4th resident to commit suicide at LLUMC since July... (3/4 are anesthesia residents)

[Mman]

I dont think there are laws stating where inpatients must stay.. I think they just need to be seen within certain amount of time? I mean when the ED is packed, they send up inpatients to their floor, but not to a room, but to the hallway on a stretcher

our state law limits number of beds a hospital can have. You can't try to artificially get around that by "boarding" people elsewhere in the hospital and pretending like they aren't inpatients.

---

Members don't see this ad.

 

[Visible Ghost]

We know that stress is never a good thing unless you actually like having high cortisol levels.

If residents are getting stressed then 1) how can they optimally perform and learn and 2) how should we not expect a lower quality of a physician and the healthcare they would deliver in the future?

My point is how is such a stressful process of learning supposed to result in quality physicians who will make less errors in care esp if It is does not work in any other field?

Athletes rest their muscles to avoid injury. Resting the brain is just as important. Just my opinion.

 

[T-burglar]

I was early on labeled as a possible problem resident because I didn’t take to being treated like a bitch, child, and a slave very well. Fortunately an attending advocated for me and coached me a little to not make waves and I ended up doing well without ever being truly on probation or anything like that. Even got accepted to fellowship at the same program. But I vividly remember the absolutely pathologic attending resident dynamics. It was closer to master slave than mentor student. I hated all of it

 

[parcus]

You guys have it easy, for some reason my seniors thought our function was going downstairs to grab food they ordered for everyone. I don't mind doing people favors every now and then, but at some point I politely told them to go grab their own food; they weren't too happy about this. Coincidentally or not they are terrible seniors and I can't remember them actually ever teaching/showing me anything interesting. Funny how the residents here are the ones who create/pass forward the poisonous cultures, the attendings who actually have a say in anything are super reasonable.

 

[anbuitachi]

You guys have it easy, for some reason my seniors thought our function was going downstairs to grab food they ordered for everyone. I don't mind doing people favors every now and then, but at some point I politely told them to go grab their own food; they weren't too happy about this. Coincidentally or not they are terrible seniors and I can't remember them actually ever teaching/showing me anything interesting. Funny how the residents here are the ones who create/pass forward the poisonous cultures, the attendings who actually have a say in anything are super reasonable.

I dont know what it was like previously but somehow i feel like our training today can't be better than what it was... literally when i was on medicine it was mostly writing notes or doing social work, documentation. If i learned something medicine related Id say its a very good day

 

[nimbus]

I dont know what it was like previously but somehow i feel like our training today can't be better than what it was... literally when i was on medicine it was mostly writing notes or doing social work, documentation. If i learned something medicine related Id say its a very good day

Didn’t learn anything presenting and decision making during rounds?? I learned a lot.

 

[Psai]

I dont know what it was like previously but somehow i feel like our training today can't be better than what it was... literally when i was on medicine it was mostly writing notes or doing social work, documentation. If i learned something medicine related Id say its a very good day

My seniors would teach me stuff all the time. We finished work with the senior in the morning, then an hour or so of attending rounds where we discussed interesting patients and went over important literature. Then noon conference was usually pretty good. Also, we had an intern lecture once a week about core topics. I think my medicine year was invaluable and I am very grateful to my program.

 

[VA Hopeful Dr]

My seniors would teach me stuff all the time. We finished work with the senior in the morning, then an hour or so of attending rounds where we discussed interesting patients and went over important literature. Then noon conference was usually pretty good. Also, we had an intern lecture once a week about core topics. I think my medicine year was invaluable and I am very grateful to my program.

I think it's very variable. Some programs treat their transition year interns the same way they would their categorical interns, which hopefully is a good thing. But I've definitely heard of programs where the transition year interns were nothing but Scott Monkeys for 12 months.

 

[Fete]

First off RIP.
Sometimes people need to learn how to deal with and overcome adversity.

 

[GA8314]

First off RIP.
Sometimes people need to learn how to deal with and overcome adversity.

What do you mean by that? You are correct, but I do not think that is within someone with deep depression's control. They can't just snap out of it and "overcome" that adversity.

 

[Visible Ghost]

First off RIP.
Sometimes people need to learn how to deal with and overcome adversity.

