Psychiatry Residency Program
Tour of Duty
Off From Work
In order to allow for time off
from work while maintaining the continuity of classes and clinical
coverage, the following guidelines have been established. Residents
receive 28 days (4 weeks) of vacation, which must be taken one week
at a time during each calendar year; in addition to 2 personal days(
LICENSURE PROCEDURE). All annual leave or sick leave request must be
submitted in the appropriate form (please contact program director's
office) The resident may request vacations to the PROGRAM DIRECTOR
who will verify feasibility for approval. The office of the Program
Director approves the vacations. Request for vacation MUST BE at the
time requested by the program director usually on June of the
PGY-I year vacations will be assigned upon requested, if feasible,
with the exception of the following transition period: July, PRITE
week, Competence exam week and In the month of December.
During the PGY-II, residents may take vacation at any time except
for the following periods: Month of July, PRITE week, Competence
exam week and December or other time as necessary in an emergency
There are similar restrictions for the residents in the PGY-III and
the PGY-IV years, PRITE week, Competence exam week. Vacation during
the last month of training is discouraged and/or there is an
emergency or call situation that might required for them not to have
The residency allows time off for licensure examinations. Requests
for any time of leave (other than vacation ,and sick) like time
outside conference time, and time for licensure examinations should
be sent in an electronic message including: resident coverage, and
submitted first to the Chief resident prior the office of the
Program Director whose approval is required. There may be
restrictions due to other resident or staff vacations, which
conflict with the requested vacation.
There are holidays per year allowed:
Residents notify to their
clinical service director, office of the Program Director, and their
supervisors of absence due to illness. They let know the office of
the Program Director of any classes that they will miss, so that
she/he can inform their teachers. The hospital has requirements
regarding sick leave that the resident will need to address. This
information will be provided in the Office of the Program Director.
Time for maternity and paternity leave should be those established
by the federal government and State local laws when applied.
Vacations and sick may be applied toward this time off. It is
imperative that any leave related to maternity or paternity’
requests be made to the Residency Program Director at the earliest
possible date, in order to allow for the necessary modification of a
resident’s individual curriculum within the training guidelines and
to allow for crucial clinical coverage.
Sick Leave – Residents will have 15 calendar days during
academic year. Absence of residents to undergo USMLE, American
Specialty Boards and State Licensure examination will be authorized.
Leave Without Pay – Is a temporary non-pay status and absence
from duty to be granted only on the employee’s request. The
authorization of LWOP is a matter of administrative discretion.
Residents on extended leave may be required to extend the period
of residency training in order to comply with the required training
experiences as stated and in compliance with the ACGME requirements.
Time On Duty / Night Call
The working day for all
residents starts at 7:30 am Monday through Friday and ends when all
work has been completed, usually not before 5:00pm. Later work hours
will be necessary when the workload requires them, for night call,
to meet with families of inpatients, to see outpatients in the early
evening after their work and/or if necessary to attend evening
seminars or individual supervision.
PGY-I residents take Internal Medicine or Pediatrics night call
while they are assigned on their Internal Medicine or Pediatric
rotation. During the Internal Medicine or Pediatrics rotation there
is no psychiatry night call. Psychiatry night call begins when the
resident begins his/her psychiatry rotations. In order of our
residency to follow the ACGME on duty hour's policy, the office of
the program director with the approval of the related committees and
faculty has created a floater system. The frequencies of night call
its determined by the PGY level at the time he/she enters the
Our residency has established a floater system that each Pgy-1 and 2
have on a weekly basis. The average number of floaters is 8 in their
first year of training and an average of 4 in the second year. The
maximum frequency of night call on weekends depends on the level of
training. The number of calls changes to the next PGY level and
continues to do so with each subsequent year according the following
PGY-1: average of 8
floaters and coverage of short calls on weekdays as well as
Fridays and Saturdays
PGY-2: average of four
to five floaters – three (3) short calls
(average)-equivalent and Sundays
PGY-3: one to two
calls per month (average) on Saturdays
PGY-4: no calls in
Weekday night call other than
on Fridays and on the eve of an official holiday runs from 4:00pm
–8:00pm and the floater resident will be on call from 8:00pm-8:00am
following day. Calls on Friday’s night runs from 4:00pm until 8:00am
following morning; Saturdays and on the Sundays prior to holidays
begin at 8:00am and last twenty-four hours or until the resident on
call is relieved by the incoming resident designated to be on-call.
