Are reported work hours posted anywhere?

[MissAmanda]

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I know residents have to report their work hours, but is that information obtainable to medical students? Is it posted anywhere? I would like to know this information to help me make decisions about residency programs, but I don't want to actually ask the programs I am applying to. Thanks!

 

[DoctorDermis]

I know residents have to report their work hours, but is that information obtainable to medical students? Is it posted anywhere? I would like to know this information to help me make decisions about residency programs, but I don't want to actually ask the programs I am applying to. Thanks!

I do not believe this information is made public, nor would I trust any list compiled by the ACGME. Although it sounds like you want to avoid the potential stigmas / consequences behind doing so, it is still better in my opinion to try and touch base with a resident at your desired programs of interest - either directly or indirectly.

Also, try and imagine how tedious it is to accurately report actual worked hours on top of a million other residency-related tasks. Add on top of that the fact that there are a number of programs where work hours are under-reported to stay at 80hrs or less.

Would you mind letting us know which specialty you are interested in?

 

[Frazier]

I know residents have to report their work hours, but is that information obtainable to medical students? Is it posted anywhere? I would like to know this information to help me make decisions about residency programs, but I don't want to actually ask the programs I am applying to. Thanks!

There are PYG-1 hours posted on FREIDA for most programs. However, how accurate those figures are is debatable.

Search by specialty -> location.

https://freida.ama-assn.org/Freida/user/viewProgramSearch.do

 

[DoctorDermis]

There are PYG-1 hours posted on FREIDA for most programs. However, how accurate those figures are is debatable.

Search by specialty -> location.

https://freida.ama-assn.org/Freida/user/viewProgramSearch.do

You are correct to be skeptical on those posted avg duty hours.
I have texted several of my friends in various programs how many hours they really worked.
Out of 5 different programs / specialties - all 5 are under-reported on Freida.

Just an example - Indiana Urology PGY-1 on Fredia is 50hrs/wk
I can tell you that 50hrs is, unfortunately, a major understatement of what is actually worked by those poor interns.

 

[SouthernSurgeon]

There are PYG-1 hours posted on FREIDA for most programs. However, how accurate those figures are is debatable.

Search by specialty -> location.

https://freida.ama-assn.org/Freida/user/viewProgramSearch.do

I have no idea where those numbers come from. They certainly aren't from any duty hours reports. I suspect self-reported.

My program just wrote 80 hrs/wk; our interns report an average of more like 70 based on the duty hour reports we see at GME meetings.

 

[Frazier]

You are correct to be skeptical on those posted avg duty hours.
I have texted several of my friends in various programs how many hours they really worked.
Out of 5 different programs / specialties - all 5 are under-reported on Freida.

Just an example - Indiana Urology PGY-1 on Fredia is 50hrs/wk
I can tell you that 50hrs is, unfortunately, a major understatement of what is actually worked by those poor interns.

heh, I figured a lot of them were too good to be true. 😉

 

[Winged Scapula]

Take FREIDA data with a huge grain of salt.

It is self-reported, usually by the program coordinator, either as a guess or what the PD tells him/her to write. Unfortunately, examples like those above put all the program's reported hours under suspicion.

OP, you will not find a centralized list of average work hours by program or specialty. As others have noted, you simply have to ask the residents if you suspect that the hours at a particular program are significantly different than others.

 

[genswim24]

Let me tell you how I report my hours. I click 6AM till 7 PM 6 days a week with one day off per week. Every single week of my residency besides vacation will be exactly 78 hours. As a surgeon that keeps me close enough to hours to not look lazy, but not high enough to ever get any department in trouble. Most of the time I work more than that, though it's only because I choose to. My program does it's best to make sure we don't violate, but I won't leave my co-residents or patients high and dry because the magical 80 hour limit has been reached. In other words, any numbers reported are worthless.

 

[DoctorDermis]

Let me tell you how I report my hours. I click 6AM till 7 PM 6 days a week with one day off per week. Every single week of my residency besides vacation will be exactly 78 hours. As a surgeon that keeps me close enough to hours to not look lazy, but not high enough to ever get any department in trouble. Most of the time I work more than that, though it's only because I choose to. My program does it's best to make sure we don't violate, but I won't leave my co-residents or patients high and dry because the magical 80 hour limit has been reached. In other words, any numbers reported are worthless.

