (6PM till 7AM Monday) Resident A
o Resident A is on call Saturday day (gets Saturday night and Sunday day
off) and on again Sunday night so that resident has 2 x half call…and gets
the post-call day on Monday.
You need 3 residents to cover the weekend
Has it been successful?
Our system is excellent and everybody likes it.