50 hr work week

[epidural man]

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did you all know that the ACGME is pushing for a 50 hr work week instead of 80? MS's, get ready for a much longer recidency, no matter what you choose.

 

[Gern Blansten]

Where'd you here this?
That is almost like a part time residency or a shared residency spot that some places offer. Why not just change the whole residency process to something online that people can do in their spare time? It would be a whole generation of advanced practice nurse equivalents.
Those hours would have no resemblance whatsoever to reality of actual practice.

 

[epidural man]

Where'd you here this?
That is almost like a part time residency or a shared residency spot that some places offer. Why not just change the whole residency process to something online that people can do in their spare time? It would be a whole generation of advanced practice nurse equivalents.
Those hours would have no resemblance whatsoever to reality of actual practice.

It is unsubstantiated, just heard it around "the water cooler." I posted the question to see if others had heard the same thing.

 

[TIVA]

So, in Europe the working week for residents is 39 hours per week. But you do get paid overtime 1.5 times for each additional hour over 39, double on Sundays and holidays. Interns get 6 weeks of paid vacation, while residents and fellows get 10 weeks of paid vacation. Thus, it's not unusual for residents to be putting downpayments on condos and BMW's.

The downside: residency takes about twice as long as it does in the States. 10 years to be a general surgeon, 7 years to be an anesthesiologist.

And in terms of training, they're pretty good. Of course, I'd expect them to be pretty good if they're going to spend that much time in post-grad training schemes.

 

[dhb]

So, in Europe the working week for residents is 39 hours per week. But you do get paid overtime 1.5 times for each additional hour over 39, double on Sundays and holidays. Interns get 6 weeks of paid vacation, while residents and fellows get 10 weeks of paid vacation. Thus, it's not unusual for residents to be putting downpayments on condos and BMW's.

The downside: residency takes about twice as long as it does in the States. 10 years to be a general surgeon, 7 years to be an anesthesiologist.

And in terms of training, they're pretty good. Of course, I'd expect them to be pretty good if they're going to spend that much time in post-grad training schemes.

😱 what country are you refering to???
average work week (not in units) for anesthesia resident based on numerous post is around 60h so 50 wouldn't be a major change

 

[coprolalia]

Will never happen. Most institutions rely far too heavily on the work of residents to do the work. Cutting the workforce, effectively, by 60% will destroy their ability to deliver effective care. And, there's just not enough money in the pot to extend residency and/or hire more residents to cover the deficit. Heck, there's not enough bodies out there in the first place. Besides, you think you hear grousing from residents now. Tell them that their residency is going to be almost doubled.

Pipe dream.

-copro

 

[Winged Scapula]

That's the talk in the surgery world. Last week was the meeting of the Association of Program Directors in Surgery (APDS) and the big topic of conversation was rumblings at ACGME of reducing the work week to 57 hrs for surgical specialties and 50 for all others (Disclaimer: second hand info from a friend that was there).

 

[urge]

Many programs work residents about 8 or 9 hrs a day. 1 call/week. My estimate is they are already working less than 50 hrs/week.

 

[Bertelman]

They might be able to accomplish this with little change if they state the 50 hr/wk is averaged over the entire year.

As it is, there are few months that I approach 80 hrs. I spend as many months working 9-10 hr days with weekends off.

 

[IctalSmile]

Will never happen. Most institutions rely far too heavily on the work of residents to do the work. Cutting the workforce, effectively, by 60% will destroy their ability to deliver effective care. And, there's just not enough money in the pot to extend residency and/or hire more residents to cover the deficit. Heck, there's not enough bodies out there in the first place................
-copro

I was thinking the same thing. If there isnt enough of us (doctors) now.....how do you function with essentially half of us? I guess it might be okay if you paid a $hitload of overtime, but that would be ******ed financially for the systm, b/c it would basically just cost a lot more for the same thing we have now.

 

[bnb93]

The director of GME at our institution just made a presentation about work hour limitations. He discussed compliance across the country, what research has shown regarding pt. safety and resident and faculty satisfaction and much more.

In short, there has been talk that a bill, similar to the Patient and Physician Safety and Protection Act of 2005 which did not pass, will be reintroduced in congress to mandate work hour limitations. The talk has been that the work hours would be limited to around 56 per week. This has been a real concern, but he felt like after recent meetings that this would probably not happen. This would be enforced by withholding medicare funding to programs not in compliance.

Limiting work hours anymore than 80hrs per week would lead to either longer training and/or earlier specialization.

In reality there are alot of things that can be done to decrease residents hours without limiting educational time. Studies have consistently shown that at least 20-25% of residents time is neither educational nor productive. This is time spent waiting on labs and other tests, attendings or other caregivers, and doing menial tasks like collecting this information. With increased IT capabilities much of this could be improved.

