Days off during residency?

[danvasta]

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Been searching for this in older threads but couldn't find anything substantial. As an IM categorical intern how many days off do you get (besides the 4 weeks off per year). I know you have to get 4 days off per month but does that sometimes include 'golden weekends' or is that a thing of the past? My SO lives in another city and I would like to visit/ have him or her visit me at least every month.. Until we figure out a move, just wondering if this was possible or are we pretty much doomed ?

 

[so721]

Been searching for this in older threads but couldn't find anything substantial. As an IM categorical intern how many days off do you get (besides the 4 weeks off per year). I know you have to get 4 days off per month but does that sometimes include 'golden weekends' or is that a thing of the past? My SO lives in another city and I would like to visit/ have him or her visit me at least every month.. Until we figure out a move, just wondering if this was possible or are we pretty much doomed ?

I think its 3 weeks/21 days off per year for PGY1. unless I'm mistaken

 

[DoctorMedic]

It's 4 days averaged over the month (technically 1/week), no requirement for golden weekends. Specifically says in ACGME rules that a program can opt to do this but it's program specific.

 

[colbgw02]

4 weeks of vacation seems like a lot for an intern. I got half that.

 

[GoSpursGo]

Just very program and rotation dependent. My program did 12 days on followed by a golden weenkend in some of our rotations. Other rotations, we got 4 random days off, and that included the "day" that was the 24 hours between flipping between days and nights.

My impression, in general, is that IM offers golden weekends much less often than peds.

 

[DoctwoB]

Varies heavily program by program and Rotation by rotation. At my shop you get one day off a week on floor and icu months. Sometimes if things are dead one intern can sign out to the other a bit early. Consult and outpatient months have golden weekends. They try to stagger hard and easy months to reduce the burnout.

The above example of a day's to nights transition day off is technically a duty hours violation, as you need to have a calendar day off, not a 24 hour period. Doesn't keep most programs from doing it though.

 

[blebb]

Transfer into rads and get every weekend off. Problem solved.

 

[KindOfScared]

4 weeks off during intern year?? My IM program must have not gotten that memo.

 

[Law2Doc]

Transfer into rads and get every weekend off. Problem solved.

The advanced paths all do an intern year (prelim or TY) first, so I don't think you solved the problem.

OP, you are going to have to work around whatever schedule they give you. Every month might be ambitious to expect to travel, but you'll likely be able to get some time together MOST months. Especially if your SO can come to you and save you the travel time.

 

[Raryn]

4 weeks off during intern year?? My IM program must have not gotten that memo.

Vacation varies from 2-4 weeks for most programs, though one program I'm aware of does a 5th (extra) week off between intern and 2nd year.

As for the other days off, highly program dependent. Some programs prioritize weekend days, some prioritize weekdays. Sometimes the days off are grouped 2 together, sometimes it is always one at a time. The only rule is you must have 4 per every 28 day block.

 

[mvenus929]

The above example of a day's to nights transition day off is technically a duty hours violation, as you need to have a calendar day off, not a 24 hour period. Doesn't keep most programs from doing it though.

False. It can be defined as a 24-hour period, though the ACGME seems to discourage having it on a post-call day.

See page 6: http://www.acgme.org/acgmeweb/Portals/0/PDFs/dh-faqs2011.pdf

 

[Mass Effect]

I think its 3 weeks/21 days off per year for PGY1. unless I'm mistaken

4 weeks of vacation seems like a lot for an intern. I got half that.

You're both mistaken. It's all program dependent. Some give 2 weeks, some give 3, and some give 4. My program gives all residents (interns, PGY 1, 2, 3, 4...) the same amount of vacation time, personal time off, and sick days. No such thing as "a lot for an intern."

