ACGME rules adopted ...

[opr8n]

Advertisement - Members don't see this ad

So I dont know if anyone has seen this yet, but it looks like the ACGME has finally adopted the new work hour restrictions on sept 26th and they will go into effect July 1, 2011.

The 16hr intern rule was kept 😱

The no averaging q3 call was not kept, can still average

The max 24+4 rule was also adopted


Thoughts ....

 

[karatekid]

So I dont know if anyone has seen this yet, but it looks like the ACGME has finally adopted the new work hour restrictions on sept 26th and they will go into effect July 1, 2011.

The 16hr intern rule was kept 😱

The no averaging q3 call was not kept, can still average

The max 24+4 rule was also adopted


Thoughts ....

Was discussed during our M&M today. I'm at a large Level 1 trauma center where the residents are constantly doing more than 80h/w.
I was kind of chocked (neurogenic maybe) when the head of the trauma maid the following comments: "staying longer does not impress us in a positive way. On the contrary, if you can't apply to the working hours, specially from next July, you would be seen as insufficient and incompetent."
Seriously, if they can't keep the hours as it is, how are they gonna make it with fewer hours/w and the same patient load??

 

[Winged Scapula]

Was discussed during our M&M today. I'm at a large Level 1 trauma center where the residents are constantly doing more than 80h/w.
I was kind of chocked (neurogenic maybe) when the head of the trauma maid the following comments: "staying longer does not impress us in a positive way. On the contrary, if you can't apply to the working hours, specially from next July, you would be seen as insufficient and incompetent."
Seriously, if they can't keep the hours as it is, how are they gonna make it with fewer hours/w and the same patient load??

Classic.

Instead of trying to find a way to solve the impending problem, they'll blame it on the residents. Same old trick programs have been pulling on residents for years.🙄

 

[glade]

Your head of trauma sounds like a major douchebag and a loser and the type of person I would relish not only running over with my car but backing over afterwards a few times. I'd just call their bluff and clock out at 80 hours without fail and then pretend you don't know what all the fuss is about when people go crazy. Either that or stop being a pu**y and start logging your real hours.

 

[goinsurg]

did anyone hear of the new 60 hr restriction rule starting next year? I just had this discussion with a friend of mine and was wondering whether this was a rumor

 

[daisygirl]

very typical of programs to blame on the resident. the crap is going to fall on seniors. at my program they can care less about my hours- which has always been the case. however, they are worried about the interns as they are more likely to voice their opinions.

if you complain about anything as a senior, you will pay for it- especially in the OR.

Thankfully this is my last year of residency...

 

[LucidSplash]

did anyone hear of the new 60 hr restriction rule starting next year? I just had this discussion with a friend of mine and was wondering whether this was a rumor

No, it is still 80 hours. You can read the pertinents in the document posted on the ACGME website. The work hours specifics are in section VI.

 

[45408]

This is rather mind-blowing to me. 16 hour rule for interns, and "DIRECT SUPERVISION immediately available for PGY-1s" is particularly concerning. What is "immediately available"?

My program will have to make serious changes without interns being able to do overnight call. Well, at least I can now brag "Back in MY day, interns had to do overnight call." 🙄

 

[gstrub]

I am wondering which services this will hurt the most (by hurt I mean force the seniors to do more, etc). Small programs, large ones, different sub-specialties? Also services with a night float? I am just wondering what to expect, and what potential questions I could ask during interviews about how departments would handle the changes.

 

[JackADeli]

I am wondering which services this will hurt the most (by hurt I mean force the seniors to do more, etc). Small programs, large ones, different sub-specialties?...

As in all things, it depends. The real issue is how resident dependent a system is. There are small programs that still have heavy demands on residents and there are also small programs that have become so resident independent.

 

[GreatSaphenous]

Prediction #1 - Surgery will morph into a 6 clinical year residency with the intern year becoming like the fourth year of medical school (if you only had surgical rotations). So no call, limited weekends, and no real responsibilty apart from prerounding and reporting changes in patient status.