Depression is a disease of the brain. Dopamine levels and receptors go down.

 

[psychMDhopefully]

Yup, from the start of med school 'till the end of residency they own your bitch ass. I knew that and made the call anyway but, from what I've seen, most people don't. No amount of nursing home volunteering or pre-med classes can prepare you for life on the inside. The closest thing to the lack of respect, freedom, human dignity, and fear for one's life/career you see in medicine really is prison, and at least no one expects anything from you there. The cherry on top of course is that if you even think to complain about any of this or, God forbid, try to change it, your ass will be out of there so fast your head will spin. Then what will you do with 200k in loans hanging over your head? You're trapped like a rat with no way out. It's a wonder more people don't kill themselves.

Dude, its crazy that I agree with this. I was recently dismissed from medical school, It sucks, but not as much as I thought it would. Somedays I'm really depressed and pissed that I don't get to be a doctor, other days it feels like I just escaped something terrible. Residency probably would have killed me. Medicine has a really horrible problem when being in jail or in a warzone are the only things that are seen as comparable. The crazy thing is a profession with so much academic talent can realize and fix the problems with its training, but there is a very masochistic bend to most med students and physicians. Most of them love to be miserable, and they think being miserable makes them better than everybody else. I told a therapist couple years ago, if I were my 18 year old self, there is no way I'd choose pre med again. The culture of medicine is just too miserable, and my peers usually had the personality of weird, passive, robotic, gunners.

 

[zero0]

Dude, its crazy that I agree with this. I was recently dismissed from medical school, It sucks, but not as much as I thought it would. Somedays I'm really depressed and pissed that I don't get to be a doctor, other days it feels like I just escaped something terrible. Residency probably would have killed me. Medicine has a really horrible problem when being in jail or in a warzone are the only things that are seen as comparable. The crazy thing is a profession with so much academic talent can realize and fix the problems with its training, but there is a very masochistic bend to most med students and physicians. Most of them love to be miserable, and they think being miserable makes them better than everybody else. I told a therapist couple years ago, if I were my 18 year old self, there is no way I'd choose pre med again. The culture of medicine is just too miserable, and my peers usually had the personality of weird, passive, robotic, gunners.

At least your school made the choice for you. Now go, be free, and tell my story. Tell everyone what you saw.

 

[DrMediocrity]

Very sad. This is tragic. Real depression. Judging by her picture. She’s skinny.

On a lighter note. I think way too many people are prescribed anti depressants. Many fat people who eat too much. The dsm criteria of depression has changed since the 1980s. Dsm 2? In the 1980s includes WEIGHT LOSS as part of depression.

Yet many people who write the dsm are brought out by drug manufacturers. So as Americans get fatter and fatter. The drug manufacturers bribed these dsm to include WEIGHT GAIN AS A PART OF DEPRESSION.

I know I’m going off topic slightly. But the vast majority of people who have true clinical depression are SKINNY. too many fat people are over prescribed anti depression drugs. They aren’t truly depressed.

The 3 people I know who have committed suicide (no drug overdose either...true clinical depression) recently in anesthesia have all been skinny with true clinically depressed as it was originally written in dsm-2 including a former colleague last September.

Dude. You are an embarrassment to the profession of medicine. I'm not active on here anymore (because I'm busy being an actual doctor now... sorry about your social life), but I came across this post while looking into the suicide at Loma Linda. Literally, you sound like a complete idiot, and if you didn't have the privilege and distinction of being a doctor I would just roll my eyes at you, but if you are truly an attending physician you represent our field to the public and I just CANNOT. You are not a Psychiatrist (thank the good Lord), the last training you had in Psychiatry was likely during your 3rd year of medical school, when you were probably too busy being a judgemental, know-it-all d-bag to actually take the time to learn from other doctors (or your patients). Don't speak about things you *clearly* know nothing about.

I'm so relieved for this young lady and her family and friends that you have determined in the wake of her taking her own life that she probably was *truly* depressed. You are a true forensic psychiatrist.

Also, nothing in medicine has changed for the better since the 1980s.... we certainly do not have improved diagnostics in any areas, and our understanding of disease processes is no better off...