 

[rokshana]

You're both mistaken. It's all program dependent. Some give 2 weeks, some give 3, and some give 4. My program gives all residents (interns, PGY 1, 2, 3, 4...) the same amount of vacation time, personal time off, and sick days. No such thing as "a lot for an intern."

though the ACGME still has the ultimate say...and if you miss more that 4 weeks (averaged) per year in vacation, sick days, leave, etc...then you will have to extend your training... so even if a program is generous and give you 4 weeks of vacation and 2 weeks of sick leave, you take all of that and you are going to have to extend your training (there is a caveat that if the discrepancy is <1 month total, the program has the discretion to say that the resident has had sufficient training to complete the residency without extra time).

 

[Doctor Bagel]

False. It can be defined as a 24-hour period, though the ACGME seems to discourage having it on a post-call day.

See page 6: http://www.acgme.org/acgmeweb/Portals/0/PDFs/dh-faqs2011.pdf

True, though I think you can officially conclude that you train at a bad program if they use technicalities like that to rob you of your day off.

And only 2 weeks of vacation? Where are these programs? My program gave 3, and it seemed like most places I interviewed at gave 4. Admittedly I'm in a cushy specialty, but vacation weeks are generally GME wide and applicable in all specialties. An additional week of educational leave is pretty typical as well.

As for golden weekends and whatnot, it depends on your program. I think with the 2011 duty hours changes, these are less frequent with the norm being more of 6 long days a week (which sucks). Overnight call isn't all bad.

 

[Doctor Bagel]

Transfer into rads and get every weekend off. Problem solved.

This seems highly unlikely as radiology provides 24/7 coverage in the hospital. Surely that means somebody is working those weekends.

 

[Mass Effect]

though the ACGME still has the ultimate say...and if you miss more that 4 weeks (averaged) per year in vacation, sick days, leave, etc...then you will have to extend your training... so even if a program is generous and give you 4 weeks of vacation and 2 weeks of sick leave, you take all of that and you are going to have to extend your training (there is a caveat that if the discrepancy is <1 month total, the program has the discretion to say that the resident has had sufficient training to complete the residency without extra time).

Either this is not true or many programs use the caveat because, at least in my specialty, 6 weeks is the standard time off after having a baby without extending training at my program and many of the programs at which I interviewed. My program actually allows 8 weeks off for maternity/paternity leave without extending training.

 

[Mass Effect]

This seems highly unlikely as radiology provides 24/7 coverage in the hospital. Surely that means somebody is working those weekends.

I will say that at my program (not rads), we do nightfloat. Weekend call is q 6 weeks, so you can get 5 weekends in a row off. Not the same as having all weekends off, but not so bad either.

 

[Dr. USMLE]

Agreed. We have at least one Radiology resident in the hospital 24/7. I understand they have night float months in every year of their training. I don't know how many hours they work at a stretch (I would guess it's shift work, similar to ER training), but working overnight for extended stretches takes a toll on everyone.

Overnight work in radiology is actually no big deal. In fact, I work fewer hours (<45 per week) on nightfloat than most people do during their routine daytime residency (in any field). That <45 hours also includes breaks for coffee, eating and a significant lull period from 2-5 AM nearly everyday.

 

[Raryn]

though the ACGME still has the ultimate say...and if you miss more that 4 weeks (averaged) per year in vacation, sick days, leave, etc...then you will have to extend your training... so even if a program is generous and give you 4 weeks of vacation and 2 weeks of sick leave, you take all of that and you are going to have to extend your training (there is a caveat that if the discrepancy is <1 month total, the program has the discretion to say that the resident has had sufficient training to complete the residency without extra time).

That caveat is pretty routinely used. That, and the requirement is you have 32-33 months of IM training, so if you take sick days and leave one or two days at a time, you still count as having worked the remainder of the month.

But the way the caveat works is, if you take 4 weeks of vacation (28 days) and then 30 days of maternity leave on top of that, you can graduate on time. If you take a 59th day of maternity leave on the other hand, you owe the program 31 days. Period. Not just one day.