Prediction #2 - PGY2 becomes the intern year with all of the scut, call, and misery that go along with it.

Prediction #3 - Surgery will see another rise in applicants who think it is now cool and easy.

Prediction #4 - The complaining from attendings about how they used to actually work becomes incessant.

Prediction #5 - The whining in #4 and the laziness in #3 falls on those dedicated few residents who have to care for sicker patients than their older attendings ever did, in less time, and with less manpower.

Prediction #6 - Surgical suicide rates go up.

Prediction #7 - Applications begin to go down.

Prediction #8 - The entire field of general surgery implodes and becomes a subset of interventional radiology (between the hours of 9 and 3) with the office work and call taken by Doctor Nurses.

Prediction #9 - You will now go back to your egg white omelet with feta cheese.

Prediction #10 - No matter what happens, I will remain the Great Saphenous!!!!

To all a good night.🙂

 

[glade]

Prediction #4 - The complaining from attendings about how they used to actually work becomes incessant.

That's not really a "prediction," since that's how it is right now. That's like me predicting today that the sun rose yesterday.

Prediction #6 - Surgical suicide rates go up.

Don't you mean surgical MURDER rates? It'll be a reverse pyramid as seniors start killing interns who are like "hey, it's 1 PM, I gotta go!!" If you can live until PGY-2, you can start doing scut work, you lucky dogs.

 

[opr8n]

This is rather mind-blowing to me. 16 hour rule for interns, and "DIRECT SUPERVISION immediately available for PGY-1s" is particularly concerning. What is "immediately available"?

🙄

this is prob one of the biggest issues of all IMO
Even if interns do night float can they be in house by themselves??? The rule is not explicit enought IMO
But if a senior does have to be in house, there are many programs that dont have enough residents to do that or PGY-4s with be taking Q3 in house call like the 2nd years, and that would svck for them
That or certain hospitals covered would not have night resident coverage then the attendings would not be happy

All around a bad situation
Thanks IOM and ACGME! 😕 🙄 😱 😡

 

[glade]

Uh, interns wouldn't be in house alone. Note that the hour restrictions only apply to interns. Therefore, PGY-2s and up are permitted to take call. So the interns would be doing shift work and everyone else would be taking overnight call, presumably. That would mean that the interns would be covered at all times. The real issue is whether anyone wants to cover them.

People are correct in saying that PDs will basically just force residents to make up for the problem. Where I am right now, essentially we have teams where the PGY-IVs and PGY-Vs are on with just PGY-Is or PGY-IIs for much of the year. Sit a while and let that **** sink in. You're at the end of your residency and your last year you're spending with some idiot intern (not their fault, but that's what they are) pestering you about how to replace potassium or something. It doesn't matter to the attendings because it never reaches them. They just "have an expectation" that matters will be taken care of. Now, you all know me, the way I handle it is I completely ignore the intern and whatever happens to the patient happens. See, I refuse to be the "fix" to a system that's broken by administrators. If you break yourself to make sure everything is great, then guess what? All the douches just pat themselves on the back about "what great leaders we are ...look how we fixed everything by just telling everyone to work harder."

 

[badasshairday]

The pussification of medicine continues.

Am I the only med student that feels like their medical education is suffering? Intern year should now be known as the 5th year of medical schoool.

 

[Apollyon]

See, people are envisioning a 6a-10p sort of thing. What if the shift was midnight-4pm? Or 8pm to noon? Or even noon-4am?

 

[glade]

Ooo, maybe the EM guys can give us a seminar on this subject! I can hardly waits!!

 

[JackADeli]

The pussification of medicine continues.

Am I the only med student that feels like their medical education is suffering? Intern year should now be known as the 5th year of medical schoool.

