16 Hour Rule

[SeekerOfTheTree]

Hello,

Does anyone know for those students starting third year in July 2011 what the impact of the new 16 hour rule will be for being on call?

Thanks!

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[BigRedBeta]

Students do not fall under the ACGME guidelines.

As a courtesy or for consistency, medical schools may choose to limit students as well, but this is a question that needs to be directed towards the clerkship directors at your school.

 

[DrBowtie]

Students do not fall under the ACGME guidelines.

As a courtesy or for consistency, medical schools may choose to limit students as well, but this is a question that needs to be directed towards the clerkship directors at your school.

This. Your clerkship director and school sets the course expectations.

 

[SeekerOfTheTree]

My Dean says that they abide by the recommendations set by the committee. So I am guessing that means that we get those rules applied to us too? I am just not sure how call would work then for med students.

 

[mordounhas]

Well, you'd likely either have short call or just no duties during the day and essentially function as night float on occasion. My school also applies ACGME guidelines to med students, but I haven't heard any chatter about abiding by the 16 hour rule for Med 3s- granted it won't affect me anyways at this point.

It will be kind of funny though if I'm pulling 30 (or 28) hour call on sub-Is next year when the interns can't do the same (which I suspect will be the case).

 

[smq123]

It will be kind of funny though if I'm pulling 30 (or 28) hour call on sub-Is next year when the interns can't do the same (which I suspect will be the case).

It's not that unusual. On one of my sub-Is, we were working 7 days a week, at about 120 hours a week. The intern, however, was protected by the duty hours, got a day off each week, and worked ~85 hours a week.

 

[mordounhas]

120 hours averaged over a month sounds brutal- I pulled close to 100 one week during surgery, and thought that was pretty rough. Anyways, I realize it's not an uncommon situation that sub-Is will work longer hours than interns because the entire point is to make a good impression and be around as much as possible. Just think it will be weird that the call rules will be so different for them than for everyone else.

 

[kdburton]

Hello,

Does anyone know for those students starting third year in July 2011 what the impact of the new 16 hour rule will be for being on call?

Thanks!

They're going to add 8 hours/day to the MS3's shifts to make up for the lazy interns

 

[C5toC9]

that's awesome

 

[kdburton]

Interns ONLY doing 30 hours??!! Man, we probably are workaholics in Mexico then. I was chugging an average of 34-36 hour call and thought I had it tame. Of course, there IS no work limit for residents in Mexico. Interns can get a "sort" of limit but residents can work 100 hours nonstop and it's 100% legal.

As a med student at the most I only had to do 12 hours of call a few times in just 2 subjects in my 4th year and really didn't do much. My university was very cush in that aspect.

This is just one of the many reasons why you don't see anyone illegally crossing the border from the US into Mexico

 

[werd]

it's unclear exactly how the new rules will affect call for residents and students. most programs are coming up with their plans right about now to accommodate the new rules. of course, the new rules are for residents (mostly interns) and not for students, but students mostly follow the work patterns of residents because they function as part of the team.

to be honest, i'm not sure how the new system will work. as bad as 30 (they're really 30-32) hour calls are, i'm not sure how things will work if interns can't do 24+ hour shifts. even most night-float programs have traditional 30-hour calls on the weekends or at least periodically. it's also odd that upper-levels can do longer shifts, because teams generally consist of an upper-level, 1-2 interns, and 1-2 students. it may be a case where upper-levels do traditional 30 hour calls but interns switch halfway through the call period. shorter shifts for interns may help in some ways, but it may cause them to have fewer days off. i'm curious to see how it all plays out, and glad that my days of 80-hour weeks are behind me.

 

[45408]

Interns ONLY doing 30 hours??!! Man, we probably are workaholics in Mexico then. I was chugging an average of 34-36 hour call and thought I had it tame. Of course, there IS no work limit for residents in Mexico. Interns can get a "sort" of limit but residents can work 100 hours nonstop and it's 100% legal.

The siestas don't count as working.

 

[Charles_Carmichael]

The siestas don't count as working.

Is the 80 hrs averaged over 4 weeks rule still in place? A lot of the physicians I've been shadowing have been complaining of the "dilution" of medical training due to work hour restrictions. I honestly don't know what to think of it since I haven't experienced it myself...

 

[HarryGary]

Is the 80 hrs averaged over 4 weeks rule still in place? A lot of the physicians I've been shadowing have been complaining of the "dilution" of medical training due to work hour restrictions. I honestly don't know what to think of it since I haven't experienced it myself...

80 hrs is still in place. Those doctors also walked uphill both to and from school.

The new work hours will simply make programs less front loaded. Residents will have a tougher 2nd and 3rd year. Good for interns next year, bad for upper levels.

 

[futuredoctor10]

Is the 80 hrs averaged over 4 weeks rule still in place? A lot of the physicians I've been shadowing have been complaining of the "dilution" of medical training due to work hour restrictions. I honestly don't know what to think of it since I haven't experienced it myself...

One physician mentioned that in other countries, residency training can take
many YEARS (i.e. 6 year residency for what we do in 3 years for instance), because the work hours are much much lower.

As in Malcolm Gladwell's Outliers, the 10000 Hour Rule says success in any field requires 10,000 hours of experience to be an "expert".

As work hours decreases, will our effectiveness decrease? Hopefully not, but it is a balance that must be struck.

I don't think super heavy work weeks are a good idea if physicians make errors on-the-job, but at the same time always reducing the hours isn't a great idea either.

 

[Cruzinman]

Future doctor is correct. In some programs neurosurgical residents have a chance to do a neurology rotation at Hammersmith Hospital in the UK, more or less the birthplace of clinical neurology. One US Resident talks about showing up at his usual 5:30 AM time for morning rounds and had to wait another 3 hours before any other physicians walked through the door.