 

[Siggy]

Been searching for this in older threads but couldn't find anything substantial. As an IM categorical intern how many days off do you get (besides the 4 weeks off per year). I know you have to get 4 days off per month but does that sometimes include 'golden weekends' or is that a thing of the past? My SO lives in another city and I would like to visit/ have him or her visit me at least every month.. Until we figure out a move, just wondering if this was possible or are we pretty much doomed ?

At my hospital, it's 20 days (4 five day weeks) that can be used during off service rotations (mainly electives). Additionally, it's 1 day a week that's a non-weekend, as well as a 24 hour period coming onto night float and leaving night float (10pm -11am). Technically, the first Saturday after night float (last intern night float day is Thursday night into Friday morning) the earliest the interns can come in is 11am, however a lot of interns skirt that rule since the earlier you come in on Saturday, the earlier you get to leave.

 

[Siggy]

Overnight call isn't all bad.

Depends... At the hospital I did my TRI at, the night float team is still an active inpatient team. That team gets all of the overnight admits unless capped, so most of night float week you spend the nights doing admits and floor pages, and then in the morning try to get as much work done on your 10 patients (since by day 2 you're going to be capped) before leaving at 11am.

 

[Doctor Bagel]

Then why are my guys such d-bags when I call them for something at 2am? Sleeping on night float?

Ditto. I always felt like ours needed a stat mental health intervention because they sounded so miserable.

 

[Doctor Bagel]

Depends... At the hospital I did my TRI at, the night float team is still an active inpatient team. That team gets all of the overnight admits unless capped, so most of night float week you spend the nights doing admits and floor pages, and then in the morning try to get as much work done on your 10 patients (since by day 2 you're going to be capped) before leaving at 11am.

Sounds pretty miserable. I was actually implying (I guess not well) that the old system with overnight call in place of night float had some advantages that included more days off (often) and shorter work days when not on call. It seems like the norm for wards for medicine and peds is now six 12 hour days a week, which just plain sucks. Call broke up some of the monotony of those long, long repetitive days. A call system certainly sounds better than your night float system.

 

[Siggy]

Sounds pretty miserable. I was actually implying (I guess not well) that the old system with overnight call in place of night float had some advantages that included more days off (often) and shorter work days when not on call. It seems like the norm for wards for medicine and peds is now six 12 hour days a week, which just plain sucks. Call broke up some of the monotony of those long, long repetitive days. A call system certainly sounds better than your night float system.

Non-night float, non-call it's preround prior to morning report (8:30), round, do floor work, go home. Depending on the number of patients and number of rocks, it's possible to get out pretty early some days.

The only thing close to six 12 hour days are the hospitalist teams (who take admissions from 7am to 3pm every day and take some overflow patients). On occasion they get an off-service intern on a team that's normally attendings and sub-I students.

 

[Mass Effect]

Non-night float, non-call it's preround prior to morning report (8:30), round, do floor work, go home. Depending on the number of patients and number of rocks, it's possible to get out pretty early some days.

The only thing close to six 12 hour days are the hospitalist teams (who take admissions from 7am to 3pm every day and take some overflow patients). On occasion they get an off-service intern on a team that's normally attendings and sub-I students.

Yeah, that's definitely not how IM works at my place. It's pretty routinely 12 hour days 6 days a week.

 

[blebb]

This seems highly unlikely as radiology provides 24/7 coverage in the hospital. Surely that means somebody is working those weekends.

You guys really jumped on that sarcastic comment. In all seriousness in my program we dont work weekends during first year and do 6 or so per year after that. Hell of a lot better than most clinical specialties.

 

[blebb]

Then why are my guys such d-bags when I call them for something at 2am? Sleeping on night float?

Exactly. Stop waking us up. I thought ortho could do their own reads?

 

[Winged Scapula]

Overnight work in radiology is actually no big deal. ...and a significant lull period from 2-5 AM nearly everyday.

I take it you're not at a Level 1 Trauma Center? 2-5 am was prime time for trauma for us.