 

[rakotomazoto]

Our system is definitely messed up in ways that extend well beyond all the issues we have touched on in this thread. It seems like most of us recognize that there are some deep flaws that we can't change as individuals, likely not even as a large group of physicians in a single subspecialty.

As individuals, however, we do retain the ability to make a small difference in the lives of the people that are also caught up in the system, whether that is med students, residents, attendings, nurses, patients, techs, custodians, etc. Everyone in healthcare deals with this nonsense to some degree, especially those of us who are actually involved in direct patient care. I have no illusions of making even a dent in the system. Some days it is hard, but I make an honest effort to stay positive and do what I can do to make the day a little better for those around me, even if that is a smile and a joke, or learning the names of the anesthesia techs or choosing to react with humor rather than rancor when confronted with someone else's bad attitude or negativity. Taking the focus of off myself as an individual in a bad situation and interacting with my fellow prisoners trapped in the hospital has allowed me to stay sane and actually make some interesting friends along the journey.

Positive attitude will not fix anyone's mental health or the system. I hope no one takes away from this that I am trying to say that rainbows and sunshine will make all the bad things melt away. The system sucks, but here we are and we have to find a way through it if we can. If I could make one change, I would make it easier to walk away from healthcare. If the real possibility of widespread resident/doctor strikes was a real and tangible threat to business as usual and the status quo, we just might have an ounce of leverage to make some change.

 

[hankbb02]

When You Subtract salary and benefits from that based on cost when I was a resident 5 years ago, you are left with between 25 and 30000 per resident per year. Given that there was an attending on that service that had to be paid, the leftover from five residence is the salary with nothing to spare for benefits or anything else like residency Administration. So at worst it would be a wash, more likely the hospital and come out ahead given how our service load was usually a fair bit less than what all of the hospitalists were seeing on a daily basis.

This is how I see the math working out during my last 2.5 years of residency and fellowship.

Let's say hospital gets paid 110,000 for "training me", i.e giving me autonomy to do my own cases. They then pay me a whopping 55,000 a year. Hospital now gets the balance of 55,000 year. If I wasn't there, they would staff these academic level cases with CRNAs and maintain the 1 to 2 level of direction

Since CRNAs only really work 30ish hours a week and don't take call, it is reasonable to say that I conservatively replace 1.5 of them. Lets call CRNA salary 150,000 a year. I am saving the hospital 225,000 a year by replacing the CRNAs they would have had to hire to replace me. Add the 55,000 from medicare and the hospital gets ~ 275,000 to "train" me. Knowing this and still being treated like less of a human is what drives me nuts.

 

[Beach bum]

Agreed - a lot of residency stuff these days is spent on nonsensical, non-doctor tasks. That's why I have little patience or respect for those who claim residency needs to be extended if hours are restricted.

During internship as a medicine PGY-1 I too spent countless hours faxing forms to get records, managing prior authorization nonsense, making appointments for patients, creating lists, telling ancillary staff to do their jobs, and writing handwritten notes despite my hospital having half of an EMR. The actual time spent doctoring was disheartening. It was all dispo, forms, and doing other people's jobs. And what did all of the hordes of administrators or ancillary staff do - those who were employed to assist the doctors? Lunch, "meetings", and heading home early due to family needs. None of that for us though - we were demanded to stay late, smile, work holidays, never complain, lie on hours worked, and do the work till the work was done. Can't do or won't do is never an option.

As an anesthesiology resident I had plenty of wasted time too. Induce the patient --> wait an hour in the OR till the surgeon showed up. Finish the case --> oh now you're on an 8 hour ICU hold while everybody screws around and you make sure the patient doesn't die... at 3am. On call you stay up all night to pre-op every patient for tomorrow so that the overlords (and CRNAs) have a nice easy pre-op day. The patient isn't being sent from the floor fast enough? Go pick them up yourself from the floor while the "transport team" hired to do that job is nowhere to be found. Oh and wipe down your machine, re-stock your cart, and go to the pharmacy to re-stock all the meds they never put in your med cart. They hire techs, but they don't do that (what DO then do?) And then stay for "teaching rounds" after you've been working for 28 hours straight. Now pay for your board exams and medical license that you'll never be reimbursed for and watch your student loans explode.

