The JMSC, in consultation with the Emergency Department, has developed the following protocol for calling in junior medical staff after hours. More details of the on call policy are available on the JMS website. Cover should be discussed with the Emergency consultant or Night Nursing supervisor as follows:

Decisions about evening or daytime weekend cover will be made by the Emergency Consultant.

Decisions to use the on call overnight registrar/resident should be made by the Night Nursing Supervisor.

If the Emergency Consultant or Nursing supervisor are unable to make this decision or locate the on call person then the Ambulatory Consultant should be contacted through the hospital switchboard, as has been the case in the past

On-call Policy

Who is Absent?	Who covers?
Who is Absent?	Day	Evening / Weekend	Overnight
Ward JRMO	Internal cover	On-call JRMO	If 1 doctor absent: no cover¹If 2 doctors absent: On-call JRMO
Ward Registrar	Internal cover	On-call Reg	If 1 doctor absent: no cover^¹If 2 doctors absent: On-call Reg
Paed ED Reg	Internal cover	Internal cover¹	If 1 doctor absent: ward Reg covers¹If 2 doctors absent: On-call Reg
ACEM	Internal cover	Internal cover²	If 1 doctor absent: Internal cover^1,2 If 2 doctors absent: on call Reg

¹ If it is exceptionally busy overnight, the registrar can contact the Night Nursing supervisor; under these circumstances it may be appropriate to use the oncall registrar/resident overnight - keeping in the mind the potential knock-on effect.

² The Emergency Department will attempt internal cover in all instances; however, in circumstances where the clinical workload of sick patients exceeds the capacity of the remaining staff, the on call registrar will be called in.

On-call doctor called in, and works until 10.30pm => Doctor works following day as usual

On-call doctor called in, and has to stay beyond 10.30pm => Doctor has next day off

Message from Director of the Junior Medical Staff about being on-call

Those of you who are on the rotating resident and registrar rosters will have times when you are rostered 'on call'. Please take this as seriously as the times when you are rostered to work. This roster is the buffer we have against last minute illness in our trainees and is important. We work hard to avoid using it unless absolutely necessary, by trying to cover all except last minute absences using the relief system, and by usually requiring units to cover themselves for weekday gaps. Therefore, when we need to call the on call person, we NEED to call the on call person and we need them to be easily contactable and able to work.

This means that you are responsible for being able to work and contactable when on call. You are responsible for being able to work and contactable when you are on call. It is your responsibility to know when you are on call and to be able to work and contactable. This may include being sure your phone is working, that switch have your current number, that your mobile is switched on, that you have your pager on you etc. Very occasionally we will find ourselves in the situation where the on call person has also become sick at the last minute and when contacted is unable to work. I cannot see a way around this other than the major step of creating a second on call system (not something that is planned).

Under all other circumstances (eg you have swapped a job / shift / week, you have a social arrangement, your pager has run out of batteries, you have been unwell for a few days) you need to behave as if the on call shift were a working day; ie make arrangements for a swap, get your pager batteries fixed or call switch with your mobile number, or tell medical staffing IN ADVANCE that you are ill and will not be able to work should you be called. This is a professional responsiblity and failure to live up to it is considered in the same way as failure to turn up to work would be. I am informed of all cases where trainees are not readily available where on call. This includes times where they have forgotten they were on, or that they swapped, or that they didn't hear the phone, or left their pager in the car. I follow up these cases and they are taken seriously, including providing formal written warnings of unprofessional conduct.

These occurences are very unusual and the vast majority of you are available and cheerful about coming in when called. Thanks for that, and thanks to those who work short-handed or pick up gaps when you are not rostered on. This flexibility allows us some ability to support your colleagues who are ill or need personal time off or have other crises. I appreciate your professionalism and willlingness to help.

Regards
Margot Nash

What is the relief roster ? What do I do when I'm on Relief?

This is our in house locum service to cover roster gaps, unexpected leave, exam leave, stress leave and sick leave in hours. Therefore it can be UNPREDICTABLE!! We do try very hard not to use this for after hours cover at short notice.