This is because you are an awesome resident. 👍
I have run into a number of residents who will peace after giving the most minuscule and skimpy sign-out possible lol

 

[514901]

How can people work these hours without wanting to kill themselves/realizing they are pissing away years of their lives? Honest question. Is it the threat of losing their career if they actually seek out halfway decent hours?

 

[Law2Doc]

How can people work these hours without wanting to kill themselves/realizing they are pissing away years of their lives? Honest question. Is it the threat of losing their career if they actually seek out halfway decent hours?

First, it's not that bad -- the days go by quite quickly if you are even moderately interested. Second, there's a lot to learn, and even with 80 hours a week, you are going to emerge from residency feeling like you didn't learn nearly enough. Third, you will be immersed in a world where all if your friends that you see every day are living the same schedule; the schedule doesn't seem that bad when everyone you associate with is doing it. Fourth, it's an investment in a career you are excited about -- don't look at it as an ordeal-- you are getting paid to learn. I honestly don't see too many people in residency fretting about pissing away years of their life or fearing loss of career-- your perspective changes after premed. It just seems hard and scary from that vantage point, but it really not like that. You will usually be your own biggest critic, in most cases you aren't fearing for your career, you will be fearing that you if don't know things well enough you could make a mistake and hurt someone.

 

[514901]

I'm not a pre-med. I am nearly finished with medical school not in America.

I don't know what you mean about 80 weeks being 'not bad' but beyond 50 hour weeks your life pretty much sucks, and I am saying this as someone who worked 60+ hour weeks prior to medical school.

I cannot imagine being paid 45k with no OT and no vacation and thinking "it is all worth it". Even for a year. No matter how you slice it, it's a ****ty existence

 

[Law2Doc]

I'm not a pre-med. I am nearly finished with medical school not in America.

I don't know what you mean about 80 weeks being 'not bad' but beyond 50 hour weeks your life pretty much sucks, and I am saying this as someone who worked 60+ hour weeks prior to medical school.

I cannot imagine being paid 45k with no OT and no vacation and thinking "it is all worth it". Even for a year. No matter how you slice it, it's a ****ty existence

Clearly your perspective isn't the same as that of those in the US, and honestly having worked in another profession where long hours (far in excess of the 50 hour threshold you cite) were common, it's really not at all bad once you are inside. That's just part of being a professional. I would point out that a professional career is voluntary, and there are literally thousands of people happy to take anyone's spot if they don't want it. I'm not really sure why you are even weighing in with the perspective if someone not even in a uS school, but I would suggest that for the 24,000 or so people who enter into the match each year it is assuredly "all worth it".

The only ones who focus on it being a ****ty existence are those that dont have a decent perspective of what's on the other side -- more of the same but with more responsibility. It's the people who think the goal is low hours and high pay that get frustrated. For the rest if us, this is getting to be a doctor in a specialty of our choosing, which was the primary goal, and being paid to learn. Here are battles ahead but you more or less already won the war. The perqs will come later but we already hit the target.

 

[514901]

Clearly your perspective isn't the same as that of those in the US, and honestly having worked in another profession where long hours (far in excess of the 50 hour threshold you cite) were common, it's really not at all bad once you are inside. That's just part of being a professional. I would point out that a professional career is voluntary, and there are literally thousands of people happy to take anyone's spot if they don't want it. I'm not really sure why you are even weighing in with the perspective if someone not even in a uS school, but I would suggest that for the 24,000 or so people who enter into the match each year it is assuredly "all worth it".

The only ones who focus on it being a ****ty existence are those that dont have a decent perspective of what's on the other side -- more of the same but with more responsibility. It's the people who think the goal is low hours and high pay that get frustrated. For the rest if us, this is getting to be a doctor in a specialty of our choosing, which was the primary goal, and being paid to learn. Here are battles ahead but you more or less already won the war. The perqs will come later but we already hit the target.