Then you're a senior resident with an abstract accepted to a conference and the department waffles on whether they'll give you time off to go... and they won't reimburse you due to "the budget". Oh and when they give you permission you share a hotel room with two other people... two other doctors. Three of you with 4 years of undergrad, 4 years of med school, and nearly 4 years of post-graduate training are sharing one room because you can't afford it otherwise.

All the while a 22 year old HR lackey with a degree in communications gets all expenses paid conference trips with hotel rooms at the W and comped meals at Nobu. They get paid more than you. And if they don't like the job they'll soon jump to the next one for more pay with better perks. They have had employer match for their 401k too, while your residency scoffs at this being something that could ever happen. So you've got no retirement savings at all.

As a resident you're trapped in ****hole. The only way out is to smile, nod, and beg for more absurdity. If you complain your career and financial life will be vengefully ruined. How dare you complicate the staffing or the schedule!? Oh and heaven forbid you ever consider having a child during all of this...

I could stomach all of this nonsense, barely, but it wore on me. For those with emotional or mental health issues... I'm not surprised it might push them over the edge.

Modern medical training is rotten to the core for the reasons I and others cited. It's infantilizing and traps high-achieving people in a prison with no options and with no respect while their peers can prosper in a world with options, better pay, and way more respect. Things in medicine are on track to get much much worse and will likely never be fixed (now there is astronomical med school tuition, no subsidized student loans, more administrators and ancillary staff who do nothing, more midlevels who claim to do your job better with their online "doctoral" degrees, now you'll get less pay, there are higher home prices, and there's way less respect overall for physicians).

I like (but don't love) my job as an attending. But often I hated my "job" and life as a resident. The pestilence of residency and medicine needs to be fixed.

And all that so you can be pimped by an AMC!

 

[aneftp]

Dude. You are an embarrassment to the profession of medicine. I'm not active on here anymore (because I'm busy being an actual doctor now... sorry about your social life), but I came across this post while looking into the suicide at Loma Linda. Literally, you sound like a complete idiot, and if you didn't have the privilege and distinction of being a doctor I would just roll my eyes at you, but if you are truly an attending physician you represent our field to the public and I just CANNOT. You are not a Psychiatrist (thank the good Lord), the last training you had in Psychiatry was likely during your 3rd year of medical school, when you were probably too busy being a judgemental, know-it-all d-bag to actually take the time to learn from other doctors (or your patients). Don't speak about things you *clearly* know nothing about.

I'm so relieved for this young lady and her family and friends that you have determined in the wake of her taking her own life that she probably was *truly* depressed. You are a true forensic psychiatrist.

Also, nothing in medicine has changed for the better since the 1980s.... we certainly do not have improved diagnostics in any areas, and our understanding of disease processes is no better off...

My statements are for the most part true

1. Dsm authors (u know the authors who write the psych manual) are finally had to disclose financial incentives. And 30% of them are paid by drug companies. Conflict of interests? Absolutely

2. I disclosed studies that showed fat people are less likely to commute suicide. That is just the plain truth

3. Depression is over diagnosed especially in USA. Look in other parts of the world. I think JAMA is a pretty reputable source.

Treatment Indications for Antidepressants in Quebec, Canada, 2006-2015

4. I never said she wasn’t truly depressed. She was. Thus skinnier people who are more likely to committ suicide. Again. I reference other studies. Not saying fat people don’t committ suicide because they are truly depressed. They do. But for the most part. Skinnier people are more likely to be depressed plus committ suicide.

Ps. I’m pretty happy with my social life. Good friends. Great job. Ready to retire way before my peers. Healthy kids. Great spouse. Travel all of the world.

 

[VA Hopeful Dr]

This is how I see the math working out during my last 2.5 years of residency and fellowship.

Let's say hospital gets paid 110,000 for "training me", i.e giving me autonomy to do my own cases. They then pay me a whopping 55,000 a year. Hospital now gets the balance of 55,000 year. If I wasn't there, they would staff these academic level cases with CRNAs and maintain the 1 to 2 level of direction

Since CRNAs only really work 30ish hours a week and don't take call, it is reasonable to say that I conservatively replace 1.5 of them. Lets call CRNA salary 150,000 a year. I am saving the hospital 225,000 a year by replacing the CRNAs they would have had to hire to replace me. Add the 55,000 from medicare and the hospital gets ~ 275,000 to "train" me. Knowing this and still being treated like less of a human is what drives me nuts.

