Night Call and Shift Policy for Clerkship Students

Night call

The maximum number of hours per week  spent in educational and clinical activities during clinical rotations is 55 hours, excluding call.

Night call is an essential mandatory educational component which should be viewed as an opportunity. It is hoped that the night call schedule in most rotations will average at least once per week for weeknights plus some weekend experience, and must not exceed one in four on average. Students are expected to spend the entire night in the hospital.

It is understood that for health and safety reasons, when post-call or post-night shift, a student will never be expected to drive or commute to a clinic, office, another hospital or to any teaching facility.

Students will be released from all duties including call by 5 p.m. on the two evenings prior to any rotation examination (Wednesday, Thursday) every 12 weeks, with the exception that students doing a shift during a rotation in emergency or emergency pediatrics will be released of all duties by 11 p.m. on the Wednesday prior to any rotation examination. Students may have to do a night call over the last weekend at the end of the first six-week rotation of a cycle. In such case, they will be relieved of duty at 5 p.m. on the Sunday to prepare for the start of the last six weeks of the rotation which begins the next morning. Students are not expected to perform night call on the last weekend of each 12-week rotation.

OSCE: The Teaching/Testing OSCE is scheduled on Monday; therefore, students will be released from call as of 11 p.m. on the preceding Saturday, and released from call as of 5 p.m. on the preceding Sunday. Students are released as of 3 p.m. on the day of the OSCE.

The last weekend between rotation blocks (every 12 weeks) should not be used for scheduling routine call.  However, under special circumstances, where agreed by the student, it may be used to make up for call or clinical sessions that students missed during the regular rotation. In this event, the student should be released after 5 p.m. on the Sunday evening.

7.2.2 Obstetrics and Gynecology

Following night call, students in this rotation must go home, provided they have handed over the care of the patients to their colleagues via in-patient rounds. Such handover shall not exceed one hour. When post-call, students are not expected to attend any other clinical activities including out-patient clinics, physicians' offices or O.R. lists.

7.2.3 Other rotations with in-house call

Clerkship students shall be relieved of their duties after ensuring adequate handover of patient care responsibilities, and no new patient responsibilities will be assigned. The handover period will not exceed two hours following the end of the in-hospital call period. When post-call, students are not expected to attend any other clinical activities including out-patient clinics, physicians' offices or O.R. lists.

7.2.4 Call from home

The handover period will not exceed two hours following the end of a night call from home if the student commences work in the hospital after midnight but before 6 a.m. or a student who works for at least four consecutive hours at least one hour of which extends beyond midnight. Otherwise the student will be expected to attend their usual duties following the end of the call. In addition, there will be no home call after 11 p.m. when a facility cannot provide a call room.

7.2.5 Evening call

At a facility that doesn’t provide call rooms, students are expected to finish their call no later than 11 p.m., including hand-over time. Under no circumstances will a student be requested to stay later than 11 p.m. in such a facility.

In rotations where night calls are scheduled to finish at 11 p.m., students are to leave the facility no later than 11 p.m. including hand-over. It is also expected that a student will attend clinical or academic activities on the following day as per the usual established schedule in that rotation. A minimal period of eight hours is to be allowed for rest between the end of such a call and the start of activities on the next day.

7.2.6 Clinical shifts

In the case of clinical shift work, such as in the emergency medicine part of the acute care rotation, students will be allowed to leave the hospital at 11 p.m. if they are expected to come back for compulsory activities on the next morning. A minimal period of eight hours is to be allowed for rest between the end of a shift and the start of activities on the next day. In addition, a student will never be expected to attend any activities on the same day after the end of a night shift.

This policy is based on the Professional Association of Residents of Ontario (PARO) regulations in effect July 1, 2009.

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