The bottom line is you should expect to be working in your relief term - it is not a holiday.

What do I do when on relief?

Contact Rosemary Mackintosh in MWU (Ext 5144) a couple of weeks before
If there are known gaps in the roster (ward jobs or nights) we will let you know at this stage. The relief doctor will work the rostered hours of the person they are replacing. This will also include any evenings or weekends the person was rostered to work (usual overtime for rostered hours will be paid). If you are replacing someone on nights the usual nights rostered hours will apply. You may also be placed in areas of high clinical need such as emergency, thoracics, cardiology.
Please note you may have to work in any of the places we send RMOs including MMC and Sunshine. This may have to occur despite you not working there before.
If you do not want unpaid leave and there are no gaps or other areas of high clinical need you will be asked to work in emergency (normal hours i.e. 8.30 am till 1800) as an extra, or you may be able to arrange educational activities such as shadowing a senior doctor or going to an extra clinic of your choice. But we expect you to be in hospital during normal working hours, with the relief pager so we can contact you at any time (as we may need to move you around to help in different units).

If there are any problems with the relief roster please contact Lisa Barrow (CRMO) Pager 4442 or Rosemary Mackintosh ext 5144.

We will always try to cover the most essential thing, or cross cover where able and juggle everyone around- but it is complicated. Please do not get cross or be rude to MWU staff or other staff if asked to help out on relief, or if asked to come in when On-Call. This is part of your job, it will not get you out of it and we will hear about it!!

Anthea Greenway CRMO 2005

Rules of Relief:

1) Call JMSD- Rosemary ext 5144 at least 2 weeks before to see what you will be doing.

2) If replacing someone you will need to do all their hours (including evenings and weekends) or even nights.

3) If there are no gaps at this stage, call back the week before

4) When on Relief go to JMSD to pick up a relief pager .

5) You may be dispatched to cover someone who is unexpectedly sick that day or to help on a busy unit, if not needed discuss other options: emergency department (0830 until 1800), shadowing a senior doctor or fellow, educational opportunities etc. but you will need to carry the pager so you remain contactable throughout the day.

Medical Indemnity for Junior Doctors

The Royal Children's Hospital medical staff are provided medical indemnity by their employer, the Hospital. This indemnity provides medical malpractice cover for acts and omissions of medical staff in respect of public and private patients which occur during the course of their employment by the hospital.

The policy does not cover the costs of legal representation at Coroner's Inquests, Medical Board hearings or other legal inquiries where you may need legal advice and or representation. Therefore, it is recommended that medical staff take out appropriate cover for these costs with a medical defence organisation or indemnifier.

The Royal Children's Hospital will support staff through the medico legal office.

The University of Melbourne

Murdoch Childrens Research Institute

Employment information

CONTENTS

Rosters (on the intranet)

2009 Positions Now Available

Job descriptions for Junior Medical posts

Updated for 2010

Other Employment Information:

Summary of on-call policy (for posts in the paediatric training program)

Detailed oncall policy and discussion document

Message from Head of JMS Department re oncall

What do I do when on Relief?

Flexible Training Issues

Medical Indemnity for Junior Medical Staff

Link to the AMA website

Position Descriptions updated for 2010

Position Descriptions updated for 2009

Position Descriptions updated for 2008

Position Descriptions updated for 2007

Position Descriptions updated for 2006

Job descriptions for Rural / Regional advanced training jobs:

Note: The Geelong Paediatric Fellow position is NOT currently accredited for 'rural' training under the General Paediatrics SAC. Please confirm accreditation of any of these posts before accepting a job!

Position Descriptions updated for 2005

Position Descriptions - not updated since 2004

Summary of Policy for calling in On-call Junior Medical Staff (established in 2004, still current)

On-call Policy

Who is Absent?

Who covers?

Ward JRMO

Ward Registrar

Paed ED Reg

ACEM