Accuracy of FREIDA info on hours for psych programs

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psychaminion

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How much do you trust the FREIDA information on PGY1 hours worked for psych residency programs? How accurate do you feel that info is? I'd especially love to hear from residents and program directors who can speak to whether they see the info for their program as fairly accurate. I know results vary from one resident to another, but if the average info is fairly accurate then it might help in determining rank order. I'm just struggling to put any kind of order to my top 5 programs and am now trying to arm myself with any kind of objective/hard numbers to help. I've been able to ask some residents what their hours were like, but it can be tough to ask this question and if you only ask one or two people you aren't really getting a good representative sample.

So, what do you think about the FREIDA data? Accurate or complete fabrication?

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So, what do you think about the FREIDA data? Accurate or complete fabrication?
I found pretty much everything on FREIDA to be pretty much garbage. Handy for figuring out which programs in which specialties are where, but that's about it. When I last used it, there were even lots of broken links to the programs. I wouldn't trust much from it.
 
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It's grossly inaccurate. Hour reporting in residencies is largely a large stakes box-checking exercise to give the appearance of rule compliance. Usually hours are under-reported. Your best information is going to come from PGY3 and PGY4 residents that are on their way out of the program. There are usually a few straight shooters in every program that will tell you how it is in the program if you are easy to get along with. You can stop reading here if that's all you want to know.

But FREIDA is garbage regarding work hours and I'll tell you why:
There is too much pressure on programs to stay within the rules, who then pressure residents in a variety of ways subtle and not so subtle to under-report hours, even in psychiatry. Attendings and program directors will say things like "Make sure you are very accurate in reporting your hours online, and we NEVER work more than 80 hours a week in our program. We will need to investigate if you report more than 80 hours." This generally means investigate why you say you work more than 80 hours, not why you actually worked more than 80 hours. Also, if you do work more than 80 hours it's not because you had 10 admissions to inpatient every night in a busy psych hospital, it's because you are probably inefficient. That's how it works.

There are a variety of consequences residents face if they report actual worked hours over 80 on average over four weeks. Some are:
1. In the long term, if you residents report that they in fact work an average of 90 hours a week every week in PGY1, then eventually your program will get put on probation, and could eventually lose it's accreditation. Which then makes the residents graduates of a non-accredited program.
2. In the short term, most residency programs are no where near big enough to allow any sort of actual anonymity in hour reporting. Think about it - in the average size psychiatry residency program, a program director is going to see around 150 residents over a 20 year career (6 new PGY1 residents per year, times 20 years, plus a few more). There are generally only about 6 PGY1's at a time in most programs. Your program director and attendings and colleagues can and will find out who is not "with the program" on making sure hours are reported as being under 80 hours on average per week over four weeks. Like with any job, there are a variety of legitimate looking ways of dealing with non-team players. It's hard to move on to another program even if you are a team player and well thought of in your program.

You can see the double bind that residents are put in regarding work hour reporting.
If residents had the job mobility that attending's have you wouldn't see this happen as much, in my opinion.

Ok, enough negativity. In psychiatry, in PGY4 and often PGY3 it is rare to work more than 40 hours in most places. And I will say that in fellowship some may have over-reported hours a little bit so we look busy, such as this week after New Years, when there were no consults and it snowed and there were a lot of clinic cancellations due to weather, and we worked maybe 30 hours that week each year. It didn't fool our Program Director at all, but again, it's all about appearances. An educational excercise in institutional politics, if you will.
 
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FRIEDA is quite separate from mandatory hours reporting, which is not reported out to the ACGME except in the case of a CLER visit.
FRIEDA is the annual "best guess" by the PD and PC when we are asked by AAMC to update our program information. I will say that they make it difficult--basically asking us to provide a general number based on PGY year that doesn't reflect individual subtlties of rotation sites, on- or off-service rotations etc. So yeah, it's not something I'd base a contract on.

As to the hour reporting...as we're assigning call schedules, etc., we make danged sure that folks in our program can honestly report under 80 hrs (no one even comes close in our program) and days off, breaks, etc. appropriately. In our program , we get the report monthly, and I can ount on two hands the number of "violations" I've seen this past year--generally of the "short break" nature, e.g. busy short call, late evening of note writing followed by an early start for some reason. And we always know which resident is involved, and usually just say "yep, she worked late that night...make sure she doesn't schedule herself for ECT on post-call AMs..."
Perhaps there still are a few psych programs that play the games that wolfvgang describes, but that kind of manipulative, retaliatory, passive-aggressive behavior is really pretty unhealthy for a program, and very rare in my experience--even in our hospital's surgery and EM programs. (Then again, I'm in the kinder, gentler heartland. Perhaps the cutthroat coasts have more issues with this.)
 
Very inaccurate, I'd suggest not to base any decision-making on the figures provided, nor much of the information about features of a program. I've asked residents on the interview trail and have found that the work hours listed on there to be inaccurate.
 
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