How does supervision work for residents in each year? Is a CA-1 required to have an attending in the room all the time at the start? That sort of thing factors in as well. Let's not forget benefits either, which conservatively are on the order of $25,000 a year.

Plus you can't forget the admin positions that residency requires.

 

[anbuitachi]

How does supervision work for residents in each year? Is a CA-1 required to have an attending in the room all the time at the start? That sort of thing factors in as well. Let's not forget benefits either, which conservatively are on the order of $25,000 a year.

Plus you can't forget the admin positions that residency requires.

Attending stay w ca1 for like 1 month. 1 month of single cover for 3 year residency is nothing. And there's no way benefits cost 25000. What benefits do residents use? No matching, insurance is basically see doctors at your own hospital which residents rarely so since they have no time

 

[rakotomazoto]

And there's no way benefits cost 25000. What benefits do residents use? No matching, insurance is basically see doctors at your own hospital which residents rarely so since they have no time

Don't forget dependents of residents, though. True, most residents are single and personally, I don't really go to see the doctor. But my wife is due with kid #3 in April, my oldest son was born two weeks into intern year. Two, soon to be three, in-hospital deliveries with epidural, etc for which I have not been charged a penny, plus all the routine care before and after. The first time, she had a complication and had to stay for a week before coming home. Total value of benefits for us is easily somewhere in the tens of thousands range.

Lack of matching to me seems like a disservice. Residency is many people's first jobs and the weak benefits package handed out to us residents creates falsely low expectations that trickles over into the new grad job search. Financial education is as neglected in residency as it is in medical school. This is just one more way that the system fails trainees. The expectation is that you will then go out into a private practice environment where you will be expected to make business decisions with no experience or training.

 

[deleted162650]

How does supervision work for residents in each year? Is a CA-1 required to have an attending in the room all the time at the start?

LOL. I woulda shot myself if that was the case. I went to program that is widely known for resident autonomy. It went like this: first 2 weeks paired 1:1 with a CA-3, 2nd 2 weeks paired 1:1 with an attending, week 5 = call me if you need me but need me if you call me.

 

[VA Hopeful Dr]

Attending stay w ca1 for like 1 month. 1 month of single cover for 3 year residency is nothing. And there's no way benefits cost 25000. What benefits do residents use? No matching, insurance is basically see doctors at your own hospital which residents rarely so since they have no time

Fair enough, s'why I asked. This forum actually serves as a great reminded how little I know about anesthesiology compared to other fields. Even us FM folks don't spend any time with y'all, and we do with literally everyone else.

Benefits could easily reach that. My malpractice insurance as an FM resident was 10k/year. I'd wager its more for you guys. As a single 27 year old male, insurance was $500/month. This was pre-ACA so likely more now but let's keep $500/month because that makes the math easy. That's 6k/year. My program paid for both long and short term disability at resident salary, extrapolating what I pay for my policy, those together are another 2k/year. The hospital gave us 2k/year into a 401K (non-matching, we got it no matter what). We're up to 20k in benefits already. If we tack on 1k CME money, DEA/licence/state DEA altogether will run about 1K/year (its actually 800 every other). We're now at 22k per year in benefits.

Sorry, I was off by a little.

 

[neoexile]

I do believe this problem depends more on the individual than the program. Some of the most malignant programs have probably had zero suicides in the past decades. More than likely Loma Linda did not have any for many years. Tragic.

Physician suicide is an epidemic and occurs at a higher rate than most other suicides. This isn't individual specific.

 

[Orin]

Physician suicide is an epidemic and occurs at a higher rate than most other suicides. This isn't individual specific.

Suicide Is Much Too Common among U.S. Physicians

I'm not sure about the term "epidemic" or the higher rate.

At the end of the day, training programs and medical systems need to protect their people, even when it is from themselves or their coworkers. It's just a good business decision, if nothing else.

 

[Resident physician]

LLUMC is supposed to be a very balanced residency program lifestyle-wise. Not sure why the rash of suicide there.