It all depends on perspective and intent....
I appreciate all the medical students whining about how much they were looking forward to ~ "earning respect" by being hazed.... But, the goal, missed by so many an attending, is to train & educate. Surgery residency has for years spoken to great education while not actually teaching or employing good teaching methods and being more of a 5 year hazing event to prove worth. The entire conversation on this matter has been hashed over hundreds of times.

I honestly don't think a 20hr week or 110hr week will make a difference. Currently, many enter the ranks of attending, having "suffered" or "earned respect" via 5+ years of abuse without any modern education approaches and now expect resident service (i.e. now your turn to pay dues).... The attendings need to extract their heads from their rectums and start teaching. Otherwise, surgical education will continue as is with just an hours shell game....

 

[glade]

Surgery residency has for years spoken to great education while not actually teaching or employing good teaching methods and being more of a 5 year hazing event to prove worth.

Surgery residency is like 5% education. The other 95% is like "you're here for the duration, whatever you happen to learn is by accident. Oh, don't forget that when you go home you're supposed to learn on your own all the stuff that you ostensibly go to work to learn but don't really at all. At the end of it, if you succeed, that's due to your great training. If you fail, that's because you suck even though you were given great training."

 

[Apollyon]

Ooo, maybe the EM guys can give us a seminar on this subject! I can hardly waits!!

You do realize that General Surgery at Duke (where you're not, I gather) has been doing 12 hour "shift work" for about 7 years now, right?

Otherwise, I don't get your comment. 16 hours for interns, and the common idea seems to be coming in in the morning and going home at night after 16.

By your thinking, maybe hospitalists and laborists can chime in, too.

 

[45408]

Honestly, I'd rather take overnight call than have to come in six days a week for 14-16 hours every day.

 

[glade]

You do realize that General Surgery at Duke (where you're not, I gather) has been doing 12 hour "shift work" for about 7 years now, right?

No, I'm not at the "Harvard of the South." I'm at like the community college down the block from the vo tech institute. But that being said, I don't particularly care what Duke (OMGOMGOMG, I said its name!!! *jizz*) does. After all, Duke (*jizz*) is the place where they used to keep everyone in house indefinitely and bragged about THAT, so they probably were under the most scrutiny when duty hours came about. Duke (*jizz*) doesn't have a leg to stand on in this debate, since they used to be so vociferously in the corner of "work 'till you drop, that constitutes education." So now that they flipped, they can hardly be like "be like us! We done seen the light!"

By your thinking, maybe hospitalists and laborists can chime in, too.

Nobody likes surgical hospitalists, either. I mean, maybe Duke (*jizz*) does, but I already established that I don't care what Duke (*jizz*) thinks. In fact, probably whatever Duke (*jizz*) thinks is exactly the reverse of what I think.

 

[DepakoteKills]

Well, apparently that answer was too offensive for Depakote and I got banned for it, so take it easy, guys.

 

[Consigliere]

Oh well......looks like SDN will start sucking again....

 

[45408]

Bummer. Somebody did get a little carried away there though...

 

[ACSurgeon]

and I was wondering why things really slowed down since this morning...

Get well soon, glade!

 

[Gryphes]

and I was wondering why things really slowed down since this morning...

Get well soon, glade!

I guess we won't see his post anytime soon, if ever. It's too bad. While I wouldn't become comfortable making acquaintance with that sort of a guy, I definitely had good laughs when I read some of his posts time to time.

And then I felt very dirty like I was watching some trashy reality show.

 

[wine thief]

a search for apollyon and duke reveals...

299 posts!

we get it.

you're an fmg who scrambled into that spot right? just clarifying.

 

[SLUser11]

Prediction #1 - Surgery will morph into a 6 clinical year residency with the intern year becoming like the fourth year of medical school (if you only had surgical rotations). So no call, limited weekends, and no real responsibilty apart from prerounding and reporting changes in patient status.

Prediction #2 - PGY2 becomes the intern year with all of the scut, call, and misery that go along with it.

