Do you pull 30-hr call shifts as a student?

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primadonna22274

primadonna22274

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Curious...I just came off a 30-hr call shift on OB. 6a Monday-12n Tuesday--stepping outside in hot and humid SC after 30 hr in the hospital was delightful.
Residents can no longer do these shifts with duty hour restrictions but no such rules for med students. When I asked my 60-yo attending about it he said "yeah, they won't let us make the residents do these anymore but if we have to be on call for 30 hr the students get to do it too."
Oddly it wasn't all that terrible. I got to deliver my first baby at 9pm last night and actually my resident let me sleep almost 6 hr--if only I had brought a toothbrush ;) one of our fellows said they did away with the 30-hr shifts her 2nd PGY and she preferred them to night float because she would get that post-call most of a day off. I'm exhausted and desperately want a shower but I can't complain about having the rest of the day off to recuperate by the pool.
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I did on surgery as a student. The post call day was nice. I never saw anything cool enough to be worth staying in the hospital for 30 hrs though.
 
Yes, for IM and for OB. However, as you mentioned, they are usually nice enough to let you get some sleep.

Making anyone stay awake for > 24 hrs is not only cruel, but unsafe. And yes, post-call is great. :)
 
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My longest was 31 hours last year.

Most of our calls were 24 hours though. Every service let us sleep at least 4-5 hours except surgery where I was at the mercy of the trauma pager.

I swear I had magic powers...I could make the pager go off by just turning the call room lights off and getting into bed. There was at least one night I didn't sleep at all.
 
I did a 24 starting at 7pm friday and had just gotten off a 12hr shift-- 1hr sleep, ER consults all night. Delivered like 3 in the span --vaginal and c-section. So much to do that I like blacked out around 7am and came to in the ER doing a consult to rule out ovarian torsion. My post call lasted one day, and i then had to start nights, AND I had to come in friday night after my shelf.
 
I had to as well. I think its ridiculous. Its unsafe, especially to drive, if you weren't able to get any sleep. If I hadn't wanted to get out the hospital so badly I probably would have taken a nap in the call room before attempting to drive home.
 
@OP: so technically our school handbook says "clerks are generally expected to work five full days (a maximum of sixty hours) per week" ... so I guess if the 30 hour call puts you over 60 hours in a week, and you really wanted to take up the beef, you could...
I think it's absurd to make medical students work longer than residents are ever allowed. If I was ready to pop out a kid, I'd surely not want a less-trained, more-sleepy person in the room helping out...
 
Many times on surgery.... Often not getting any sleep. I think my longest was 34 hours with 0 minutes of sleep... we had a consults on top of consults, then had a trauma that required too many sutures to count and took 3ish hours to finish up... consult list got even longer... then got an acute abdomen which we took to the OR around 2am.... got out about 5:30 just in time to write notes and make it to morning report before scrubbing in on a case that lasted until 3pm

I never mind it as long as we are busy.... it's when we are sitting around just waiting for something that I start disliking it...
 
Yes, we have 24+6 hour overnight call. Like the above poster mentioned, it's not too bad when things are busy.

Personally, I think it's very important to have this overnight call in certain specialties (ex. surgery). Why? Because I want to make a decision to enter a field based on a realistic view of the field. As far as I know, only interns are limited to 16 hrs. All our PGY-2+ do full-blown 30-hr call (unless I'm severely misreading the schedule). If my rotation was a nice little 8-5 scenario, that's pretty misleading of how actual training (and possibly, beyond-training) life can be. I don't want to find out during the first month of residency that the field is not what an easy M3 rotation made it out to be. I'd rather make an informed decision. That's just my opinion. Plus, almost everyone I've talked to has complained that the 16 hr sessions are much more fatiguing than doing long-call and having the post-call day.

Also, I've found call to be pretty useful in learning and remembering stuff. All the traumas seem to happen at night and I remember learning how to work-up a potential acute abdomen late into the night -- I don't think I'll ever forget that patient or what we did to work him/her up and come to a decision regarding surgery.

Again, this is just my opinion and experience.

Just curious, but for the people who are complaining about the hours, did you not look up the kind of hours training and work-life as a physician entailed before deciding on medicine? Genuine question here, since I've actually come across some people who had no idea at all about what to expect beyond the first two years of med school. Maybe I'm just an outlier who researched the crap out of what med school and residency would be like before committing to med school?
 
