Resident On-Call Policy

University of Toronto
Neurosurgery Residency Program
Resident On-Call Policy 

Background:

Time on-call by neurosurgery residents serves both a service and education component. It is important that an appropriate balance be achieved during the entire residency to allow every resident to progress in their decision-making, clinical management, and surgical skill.

Guidelines for determining on-call requirements for neurosurgery residents:

Residents who are on neurosurgery service at one of the four primary teaching sites (TWH, SMH, SHSC, Sickkids) will adhere to the current PAIRO guidelines for call, as practiced across the University of Toronto Department of Surgery.

Residents in the pre-Chief years will take in-house first call.

Residents in their Chief year will take, primarily, second call while backing up a junior resident.

If gaps in the on-call schedule occur, then the following should be the preferred order of filling in gaps in the first-call schedule:

a) Off-service residents rotating on the neurosurgery service (e.g., ENT or Neurology residents)
b) Fellows rotating on the neurosurgery service
c) Volunteer call offered by neurosurgery residents who are on research or elective time. The resident is required to ensure that they have a priori permission from their supervisor.
d) Volunteer call offered by neurosurgery residents who are rotating on off-service rotations and who have not otherwise reached their maximum of PAIRO guideline on-calls for the month. The resident is required to ensure that they have a priori permission from their supervisor.
e) As an absolute last resort, after failure of a), b), c), and d) above,  Chief residents might be asked to cover the rare gap in first call. This is expected to be under the most unusual circumstances only, in order to preserve the educational integrity of the Chief year.

Safety requirements for residents on-call are addressed in the Safety Policy and must be adhered to.