University of California San Francisco

Guidelines for Jeopardy Coverage

Administration

Drs. Kenzo Hirose and Clara Gomez-Sanchez will be the principle adjudicators of the jeopardy system, which is governed by the EmergenTree . Requests for coverage should be directed to the moonlighting coordinators who will obtain approval for all jeopardy requests from Dr. Hirose and/or Dr. Gomez-Sanchez. If requests for coverage are less than 24 hours in advance, timely communication must be made via group text or phone call, rather than email. Once approval is obtained, the moonlighting coordinators will facilitate jeopardy activation. Issues regarding service coverage and long term absences will continue to be the purview of Dr. Hirose. 

The jeopardy call schedule will be made on a yearly basis by the moonlighting coordinators. Any service is eligible for coverage at any time in the case of illness or emergency of any resident working any shift (including moonlighting shifts.) However, there are certain services in which jeopardy coverage will not routinely be provided for:

  • Subspecialty surgery services (e.g. urology and plastics), gastroenterology, and ICU
  • CPMC
  • UCSF Vascular R4/5 (fellow to cover)
  • Mission Bay R3/4 (Surg Onc and Gold can cover each other)
  • ZSFG Emergency Department
  • UCSF Thoracic R4 (fellow to cover)
  • VAMC vascular and GS R4/5 (can cover each other)
  • APP callout (APP overtime pool will cover)

Note: In some instances, absences will not be covered by a jeopardy resident if the case-load, call schedules, and resident staffing of the service permits. This decision will be at the discretion of Dr. Hirose and Dr. Gomez-Sanchez in consultation with the service chief.

Expectations of Residents Requesting Coverage

Elective Requests

Coverage will be considered for:

  • fellowship and job interviews
  • presentations at meetings

For elective absences, requests must be made 6 weeks in advance.

Before requesting jeopardy coverage, all attempts should be made to get the deficiency covered from within the service (switch call, etc). Every effort should be made to minimize the absence. For example, residents should request coverage for an academic meeting only for the length of time necessary for travel and to present the paper, not for the entire length of the meeting.

Emergency Requests

  • brief medical disability (serious acute illness, operations)
  • family emergencies (e.g. serious illness or death)

Emergency requests will be afforded greater flexibility. As much advance notice as the situation permits is expected. (Note: Long term absences due to medical disability may require shuffling rotations at the discretion of Dr. Hirose.)

Residents must inform their service chief of the proposed absence and their intent to request a jeopardy resident. Service chiefs may determine that jeopardy coverage is not necessary if the case load, call schedules, or resident staffing of the service permit, as noted above.

Residents must not assume that their absence will automatically be covered by jeopardy. While these guideline broadly describe appropriate requests for coverage, all requests will be individually considered. Residents that are perceived to be abusing the system can have their privilege of jeopardy coverage withdrawn.

Residents should request coverage for no more than 3 consecutive days and no more than 9 days total in a year.

Dr. Hirose/Dr. Gomez-Sanchez will individually consider all requests for jeopardy coverage.

Expectations of Lab Residents

Jeopardy call accompanies the privilege of moonlighting at UCSF. All UCSF lab residents that have completed their clinical PGY3 year are subject to jeopardy. Residents from other programs and post-PGY2 residents are subject to jeopardy at the discretion of Dr. Hirose and Dr. Gomez-Sanchez.

In the spring, a list of eligible lab residents for the coming year will be compiled and a jeopardy schedule generated by the surgery education office. Lab residents may request certain weeks are protected (e.g., for events like wedding that are anticipated well in advance). During weeks on jeopardy call, the jeopardy resident must remain local and be available to contact by pager or phone to be in the hospital within 1-2 hours. In addition, the jeopardy resident will not be scheduled for moonlighting shifts to avoid conflicts.

In reality, jeopardy is relatively rarely called upon. In addition, conflicts will come up. Swapping call weeks will be permitted. If (very rarely) a second ‘back-up’ jeopardy resident is needed, this person will be picked based on an alphabetical list. Back-up jeopardy assignments will be made in order according to the list.

If the resident that is jeopardized has a pressing conflict, it is his/her obligation to find a replacement (likely the next person on the list). That resident then remains at the top of the list for the next back-up jeopardy assignment. When the entire list is exhausted, assignments will begin at the top again. The order of the list remains the same. If a lab resident delays their jeopardy coverage, they still are called up in alphabetical order on the next go-round

Lab residents may not be jeopardized for more than 3 consecutive days or more than 24 consecutive hours. Lab residents are subject to 8 hours off between shifts or 14 hours off after 24 hours, in accordance with ACGME work hours requirements.

Jeopardized residents will be paid the standard moonlighting pay for that shift. Please note that surge rates do not apply to jeopardy shifts, only for moonlighters picking up shifts. 

Any complaints, concerns, appeals, or suggestions should be addressed to Dr. Hirose and Dr. Gomez-Sanchez and will be discussed at the next SEC meeting.

revised 02/2025

revised 6/27/2013