I agree my perspective isn't the same, as I would rather have balance in my life. I'd rather make 150k less a year to work reasonable hours than to be a big baller with no free time. I can pick up the same aspects of medicine working reasonable hours as you can doing 80 hours, because the reality is that beyond a certain amount of hours a week the productivity ceases.

I guess in Australia we don't see the need to work unnecessary hours to keep up with the Joneses and with outdated concepts of medical tradition. And as long as you're content with the sweatshop conditions, than who am I to complain? My original query was about how those justify the lifestyle, and you have already explained it, albeit it in a condescending and self-interested manner

 

[Instatewaiter]

I'm not a pre-med. I am nearly finished with medical school not in America.

I don't know what you mean about 80 weeks being 'not bad' but beyond 50 hour weeks your life pretty much sucks, and I am saying this as someone who worked 60+ hour weeks prior to medical school.

I cannot imagine being paid 45k with no OT and no vacation and thinking "it is all worth it". Even for a year. No matter how you slice it, it's a ****ty existence

Well you are more than welcome to do your residency not in America as well.

 

[514901]

Well you are more than welcome to do your residency not in America as well.

of course, who would live in America when they can be somewhere far better?

 

[JP2740]

of course, who would live in America when they can be somewhere far better?

Thank god it isn't here.

Where do you live?

 

[ferning]

Yea australia where residents make 100k easy. all labor there gets time and half when working over 40 hours. Doing mindless floor work vs extra hours to read and actually learn is clearly the more beneficial for your education and future patients

When old docs brag about their hours u dont realize they did like 1/10 the work todays docs and physicians do in that time. Their patient census didnt turn over so quick and didnt see as many patients. They weren't dealing with paperwork, dictating computer orders, as many consults. They were still basically snake charmers and sat back with coffee while nurses handled floor work. They werent in the crap economic situation we are in either. Those guys dropped the ball and got greedy/lazy so now medicine is totally undermined by corporations.

Hospitals will cough up more if you better use your resident union. Still cheaper than hiring a PA or APN, besides the fact that resident:bed ratio provides like a 30% boost to medicare payments

 

[KnuxNole]

50 hour weeks would be easy...that isn't even close to being tiring at all haha. Over 80 is intense but 50 is ONLY 10 hours for 5 days, that's easy peasy haha. Plus, 50 hour max would make residency longer :O

 

[GoSpursGo]

How can people work these hours without wanting to kill themselves/realizing they are pissing away years of their lives? Honest question. Is it the threat of losing their career if they actually seek out halfway decent hours?

I agree my perspective isn't the same, as I would rather have balance in my life. I'd rather make 150k less a year to work reasonable hours than to be a big baller with no free time. I can pick up the same aspects of medicine working reasonable hours as you can doing 80 hours, because the reality is that beyond a certain amount of hours a week the productivity ceases.

I guess in Australia we don't see the need to work unnecessary hours to keep up with the Joneses and with outdated concepts of medical tradition. And as long as you're content with the sweatshop conditions, than who am I to complain? My original query was about how those justify the lifestyle, and you have already explained it, albeit it in a condescending and self-interested manner

As others have said, you either work long hours or "piss away" more years of your life doing a longer residency; you don't work 50 hours a week for 3 years and magically learn everything you need to be a competent doctor in your field. There are certain things you can only pick up from seeing a high volume of patients and following the progression of their disease over the course of the day and their hospital stay.

Certainly, the work-life balance can be grueling, but everyone knows what they're getting themselves into, and if someone does not want to work 65-80 hours a week they'd better work their butt off in med school to get into derm or some other cush residency, or they are also welcome to not go into medicine. But that's the tradeoff you make in the US for the intellectual stimulation and relatively safe future earning potential that you find in medicine.

 

[tiedyeddog]

of course, who would live in America when they can be somewhere far better?

Why do you even post in here?

 

[514901]

Why do you even post in here?

Because it's still good to understand how the American medical system works and to see the changes that are occurring in our generation of doctors.

And I disagree about needing to work 80 hour weeks to achieve better competency. I've been doing 45-55 hour weeks here and feel perfectly comfortable in my capability.

But 80 hour weeks? That just means you go to sleep, wake, go to work, and have no life balance. Not to mention the repercussions to your own health.