Prediction #3 - Surgery will see another rise in applicants who think it is now cool and easy.

Prediction #4 - The complaining from attendings about how they used to actually work becomes incessant.

Prediction #5 - The whining in #4 and the laziness in #3 falls on those dedicated few residents who have to care for sicker patients than their older attendings ever did, in less time, and with less manpower.

Prediction #6 - Surgical suicide rates go up.

Prediction #7 - Applications begin to go down.

Prediction #8 - The entire field of general surgery implodes and becomes a subset of interventional radiology (between the hours of 9 and 3) with the office work and call taken by Doctor Nurses.

Prediction #9 - You will now go back to your egg white omelet with feta cheese.

Prediction #10 - No matter what happens, I will remain the Great Saphenous!!!!

To all a good night.🙂

Best post ever.

The pussification of medicine continues.

Nice George Carlin reference. Another good post.

No, I'm not at the "Harvard of the South." I'm at like the community college down the block from the vo tech institute. But that being said, I don't particularly care what Duke (OMGOMGOMG, I said its name!!! *jizz*) does. After all, Duke (*jizz*) is the place where they used to keep everyone in house indefinitely and bragged about THAT, so they probably were under the most scrutiny when duty hours came about. Duke (*jizz*) doesn't have a leg to stand on in this debate, since they used to be so vociferously in the corner of "work 'till you drop, that constitutes education." So now that they flipped, they can hardly be like "be like us! We done seen the light!"



Nobody likes surgical hospitalists, either. I mean, maybe Duke (*jizz*) does, but I already established that I don't care what Duke (*jizz*) thinks. In fact, probably whatever Duke (*jizz*) thinks is exactly the reverse of what I think.

First time I've LOL'd on SDN for a while. Sorry it got you banned. Better to burn out than to fade away.

It's too bad that some of the best quotes have to come in such an emotionally charged thread. Honestly, I have nothing to add, but I'm loving this very much.

 

[ACSurgeon]

I guess we won't see his post anytime soon, if ever. It's too bad. While I wouldn't become comfortable making acquaintance with that sort of a guy, I definitely had good laughs when I read some of his posts time to time.

And then I felt very dirty like I was watching some trashy reality show.

For sure... I'm thinking of creating a tribute for glade... you know a collection of some of his posts/threads.

RIP, glade!

P.S. I'm sure he'll be back. SDN ain't the same without him.

 

[Apollyon]

a search for apollyon and duke reveals...

299 posts!

we get it.

you're an fmg who scrambled into that spot right? just clarifying.

First, who is "we"? Who are you?

Second, your "clarification" is trying to be witty and insulting. However, who is it that you insult? FMG's? Sure - just pile on. You're not the first. Scramblers? About 1/14 US seniors every year - including a lot of people that post on SDN - so, if you want to paint all scramblers with the same brush - well, have at it. Finally, is it Duke? I'm sure that there are few people that, given the chance, would decline training there.

And, as to your "clarification", I've never hidden or obfuscated that - you are trying to use something to "discredit" me which I've never deigned to hide - at all. However, you can search vBulletin - yay for you! - but you lack context. I haven't been bothered to look for your other 3 posts. People here, though, often, talk about where they trained, to compare and contrast. And, considering over the last 7 years, I have about 13K posts here (averaging under 5/day), 300/13k ~= 2.3% - and that's not even confirming I was talking about the university or medical center in those posts (as I've mentioned Arthur Wellesley, the Duke of Wellington, and other royalty on SDN). Likewise, I paraphrase Jim McMahon when he was talking about BYU - "The best view of [Duke/BYU] was in the rear view mirror".

So, your apropos to nothing "clarification" changes nothing about General Surgery at some places being on a shift schedule, with one example given. Likewise, it contributes nothing to the idea that the 16 hours/day don't have to commence at 6am.

 

[wine thief]

just clarifying information you've posted before, so no need to be defensive. thanks for the stats. aloha.

