Effects of 24-hour versus night-float call schedules on the clinical and operative experiences of postgraduate year 2 and 3 neurosurgical residents

Stephen G. Bowden, Dominic A. Siler, Maryam N. Shahin, David J. Mazur-Hart, Daniel N. Munger, Miner N. Ross, Brannan E. O’Neill, Caleb S. Nerison, Michael Rothbaum, Seunggu J. Han, James M. Wright, Josiah N. Orina, Jesse L. Winer, Nathan R. Selden

Research output: Contribution to journalArticlepeer-review


OBJECTIVE To comply with the removal of the 88-hour week exemption and to support additional operative experience during junior residency, Oregon Health & Science University (OHSU) switched from a night-float call schedule to a modified 24-hour call schedule on July 1, 2019. This study compared the volumes of clinical, procedural, and operative cases experienced by postgraduate year 2 (PGY-2) and PGY-3 residents under these systems. METHODS The authors retrospectively studied billing and related clinical records, call schedules, and Accreditation Council for Graduate Medical Education case logs for PGY-2 and PGY-3 residents at OHSU, a tertiary academic health center, for the first 4 months of the academic years from 2017 to 2020. The authors analyzed the volumes of new patient consultations, bedside procedures, and operative procedures performed by each PGY-2 and PGY-3 resident during these years, comparing the volumes experienced under each call system. RESULTS Changing from a PGY-2 resident–focused night-float call system to a 24-hour call system that was more evenly distributed between PGY-2 and PGY-3 residents resulted in decreased volume of new patient consultations, increased volume of operative procedures, and no change in volume of bedside procedures for PGY-2 residents. PGY-3 residents experienced a decrease in operative procedure volume under the 24-hour call system. CONCLUSIONS Transition from a night-float system to a 24-hour call system altered the distribution of clinical and procedural experiences between PGY-2 and PGY-3 residents. Further research is necessary to understand the impact of these changes on educational outcomes, quality and safety of patient care, and resident satisfaction.

Original languageEnglish (US)
Article numbere12
JournalNeurosurgical focus
Issue number2
StatePublished - 2022


  • Resident curriculum
  • call schedule
  • duty-hour restrictions
  • learning curve
  • night-float

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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