But that's how it is in America I guess, because as the lawyer guy mentioned, there's a hundred other people waiting to steal your job.

 

[KnuxNole]

The surgeons are laughing at the idea that 45hrs a week is even close to being amazing experts at their field. After all the goal isn't to be barely passable haha.

80hr workweeks aren't hell. Hard, yes. But time management and balance are your friends.

We can both agree that 40 hours a week is a joke in terms of difficulty. None of us here would break a sweat.

 

[ChiDO]

Let me tell you how I report my hours. I click 6AM till 7 PM 6 days a week with one day off per week. Every single week of my residency besides vacation will be exactly 78 hours. As a surgeon that keeps me close enough to hours to not look lazy, but not high enough to ever get any department in trouble. Most of the time I work more than that, though it's only because I choose to. My program does it's best to make sure we don't violate, but I won't leave my co-residents or patients high and dry because the magical 80 hour limit has been reached. In other words, any numbers reported are worthless.

I do the same thing..hah.

Also remember the 80hr/wk is averaged over 4 weeks. So you could work 120 week 1 and 40 hours week 2 and be complaint.

If you become that resident that watches the clock and leave your co workers, no one will like u. I've had numerous days where I was done being on call but we had 4-5 consults pending and more stuff rolling into the er n then u end up staying to help everyone out.

 

[notbobtrustme]

Yea australia where residents make 100k easy. all labor there gets time and half when working over 40 hours. Doing mindless floor work vs extra hours to read and actually learn is clearly the more beneficial for your education and future patients

wait, residents in Australia make 100k? ****.

 

[GoSpursGo]

But 80 hour weeks? That just means you go to sleep, wake, go to work, and have no life balance.

That's just not true You find a way to strike a balance, and you accept that some weeks are going to be really hard, but my life is good.

Granted, I'm not in a specialty where I'm routinely hitting the 80 hour mark, but I'm easily above the 50 hour threshold you threw out (I'd say 65-70 is a decent guess on average), but in any case it's all about managing your time well, and deciding what's really important and what you can live without.

 

[oldbearprofessor]

I cannot imagine being paid 45k with no OT and no vacation and thinking "it is all worth it". Even for a year.

Of all the things you've said, and all your harsh criticism of a system you've never been part of, this comment stands out to me. When choosing to do pediatric subspecialty training, residents are agreeing to do an extra year of 80 hour work weeks that they don't need to do to be general pediatricians. They do get vacation and the pay is a bit more than 45K, but that's detail. 😉

Whether you believe this is necessary, yucky or whatever, this is the decision they must make and that I counsel them about. Although fellowships are 3 years, the last two years are generally easier with only a relatively few months at 80 hour weeks while the fellows do research projects. Some have had it with the trainee life of 80 hour weeks and decide to forgo fellowship. Some can't fit it into their current life (babies at home, etc). Most understand that one year of a tough schedule is worth it to spend the next 30-40 (or more!) years doing what they want with their life. For me, it was an obvious choice and one I have never regretted (fellowships averaged 90-100 hours/week then and it wasn't cushy work).

You can't imagine making that choice, and I understand that. Others see it differently, but everyone has to decide this on their own. I think you'd be surprised how many people are willing to choose a single tough year for decades of career satisfaction.

 

[514901]

wait, residents in Australia make 100k? ****.

Well over 100k as an intern. Especially rural.

 

[tiedyeddog]

Because it's still good to understand how the American medical system works and to see the changes that are occurring in our generation of doctors.

And I disagree about needing to work 80 hour weeks to achieve better competency. I've been doing 45-55 hour weeks here and feel perfectly comfortable in my capability.

But 80 hour weeks? That just means you go to sleep, wake, go to work, and have no life balance. Not to mention the repercussions to your own health.

But that's how it is in America I guess, because as the lawyer guy mentioned, there's a hundred other people waiting to steal your job.

How long is your residency and what speciality is it, just so we can compare to the American equivalent?

And there are more that 80 waking hours in a week...

Edit: I see you're a medical student, how long are some common residencies?