 

[Apollyon]

just clarifying information you've posted before, so no need to be defensive. thanks for the stats. aloha.

You're not clarifying - there is nothing to be made clear. You're bringing up something that you think is denigrating or embarrassing. It's neither, and you've "exposed" nothing that I haven't plainly stated or wished wasn't known, so your attempt to derail the thread by insulting me has failed. And your "internet psychiatrist" statement of "no need to be defensive" is just lame. You're just being a ****.

 

[Encephalectomy]

Free glade!

 

[SLUser11]

...so your attempt to derail the thread by insulting me has failed. And your "internet psychiatrist" statement of "no need to be defensive" is just lame. You're just being a ****.

I think his attempt has been completely successful, because he's gotten you so worked up. I would just let it slide. "Wine Thief" has 4 posts for a reason, because it's obviously a troll. Just ignore trolls, and they go away (as you know).

 

[naus]

You're not clarifying - there is nothing to be made clear. You're bringing up something that you think is denigrating or embarrassing. It's neither, and you've "exposed" nothing that I haven't plainly stated or wished wasn't known, so your attempt to derail the thread by insulting me has failed. And your "internet psychiatrist" statement of "no need to be defensive" is just lame. You're just being a ****.

At this point, you're doing most of the derailing...

I echo others, free glade, don't hide behind your moderating privilege.

 

[Winged Scapula]

glade will not be "freed".

He received several warnings, infractions and post-holds and yet continued to violate the TOS. Its too bad really, as he has some insightful things to say *at times*.

And while I did not administer the final hammer, it was deserved, especially since he has been banned under another user name in the past and is well aware of what's allowed and not allowed. Everyone signs the same TOS when they register...it is not fair to allow some to violate and not others.

Maybe he'll be at ACS and you guys can continue to hero worship him there. 🙄

Other users in this thread should also be reminded the insulting each other is a violation of the TOS and that if it continues, infractions will be issued and the thread closed.

 

[SouthSideSteve]

I miss glade already. Can we at least bring Misterioso back?

 

[opr8n]

too bad this thread is about the new ACMGE rules residents have to live by next year and NOT glade
maybe people should make their own thread worshiping him somewhere else

 

[karatekid]

too bad this thread is about the new ACMGE rules residents have to live by next year and NOT glade
maybe people should make their own thread worshiping him somewhere else

I don't think people "worship" Glade, as much as they envy him for saying the things that they go around and think but don't say! If you don't want to have a European medical system, which sucks, and by all the new regulations and Obama care you are heading in that direction, I think we would need people like Glade. I don't agree with him on many things he had said during the last couple of months but I honestly can't say that his comments didn't make me think twice about the subject.

So I would also vote YES on the "free Glade" proposal!

 

[JackADeli]

I don't think people "worship" Glade, as much as they envy him for saying the things that they go around and think but don't say!...

So I would also vote YES on the "free Glade" proposal!

Tragic if not pathetic. This is an online ~anonymous discussion forum. Almost the perfect medium to freely discuss almost all ideas... (though read TOS and discuss in correct forum).

However, this ~worship of one person because they actually spoke out in a manner individuals feel uncomfortable if not innapropriate to speak on an anonymous forum? please, enough with the drama and hyperbole.

If people can not speak like adults and discuss ideas within the relatively loose framework of the TOS, do not come back fawning over the grenade throwers. In as much as that emphasizes a je ne sais quoi  of the ~hero, it emphasizes the ridiculousness of the silent.... If you all want a political rally, you should go to the political forum and rally for your representative.

PS: everyone here to my knowledge is free... so choose what you do with the freedom.

 

[filter07]

I feared this would happen to me. All that scutwork and crap hours as an intern and when it comes time for me to reap the benefits, the system is reformed. Just my luck. Oh well, good for the interns and patients at least. I always figured that this stupid system of crapping on the intern couldn't last.