Sunday's calls are run in two shifts: one from 8:00am until 4:00pm
and the other turn from 12:00n (noon) until 8:00am next morning.
This system of floater and divided shift were done to comply with
residents ACGME requisite of working hours and continuity of patient
care. The resident on-call may not leave the hospital until relieved
by the incoming resident. PGY-III calls will be mostly on Saturdays,
Sundays and Holidays from 8:00am to 4:00pm in the Acute Inpatient
Ward at the San Juan VAMC. PGY 2 & 3 will be second call for PGY-1.
All patients seen and evaluated must be consulted with the Attending
Physician on call at the San Juan VA Hospital When less night call
is needed per month, there will be a reduction in night call per PGY
level, although the overall frequencies among residents in the same
level of training will be kept equitable. Further reduction of night
call will be distributed based on seniority.
There is also a list for back-up call of residents who take over
should either of the two first call residents. Become suddenly
unable to complete call. Each resident will agree to sign up for two
separate weeks of call back up per year (July 1 – June 30). The
back-up call resident must be available that week for emergencies.
First year residents will be responsible for back up call over the
two weeks of Christmas and New Year’s, and each holiday week
satisfies back up call for the year. If a resident is asked to do
back up call, the resident who is off will have to pay that resident
back for the call that was covered. If possible, senior
residents will be assigned only one week of call back up for the
year, and if a senior is called in, the resident who is off will be
assigned an extra make-up call. The call schedule will be redone, if
needed, to protect the back-up call resident from two consecutive
nights of call. The above will be done following closely ACGME
Common Duty Hours Standards.
The PGY-2 assigned assistant to the chief resident has the
responsibility of arranging the monthly night call schedule. During
the orientation period (four weeks in July) there will be a special
night call schedule, during which time new residents will audit call
with ongoing residents; audit call only lasts for several hours and
does not count as regular call. During the orientation period the
chief resident will explain to the new residents various aspects of
night call including the proper notification procedure for time away
Attendance to off campus rotations is a requirement. If an off
campus class or rotation is canceled on a day that is not a holiday,
residents are expected to report to the clinic and use this time to
complete their administrative work, assist in the clinic, or read.
Duties While On Call
At the VACHS-San Juan VA, the
resident on call is responsible for covering the inpatient and
emergency (PIC) psychiatry units and providing consultation to the
other services floors. After4:00pm in week days consults are
delegated to the on call resident. The resident is to call the
attending on call when guidance is needed regarding decision making.
The resident in the Psychiatry Intervention Center (PIC )is open 24
hours a day 7 days a week . The resident on call will do
consultations to the medical emergency room. If the psychiatric
emergency room physician determines that a patient needs evaluation,
he/she will then contact the psychiatry resident on call that will
assess the patient and consult with attending physician on call. If
the patient needs admission to the psychiatric ward, the resident
may proceed with admission to the floor. Patients admitted to the
floor are required to have a full history and complete physical
examination done upon admission by the on call resident. In acute
and critical medical decompensate, the resident on call may call
other departments such as medicine for emergency consults.
An attending physician is always available as administrative back up
to the on call resident for consultation about any serious problems
on the call and must be consulted at all times. During the first
month of call there will be an additional upper level resident
serving as back up for the PGY-1 resident on call.
Moonlighting is not encourage
and prohibited for the resident on level 1 to 3; PGY-4 are allowed
to perform moonlighting if follow the rules and policies as
established by the program. The program Director must approve the
time work in moonlighting in order to observed residents comply
common duty hour's standards. Moonlighting is only allowed at
affiliates sites of the Institution.
After a resident has completed
one year of training in psychiatry and in good standing then, he/she
becomes eligible to receive additional days of time off for
attendance to conferences approved by the
These must be requested at least three months in advance, using the
appropriate form and procedures available at the office of Training
Director. Approval for attending outside conferences is dependent
upon classroom attendance, and will be based on the consideration of
the merits of the conference and whether it enhances or augments
your ongoing residency training.
Residents are strongly encouraged to join the APA, which provides
free membership during the PGY-1.