Twilight is an evening rotation that admits patients to the geographic pods, allowing the primary ward teams to stop admitting at 4 p.m. and go home by 5:30 p.m.
Nightfloat is an overnight rotation that covers admitted inpatients and admits new medical patients overnight, after Twilight teams go home.
Twilight Teams (4 p.m. – 10 p.m.):
There are two Twilight teams in-house which start their admitting duties at 4 pm. Each team covers a primary geographic “tower”. Twilight teams attend teaching attending rounds from 4-5 pm with the day teams, prior to start their admitting duties. Each team is comprised of a junior or senior resident, two interns, 0-1 subinterns, and 1-2 Core 1 students.
Intern Night Float (5:30 p.m. - 7:30 a.m.):
Interns are responsible for cross-covering all inpatients overnight on the West Campus. Each night the on-call interns sign out the ward patients to a night float intern. The night float's primary responsibility is to manage acute issues overnight as well as follow up on labs and studies that are pending at the time of the call team's sign-out. Each night float intern covers approximately 10 intern's patients. Interns at BIDMC are supervised by the MERIT resident whose primary responsibility is intern support overnight. Intern night float rotations are located on the BIDMC West Campus. Typically, this is a two week rotation with one night off per week.
Resident Night Float (8:30 p.m.- 7:30 a.m.):
Three junior/senior residents are responsible for all overnight admissions to the medical, cardiology, and liver/kidney services WITHOUT cross-coverage responsibilities. Residents admit in a geographic format and usually admit approx 5-6 patients/ night. This rotation allows for significant resident autonomy and co-resident collaboration — a strength of BIDMC residents! This is a one week rotation and residents typically have two night float rotations per year. Residents also may rotate as night float at the VA hospital, with similar responsibilities as the BIDMC night float rotation.