80 hour cap revolutionizing residency?

[Archdelux]

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Hello everyone,

I have been going through a lot of old threads, and it seems that a lot of people have differing opinions on this--I was hoping to create a centralized location for the discussion.

Surgery, Neurosurg, etc. have always been the specialties that had residencies with the most difficult hours (read: harder to be with wife and kids). With the new 80 hour cap, has this changed? One of the reasons that I am reconsidering doing surgery is because I want (somewhat) of a life outside of medicine. Does the 80 hour cap make things easier?

I have read that after residency, as a surgeon, you have opportunities to create your own schedule--has the 'new' residency made the whole thing more manageable?

I am very interested in Neurosurgery (supposedly the hardest with regard to free time). Can anyone please comment on their experiences in neurosurgery and other surgical fields as well?

Thanks for the advice!!

 

[SocialistMD]

1. Most neurosurgery residencies have an 88-hour work week vs. an 80 hour work week due to a 10% exemption. Couple that with the fact that many programs do not adhere to the 80-hour week (read a myriad of threads in this forum on this topic), and you can draw your own conclusions.

2. I think that, at the programs that are compliant with the hours regulations, it has made a difference. I am off at least one day each weekend (and if I'm on call Saturday, I get the hallowed "golden weekend" the following weekend with both Saturday and Sunday to myself) and I see my wife most nights. There are those of us at my program who compete in recreational sports and are able to make most of our games/practices. I have been to the movies to see the films I really want to see and I haven't fallen asleep in the theater (yet...). I do get to see my family when they come to town. That said, I think that if you come into the field with these expectations, you may find yourself disappointed with your choice of career.

I'm not trying to discourage you at all, but again it sounds like you might be a person who would find emergency medicine a great fit with your desires. They work ~18-20 shifts/month with their time off reserved for them. When I'm in the emergency room as the surgical consult resident, I work more in a month in the ED than the EM residents do. Attendings work the same to even less and have much more play in their schedules than any surgeons or internists. Just something about which to think.

 

[Winged Scapula]

I would encourage you to look at more recent threads regarding the 80 hour work week.

Despite the ACGME's crowing that 97% of programs are in compliance, the Committee of Interns and Residents state that less than 50% are.

Reporting hours to the ACGME and in many cases, your program, is fraught with danger - you are likely to be discovered and "outed" as the one endangering the program's existence. Therefore, I would take any reporting to the ACGME with a grain of salt.

What the above means is that there are programs in compliance and there are just as many, if not more, that are not. Nsgy is even worse, because as noted above, most programs have the work hours exemption, increasing them to 88 average per week and then, programs still violate that.

My last two years were under the "80 hr" work week in a non-compliant program - they tried but without allied health and a change in attitude from above, it can't work. It could have been easier, and it was as I didn't take in house call as much, however, my pager NEVER went off as a Chief on service unless I was on vacation. I was able to go out to dinner and do a few more things that I wouldn't have been able to do while in house on call, but it was always with the thought that I might have to go in or answer pages during dinner.

You should not choose surgery because of the work hour changes - you cannot just leave when your "shift" is up - even as an attending. You must have the mentality that if there is work to be done, it needs to be done and best to be done by you rather than signing it out to someone else, or leaving it to the morning. Your family needs to understand this as well.