The 3 statuses of Clinical Clerkship

Dear incoming Junior Intern/Clinical Clerk,

Since we entered medical school, most, if not all of us, wondered how going on duty as an intern/clerk feels like. We would become dreadful of that so-called 36-hour duty because of fears that we might not find enough time to sleep, or maybe lose that social life that we are trying our best to balance with internship.

Recently, our batch was involved in a scuffle with the admin and consultants, wherein a certain JI sent a letter to CHEd regarding our revised duty schedule. He/she apparently called our "from" status "garbage hours" because of the observation that JI's apparently do nothing at all once they are "from" status. That incident caused a stir within the higher-ups, and because of that, a new schedule was born.

Based on the current status, here are the three duty statuses that each JI/CC must know and understand:

1. Pre-duty (7:00am - 5:00pm; 8:00am - 12:00nn Sundays)

• From the word itself, this is the status that JI's observe before going on a 24-hour duty. Pre-duty JI's are the ones who usually monitor patients in the morning up until the time they are relieved from their posts. In some departments, they also admit and deck patients to themselves if they follow the so-called "grand" decking (to be explained in a different blog).

2. Duty (7:00am - 7:00am next day, 8:00am - 7:00am Sundays/Holidays)

• This is the 24-hour duty each and every JI has to follow. This is the one of the bread and butter essentials in JI-ship: the overnight duty. Based on the new schedule, JI's on duty status start working/monitoring from 5:00pm - 7:00am the next day. The hours prior to 5:00pm for those on duty are for "in-charge" work, or for those clerks who have patients-in-charge who need to be taken care of, like working on protocols, diagnostics, etc. They are also the ones who admit patients during the afternoon until the next morning, once they are relieved by the Pre-duty clerks. In some departments, they are the ones who admit patients throughout the day if they follow the so-called "duty" decking (to be explained in a different blog).

3. From-duty (7:00am - 12:00nn; 8:00am - 12:00nn Sundays)

• This was the so-called "garbage" hours that was reported to CHEd a month ago. During the months prior to December 2012, the original schedule of the from-duty status was from 7:00am next day - 5:00pm. This status was scrapped for 2 months starting December, and was then replaced to a "once relieved" status, or in short, a "day-off" for JI's. Because of certain issues stemming from that "once relieved" status, the "from" status was reinstated in February, and this caused a stir within the JI ranks. This prompted someone to report to CHEd, and the said body acted on this issue days to weeks after the letter was received. The effect: angry and frustrated consultants, and stressed-out interns/clerks. Because of that incident, the schedule was then changed from 7:00am next day - 12:00nn. 
• This status is also called the "untouchable" schedule because those on this status are free to do anything, unless they have patients-in-charge to be taken care of. They also accept and deck patients if they follow the "grand" decking. This is the time to recuperate from a 24-hour duty by taking a bath, eat breakfast at the canteen, or read a book during spare time. After 12:00nn, they can now go home and sleep the rest of the day off, or maybe do something else.

For holidays, there is the "Skeletal" duty, wherein only those on duty status will go to the hospital and literally work for 24 hours. Those on pre-duty status need not come to the hospital, while the ones on from-duty status are relieved at 8:00am. In short, malas mo lang pag duty ka on a holiday.

Recently, some incoming freshman from a med forums page shared his discontent on the usual JI schedule. Kinda premature for an incoming med student to say such thing. Hindi mo pa nga napapasa Biochemistry, gumaganyan ka na? Tsktsk. Pero, it was his opinion, so it's best to respect it anyway.

Well, this just explains what JI's go through everyday. I hope this helps. Good luck!