Reshaping the emergency radiology call experience after the merger of two programs: the Yale experience

In the summer of 2013, 16 radiology residents from the Hospital of Saint Raphael (HSR) joined the 38 residents of Yale-New Haven Hospital (YNHH) to become a single 54-resident program. This posed a significant challenge given the number of residents and very different call structures of the two institutions. After evaluating the emergency radiology volume at both hospitals, it was determined that implementing YNHH's traditional call system at HSR would increase call by approximately 25 %. In order to negate this increase, the SRC rotation was created at HSR. This Monday-Friday rotation covered by R3s starts at 1 p.m. with afternoon conference. Residents then read cases on a subspecialty service from 2-5 p.m. and then cover the entire hospital until 10 p.m. with a single attending. Because of this rotation, call did not increase for the YNHH residents and third year residents were provided with increased responsibility. For programs not undergoing a merger, call rotations can also be extremely beneficial. These rotations allow third year residents to have more "call-free" weeks prior to the ABR core exam. Also, patient care can be improved, as the shift length for on-call residents is reduced, which has been shown to improve accuracy.