Duties and Responsibilities
Emergency Radiology Day Rotation (The “Wet Desk”)
In the past, the "wet desk" was the online film consultation service in a busy x-ray department. It was called the wet desk because the radiologist was often asked to review x-rays that were still in film processing tanks and had not been hand passed to the dryers (which took another 20 minutes). Even though we have gone from hand processing, to automatic processors, and now to PACS, the name is still appropriate for online image consultation.
There is a resident run “wet desk” in the emergency radiology reading room from 8 a.m. - 5 p.m. weekdays and weekends. This rotation is divided into a two-week block. The resident assigned to “wet desk” is responsible for any ED study ordered during the shift, however, all residents are encouraged to dictate and help with ED “red dot” (emergency) list.
Senior residents are assigned to the ED day rotation for the first 5 months of the academic year. This allows PGY2 residents to cover and focus on their core rotations as well as studying in preparation for their own ED day rotations. PGY2 residents are encouraged to shadow the seniors to gain knowledge on how to handle phone calls and other responsibilities as well as an educational opportunity from the senior residents on dictating, patterns on how look at studies, etc.
The faculty member assigned to the ED provides coverage on-site or by telephone transfer during conferences and lunch. Other residents and additional faculty are also available for consultations on difficult cases and coverage when the assigned resident needs to be away.
The resident manning the “wet desk” may continue to work on their service obligations, but primarily answer all telephone and on-site consult requests and/or refer them to the appropriate reading station. It is acceptable to jot down the identifying information and to call back with a report within a reasonable time frame. All verbal consultations need to be accompanied by a written preliminary note in the PACS. As with other preliminary reports, major discrepancies with the final written report need to be communicated to a referring physician as a critical finding.
The “wet desk” reading station is located in the emergency radiology suite.
PGY2 residents are always supervised with in-house faculty and senior residents.
Weekend Day Call
In addition to the ED Day rotation during weekdays, residents also cover the “wet desk” during weekend days. This shift is also from 8 a.m. – 5 p.m. Saturday and Sunday. Senior residents (PGY3-5) cover the first four and a half months for a total of 18 weeks or two weekends each senior resident. This allows PGY2 residents to focus on their core rotations and dedicate time to studying in order to prepare for solo weekend coverage. For the remaining of the academic year, weekend “wet desk” coverage is provided by PGY2 residents after ample time to prepare through at least one full rotation of each core subspecialty.
PGY2 residents alternate the weekend shifts with an average of one or two weekend day calls per month.
At least one faculty is always present during the weekend.
Night Float
Night float rotation blocks:
- PGY2: No night float rotation
- PGY3: One and a half rotations divided into three, two-week blocks
- PGY4: One and a half rotations divided into three, two-week blocks
- PGY5: One and a half rotations divided into three, two-week blocks
There will be one resident assigned to a two-week night float block. The resident is assigned Monday-Friday, 5 p.m. – 2 a.m. and is responsible for all ED studies ordered during their shift. The weekends are covered by an additional senior resident (PGY3-5) who is assigned to the night shift on Saturday and Sunday also from 5 p.m. – 2 a.m.
Vacations
Vacation is approved for no more than 15 working days for PGY2 and no more than 20 working days for PGY3 and above. Approval is subject to residency program requirements. Away days for conference or interviews do not count as vacation days, within limitations. Timing and scheduling of vacations is at the discretion of the individual services. Vacation benefits do not carry forward from year to year and must be taken within the current contract agreement year. Unused vacation benefits are not paid upon completion or termination of the agreement.
Leave requests must be completed through “QGenda” where the chief residents and program director will approve/deny after adequate review.
No more than one week of vacation per a four-week rotation of service assignment is permitted depending on PGY level, no more than two residents are allowed on vacation during the same week, and vacation days cannot be taken if assigned to a ED day/night rotation. Approval for more than one consecutive week of vacation must be scheduled before the beginning of the year so that it can span two blocks (last week of one and first week of the other). Approval is not guaranteed.
Every effort is made to allow residents and fellows to obtain vacation when they wish, provided service assignments and weekend call can be adequately covered. They can expect to have limited vacation time available during June and July when fewer trained residents are on duty. Times of the major radiological meetings (RSNA, ARRS, AUR) and American Board of Radiology or in-service examination times are also not suitable for vacation.