 

[ferning]

Lets not overstate the educational utility during these 80 hours and while surgery is different in term of acquiring techincal proficiency, they are still doing alot floor work and spending a large portion dictating, filling out brainless forms, etc.

And I doubt our friend from down under is working 45 hours a week and then running to the pub. He is probably able to do the reading and research that all US residents wish they had more time for or weren't so tired to do it after a 13 hour day

Don't blindly accept your situation as ideal or necessary without recognizing that their are aspects of your training that could be improved or you could use less of so you can read. Saying its perfect and necessary without reservations would be denial.

And how would your training be made worse by receiving a salary comparable to australian?

Training is longer with the trend for fellowship, education debts are sky high, and Docs arent dripping gold like they used to ( if the promise of future wages pays your labor for today) so why is that type of salary something we don't have. The money is there as nothing prevents a hospital from supplementing medicare direct gme.

Residents are unionized at the hospital level already usually to collectively bargain for it. And that salary range is the same as a new PA who works 40 hours a week at more human a pace. A resident clearly is a better deal than that alternative. And thats only half the story, as besides direct gme funding from medicare that doesn't come out of the hospitals pocket. More so there is indirect gme which is increases a hospitals medicarw payments by 33-42% approximately. Based on resident: bed ratio.

This makes residents quite a bit more lucrative and a better alternative to a PA. These gme payments are attached to the residents, the hospital isn't allowed them without residents. So better wages shouldn't be seen as out of line in this context.

And it is illegal for program directors or hospitals to interfere or dissuade residents from doing collectively bargaining for. Federal laws protect the rights of labor unions to function as one without interference from employers and nonmembers.

Other resident groups have done it, but the bar shouldnt be set so low when people do it again.

 

[514901]

How long is your residency and what speciality is it, just so we can compare to the American equivalent?

And there are more that 80 waking hours in a week...

Edit: I see you're a medical student, how long are some common residencies?

Well our residencies are much longer because we do not have a standardized exam like the USMLE to funnel students into residency. So you do PGY-1, PGY2, then you keep feeding into the hospital system until you match onto the physician/surgeon/GP/OBGYN pathways which are all very difficult to get into...so unlike in the US, you do not know what field you will match into straight away, which has its disadvantages.

Yeah I mean I work 40-50 hour weeks and I of course study nearly that amount in my free time, but I do get free time to surf nearly every weekend and don't have to deal with all the red tape and politics in the US system (which I hear make medicine pretty much pointless now)

 

[WellWornLad]

I never had a problem with spending 80 hours a week in the hospital, because the time really does fly by. There is always something to do, some trauma coming in, someone coding, some consult to see...before you know it it's time to sign out. Prior to medical school I worked a lot of jobs, and couldn't imagine doing 13-hour shifts regularly in any of them.

The real problem is the lack of time outside of the hospital. It's hard to do regular stuff like going to the dentist, banking, post office, or get your car inspected when you're tied up from 5:45 am to 6:15 pm 6 days a week. Then your one day off you're doing laundry, buying groceries, cleaning up the house.

 

[Kal EI]

I never had a problem with spending 80 hours a week in the hospital, because the time really does fly by. There is always something to do, some trauma coming in, someone coding, some consult to see...before you know it it's time to sign out. Prior to medical school I worked a lot of jobs, and couldn't imagine doing 13-hour shifts regularly in any of them.

The real problem is the lack of time outside of the hospital. It's hard to do regular stuff like going to the dentist, banking, post office, or get your car inspected when you're tied up from 5:45 am to 6:15 pm 6 days a week. Then your one day off you're doing laundry, buying groceries, cleaning up the house.

Yeah, that sounds awful.

That's just not true You find a way to strike a balance, and you accept that some weeks are going to be really hard, but my life is good.

Granted, I'm not in a specialty where I'm routinely hitting the 80 hour mark, but I'm easily above the 50 hour threshold you threw out (I'd say 65-70 is a decent guess on average), but in any case it's all about managing your time well, and deciding what's really important and what you can live without.

In all fairness, the difference between 65 and 80 is huge. If someone asked you to work 15 hours on your day off, that would take a toll.

How can people work these hours without wanting to kill themselves/realizing they are pissing away years of their lives? Honest question. Is it the threat of losing their career if they actually seek out halfway decent hours?

