80 Hour Workweek SurgPath Rotations = Good Program?

[Thaitanium]

I just read an old post where someone mentioned good training programs are the ones that work you hard. You guys/gals think this is true?

Those in programs where you work 80 hours a week..what is it that makes your training superior to those who are in programs like mine where I go home 6-7 pm on surg path?

Just because you work harder equates to better pathologist down the road? I mean are you guys seeing some crazy tumors everyday? What are the specimens you are seeing daily? I mean if you are seeing colectomies for colon cancer, mastectomies for breast cancer...I mean after the 30th time, it gets boring. If you are seeing some interesting cases within that 80 hour workweek I can understand.

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[Blind Guy]

Hello,

First post so go easy on me.

I trained at a mid western location starting in the early 2000's. The first two years I averaged about 70 hours per week more because I was slow and had done more CP than AP prior to starting. It was the kind of program where one learned by doing not by reading. The latter years were less intense. I even stayed and did the selective pathology fellowship that counted as my fifth year under the pre 2002 system where I worked about 50 hours per week on average. In the first two year there were a lot of colectomies and mastectomies (dead legs, toes, hernia sacs), but we did average a Whipple per week as pgy 1's and 2's. But in summation having my traning institution attached to my name helped with job hunting; however, I don't think I needed as much character development as I got from the long hours to be a good pathologist. Maybe all I needed was the selective pathology fellowship on top of a 2/2 AP/CP program to round out the training.

 

[Entgegen]

Word on the street seems to be that the ones with 80-hour work weeks are the ones that have you grossing into the night. As far as I know, no one is going to be signing anything out at night...so what else is there for a resident to be doing that late but grossing (provided they're on a surg path rotation and not blood bank or something)? If you're staying behind and previewing late, it seems that you would be there late on your own accord, not that you're "being worked" late.

But then I'm just a med student, so others with more experience should pitch in some thoughts as well.

 

[Blind Guy]

Very true, I pushed a lot of meat at night. I know other programs are different but in my program previewing was equivalent to prerounding. We were expected to have a micro and diagnosis with differential at sign out by 9am for most of the attendings. You either did it early or late. There was also conference prep for five conferences a week as a 1st year and four as a 2nd year. Towards the end when you were exprected to run with the case as your own, it took less time. Mostly what I remember from my experience was wailing and gnashing of teeth (the best was when our chief resident, who was wheel-chair bound, was screemed at by the assistant anatomic pathology director for something beyond his control--when that happened we dove into whatever hole was available and curled up into a small ball and tried to be invisible). Actually, my time in residency and fellowship was like being jabbed with a hot poker for six years and when it stopped you wondered why no one was poking you.

 

[2121115]

Actually, my time in residency and fellowship was like being jabbed with a hot poker for six years and when it stopped you wondered why no one was poking you.

This sums up my experience as well. I trained at one of these so-called 80 hour + programs. I can tell you that it is 100% about "character development" and teaching humility than pathology.

Also, that is the price you pay for having the name on your CV when you finish which helps in finding good jobs (maybe it shouldn't be this way, but it is in my experience).

 

[KCShaw]

Well.. again, more is more. To a point. Where that point is, is different for everybody -- not everyone can survive and learn in an 80hr work week environment for 3-5 years. Some degree of time pressure is helpful, though -- forces you to learn some efficiency and just how far you can handle something on your own. It's also helpful so when you get your first job and are handed a stack of trays so high you can't see your walls anymore, you know you can get through it and start all over again tomorrow. It's "always" easier to go down in volume rather than up.

Grossing all night hopefully means you have a lot of cases, not that they accept specimens for same-day grossing until 8 PM, and not that the program can't/won't splurge for adequate grossing coverage. If you're grossing too late, cassettes won't be processed & cut in time for you to preview, so you end up not grossing the cases you sign out. Somewhere there's a balance.

As for character, working 80 hr weeks does nothing good. If anything, it obliterates what character you may have once had, unless you are strong of spirit and pure of heart. But so long as it doesn't turn you into a person who can stretch 3 cases into 11 hours, rather than being able to pack 120 cases into 2 hours, or someone who is horiffically grumpy and sour on life, it may work out alright.

 

[lipomas]

A long work day/week is not a proxy for program quality. At some programs, long hours can add positively to the educational experience. At others, it can detract from it.

 

[KCShaw]

 

[caffeinegirl]

Most of these "80hr workweek" programs are not 80hours a week every week. There may be busy rotations/services that are 80 hours a week, but it's not every rotation/service.

I liked going to a busy program. If I'm not pushed hard, then I won't work. I'm also the type of person who learns by immersion and experience, and a busy high volume program was a great fit. Of course, I wasn't working 80hrs a week every week...maybe one to two weeks a month, and that was during surg path as a first year...the hours got much better as I got more efficient. And, during those "easy" rotations that were like 40 or less hours a week...I didn't learn much, wasn't as efficient, and wasted a lot of time.

The skills I learned during those busy weeks about time management, efficiency, and also how to quickly assess a case were crucial when it came down to working in the real world, and made a smooth transition to being independent.

 

[2121115]

The skills I learned during those busy weeks about time management, efficiency, and also how to quickly assess a case were crucial when it came down to working in the real world, and made a smooth transition to being independent.

This.

 

[pathstudent]

80 hour per work week is the way to go. Immersion is the key.

But the important thing is to make sure you have ample time to look at slides. You should avoid any program that makes you sign-out "big" cases the same day you get the slides and ones that don't let you preview the biopsies. It is understandable/necessary that many biopsies get signed out the same day but you should still get a chance to look at them on your own first.

If you are working 80 hours a week and don't get ample time to preview slides, then either you are at a malignant program or you are inefficient or have some personal issue that hampers all parts of your life.