IN BRIEF REPORT Decreasing Inter-resident Conflict by Using Computer-generated On-call Schedules Chandlee C. Dickey & Tetanya Tarnavsky & Ilea Khan & Lawrence P. Panych Received: 24 May 2013 /Accepted: 4 December 2013 # Academic Psychiatry (outside the USA) 2014 Abstract Objective Although significant attention has been paid to the number of hours worked by residents, little consideration has been given to how the hours are assigned. This project de- scribes an alternative to having Chief Residents manually create on-call schedules. In order to enhance objectivity and transparency, reduce perceived inequities in the process, and reduce inter-resident conflict, Harvard South Shore Psychiatry Residency Training Program experimented with a computer- generated on-call schedule. Method A locally written MATLAB script generated an on- call schedule for academic year (AY) 2012–2013. Measure- ments to assess the manual scheduling method (from AY 2011–2012) and the computer-generated method included the balance in the total number of hours assigned to individual residents; the number of call switches over two six-month periods; and survey of the residents’ perception of fairness of the two scheduling methods and preferences. Results A retrospective analysis of the AY 2011–2012 Chief Resident-generated call schedule found a range of differences of up to 25.8 % between total hours assigned to individual residents in a given year. In the AY 2012–2013 computer-generated schedule, the differences in total hours assigned were reduced to a maximum of 6.1 %. There were 63 % fewer call switches resulting from the computer-generated as compared to the Chief Resident-generated method. Resident survey response rate was 76 %. Seventy-seven percent of resident respondents (N=22) perceived the computer-generated method to be fairer, and 90.9 % of residents preferred having a summary table of hours of call per resident. Residents perceived the computer-generated method as resulting in less inter-resident conflict. Conclusion Methods for assigning duty hour schedules that are transparent, equitable, and require less Chief involvement may result in perceptions of greater fairness and less inter- resident conflict. Keywords Psychiatry residents . On-call . Chief resident Since the turn of the last century, interns and residents have been taking call to gain experience in clinical medicine and to supply hospitals with inexpensive labor [1]. Hospitals expand- ed this practice dramatically over time [2], relying on this work force to provide huge cost savings [3]. Recent reports focused on the negative aspects of call in terms of sleep deprivation, duty hours, well-being, fatigue, and service/ education balance [4–12]. Sleep-deprived residents described themselves as less empathetic, more detached from the world around them, more irritable, and more short-tempered [5]. Extraordinary changes nationally have been made to balance service demands with a physician’ s need to sleep [3]. The impact of these changes on professionalism and residents’ sense of well-being, however, is still unclear [9, 10, 13]. These studies examined the absolute number of hours worked. Ab- sent from the discussion, is how these hours have been assigned. The “how” may be nearly as important as the “how many.” Traditionally Chief Residents create call schedules. Main- taining an equitable balance of total hours worked can be extremely difficult. In the Harvard South Shore (HSS) Psy- chiatry Residency Training Program, for example, the Chief Residents assign to 24 residents almost 15,000 h in over 1,400 C. C. Dickey (*) VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA e-mail: Chandlee.Dickey@va.gov T. Tarnavsky : I. Khan Harvard Medical School, Boston, MA, USA L. P. Panych Brigham & Women’ s Hospital, Harvard Medical School, Boston, MA, USA Acad Psychiatry DOI 10.1007/s40596-014-0060-8