q
Warning: Cannot modify header information - headers already sent by (output started at /home/customer/www/medicalschoolexpert.co.uk/public_html/wp-content/plugins/code-snippets/code-snippets.php:1) in /home/customer/www/medicalschoolexpert.co.uk/public_html/wp-content/plugins/mediavine-control-panel/src/Security.php on line 49
What Does Being 'On-Call' Mean For Doctors In The UK?

What Does Being ‘On-Call’ Mean For Doctors In The UK?

Updated on: December 3, 2023
Photo of author
Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

I’m sure you’ll have heard doctors referring to being ‘on-call.’ Whether that be friends of yours, in medical dramas or on the news. But what does being ‘on-call’ actually mean for doctors in the UK?

Being ‘on-call’ for a doctor means being immediately available to see patients when requested. The specifics of how on-call shifts work varies from hospital to hospital and between departments. However, the core concept is that the doctor can be easily contacted for an opinion or review of a patient.

It’s a difficult term to define because there isn’t one exact meaning. In this article, I’m going to explore how it’s used in different contexts and what exactly being on-call means for a doctor.

How Does Being On-Call Work For Doctors?

At the heart of it, being on-call means that as a doctor you’re available to work. But what an actual on-call shift looks like can be quite a few different things.

The main uses of the term in the UK are:

  • For any out-of-hours shifts. So if you’re a doctor working on the weekend or overnight then you’re ‘on-call.’
  • When you’re part of the team in charge of seeing new patients. For example, at any one time out of all the surgical doctors in the hospital, one team will be in charge of seeing all the new surgical patients that come in. If you’re part of that team then you’re ‘on-call.’
  • When you’re available at request. Overnight there often isn’t a need for say a kidney specialist to be in the hospital. But, if for whatever reason a doctor working overnight needs a kidney specialist’s opinion, then there needs to be someone that can be contacted. That doctor who can be reached is ‘on-call.’

As you can see, there’s quite a wide variety of meanings behind the term. A doctor on-call could either be a junior doctor working frantically on a weekend shift or it could be a surgeon tucked up in bed overnight but with their phone on loud by the bedside.

Doctors working at the ward workstation

Which of these meanings being on-call means is dependent on the hospital and indeed department that a doctor’s working in. For example, some hospitals may allow a surgeon on-call to sleep in their own bed (as long as they can get into the hospital quickly) while others will require them to stay on-site.

I’ve got to admit it took me working as a doctor a while to get my head around all the different nuances of what people meant when they said they were on-call- so it’s natural to find it all a bit confusing!

How Often Are Doctors On-Call?

How often a doctor is on-call will depend on their rota, where they work in the country and in what department they work.

Specialties that have fewer ’emergencies’ are less likely to have busy on-call rotas. So for example, if you work in:

  • Dermatology
  • Rheumatology
  • Psychiatry

Then it’s unlikely that you’ll be urgently needed in the hospital out-of-hours. However, if you work in:

  • General surgery
  • Orthopaedics
  • Anaesthetics

Then you’ll likely have a very busy on-call rota. That’s because doctors from these specialties are frequently needed to see patients out-of-hours on a time-critical basis. So more doctors are needed to fill the on-call rota.

As doctors become more senior they’re also less likely to be on-call. That’s because the majority of things can be handled by a trainee in that specialty.

Although they’re technically still in training, a specialist trainee (or registrar) can be a very experienced doctor and will have a far deeper knowledge about their particular area of medicine than other doctors.

The registrar will likely still be able to contact the consultant (the top-level doctor) if they need expert help but will be able to manage the majority of things by themselves. That means that although they can still be on-call, the more experienced doctors don’t have to do as much work.

If you’re interested in real-life figures, then I explored how many hours doctors actually work in this article here.

Do All Doctors Have To Be On-Call?

If you want to become a doctor but don’t like the idea of having to be contactable 24/7 then you’re not alone. But do all doctors have to be on-call or is there a way to not do it?

The vast majority of doctors will at some point have to be on-call. Junior doctors do most of the on-call shifts at a hospital but there is always top cover needed from more experienced doctors. Only if specifically negotiated can doctors not have to be on-call.

Being on-call is normally baked into doctor’s contracts- setting out how often they have to do it and in which hospitals. This is especially true for doctors in a specific training program.

One way for a doctor to avoid being on-call is by signing a job contract that specifically doesn’t include any on-call shifts in its work pattern.

GPs are most likely to be able to do this as only very few doctors are needed on-call in the community after GP practices shut.

Another way is if a doctor is only working as a locum. A locum doctor is essentially like a temp teacher. This means they can pick and choose which shifts they want to work.

This can be a great option for doctors that can only work in traditional 9-5 days due to constraints outside of work (such as children). They wouldn’t be able to dedicate the time needed to be on-call overnight or at weekends.

Can Doctors Sleep While On-Call?

You may have heard of doctors doing 24 hour on-call shifts. Thankfully, this isn’t the same as a doctor having to be on the ward and working for 24 hours straight. They’re allowed to rest during quiet periods… but can they sleep?

Doctors can sleep while on-call. This can be either in their own bed at home or in specific on-call rooms at the hospital. If sleeping, the doctor must be easily reachable by phone or pager to contact them if they’re required in the hospital.

If you’re a junior doctor on-call overnight (i.e. you’re covering the wards till morning) then you are able to sleep if it isn’t busy. You won’t be able to sit down for longer than five minutes on some nightshifts while I’ve had others where I’ve had at least five hours of sleep!

A doctor catching some much needed shut-eye!

It really is just the luck of the draw as to how busy you’re going to be and so whether you’ll be able to get any shut eye.

When doctors talk about the other definition of being on-call (i.e. being available on request) then they’re much more likely to be able to sleep. A cardiologist might be on-call overnight but if no one comes into the hospital needing a specialist cardiology opinion then they’re not going to be phoned and woken up.

In some hospitals the way it will work is that a designated surgeon will be on-call overnight at home but then in charge of seeing the new surgical patients during the day.

So they need to sleep as they’re working during the days but will have to come in if a patient needs an emergency operation overnight. This can result in some very tired surgeons if they’ve had to be up in the night and are busy during the days.

I actually recently surveyed over 1000 doctors to find out how much they sleep on average. You can find the results from that poll here.

Final Thoughts

If you don’t work in a medical field then it can be quite confusing to get your head round what doctors mean when they say they’re working ‘on-call.’

Which isn’t in the least helped by the fact that there’s a few different meanings behind the term- multiple of which could be used by a doctor in the same sentence!

Hopefully you’ll now have a clearer understanding of what doctors mean now when you hear it in Scrubs, House or Grey’s Anatomy!

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.