People work like this because their chasing after something they've never experienced. Once they arrive the feelings are lackluster at best, most are dissatisfied with what they had to give up. Look at any physician satisfaction survey, usually about 50% or so are unhappy with medicine or their field.

Balance is key from day 1.

 

[deleted547339]

I agree my perspective isn't the same, as I would rather have balance in my life. I'd rather make 150k less a year to work reasonable hours than to be a big baller with no free time. I can pick up the same aspects of medicine working reasonable hours as you can doing 80 hours, because the reality is that beyond a certain amount of hours a week the productivity ceases.

I guess in Australia we don't see the need to work unnecessary hours to keep up with the Joneses and with outdated concepts of medical tradition. And as long as you're content with the sweatshop conditions, than who am I to complain? My original query was about how those justify the lifestyle, and you have already explained it, albeit it in a condescending and self-interested manner

I find it ironic to call someone condescending while exuding a great sense of superiority.

Because it's still good to understand how the American medical system works and to see the changes that are occurring in our generation of doctors.

And I disagree about needing to work 80 hour weeks to achieve better competency. I've been doing 45-55 hour weeks here and feel perfectly comfortable in my capability.

But 80 hour weeks? That just means you go to sleep, wake, go to work, and have no life balance. Not to mention the repercussions to your own health.

But that's how it is in America I guess, because as the lawyer guy mentioned, there's a hundred other people waiting to steal your job.

Yea, 80 hours a week sucks, but it doesnt mean that you live in the hospital. 5 days of 16h days are long, but you would get 2 days a week off. 13 hour days 6 days a week is long, but you have a day a week off, and you don't just go home and sleep, you have several hours of day left before you go to bed (usually). Plus, I enjoy my work. Every day I'm learning a TON. I'm helping people and, very literally, saving lives.

People work like this because their chasing after something they've never experienced. Once they arrive the feelings are lackluster at best, most are dissatisfied with what they had to give up. Look at any physician satisfaction survey, usually about 50% or so are unhappy with medicine or their field.

Balance is key from day 1.

Great perspective on life as an attending from a med student, lol.

 

[Kal EI]

Great perspective on life as an attending from a med student, lol.

There was a day that we as pre-meds weren't around attendings 50-60 hrs a week - and we had to guess what they thought. Now we can just ask their perspectives.

I'm repeating what I've heard along with my own analysis. Obviously I don't include every physician, I even mentioned only 50% were dissatisfied (and also I wouldn't say that all of them fall into my analysis - but many do). Specifically this results from a neurosurgeon and CT surgeon I talked to reflecting on missing their kids growing up because of residency.

Whatever though, we all believe what we want. I'm not trying to persuade anyone

 

[Law2Doc]

I agree my perspective isn't the same, as I would rather have balance in my life. I'd rather make 150k less a year to work reasonable hours than to be a big baller with no free time. I can pick up the same aspects of medicine working reasonable hours as you can doing 80 hours, because the reality is that beyond a certain amount of hours a week the productivity ceases.

I guess in Australia we don't see the need to work unnecessary hours to keep up with the Joneses and with outdated concepts of medical tradition. And as long as you're content with the sweatshop conditions, than who am I to complain? My original query was about how those justify the lifestyle, and you have already explained it, albeit it in a condescending and self-interested manner

Actually I think the consensus here is that as duty hours have limited time in the hospital for residents, the residents are in fact learning appreciably less, and proving that no you aren't "picking up the same aspects of medicine working reasonable hours". It's unfortunate but true. While there is undoubtedly a point of diminishing returns where sleepiness overcomes all ability to learn usefully, and I won't pretend that learning at 2 am after a 20 hour stretch of work is the same as at 7 am after a good nights sleep, I think we are proving that the threshold is somewhere far beyond the 80 hour/week cap we presently have. You are speculating, we actually are testing the theory in practice and proving you wrong. Most foreign trained doctors I've met who come here, while they consider their education and training equally top notch, concede that it takes them many more years of 40-50 hour work weeks to get to the point of a US resident working 80+ hours per week. I'm not looking to debate other systems, just saying an outsider has no useful perspective as to what's a ****ty existence.

