Updated 5/1/17

Medicine Resident On-Call (MROC)

Purpose:

The purpose of the MROC is to provide extra manpower on an as needed basis for the internal medicine housestaff including during Dr. Cart events, patient care responsibilities, and to occasionally help with admitting to housestaff services.

Eligibility

  • Second and third year residents are eligible for 1-2 MROCs per 2 week period of ambulatory, geriatrics, consults, dayfloat, or elective-o.
  • When dayfloats are required to be MROC, the on-call dayfloat will be MROC from 8 am to 6 pm (and return the following day to be with the post-call team). The post-call dayfloat will take over the MROC from 6 pm to 8 am (after working with the post-call team earlier in the day). The post-call dayfloat will then be post-MROC the following day and will be excused from their usual duties with the on-call team on the day after their half-MROC.

Responsibilities

  • Arrive at 8AM to relieve the previous night’s MROC and take over the MROC (1212) pager. The new MROC should check in with the outgoing MROC for any sign out they might need to pass along.
  • Respond to Dr. Cart events as outlined in the most recent iterations of the UCH and program Dr. Cart policies.
  • Act as primary Dr. Cart in Mitchell at night (7 pm-7 am) and weekends (8 am-8 am).
  • Help busy admitting teams with procedures, triage of patients, road trips, or other patient care requests.
  • Help make sure that admitting teams stay within duty hours.
  • Fill out the MROC tally before leaving at the end of your MROC

Admitting:

  • Admitting Cap is 5 patients. Jeopardy may be called beyond this number at the discretion of the CROC.
  • Cards: When cards has capped, the hospitalists will admit overflow of general cards patients. Advanced HF patients (as determined by the Advanced HF faculty) will be admitted by the Advanced HF APN service. There may be an occasion when a patient who has been seen in AHF clinic is not felt to be an “Advanced HF patient” meaning, the Advanced HF attendings do not feel that the patient needs to be staffed by an Advanced HF attending during their admission. In these circumstances, those patients can go to general cardiology, general medicine, etc as the admission dictates. The Advanced HF APN service should be able to clarify with the AHF attending on-call if the AHF faculty plan to staff this patient and therefore want this patient on the AHF APN service. As of 8/10/15, both hospitalists and housestaff teams are admitting CHF pathway patients. Once the housestaff teams cap, patients admitted on the pathway may be admitted by hospitalists similar to other general cards overflow admissions. Please contact the CHF pathway pager if any questions arise.
  • HONC: Hospitalist service does not admit leukemia, lymphoma or multiple myeloma. If the on-call housestaff oncology team caps and new liquid oncology patients need to be admitted, the MROC be asked to admit these patients. The MROC should manage the patient overnight and present it as a holdover to the on-call team the following morning.
  • MICU: The MROC should be available as needed to provide assistance.
  • CCU: The MROC should be available as needed to provide assistance.

Medicine Intern On Call (MIOC)

Purpose

The purpose of the MIOC is to give the Cardiology night float intern a day off.

Eligibility

Interns are eligible for 1 MIOC per 2 week block of Urgent Care, Geriatrics or consults, for a total of 1-2 MIOCs during the course of the year.

Responsibilities

  • Arrive at 8 pm to take over Cardiology intern duties (admitting, Dr. Cart intern, cross-cover) and receive sign out from the day intern. The MIOC should take over night intern pager (4279) as soon as they arrive.
  • Respond to Dr. Cart events as outlined in the most recent iteration of the UCH and program policies on Dr. Cart coverage areas.
  • The MIOC should admit patients with the on-call resident and complete all documentation (H&Ps and sign out) prior to morning rounds at 7:30 am
  • The MIOC should depart the hospital by 8:30 am on the following morning.