Body Imaging Call Rules and Priorities

IMPORTANT: Residents and fellows are absolutely required to comply with ACGME-mandated duty hours restrictions. Therefore, while house officers are expected to make a sincere effort to read all cases that occur during their call hours, but this MUST not require them to stay beyond their assigned hours. The incoming house officer must understand that sometimes they will arrive and inherit a backlog of cases.

Evening Body Fellow Call:

Fellow Hours: 5:00 – 9:00 PM. Fellows should plan their work so that they are able to leave by 9:30.

Location: 3 Gibbon Body CT reading area.

Expectations: The fellow will attempt to read all ER and STAT or urgent inpatient CT and MRI cases that are completed before 9:00, but must plan their work so that they will be able to leave by 9:30. The fellow must also view non-urgent inpatient body CT and MRI cases to determine if there are unexpected important findings. Please dictate non-urgent CT cases if possible, although non-urgent body MRI and CT can wait until the next morning. If a full dictation is not possible, please write a note in the memo field about pertinent findings and communications, so that the staff the next day can dictate this.

CT cases are assigned to the attending covering outpatient (JCCI) CT the next morning, while MRI cases are assigned to the attending covering body MRI the next morning.

The fellow should also make sure that all body CT and MRI inpatient requests have protocols. This requires determination if there is any allergy or reduced renal function. If the case had been requested earlier in the day but had not been protocoled, please notify the body CT or body MRI division director.

Weekend Body Fellow Call:

Fellow Hours: 8:00 AM – 8:00 PM.

Location: 3 Gibbon Body CT reading area, except Saturday morning at JCCI while injections are occurring.

Expectations: The fellow will attempt to read all ER and inpatient CT cases that are completed before 7 PM, but must plan their work so that they will be able to leave by 8:00. It will not always be possible to read all studies completed by 7 PM, and residents and fellows must understand that they may inherit a backlog when they arrive.

Priority for reading cases:

1. All ER CT and MRI body cases.

2. All urgent inpatient CT and MRI cases.

3. All non-urgent inpatient CT and MRI cases.

4. If the CT attending reads MRI: all outpatient CT and MRI cases, oldest first.

NOTE: If the fellow is asked to help with an interventional procedure, that takes precedence over the fellow’s other responsibilities. If interpretations are needed during such a procedure, the attending on-call should provide that service, as well as handling phone calls.

If the CT attending does not read MRI:

1. CT outpatients take priority over MRI outpatients

2. To allow expeditious reading of ER and inpatient body MRI cases, the CT attending is expected to dictate ER and urgent inpatient CT studies when needed.

3. For expeditious phone discussion of MRI cases with the MRI attending, the fellow and CT attending should agree on a suitable time, during which the CT attending should answer the phone and otherwise cover the fellow responsibilities. The optimal time for this is usually 1-3 PM.

Ultrasound: Cases are performed by the sonographer, but the fellow is responsible to assure that requests are medically appropriate. US dictations and procedures are generally the responsibility of the US attending, but the fellow may be asked for assistance. The fellow is also expected to review any ultrasound case when requested by the technologist on call.