 

[dynx]

Tragic if not pathetic. This is an online ~anonymous discussion forum. Almost the perfect medium to freely discuss almost all ideas... (though read TOS and discuss in correct forum).

However, this ~worship of one person because they actually spoke out in a manner individuals feel uncomfortable if not innapropriate to speak on an anonymous forum? please, enough with the drama and hyperbole.

If people can not speak like adults and discuss ideas within the relatively loose framework of the TOS, do not come back fawning over the grenade throwers. In as much as that emphasizes a je ne sais quoi  of the ~hero, it emphasizes the ridiculousness of the silent.... If you all want a political rally, you should go to the political forum and rally for your representative.

PS: everyone here to my knowledge is free... so choose what you do with the freedom.

Well how about if people just thought he was funny and enjoyed reading his posts?
Can't we lighten up a bit with the TOS? who's getting all butt-hurt over a few insults anyway? it's not like he pointed out somone was a FMG at duke.
I'm sure the prez-o-dent will be back at somepoint, till then hopefully someone will keep this place lively.

 

[Apollyon]

Well how about if people just thought he was funny and enjoyed reading his posts?
Can't we lighten up a bit with the TOS? who's getting all butt-hurt over a few insults anyway? it's not like he pointed out somone was a FMG at duke.
I'm sure the prez-o-dent will be back at somepoint, till then hopefully someone will keep this place lively.

No, no, not "pointing out" - clarifying. Get it right!

 

[LucidSplash]

My $0.02. I've had glade on my ignore list for months. I didn't find him funny and I don't find that he "[said] the things that go around and think but don't say." Not only did I feel that the majority of his input added little to the conversation on this forum, but I feel that his contributions routinely interferred with more productive discourse. I consider him on the same level of disruptive to true discourse as any media blowhard such as Limbaugh or Ann Coulter or Bill Maher. Obviously I'm not sorry glade is gone as I wasn't reading his posts anyway. It saddens me a little that people found him entertaining and ignore how he continually mananged to derail otherwise great conversation among peers. I agree with JAD in that if you have something to say, you should say it as this is an anonymous forum but there are many more productive ways to state your beliefs and feelings on a given topic and engage those around you in good discussion than glade's style of posting. I also certainly disagree that he is the type of person we "need" given the increasing involvement of government, potential disasters of ObamaCare, etc. He is NOT who I want speaking for me or my peers because he doesn't speak in a way that invites discussion from those of opposing viewpoints - it just makes people shut down. He preaches exclusively to the choir which is NOT what we need in the coming months and years.

Again, just my $0.02 on the issue as this otherwise interesting thread about the new ACGME regs has been derailed by those calling for his reinstatement.

 

[treehorsio]

hear, hear lucidsplash. I can say for a fact that if any of my junior residents went around saying, or even thinking, half of what glade said, I'd whip slap them. Glade seems to be a very unhappy, bitter surgery resident - to which I say, then freaking drop out and stop your b***in' already. There's plenty of us who actually enjoy what we do (most of the time) and respect our co-workers. I do agree with a previous poster who said he gives GS a bad name. He embodies the worst of the new school of surgery (whining) AND of the old school (sexism, elitism).

Good riddance.

And to rerail this thread, I have to now figure out how to make the VA call schedule for next year between two institutions gen surg programs...sigh. Another hospital we rotate at hires surgical PAs to cover at night; I'm suggesting we do the same (8pm to 6 am). Any other thoughts on how you guys will cover it? There are some rotations that do not work for night float (like a private hospital where 3 residents rotate only (PGY 1, 3, and 5) - you can't have the intern be nightfloat and hte 3 and 5 q2 inhouse backup (isn't that what the new rules state? direct intern supervision?) It's bad enough being inhouse q3.

