In-House Notes

Hours

	Sun-Thurs	Fri-Sat
Resident	1600-1900	1600-2100 (no pts after 2015)
Routine consults	None	Until 0300
Admits	All (unless 👀 by resident)	All
ICU	All	All
HF/Txp	All	All

Onboarding

• General fellows:
  • Shadow a more senior fellow for 2 shifts
  • 1 st shift: 6pm-midnight (unpaid)
  • 2nd shift: full 6pm-7am (50% paid) where the orienting fellow completes all in-house duties with a senior fellow in the hospital as backup
  • After this, can proceed to taking independent AM or PM shifts.
• Research fellows:
  • Shadow a senior fellow for 2 weekend AM shifts
  • 1 st shift: 7am-4pm (unpaid)
  • 2nd shift: full 7am-7pm (50% paid) where the orienting fellow completes all in-house duties with a senior fellow as backup (in the hospital)
  • Will continue with weekend AM shifts only, until further approval from IH committee regarding PM shifts owing to the need for additional resources
• Advanced fellows (IC, EP, Heart Failure, Imaging):
  • Shadow a senior general fellow for one weekend AM shift (7am-4pm)
  • Can proceed to an independent shift preferably starting with a few AM shifts (7am-7pm) before taking PM shifts.

Who do I see now?

• Admits
  • Either you or the short call resident must see all new admits to Cardiology overnight.
  • As of July 2023, there will be no admissions to cardiology after 9PM, except ICU, HF/txp, outside transfers, direct admits.
• Consults:
  • You are not expected to see routine consults Sun-Thurs after 4:30PM.
  • You are expected to see routine consults up until 3AM on Fri, Sat.
  • “STAT” consults should be discussed with ordering doc - most pre-op consults can wait until morning.
  • In general, neuro-lCU consults can wait until morning, but MSTICU consults should be seen overnight. These should be reviewed on a case-by-case basis.

Who else is around?

• • Resident short call:
  • Sun-Thurs: 4-7PM (last time to give them a patient is 1900)
  • Fri-Sat: 4-9PM (last time to give them a patient is 2015)
  • Residents cap at 3 patients per short-call, 5 new patients in 24 hours, 8 new patients in 48 hours
  • Use their time effectively, both for their learning as well as for your efficiency, by assigning them admissions and interesting consults.

Vascular Complications

• Call the Interventional Cardiology fellow on call. On nights that there is not IC fellow call coverage, contact the IC attending on call directly.
  • If needed, the IC fellow will then involve the IC attending on call.
  • For the ICU, the IC fellow will involve the B service attending for perceived serious vascular issues (and can involve the IC attending on call if the B service attending requests this).