I don't know what your source for this statement is. The truth is, NO resident program is what it seems from the outside. Even within a residency program, you may not know what your co-residents are going through. Residency programs are masters of deception and bullying people into silence or putting up a happy facade.

 

[nimbus]

I don't know what your source for this statement is. The truth is, NO resident program is what it seems from the outside. Even within a residency program, you may not know what your co-residents are going through. Residency programs are masters of deception and bullying people into silence or putting up a happy facade.

Wow. Not my experience at all.

Hard work? Yes
Bullying and deception? No

 

[deleted162650]

Wow, some of you guys picked sh*tty residency programs.

 

[GravelRider]

What's so hard to imagine about bullying and deception? Lying on work hour logs is a common occurrence. That's deception. Why do residents lie about work hours? They are told that it's not in their benefit to be apart of a program that is put on probation or loses accreditation. That's bullying.

We can either admit there is something absolutely rotten about medical education and training in this country or we can continue to put up this macho facade that gives institutionalized hazing a pass. Residents are not killing themselves because they suffer from crippling depression. They are killing themselves because they are part of a broken system.

 

[nimbus]

What's so hard to imagine about bullying and deception? Lying on work hour logs is a common occurrence. That's deception. Why do residents lie about work hours? They are told that it's not in their benefit to be apart of a program that is put on probation or loses accreditation. That's bullying.

We can either admit there is something absolutely rotten about medical education and training in this country or we can continue to put up this macho facade that gives institutionalized hazing a pass. Residents are not killing themselves because they suffer from crippling depression. They are killing themselves because they are part of a broken system.

I was never asked to lie about ANYTHING by my residency program. If you were, you should out the program to let Medical students know.

 

[anbuitachi]

I was never asked to lie about ANYTHING by my residency program. If you were, you should out the program to let Medical students know.

Not many programs do, but i think its not uncommon for residents to lie about it. Most people i know just put 6-6 everyday, with some adjust for calls/weekends etc. You are already working a ton of hours, this is literally an extra assignment for you to do. The resident is probably tired, and unless there are MAJOR violations, most likely nothing will change and even if it does it probably will be after you are done with whatever rotation etc. And residents know if the program gets too many violations, it can be put on probation and even shut down, so unless the conditions are extremely bad they just let it slide since having the residency on probation does no good for its residents.

 

[nimbus]

Not many programs do, but i think its not uncommon for residents to lie about it. Most people i know just put 6-6 everyday, with some adjust for calls/weekends etc. You are already working a ton of hours, this is literally an extra assignment for you to do. The resident is probably tired, and unless there are MAJOR violations, most likely nothing will change and even if it does it probably will be after you are done with whatever rotation etc. And residents know if the program gets too many violations, it can be put on probation and even shut down, so unless the conditions are extremely bad they just let it slide since having the residency on probation does no good for its residents.

I was only speaking from my own experience. I was never asked to lie and only ever approached 80 hrs during a NICU elective because the postcall rounds took a long time. If there are programs routinely exceeding 80 hours they should be publicized. My program wasn’t even close. There was no reason to lie. Maybe the program was exceptional and work hours violations are common. I have no idea.

 

[abolt18]

Not many programs do, but i think its not uncommon for residents to lie about it. Most people i know just put 6-6 everyday, with some adjust for calls/weekends etc. You are already working a ton of hours, this is literally an extra assignment for you to do. The resident is probably tired, and unless there are MAJOR violations, most likely nothing will change and even if it does it probably will be after you are done with whatever rotation etc. And residents know if the program gets too many violations, it can be put on probation and even shut down, so unless the conditions are extremely bad they just let it slide since having the residency on probation does no good for its residents.

My program has 2 surgery months in intern year where you will average close to 80. My average on one of them was actually slightly more than 80, but it's because it was my first rotation and I didn't know my way round the hospital, didn't know the EMR, and didn't know anything about expectations for intern year.

Last year the interns were exceeding 80hrs per week on the rotations, so they they added a 3rd intern to each of the services this year, basically cutting the work and call load down significantly. Our program is very responsive to these issues.

We'll not discuss how many hours the PGY 2-5 gen surgery residents work vs how many they document. But I can tell you there is a significant discrepancy. They definitely have an unspoken rule of documenting 80 no matter how much more than that you work.