WhitJord85 said:
I never mind it as long as we are busy.... it's when we are sitting around just waiting for something that I start disliking it...
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So you're happy doing 30 hour call, unless you have any time to rest.
 
At where I rotated at, we had 30 hour calls (by the time all was said and done) for IM and surgery. IM was generally bad because you were the admission team for IM and the rapid response/code team for the hospital. Generally, there was a couple of hours around noon when the sub-I teams (MS4s plus attendings) took admits, but besides that you were generally up and going most of the night.

For surgery, students saw admits first, responded to trauma calls, and scrubbed in. Thankfully, one of the other schools also had their students do surgery night float, so if there was a 12 hour night float student on over night, the 30 hour call students generally got a full nights sleep.

Also, on this note, 30 hour call isn't necessarily the worse. The family med teams will go from a day shift one day to 2 night shifts in a row before a day off. I think my circadian rhythm almost ran away after that month.
 
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Did 24ish hour calls in Surgery. Round morning, do full day of surgery, stay overnight to cover trauma, round on patients next morning, go home before surgeries started up the following day. Ended up being about 26-28 hours depending on how early I had to pre-round one day, and how late we did resident rounds the post-call day.

If I had to stay until noon, I would probably pass out at some point. OB and IM both had night float (we did OB nights for a week, but never did IM nights).
 
IGotGas said:
So you're happy doing 30 hour call, unless you have any time to rest.
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I want to do surgery, so no I don't mind doing it. Like other people mentioned you often get the chance to do things you don't get to do during the day. So yeah sometimes it can be fun. And I guess because I wanted to do surgery, I long ago accepted that long hours will be a part of my life.

I'd rather work 30 hours and be busy, then work 15 hours and have very little to do
 
Yes, on surgery, every saturday was a 30-hour call for me. I slept maybe 1 hour max or no sleep at all.
 
Post call after a 30 hour shift with little or limited sleep?

Sleep for 4-6 hours, maybe do some work, maybe watch some TV, do chores for a couple of hours. Go to sleep so I can get up in time to preround the next day.
 
Siggy said:
Post call after a 30 hour shift with little or limited sleep?

Sleep for 4-6 hours, maybe do some work, maybe watch some TV, do chores for a couple of hours. Go to sleep so I can get up in time to preround the next day.
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.
 
Bacchus said:
Its not unsafe until you wind up in the opposite lane.
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There's been a few times following 30 hour shifts and night shifts following a day shift (5pm-9am L&D shift following a 8am-6pm OB/Gyn clinic shift) where I'm not entirely sure how I got home safely.
 
I had to do them in OB and surgery as well.

The only use I can see for the long shifts are for those on the fence about those fields for whom masochism is not appealing.

I never understood the people who extol them as an opportunity to learn. An opportunity to prove your tough enough to an evaluator or LOR writer perhaps. All I learned is an increased respect or maybe more a sense of incredulity for my colleagues who would enter those fields regardless of their respective cultures.
 
As a second yr pa student on trauma surgery rotation(my first) I did alternating 24 and 12 hr days for 5 weeks with one day off during the whole rotation. I lived there in residents quarters and ate in the hospital cafeteria. great rotation site. washington hospital center medstar trauma team in D.C.
 
Doing a 30 hour call? safe. welcome to medicine. If you don't like it, avoid the fields that do it.
Driving home after a 30 hour call with little to no sleep? stupid (I've done it before and in retrospect, a minimum 20 minute nap before driving would've been smarter)
 
primadonna22274 said:
Curious...I just came off a 30-hr call shift on OB. 6a Monday-12n Tuesday--stepping outside in hot and humid SC after 30 hr in the hospital was delightful.
Residents can no longer do these shifts with duty hour restrictions but no such rules for med students. When I asked my 60-yo attending about it he said "yeah, they won't let us make the residents do these anymore but if we have to be on call for 30 hr the students get to do it too."
Oddly it wasn't all that terrible. I got to deliver my first baby at 9pm last night and actually my resident let me sleep almost 6 hr--if only I had brought a toothbrush ;) one of our fellows said they did away with the 30-hr shifts her 2nd PGY and she preferred them to night float because she would get that post-call most of a day off. I'm exhausted and desperately want a shower but I can't complain about having the rest of the day off to recuperate by the pool.
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Never as a student. Very rarely as a resident.
 
