Article Text

Download PDFPDF
Call karma among senior internal medicine residents: a diagnosis of delusion
  1. Chrystal Chan1,
  2. Bo Zheng2,
  3. Cassandra Fayowski1,
  4. Stéphane Voyer1
  1. 1Medicine, University of British Columbia, Vancouver, Canada
  2. 2Emergency Medicine, University of Ottawa, Ottawa, Canada
  1. Correspondence to Chrystal Chan, 3330 Hospital Dr, Calgary AB T2N 4N1, Canada;chrystal.chan{at}

Statistics from

The concept of call karma, or cloud colour, is a prevalent belief among physicians.1–4 Physicians with bad call karma, or ‘black clouds’, are perceived to be up all night seeing consults, resuscitating inpatients and answering pages. Physicians with good call karma, or ‘white clouds’ tend to have calmer nights, and a busy night can usually be attributed to an external factor, such as being on call with a black cloud physician.1–4 The internal medicine service receives the highest percentage of consults from the emergency department; however, senior medicine call has not been specifically examined from a call karma perspective. The objective of this study was to determine whether self-reported call karma by senior internal medicine residents reflects overnight workload.

We conducted a prospective cohort study of senior internal medicine residents over one academic year at two tertiary-care teaching hospitals in Vancouver, Canada. We ascertained self-reported call karma using an online survey at the beginning of the academic year. The primary outcome was number of consults received during overnight call, inferred from review of consult logs recorded by senior residents.

We compared mean consults by site, day of week and unlucky (Friday the thirteenth or full moon) versus standard days using Student’s …

View Full Text


  • Contributors BZ and CC conceived the idea for the study. CC, CF and SV were involved in study design and data collection. CC and BZ were responsible for data analysis and manuscript preparation in consultation with all authors. All authors had access to study data, take responsibility for the accuracy of the analysis, had authority over manuscript preparation and have read and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.