 

[Psai]

What's so hard to imagine about bullying and deception? Lying on work hour logs is a common occurrence. That's deception. Why do residents lie about work hours? They are told that it's not in their benefit to be apart of a program that is put on probation or loses accreditation. That's bullying.

We can either admit there is something absolutely rotten about medical education and training in this country or we can continue to put up this macho facade that gives institutionalized hazing a pass. Residents are not killing themselves because they suffer from crippling depression. They are killing themselves because they are part of a broken system.

I don't log work hours accurately because it's a waste of time not because I'm scared of my program.

 

[Iso4ane]

I don't log work hours accurately because it's a waste of time not because I'm scared of my program.

I lie to. But, usually I'm overshooting my hours, and I still come below 80 hours.

 

[anbuitachi]

There are a lot of gray areas too. I remember on surgery we had a ton of patients and had to round and write notes on all of them. Notes were mostly written during rounds since you need to accomplish the plans during the day, and OR as well. A lot of the notes were so bad its ridic. Especially the physical exam part. Ive seen notes that said discharge patient and the exam says intubated , clearly copy pasted from like day 1. But you kind of have to speed things along if you want to leave the hospital

 

[Ronin786]

Let's not pretend that duty hour violations are the only terrible thing that can happen during residency. Some folks are lucky enough to go to a handful of programs where the residents are respected, treated as colleagues and learners and nurtured with people truly looking out for their well-being.

The unfortunate truth though is that a majority of programs rely on residents as cheap labor that is justified as a rite of passage. Residents are encouraged to keep their head down and get through it. These same programs have attendings who chose academic institutions due to the ability to coast off the work of residents and have been granted teaching positions without any background to support that position or burden. And the bigger problem is, when any of these issues are mentioned, it is the residents who are "ungrateful and lazy". I've seen both sides of the coin where I trained, but I'm not surprised that there are a lot of programs that might not bring up red flags, yet still can be a toxic environment that won't change due to the work burdens and the fear of a stigma of probation or loss of accreditation.

It's a problem, and the sooner we stop pretending it doesn't plague the majority of programs out there, the better.

 

[nimbus]

Let's not pretend that duty hour violations are the only terrible thing that can happen during residency. Some folks are lucky enough to go to a handful of programs where the residents are respected, treated as colleagues and learners and nurtured with people truly looking out for their well-being.

The unfortunate truth though is that a majority of programs rely on residents as cheap labor that is justified as a rite of passage. Residents are encouraged to keep their head down and get through it. These same programs have attendings who chose academic institutions due to the ability to coast off the work of residents and have been granted teaching positions without any background to support that position or burden. And the bigger problem is, when any of these issues are mentioned, it is the residents who are "ungrateful and lazy". I've seen both sides of the coin where I trained, but I'm not surprised that there are a lot of programs that might not bring up red flags, yet still can be a toxic environment that won't change due to the work burdens and the fear of a stigma of probation or loss of accreditation.

It's a problem, and the sooner we stop pretending it doesn't plague the majority of programs out there, the better.

The entire post is worthless without naming names. It would have been more useful to name these “majority of programs” before match lists are finalized.

 

[GravelRider]

I was never asked to lie about ANYTHING by my residency program. If you were, you should out the program to let Medical students know.

I never lied about work hours nor did I really ever experience bullying during anesthesia residency (IM residency is another story). I was already board certified in another specialty, so I was treated pretty well. If not for the insulting pay, I may even go so far as to say I enjoyed anesthesia residency. However, my example is just an example of how a resident can feel there is deception and bullying. It's not hard to me to envision.

 

[meister]

When I was in training, the thing that weighed on me most, and at times pushed me in the general direction of burnout, wasn't the long hours, the sleep deprivation, or taking another human's life into my hands several times per day.

It was being a grown up adult, a married man, a father, a person who made the cut to get into medical school and graduated and passed the USMLE, a person who held an unrestricted license to practice medicine ... and yet I lived and worked in this surreal kindergarten-like world where I and a bunch of other people like me were constantly seeking approval from attendings like they were distantly neglectful parents.

Couldn't agree more.