 

[Winged Scapula]

As someone who has worked in both systems (Australian and US), some thoughts:

Australian house officers (junior residents) do not routinely "make $100,000" per year. Base salaries tend to range between $65 and $75K AUD per year. This data is easily available on-line.

While Australian house officers do earn overtime, most hospitals have strict policies about avoiding this. We always had to watch the clock closely because we were instructed that overtime was frowned upon and that the hospital did not wish to pay it.

There is no right or wrong way to do it; longer training schemes in Australia with shorter hours are what Australians are used to. You poll Americans and they wish to work longer hours for shorter periods of training; its what we are used to. To each his own. But there is no doubt that the average Australian and average American are different. Americans work longer hours, take less vacation, etc. A friend of mine, a psychiatrist in Sydney, vacations several times a year and "wouldn't feel comfortable being gone for more than a month at a time". Most American physicians wouldn't feel comfortable being gone for more than 2 weeks given the demands of patients here.

The major issue I have with the Australian training is the amount of subjectivity there is in advancing someone from HO to Registrar and finishing specialist training. On more than one occasion I observed a Registrar anger a Consultant and having that result in additional training required (ie, adding on a year to their training).

In comparing house officers between the 2 countries, I find that Australian physicians tend to be better clinically but many lack in depth knowledge of tests performed/basic science that US junior residents have. However, at the completion of training, I see no difference between the 2 countries.

I've worked as a resident prior to the US work hour restrictions and I can verify that not all of those triple digit work weeks were filled with educational experiences. But there has to be a breaking point at which the hours worked:education becomes unfavorable. I don't know what that number is. The problem with stating "I work 40 hours a week and feel comfortable with my knowledge" is that we generally are not the best judge of such things. You don't know what you don't know.

Lastly, as L2D notes, its not really fair for anyone to judge another's idea of paradise/appropriate work hours. My life might be wonderful or boring in another's eyes, but what matters is what I think.

 

[514901]

As someone who has worked in both systems (Australian and US), some thoughts:

Australian house officers (junior residents) do not routinely "make $100,000" per year. Base salaries tend to range between $65 and $75K AUD per year. This data is easily available on-line.

While Australian house officers do earn overtime, most hospitals have strict policies about avoiding this. We always had to watch the clock closely because we were instructed that overtime was frowned upon and that the hospital did not wish to pay it.

There is no right or wrong way to do it; longer training schemes in Australia with shorter hours are what Australians are used to. You poll Americans and they wish to work longer hours for shorter periods of training; its what we are used to. To each his own. But there is no doubt that the average Australian and average American are different. Americans work longer hours, take less vacation, etc. A friend of mine, a psychiatrist in Sydney, vacations several times a year and "wouldn't feel comfortable being gone for more than a month at a time". Most American physicians wouldn't feel comfortable being gone for more than 2 weeks given the demands of patients here.

The major issue I have with the Australian training is the amount of subjectivity there is in advancing someone from HO to Registrar and finishing specialist training. On more than one occasion I observed a Registrar anger a Consultant and having that result in additional training required (ie, adding on a year to their training).

In comparing house officers between the 2 countries, I find that Australian physicians tend to be better clinically but many lack in depth knowledge of tests performed/basic science that US junior residents have. However, at the completion of training, I see no difference between the 2 countries.

I've worked as a resident prior to the US work hour restrictions and I can verify that not all of those triple digit work weeks were filled with educational experiences. But there has to be a breaking point at which the hours worked:education becomes unfavorable. I don't know what that number is. The problem with stating "I work 40 hours a week and feel comfortable with my knowledge" is that we generally are not the best judge of such things. You don't know what you don't know.

Lastly, as L2D notes, its not really fair for anyone to judge another's idea of paradise/appropriate work hours. My life might be wonderful or boring in another's eyes, but what matters is what I think.

Maybe you were working at a huge city hospital like the RBWH or PA but in a rural hospital you will VERY easily clear 100k as an intern

 

[Winged Scapula]

Maybe you were working at a huge city hospital like the RBWH or PA but in a rural hospital you will VERY easily clear 100k as an intern

If you'll read your previous post you imply that *all* interns in Australia make well over $100,000.