Rendar5 said:
Doing a 30 hour call? safe. welcome to medicine. If you don't like it, avoid the fields that do it.
Driving home after a 30 hour call with little to no sleep? stupid (I've done it before and in retrospect, a minimum 20 minute nap before driving would've been smarter)
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Thank you. No one said you have to jump right in your car and drive home immediately. If you don't think its safe to drive then don't. But there is nothing inherently unsafe about a 30 hour shift. And before someone starts in on patient safety go read what research is out there before you start banging that drum (it may surprise some people).
 
JRjcu08 said:
@OP: so technically our school handbook says "clerks are generally expected to work five full days (a maximum of sixty hours) per week" ... so I guess if the 30 hour call puts you over 60 hours in a week, and you really wanted to take up the beef, you could...
I think it's absurd to make medical students work longer than residents are ever allowed. If I was ready to pop out a kid, I'd surely not want a less-trained, more-sleepy person in the room helping out...
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Do you really want to be that guy that pulls out the handbook over a 60 hr/wk rule? Especially when your classmates are doing 60+ as well? Technically, yes, you're correct, but your evals won't be pretty.
 
Banned said:
Do you really want to be that guy that pulls out the handbook over a 60 hr/wk rule? Especially when your classmates are doing 60+ as well? Technically, yes, you're correct, but your evals won't be pretty.
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I certainly won't be the one to complain...it's only a month of my life, really, and the rotation is intimately connected with a residency program that is on my list...better just to suck it up.
 
On surgery, yes, but it's often closer to 26 hours or so I'm told. I don't think I have it on OB, but I have a week of night float.
 
When I was gunning ortho, I took call everyday when no other student would. On one rotation, I ended up actually working 4 days in a row on call where I only slept from 2-4 am each night. :eek: That wasn't fun, but then again I did match, so :smuggrin:
 
Banned said:
Do you really want to be that guy that pulls out the handbook over a 60 hr/wk rule? Especially when your classmates are doing 60+ as well? Technically, yes, you're correct, but your evals won't be pretty.
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Pretty much this. The student coordinator at my main hospital told us to go to them if we were asked to work over 24 hours straight. Yea... um... pretty much everyone agrees that that isn't going to happen.
 
As students, we followed the work hour restrictions of the upper levels, which means we could work 24 hour shifts without complaint. We had to do them on surgery (min of 2 during the 8 weeks)... my first one, I slept for like 5 hours, so it was awesome (because I got the whole post-call day off too. The second one, I only got like an hour of sleep at 5am, because we had consults running all night. It's not bad as long as you stay moving.

We were expected to do them on internal medicine. We had a night float system in place for Sun-Thur, so if we were on call Fri or Sat, we were expected to stay 30 hours and round the next day with our team. In actuality, my residents sent me home at like 8pm and told me to come back fresh the next day to help out the intern.

I technically had to do one when I was transitioning to nights on Peds. We came in Sunday morning, stayed for 24 hours, then did a week of nights. But they only did that at one location for peds, and not our main hospital.
 
Banned said:
Do you really want to be that guy that pulls out the handbook over a 60 hr/wk rule? Especially when your classmates are doing 60+ as well? Technically, yes, you're correct, but your evals won't be pretty.
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Wasn't suggesting it, just staying what the actual policy says.

However, on a similar note, who is the guy responsible for making sure the 80-hour week is followed for residents? As strict as those policies are, it's curious that medical students are not part of them.

Rotations are for learning clinical medicine, not learning how to be someone else's work horse just because nobody is willing to stop it from happening.
 
No. At my school, students follow the intern work-hour rules. Sometimes we might go a little over, but it's never too bad. A 30-hour shift would bring the school admin down on the offending clerkship fast.
 
