30-hour shifts?

[kaiasunshine]

I've read several articles online today that have talked about hour cut-offs for doctors and residents, and I'm just curious what was/is typical for Canadians currently doing their residency? According to these articles, working 30-hour shifts is fairly commonplace (although this may be more for surgical residents and rural practitioners?), and there are no real set restrictions on how many hours a resident or doctor can work in a week.

http://www.cmaj.ca/cgi/content/full/180/11/1095

*there are a few threads about this already that I saw, but I'd like to get a consensus from people who work in areas other than rural or surgical!

So what's typical for you in your residency? Do 24-30 hour shifts happen often, occasionally, or rarely? I'd love to hear your input! 🙂

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[HDMTX]

I can tell you that when I trained at UBC (handful of yrs ago) in IM, 30 hr shifts were very common q3-q4 during most months, when I was on CCU, it seemed like q3 average. I used to love hearing my US counterparts whine about having to stay overnight if that every happened back then. We didn't have a night float,... most programs in Canada didn't, although I believe Winnipeg may have.

 

[kaiasunshine]

Very interesting, thanks for the reply! I have no problem with working long shifts if it means I get the opportunity to do this kind of work, it's just nice to get a realistic idea of how things work in Canada since there's so much information out there about American med schools but not so much about our country 😉 Thanks again for the input!

 

[DubZteR]

The hours during residency in Canada are much more sane than in the US in general. I went to med school in the states and the residents I worked with on medicine for example, came in much earlier and left much later. At McMaster which has one of the strongest IM programs in Canada, the average workday for a medicine resident when they're not on call is 9-5 pm with two hours of teaching daily at 8 am and 12 pm.

The concept of night float is practically non-exist in Canada so when you're on call and it's inhouse, you can expect to be in the hospital from 8 am until 10 am the following morning. Staff are excellent at making sure you leave by 10 am. In Ontario, you get paid $155/inhouse call and $53/home call. The amount reimbursed per call varies from province and is highest in Alberta and lowest in Quebec.

There are definitely strictly enforced restrictions on hours worked by residents in Canada.

In general, residency in Canada provides much more sane work hours than the US.

I've read several articles online today that have talked about hour cut-offs for doctors and residents, and I'm just curious what was/is typical for Canadians currently doing their residency? According to these articles, working 30-hour shifts is fairly commonplace (although this may be more for surgical residents and rural practitioners?), and there are no real set restrictions on how many hours a resident or doctor can work in a week.

http://www.cmaj.ca/cgi/content/full/180/11/1095

*there are a few threads about this already that I saw, but I'd like to get a consensus from people who work in areas other than rural or surgical!

So what's typical for you in your residency? Do 24-30 hour shifts happen often, occasionally, or rarely? I'd love to hear your input! 🙂

 

[coastal]

The hours during residency in Canada are much more sane than in the US in general. I went to med school in the states and the residents I worked with on medicine for example, came in much earlier and left much later. At McMaster which has one of the strongest IM programs in Canada, the average workday for a medicine resident when they're not on call is 9-5 pm with two hours of teaching daily at 8 am and 12 pm.

The concept of night float is practically non-exist in Canada so when you're on call and it's inhouse, you can expect to be in the hospital from 8 am until 10 am the following morning. Staff are excellent at making sure you leave by 10 am. In Ontario, you get paid $155/inhouse call and $53/home call. The amount reimbursed per call varies from province and is highest in Alberta and lowest in Quebec.

There are definitely strictly enforced restrictions on hours worked by residents in Canada.

In general, residency in Canada provides much more sane work hours than the US.

Yeah, from a surgical perspective I would disagree. The US has the 80 hour max on your work week. Not trying to take a shot at internal medicine, but I don't think many IM residents hit 80 hours (they don't at my centre at least). As a Canadian surgical resident I've crossed 100 hrs in-hospital in a week numerous times. There are mechanisms in place so one can go home after being on call, but it is frowned upon and there are no repercussions to staying (besides fatigue). I was on elective in the US this year and they forced their residents to go home post-call (it was the law). They definitely had an easier go of things than we do (including night-float, which is brilliant although it does cut into the amount you see in residency).

To the original poster, things are changing very rapidly and the hours will likely get significantly better in the next decade.

 

[Arb]

The 80 hours is averaged over 4 weeks. I believe senior residents don't have strict limits but that may have changed.

 

[DubZteR]

Yeah, from a surgical perspective I would disagree. The US has the 80 hour max on your work week. Not trying to take a shot at internal medicine, but I don't think many IM residents hit 80 hours (they don't at my centre at least). As a Canadian surgical resident I've crossed 100 hrs in-hospital in a week numerous times. There are mechanisms in place so one can go home after being on call, but it is frowned upon and there are no repercussions to staying (besides fatigue). I was on elective in the US this year and they forced their residents to go home post-call (it was the law). They definitely had an easier go of things than we do (including night-float, which is brilliant although it does cut into the amount you see in residency).

To the original poster, things are changing very rapidly and the hours will likely get significantly better in the next decade.

The new ACGME rules in the US have only been in place recently and there are still lots of programs that abide by the "80 hr rule" on paper but in reality keep their residents working way beyond this cap. I'm glad to hear that during your elective in the US, the program you rotated with was receptive and enforced this change!

I'm also a resident in Canada now and have not had any direct exposure to gen surg during residency but as a med student in the US (before the new ACGME rules came out), I felt the gen surg residents worked longer hours and overall their quality of life was worse than that what I've seen and heard from my friends who are doing gen surg here in Canada now. My own surg experience as a resident has been limited to a few areas such as surg onc and gyne onc, both of which I didn't have to do any call as rad onc resident so I was in by 8 am usually and done by 5 pm ... but I agree that regardless of whether you train in Canada or the US, the lifestyle of gen surg is pretty brutal.

 

[bithorax]

when i was a rotating in surgery at mcgill a few months ago, the staff went on a 45 minute rant (on my watch) about how the government should mind its own business and that working hours for residents was an internal matter that needed to be addressed by the surgeons among themselves. he was also disdainful of residents not attending lectures or rounds after 28+ hour shifts given that, supposedly, the restrictions on working hours were put in place to protect patients - so as long as you're not dealing with patients there's no reason not to stay. Anyhow, for sure even as a student I put in more than 80 hours per week and my residents even more. One had moved in the call room for a few days. Just saying.