 

[Jeff05]

get ready for more midlevels....

 

[Ender]

The director of GME at our institution just made a presentation about work hour limitations. He discussed compliance across the country, what research has shown regarding pt. safety and resident and faculty satisfaction and much more.

In short, there has been talk that a bill, similar to the Patient and Physician Safety and Protection Act of 2005 which did not pass, will be reintroduced in congress to mandate work hour limitations. The talk has been that the work hours would be limited to around 56 per week. This has been a real concern, but he felt like after recent meetings that this would probably not happen. This would be enforced by withholding medicare funding to programs not in compliance.

Limiting work hours anymore than 80hrs per week would lead to either longer training and/or earlier specialization.

In reality there are alot of things that can be done to decrease residents hours without limiting educational time. Studies have consistently shown that at least 20-25% of residents time is neither educational nor productive. This is time spent waiting on labs and other tests, attendings or other caregivers, and doing menial tasks like collecting this information. With increased IT capabilities much of this could be improved.

We have a lot of British rotators at my institution (UK anaesthetists/critical care docs) who come here for a year and are basically attendings here. I was talking to one the other day about this exact same issue. He said that they tried to pass a similar law in the UK to protect patients. They actually had to change the law or else it would have made the whole system colapse. They passed the ~50 hr work week, but paid residents overtime to fill in the extra hours that were needed (as mentioned by another post above). Some of the attendings really did not like it because all of the sudden there were residents making more then they were as full "consultants." This may be what happens here. The hospitals already get paid about 150 grand per year per resident by the US government. With mediocre benefits and 40-45 thousand yearly salary, how much do they pocket? Not only do they have slaves that will work 80 hrs per week, they also do not have to provide for us at all and actually profit by providing less. If this passes my bet is that we will just get paid more and work about the same hours. Just my thoughts.

Ender

 

[svaefinga]

The European Union's working time directive limits the maximum length of a working week to 48 hours in 7 days, and a minimum rest period of 11 hours in each 24 hours. Up to 60 hours in 7 days are allowed under certain circumstances nevertheless. In some countries it is possible to "opt out" of the 48 hour week and work longer without much restrictions. In Germany "opt out" can be part of the empolyment contract but the hospital I am working at chose to refuse this option for whatever reason. I am now never working longer than 17.5 hours in a row (in the OR) or 19 hours in a row (in the SICU) on regular working days and only 25 hours during weekends (only in the OR, in the SICU it stays 19 hours maximum). My average working time is slightly below 50 hours a week and it feels great in comparison to far more hours and longer shifts 16 months ago. I am not so easily pissed off by jerk surgeons at 3 a.m. any longer. 🙄 It has its downsides though I am doing more weekends now especially when working in the SICU.
I am a resident in anaesthesiology just finishing 4th year which means in the German system one more year to go until I can take the boards and I don't think the changed working times have much effect on my training.

 

[Coastie]

I'd say it's optimistic to say midlevels do half the work of residents in a given time. I'd say that's the high end of things.

At least double pay for half the time. How many do you see working over 40 when we're popping "80" on a regular basis? Have a PA buddy who just signed 40 hrs a week, 110k starting with 5 weeks vacation working for a interventional pain doc. The ones in ICU here make no less than 80k to start so they can only do morning and aft rounds, with no morning notes, no admits, and aft notes only, a total of 14 10 hour shifts a month max, and they end up leaving early (but still claiming they worked the full) after 7-8 hours.

We have a lot of British rotators at my institution (UK anaesthetists/critical care docs) who come here for a year and are basically attendings here. I was talking to one the other day about this exact same issue. He said that they tried to pass a similar law in the UK to protect patients. They actually had to change the law or else it would have made the whole system colapse. They passed the ~50 hr work week, but paid residents overtime to fill in the extra hours that were needed (as mentioned by another post above). Some of the attendings really did not like it because all of the sudden there were residents making more then they were as full "consultants." This may be what happens here. The hospitals already get paid about 150 grand per year per resident by the US government. With mediocre benefits and 40-45 thousand yearly salary, how much do they pocket? Not only do they have slaves that will work 80 hrs per week, they also do not have to provide for us at all and actually profit by providing less. If this passes my bet is that we will just get paid more and work about the same hours. As for midlevels, from what I have seen, it is too expensive to have a bunch of midlevels. They do less than half the work of residents in the same time frame (not all of course, but a lot...I'm speaking strictly of PAs, and NPs, not CRNAs, I haven't work with them yet), they demand over two times the salary, (which is NOT covered by the US government), and work only three days a week (three 12hr shifts per week). I don't understand how hospitals can afford to pay midlevels at all. I think it will be a failed experiment in the end. Just my thoughts.

Ender

 

[epidural man]

bumping this because i want to know if anyone has heard something more about discussions to make the work week 52hr?