While that may be true in some rural centers (and I dont have data or friends who can verify that), even the AMC notes that average salaries are between 60 and 80K.

I'm not sure the comparison is fair anyway, given the higher COL in most of Australia compared with most of the US. I would expect to make more there.

 

[514901]

If you'll read your previous post you imply that *all* interns in Australia make well over $100,000.

While that may be true in some rural centers (and I dont have data or friends who can verify that), even the AMC notes that average salaries are between 60 and 80K.

I'm not sure the comparison is fair anyway, given the higher COL in most of Australia compared with most of the US. I would expect to make more there.

I don't care about the semantics, but if you're willing to work OT you'll get it, and you'll clear 100k. If you're based at a large city hospital with a large supply of interns and less patient contact, you won't get the OT opportunities that you would in a coastal 'rural' hospital.

I don't care about your opinion because I know how the system works. Australia is no more expensive than LA, SF, NYC, Chicago, and Miami.

 

[Law2Doc]

...
I don't care about your opinion because I know how the system works....

I think this is what most Americans would say about your prior posts commenting on the US system as well. Everyone is qualified to comment on their own system but poorly situated to decide what other system constitutes a ***ty existence.

 

[Winged Scapula]

I don't care about the semantics, but if you're willing to work OT you'll get it, and you'll clear 100k. If you're based at a large city hospital with a large supply of interns and less patient contact, you won't get the OT opportunities that you would in a coastal 'rural' hospital.

I don't care about your opinion because I know how the system works. Australia is no more expensive than LA, SF, NYC, Chicago, and Miami.

I'm not sure why you're being so ugly about this. I've worked in both countries, so I know how it works as well and without all the qualifiers.

In the US a family medicine physician can earn $500,000 if they're willing willing to work in a rural environment but there aren't that many of those jobs available and most people don't want them so it's no use pushing that forward as an example as it represents the exception not the rule. Most HO in Australia work in the major centres and not places like Booleroo or Alice.

You don't have to care about my opinion but you don't have to be insulting about it. Frankly since you've never worked as a physician in either, I'm not sure why we should care about your opinion.

FWIW COL for rents may be comparable in Australia and the major cities in the US but Australia is more expensive overall in terms of clothing, food, cars, electronics, etc. as one would expect given that many of these things have to be imported or without competition.

 

[Instatewaiter]

5 days of 16h days are long, but you would get 2 days a week off. 13 hour days 6 days a week is long, but you have a day a week off, and you don't just go home and sleep, you have several hours of day left before you go to bed (usually). Plus, I enjoy my work. Every day I'm learning a TON. I'm helping people and, very literally, saving lives.

The worst thing to come to the American residency system was preventing interns from working more than 16 hours at a time. The problem is that the 80 hour ceiling didn't go anywhere.

With the old call system, interns could take call. That would mean three to four 10 hour days + one to two 30 hour calls. Call was about 8am-12 noon the next day. So, your post-call day was essentiallly a day off (in addition to your real days off). You could go out with your friends get errands done. It is much gentler than the new system of 13-16 hour days 6 days a week. Then you never have time of your own during the day.

I don't care about your opinion because I know how the system works. Australia is no more expensive than LA, SF, NYC, Chicago, and Miami.

I don't think anyone in the US would be angry if we made more as residents. I never understood how hospitals can get $100K from medicare, get work from the residents and then pays residents much less than $100K .

That said, I think the 80 hour week for surgical or procedural fields is good. Also, I think most people in the US would rather longer hours and a shorter residency than shorter hours and more years spent in training. Now, if I were making over $100,000 I might have a different perspective.

 

[tiedyeddog]

I don't care about your opinion because I know how the system works.

lol, says the bro who is still a medical student. He hasn't earned a cent as a doctor and yet is intimately knowledgable about the details of physician payment.

I think guy is just jelly Americans make bank and finish residency in a predetermined amount of time.

Here are some numbers about the COL difference between Australia and the US. http://www.numbeo.com/cost-of-livin...jsp?country1=Australia&country2=United+States

Local purchasing power is 30% greater in the US....