Knitress said:
No. At my school, students follow the intern work-hour rules. Sometimes we might go a little over, but it's never too bad. A 30-hour shift would bring the school admin down on the offending clerkship fast.
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Here's what sucks about this: I'm expected to do a minimum of 5 30-hr calls during this 4 wk rotation including one weekend. Missed this weekend and Mon-Tues for my mother-in-law's funeral (sudden and unexpected). Will restart Wed am, pick up 30-hr call Thurs-Fri and Sat-Sun and still have to do one more that last week to not be deficient...and take my shelf exam next Friday and on to next rotation another 4 hr away the following Monday.
No rest for the weary.
 
primadonna22274 said:
Here's what sucks about this: I'm expected to do a minimum of 5 30-hr calls during this 4 wk rotation including one weekend. Missed this weekend and Mon-Tues for my mother-in-law's funeral (sudden and unexpected). Will restart Wed am, pick up 30-hr call Thurs-Fri and Sat-Sun and still have to do one more that last week to not be deficient...and take my shelf exam next Friday and on to next rotation another 4 hr away the following Monday.
No rest for the weary.
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DO school?
 
primadonna22274 said:
Yes but not a DO rotation--hospital sponsors 2 dually accredited residencies, FM and gen surg.
Not sure of the point?
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It's been my experience DO schools work their students to the bone. Had way too many 30+ hour days as a student. Not sure it teaches much beyond how to resent the hell out of the people inflicting such torture on you.
 
laconfidential said:
It's been my experience DO schools work their students to the bone. Had way too many 30+ hour days as a student. Not sure it teaches much beyond how to resent the hell out of the people inflicting such torture on you.
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Irony is that I set this rotation up myself (and most of my rotations) outside of my school's usual network. This is the only one that's been so rough hours-wise. When I got the text Friday morning after rounds from my husband saying his mother had died the night before I had already been in the hospital 65+ hr that week. Between 6am Wed and noon Sunday I will put in 76 or so to make up my bereavement leave. Ok, done whining now...it really is a good rotation all around and I have learned a lot.
 
JRjcu08 said:
However, on a similar note, who is the guy responsible for making sure the 80-hour week is followed for residents? As strict as those policies are, it's curious that medical students are not part of them.
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The residents self report hours at my hospital. This, of course, results, in the problem of residents self reporting "80 hours" regardless of how much over they go. After all, you don't want to be the one resident putting your work on the other resident, nor do you want to be the one resident that can't meet the hour restriction.
 
laconfidential said:
It's been my experience DO schools work their students to the bone. Had way too many 30+ hour days as a student. Not sure it teaches much beyond how to resent the hell out of the people inflicting such torture on you.
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This is what I insinuating. The DO students that did internal medicine with us at my hospital had to work a weekend day every weekend as MS3s and routinely stayed longer than the other students on rotation. Combine that with the messed up shelf-scheduling that LECOM has, and it wasn't a fun time for most of them.
 
evilbooyaa said:
This is what I insinuating. The DO students that did internal medicine with us at my hospital had to work a weekend day every weekend as MS3s and routinely stayed longer than the other students on rotation. Combine that with the messed up shelf-scheduling that LECOM has, and it wasn't a fun time for most of them.
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Ha, add in accelerated 3-yr experimental LECOM group and you have a shelf exam every month for the first 6 rotations then step 2 CE & PE then exhaustion.
 
For OB rotations at our school, we took call every 3 to 4 nights. On those days, we had to pre-round before 7AM, then round with the attending at 7, then spend the day in clinic with the attending until 5PM or so (running back and forth between clinic and hospital for deliveries). After clinic, we reported to the maternity ward for call until 7AM the following morning, after which you had to round again with the attending and then spend ANOTHER full day in clinic until between 5 or 6 PM. Then you're finally allowed to go home and get ready to come in bright and early the next morning. So all together, roughly 34-36 hours in a row between the hospital and clinic. We were allowed to sleep in between deliveries during the night, but if it was a busy night, that didn't happen. I was usually so exhausted I felt like I was driving drunk on the way home.
 
^ Holy ****, and I thought my 24-hr call on OB with tough. Most clinical sites for my school don't do 24-hr call on OB except for the site where I did my rotation. No sleep, and I felt every single one of the 24 hours. Seemed like it would never end. Probably could have slept and no one would have cared but the residents never did so I felt bad passing out while everyone else was working (it was my first rotation).
 
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