 

[Ronin2258]

And to rerail this thread, I have to now figure out how to make the VA call schedule for next year between two institutions gen surg programs...sigh. Another hospital we rotate at hires surgical PAs to cover at night; I'm suggesting we do the same (8pm to 6 am). Any other thoughts on how you guys will cover it? There are some rotations that do not work for night float (like a private hospital where 3 residents rotate only (PGY 1, 3, and 5) - you can't have the intern be nightfloat and hte 3 and 5 q2 inhouse backup (isn't that what the new rules state? direct intern supervision?) It's bad enough being inhouse q3.

I suppose throwing in a 2 for that 1 would be problematic?

A couple of questions to help you along:
*How many interns/residents per level do you have to play with?
*How many hospitals do you have to cover, and how many are essential (i.e. have something required for surgery (hearts, transplants, etc,) that isn't taken by the other hospitals?)
*How much are you contractually/politically required to cover?

I realize a few of the questions are on the QT or Best Not Discussed in Public, but those are going to be things to consider.

Just by a mental exercise, I went through my old program, (interns: 3 cat, 1 prelim., and residents: 3 for each of the 4 classes,) and found the upper levels didn't change that much, (actually, since they expanded to 3 residents per level, it made the call schedule easier as 2s and 3s were on the same schedule, and 4s and 5s were on the same schedule.) Only thing is that the juniors who did at home call on consult (backup hands,) would now be in house.

That intern year is just going to suck regarding schedule and logistics. If we assume full above board reporting of hours, 16-hour days is a 5-day work week at 80 hours. Though with the idea of 10 hours between shifts offline, you are looking at 14-hour days (70 hours at 5 days a week.) 6 days/week would only give you 12-hour days, with signout (assuming nightfloat system,) being given to the incoming intern(s) via the upper level residents, as interns wouldn't be able to talk more than a few minutes back and forth to each other without pushing the line on hours.

I don't envy the scheduling headaches this is causing. And the thought of going down to 60 hours a week? As thin as some programs are right now?! Ugh.

I know I may be rambling, but I hope some people are getting ideas out of it.

 

[wine thief]

There are some rotations that do not work for night float (like a private hospital where 3 residents rotate only (PGY 1, 3, and 5) - you can't have the intern be nightfloat and hte 3 and 5 q2 inhouse backup (isn't that what the new rules state? direct intern supervision?) It's bad enough being inhouse q3.

i think interns can still be in house by themselves. maybe i'm not interpreting the acgme doc correctly?

"For many aspects of patient care, the supervising physician may be a more advanced resident or fellow. Other portions of care provided by the resident can be adequately supervised by the immediate availability of the supervising faculty member or resident physician, either in the institution, or by means of telephonic and/or electronic modalities."​

(and sweet jaysus, i thought he must be a 4th generation legacy to mention it 300 times.)

 

[badasshairday]

Do you guys actually think the ACGME's new work hour rules are a good thing?

I don't get how they won't extend residencies another year. Maybe 4th year of med school should be more tailored to what you are going into. You are going into surgery? Then 4th year you should rotate through a lot of surgery so you are competent and up to speed when internship starts. Currently, it seems like people actually regress by the time July rolls around and intern year starts because they haven't done a hard rotation for several months.

 

[45408]

That intern year is just going to suck regarding schedule and logistics. If we assume full above board reporting of hours, 16-hour days is a 5-day work week at 80 hours. Though with the idea of 10 hours between shifts offline, you are looking at 14-hour days (70 hours at 5 days a week.) 6 days/week would only give you 12-hour days, with signout (assuming nightfloat system,) being given to the incoming intern(s) via the upper level residents, as interns wouldn't be able to talk more than a few minutes back and forth to each other without pushing the line on hours.

Well, you could do 14-hour days, 6 days a week for 3 weeks, and then one week of 5 days of 14-hour days. That's 80.5 hours (close enough). That's a crappy schedule though. At work from 5am to 7pm, every day of the week? Go home and do some reading and then go to bed to rinse and repeat 😎