m d r h T d w m m r p p oth academic and private pracices have faced increased demand or 24/7 radiology coverage. This aper describes our experience with overing a large academic practice ith a combination of radiology esidents and attending radiologists round the clock. In past decades, it was acceptable o leave emergency room (ER) and npatient cases until the next day or ver the weekend for final interpreations. Traditionally, academic ractices have used resident call ools to provide interim prelimiary interpretations. In recent ears, more and more health care ystems are finding this level of covrage unacceptable and are pressurng practices to offer 24/7 coverage y attending radiologists [1]. Some ractices meet this requirement by utsourcing after-hours studies to nighthawk” companies [2-5]. At ur practice, we have found 24/7 n-house coverage to be a better soution. Twenty-four/seven or “afterours” radiology includes not only ases from emergency departments, ut also an increasing number of npatient examinations. The specrum of studies involved is wide, ncompassing all diagnostic imagng subspecialties and all imaging odalities. General radiologists, mergency radiologists, or other ractitioners with wide skill sets are equired. Many academic radioloists, by the very nature of their t ubspecialization, lack these broad kill sets. As such, an academic ractice may face greater challenges n providing after-hours coverage han many private practices. The Department of Radiology at ndiana University School of Medcine is a large practice (Indiana Raiology Partners, Inc.) that covers 8 ospitals and multiple outpatient enters, with approximately 86 raiologists. We have 60 radiology esidents and a variable number of ccredited and unaccredited felows. All of our hospitals require ome degree of after-hours coverge, much of which, using a systemide picture archiving and comunication system, can be done by esidents. Among our 8 hospitals, e cover 2 busy level 1 trauma ceners (each with approximately 00,000 patient visits per year). At ur largest facility, we have both esident and attending radiologists n duty, in house, 24 hours a day. t our second trauma center, we ave resident coverage 24 hours a ay, with an attending radiologist n house from 7 AM until midnight. There are several potential ways or a practice to provide 24/7 atending radiologist coverage withut outsourcing. A traditional call ool, with after-hours responsibiliies spread among many members f the practice, is one option. This as the benefit of lower cost and ay obviate the need to hire addiional radiologists. Alternatively, o