A Day in the Life of a Duke Anesthesiology Resident

John Nardiello, MD, CA-3 Resident

Night Call

Overnight call in the main OR for Duke Anesthesiology residents is very reasonable in that we seldom do 24 hour shifts. This is because we employ a night float system, which we feel greatly improves the quality of life for Duke Anesthesiology residents. Call is taken in one-week blocks, with residents being assigned roughly three to five weeks per year.

Night call is often the most challenging, yet fun time in your anesthesiology training at Duke. For the junior resident, it is a time to gain advanced clinical experience otherwise not routine for your level of training. For the senior resident, it is a transition from training to supervision, as you assume the role of an attending on-call. Spending a week working side-by-side with another resident is an invaluable experience, as we often work in isolation from fellow residents. Call week is a chance to learn from one another and develop camaraderie from shared experiences.

Logistically, the call week is a seven-night stretch of 12 hour shifts, starting at 6:30PM and ending at 6:30AM the following morning. The call team consists of one senior resident (CA-3), one junior resident (CA1 or 2), one CRNA and an attending anesthesiologist. The week for the junior resident starts on Saturday night and ends the following Saturday morning. Call weeks start on Fridays for the senior resident (thus a 24-hr day for the senior), but the compensation is a 3-day weekend at the end.

Call nights start by relieving any cases still running from the day and starting cases added on for that night. The resident and CRNA provide the bulk of the patient care in the OR under the supervision of the senior resident in consultation with the attending. All the while, the senior resident is coordinating the OR, caring for patients in PACU, evaluating patients, formulating anesthetic plans with the junior resident, responding to pages for the pain team and airway emergencies, preparing for surgical emergencies/traumas and ensuring the entire teams gets breaks when possible.

The junior resident gets priority for the interesting cases on call, which is a chance to care for challenging patients and perform procedures not typically scheduled for CA-1’s on the day shift. The senior assists the junior resident with challenging cases and also cares for the patients beyond the junior’s current level of training, such as high risk pediatrics and liver transplants. When a trauma rolls in, it is often the whole team together caring for the most critical of patients. This teamwork in a stressful situation fosters a camaraderie that is palpable and enduring beyond the call week. The week usually ends with the whole team recounting “war stories” over a collegial breakfast together at a local restaurant. The call weeks are typically busy and a challenge for the whole team, but are always met with great enthusiasm by the residents. These sometimes trying weeks are where learning happens in miles rather than inches and residents develop the maturity, confidence and solidarity that will propel them to future excellence.

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