Rotation and Call Schedules

Overview

Inpatient rotations for PGY-2 through PGY-4 years are generally scheduled in blocks of 1 or 2 weeks, depending on the rotation. Required outpatient rotations are scheduled in blocks of 1-4 weeks, depending on the rotation.

Most clinical electives and all academic/research electives are scheduled in 1-week blocks, though select clinical electives require multiple consecutive weeks. Multi-week elective blocks can be requested in any academic year but are particularly difficult to arrange during PGY-2 given the relatively fewer weeks of elective time available.

Continuity clinic is scheduled on an X + Y model, consisting of one week of outpatient continuity clinics followed by 4 weeks of other rotations.

Below are descriptions of the various roles that residents perform in our program, followed by tables summarizing the year-by-year rotations and the call schedule. Residents from each class year will be assigned equivalent amounts of inpatient time, day/night call, jeopardy call, and elective time over the course of their training; if the block schedule for a given year is affected by a residents leave of absence or pressing program coverage needs, future year block schedules may be adjusted accordingly.

Please see the Goals and Objectives section for individual rotations for more detail about their operations.

Inpatient Service Residents

The main inpatient services at the UW Health main campus and the Veterans’ Administration hospital are always covered by a resident and consists of Stroke Inpatient, Stroke Codes/Consults (which includes all stroke codes), General Inpatient, General Consults, Pediatric Neurology, and Epilepsy.

In brief, the majority of inpatient rotations are scheduled Sundays through Saturdays (see individual rotation descriptions and Goals and Objectives for details). The General Consult, Peds Neuro, and Epilepsy residents work a 5-day week with no clinical obligations on weekend days. The Stroke Inpatient, Stroke Consult, and General Inpatient service residents work 7-day weeks that include 1 day of weekend call and 1 weekend day off.

For the first several weeks of the year, the Stroke Consult and General Inpatient teams have a Ward Senior working side-by-side with the junior for orientation and mentoring.

Day Float

The Day Float week starts on Sunday, when the Day Float resident arrives at 8 am to assist the off-going Night Float resident with rounds on the General Neurology service. The Day Float resident works in conjunction with the Stroke Inpatient resident to cover the neurology services with cross-cover and new consults through the day until 6 pm.

On weekdays, the Day Float resident arrives at 3 pm. Their main initial duty is assisting day teams (particularly day consult teams) to wrap up their work day. At 4 pm, the Day Float resident begins taking first call for new stroke codes, consults, and admissions, with backup from the Night Float resident (see below). The Day Float resident remains first call on pager until 10 pm. After 10 pm, the Night Float takes over all duties.

The Day Float resident is off on Saturdays.

Night Float

There are two residents assigned to the 2-week Night Float rotation (scheduled as Night Float A for the first week and Night Float B for the second week). Night Float A and B alternate nights on call. This system ensures that on-service residents have no overnight calls, off-service residents are not pulled into weekend rounds, and the night float residents have plenty of time off.

On weekdays, the Night Float resident arrives at 4 pm and takes sign out from the day teams for the existing service patients covered by the inpatient and consult teams (including Epilepsy and Pediatrics). From 4 pm to 10 pm the Night Float resident takes cross cover phone calls and, after the clinic phone lines close, phone calls from patients with urgent/emergent questions (“2-2122 calls”). The Night Float is also expected to work collaboratively with the Day Float resident and assist with high volumes of new consults, stroke codes, or admissions on higher volume evenings. From 10 pm – 8 am, the Night Float resident covers all neurology services for new issues and for cross cover. At 8 am, the Night Float resident signs out to the day teams and is then off duty from 8 am on their post-call day until 4 pm the following day (16 hours on / 32 hours off).

On weekend days, the post-call Night Float resident makes rounds with whichever service (Stroke or General) does not have their regular resident in house before leaving. The Night Float shift begins at 6 pm both weekend nights, at which point the in-house Night Float resident covers Neurology service needs until rounds are complete the following morning (Saturday night into Sunday) or until 8 am (Sunday night into Monday morning).

The Jeopardy Resident 

As also described in the section Work Hours, Leave, and Moonlighting, there are circumstances where a resident will need time off during an otherwise scheduled work day. Our program is committed to the health and welfare of our residents, to ensuring that residents can obtain needed coverage without fear of negative consequences, and to the continuity of patient care when a resident does require clinical coverage. To that end, each week one resident is assigned to the Jeopardy rotation.

Jeopardy is its own clinical on-call rotation specifically designated to fill in residents who need time off for specific program-approved reasons. By creating a role solely for this purpose, we intend to remove the difficulty and worry associated with the need to obtain coverage, while ensuring appropriate continuity of care for our patients and a fair distribution of the responsibility for coverage. At the discretion of the chief residents and/or program administration, the Jeopardy resident can also be activated to provide backup for residents on service when a service is exceptionally busy or a resident otherwise needs hands-on help.

Please see the Work Hours, Leave, and Moonlighting section, the Jeopardy Activation and Voluntary Coverage section, and the Jeopardy Rotation goals and objectives for additional details.

Electives

Specific clinical or non-clinical rotations to be done during elective time must be chosen and submitted for approval by the relevant faculty and the Program Director. We encourage residents to submit elective requests as early as possible, as electives are generally assigned on a first-come first-serve basis. Some clinical electives are unavailable during certain times of the year—for example, during national subspecialty conferences or when other learners are rotating through specific clinics. Other clinical electives rely on other departments for scheduling and as such may not be available without substantial advance notice.

For the highest likelihood of receiving their desired electives, residents may include elective requests as part of annual block scheduling. Once the block schedule is released, residents may submit request forms anytime from the beginning of the academic year forward. If residents have not selected electives within 2-4 weeks of their start date, program staff will assign one.

Residents who choose a non-clinical elective (e.g., research time or academic time) must be in good academic standing and must provide a detailed outline of their proposed activities, a proposed attending mentor, and an anticipated end-of-rotation work product.

Residents who wish to participate in an off-site international or rural elective (or any other off-site elective) must be in good academic and administrative standing and must be approved by the Program Director to apply. There are specific deadlines for funding proposals and approval of off-site rotations imposed by the UW Health GME office. Interested residents should review the relevant institutional GME policies before applying, which are available to current residents on the Pulse.

Block Schedules

¹ In the second half of the year
² Including, if desired, the global health experience in Ethiopia
³  Assisting and supervising junior residents at the beginning of the year

Latest revision: 06/01/2025
Natalie Wheeler, MD