Anyone *prefer* circadian shift progression to a regular schedule?

[joshmir]

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As in, prefer switching shifts *forward* to doing the same shift seven days in a row, etc. I haven't met anyone that thinks this way, and that worries me (am I OCD?)

I know switching from nights back to days is rough, but that adjustment probably doesn't happen more often than once a week, right?

I am always sleep deprived...it seems like this may be the only way out of it...the ability to sleep in every couple of days when you switch from morning shifts to mid-day shifts, mid-day to night shifts, etc...It is much easier for me to stay awake late and wake up later than to stick to a normal schedule. Anyone else feel this way?

I haven't met anybody that *prefers* circadian shift progression, (which really worries me) and I wonder why, since I'm looking at this (doing circadian shift progression) as a way to *save* myself from a life of miserable fatigue.

BTW, I have a friend that's a day trader in hawaii/california, and another who does computer programming as a consultant...they *never* wake up via alarm clock, and work when they want to to me, that's seems tre joyous.

 

[jazz]

i actually think studies have shown that forward shifting is easier to get used to. (no i don't have any references off hand)

a lot of programs use forward shifting schedules (days to middles to nights) which i think works out easier for residents than random shifts and switches from day to night.

 

[aphistis]

Originally posted by jazz
i actually think studies have shown that forward shifting is easier to get used to. (no i don't have any references off hand)

a lot of programs use forward shifting schedules (days to middles to nights) which i think works out easier for residents than random shifts and switches from day to night.

Yeah, there have been some psych studies strongly suggesting this. Our "natural" circadian rhythm is actually a bit longer than 24 hours, so most people have an easier time staying up late than going to bed early. On the same principle, jet lag tends to be worse after an eastward flight (toward nightfall) than westward (away from nightfall).

 

[joshmir]

I certainly agree circadian shift progression is better than random switches.

But do you know anyone who prefers it to *waking up at the same time every day*? ie, what the rest of the world calls a normal schedule, not a "normal EM schedule."

as a member of the rest of the world, i am having problems with the waking up at the same time on a regular schedule thing, and looking to EM and circadian shift progression to save my life...
so if anyone has heard of someone that prefers switching forward to a 9-5 existence, please validate my neurosis!

(maybe i should just get my thyroid checked)

 

[ERMudPhud]

During residency we worked a 7-3x2 then 3-11x2 then 11-7x2 then 2 days off progression. I loved it. After the second 7-3 you could stay out late or do something(ski, bike, golf, etc...) during the following day because you knew you didn't have to be at work until the afternoon. Likewise after the second 3-11. It was almost like having an extra day off every 2 days. After the second night shift I would find something fun to do so I could stay awake until evening and get back on a day schedule. There is good evidence that night work or rotating shift work is not great for you long term health but I loved that schedule. I definately preferred it to constant 8-5's

 

[joshmir]

That's the answer I was looking for, thanks, MD/PhD.

BTW, do you think going to get a PhD after medical school would help a someone with average numbers/letters match into EM?

would you say it would help a whole lot, or just a little?

thanks!

PS- Could you quote the reference for the "good evidence" that it's bad for your health? Sounds like an interesting read...

 

[ERMudPhud]

Originally posted by joshmir
do you think going to get a PhD after medical school would help a someone with average numbers/letters match into EM?

PS- Could you quote the reference for the "good evidence" that it's bad for your health? Sounds like an interesting read...

Try these to start
1: Knutsson A.
Health disorders of shift workers.
Occup Med (Lond). 2003 Mar;53(2):103-8. Review.
PMID: 12637594 [PubMed - indexed for MEDLINE]

2: Kuhn G.
Circadian rhythm, shift work, and emergency medicine.
Ann Emerg Med. 2001 Jan;37(1):88-98. Review.
PMID: 11145778 [PubMed - indexed for MEDLINE]

3: Scott AJ.
Shift work and health.
Prim Care. 2000 Dec;27(4):1057-79. Review.
PMID: 11072299 [PubMed - indexed for MEDLINE]

As for getting the PhD I'm sure it helped me match but you would have to be completely insane to spend an extra 3-6 years getting a PhD just to help you match in EM. Do some research with somebody doing even vaguely EM related work during medical school and then do your best to get as good letters and grades as you can.

 

[jazz]

i didn't go into er solely for the "non normal" scheudule... but now, i look at my schedule and realize that out of anywhere between 8-10 days, i only have to get up for twice for a "normal" day and consider myself so lucky. i've never liked getting up early. the "normal" world was never for me. i actually think that if you like doing all 8-5's and can't circadian shift, then you will be miserable in er.

 

[joshmir]

MudPhud- why do you not work this schedule now? Is it b/c of your research?

Jazz-would you like to keep this schedule as an attending?

Thanks!

 

[MoCookiess]

The circadian shift schedule sounds like heaven to me. Glad to know there's other people out there who hate getting up at the same time every day. In what other specialties is this sort of a schedule common?

 

[jazz]

Jazz-would you like to keep this schedule as an attending

hopefully i will not be doing as many overnights. however, i definitely would prefer the middle shifts more so than the morning ones.