Tulane Home Tulane Shield logo linking to site home page

Clinical Rotations & Call

 

First Postgraduate Year

The first year focuses on inpatient rotations in psychiatry, internal medicine, and neurology. Your first few days of residency always starts by shadowing the rising interns so they can show you the ropes just before they transition to their second year rotations. New interns usually find this is a great way to start residency with plenty of support. Rotation sites are a combination of three main New Orleans hospitals: Tulane Medical Center (TMC), University Medical Center (UMC), and the New Orleans VA, all within a few blocks of one another near downtown New Orleans.

  • Inpatient psychiatry
    • Acute psychosis unit aka ‘BH3’ (UMC)
    • General mental health unit aka ‘5D’ (VA)
  • Internal medicine - wards (combo of UMC, TMC, and/or VA)
  • Neurology - consults (combo of UMC, TMC, and/or VA)
Second Postgraduate Year

The second year is a blend of inpatient psychiatry, consultation psychiatry, and call, as well as a mix of various outpatient clinics scattered throughout your schedule to provide ‘systole and asystole,’ if you will. This is also the year with the most call. Call schedules are made with significant input by the second year residents, allowing for accommodations to be made for personal/important events. See below for more details on call. This year you will find even more independence and quickly learn how to triage ED and floor consults and balance call coverage.

  • Inpatient psychiatry
    • Mood unit aka ‘BH2’ (UMC)
    • Med-psych unit (Ochsner-St. Charles)
    • General behavioral health unit (Ochsner-St. Charles)
  • ED & Consult Liaison psychiatry (TMC)
  • Child & Adolescent psychiatry
    • Consults (Children’s Hospital New Orleans, CHNO)
    • Inpatient behavioral health unit (CHNO)
  • Night float
  • Substance use/addiction psychiatry
  • Forensic psychiatry
  • MHICM (assertive community treatment team at VA)
  • Geriatric psychiatry
Third Postgraduate Year

Third year is all outpatient clinics and electives. There is no night float or weekend call. Yes, you read that right: NO nights or weekends unless you choose to moonlight! You will find yourself occasionally holding an intern’s pager on a weekday so they can have uninterrupted didactics, but otherwise you have no call responsibilities of your own. The emphasis is on learning various psychotherapy modalities and finding your own style, with the help of a supervisor that you are paired with according to your interests. You also have the freedom to choose your own therapy patients and grow with them over the year. Your week’s schedule is a combination of half days. While weekly meetings with your therapy supervisors are required, they are often wonderful and invaluable relationships.

  • Med mgmt. + Psychotherapy clinics at the VA (aka ‘AMH’) and Tulane (aka ‘TUBC’)
  • Electives
    • Child & adolescent psychiatry
    • Community psychiatry
    • Palliative medicine/psychiatry
    • VA group therapy
    • Women’s health
    • Veteran’s trauma clinic
    • Research
    • and more!
Fourth Postgraduate Year

The fourth year also consists of outpatient clinics and electives, but with more emphasis this year on your specific areas of interest as a senior resident. Again, there is NO overnight or weekend call unless you choose to moonlight! Have an elective in mind that’s not listed? Make one! Dr. Pletsch (our PD) is always open to hearing what you want to do and new electives are being added all the time. For those who are interested in continuing to hone their skills in psychotherapy, there are still plenty of opportunities to carry on with existing patients from your third year.

  • Med mgmt. clinics at the VA (aka ‘AMH’) and UMC
  • Electives
    • Tulane med mgmt. + psychotherapy clinic (aka ‘TUBC’)
    • Residential rehab
    • Suboxone clinic
    • Substance use drug treatment
    • Group therapy at the VA
    • QI
    • Perinatal consults
    • Women’s mental health
    • Research
    • VA psychotherapy clinic
    • ECT
    • MHICM (assertive community treatment with the VA)
    • Junior attending
    • Forensic psychiatry
    • Early psychosis clinic (aka ‘EPIC’)
    • and more!
Call at a Glance

(Please note this pertains to call while you are on psychiatry rotations, not while you are on off-service rotations such as internal medicine or neurology. During those times, psych residents are responsible for call as deemed by those specific programs and rotation sites.)

PGY-1
During the first year, call consists of regular patient care, rounding, and clinical documentation, as well as being available for patient care weekdays 7 am - 5 pm. Essentially, it is much like a regular work day; you may finish work early, but you must be available to respond to calls and patient care concerns. There are two residents rotating on each inpatient psych unit and weekends are split up between them, e.g. every other weekend. There is NO overnight call coverage during your first year and coverage is only for the one hospital you are currently working at.

PGY-2
During second year, there is weekend call and night float. Night float (from home) happens in 2 week blocks throughout the year. While on night float, you will be responsible for calls at the VA, going in to see patients at Tulane Medical Center from 5 pm to 6 am the next morning, and calls from University Medical Center from 5 pm to 10 pm.

The weekend call schedule is planned ahead for each semester with everyone in the call pool (categorical PGY-2s, some med-psych residents, and some triple-board residents) contributing throughout the year. There are two main call shifts: Saturday 6 am - Sunday 6 am (24 hr) and Sunday 6 am - 5 pm (11 hr).

The frequency of call depends on your schedule and which shifts you have (24 vs. 11 hr). We work using a point system, where every categorical resident is required to meet 14 points for the year. A 24 hr shift is worth two points and an 11 hr shift is worth one point.

PGY-3 and PGY-4
There is no overnight or weekend call coverage for the last two years!