 

[Perrotfish]

Yeah, that's definitely not how IM works at my place. It's pretty routinely 12 hour days 6 days a week.

At my place its 12 plus sign out for 12.5 hours on most day shifts

Night float signs out multiple services for 13 hours a day minimum. You might notice that is almost exactly the work hour limit.

We have one ICU rotation that is a true 12: 11.5 + sign out. Its sad how relaxing it felt to get that extra half hour.

 

[Dr. USMLE]

I take it you're not at a Level 1 Trauma Center? 2-5 am was prime time for trauma for us.

Prime time for trauma here is 10pm to 2am (basically when people party) at my level 1 center.

Of course trauma still comes in from 2-5am and we are still busy, but the pace is very reasonable and allows for breaks.

 

[Winged Scapula]

Prime time for trauma here is 10pm to 2am (basically when people party) at my level 1 center.

Of course trauma still comes in from 2-5am and we are still busy, but the pace is very reasonable and allows for breaks.

Ah...we started getting it more frequently after the bars closed at 2 am.

 

[Radignator]

Overnight work in radiology is actually no big deal. In fact, I work fewer hours (<45 per week) on nightfloat than most people do during their routine daytime residency (in any field). That <45 hours also includes breaks for coffee, eating and a significant lull period from 2-5 AM nearly everyday.

At my hospital night float is significantly more brutal for radiology. It's 6 nights a week and the shifts are 12 hrs, plus an extra hour or so to quickly go over the studies with an attending in the morning.

 

[ThoracicGuy]

True, though I think you can officially conclude that you train at a bad program if they use technicalities like that to rob you of your day off.

And only 2 weeks of vacation? Where are these programs? My program gave 3, and it seemed like most places I interviewed at gave 4. Admittedly I'm in a cushy specialty, but vacation weeks are generally GME wide and applicable in all specialties. An additional week of educational leave is pretty typical as well.

As for golden weekends and whatnot, it depends on your program. I think with the 2011 duty hours changes, these are less frequent with the norm being more of 6 long days a week (which sucks). Overnight call isn't all bad.

With the new intern work hour rules, depending on the service, the 24 hours between an 8 am and 8 am or whichever is sometimes all you can work out. These restrictions, I feel, made intern life worse rather than better, at least in the surgical field. Hopefully the trial that is ongoing will show that the prior method is better than this current set of rules.

 

[rokshana]

Either this is not true or many programs use the caveat because, at least in my specialty, 6 weeks is the standard time off after having a baby without extending training at my program and many of the programs at which I interviewed. My program actually allows 8 weeks off for maternity/paternity leave without extending training.

again that is averaged over the course of your training..so if you are in a 3 year program, then you can take 12 weeks off and still be ok...actually every one is allowed 12 weeks off per FMLA but of course that potentially can cause you to extend training.

 

[Dr. USMLE]

.

 

[Doctor Bagel]

Agreed. Pre-2011 the DOMA (day off, my ass) was unusual and a likely sign of a malignant program.

Post-2011 it is very common (and sucks) in surgical residencies.

OK, so maybe I'm missing a cultural piece, and it's the norm for tougher specialties. I would guess it's a sign of a not so great program if it's happening in non-surgical fields.

 

[mvenus929]

OK, so maybe I'm missing a cultural piece, and it's the norm for tougher specialties. I would guess it's a sign of a not so great program if it's happening in non-surgical fields.

At my (Peds) program, our Chiefs do their best to give a calendar day off instead of just a 24 hour period, but on some of the rotations where staffing is tight, that 24 hour period may be the only way to actually get all 4 days off in a month. They don't do it frequently, and they will only count one of the 24 hour periods as a day off, but it does happen sometimes.

 

[GoSpursGo]

Similarly to mvenus, at my peds program most of our gen peds ward months and our ICU months have to include those 24 hour flip periods as "days off." It sucks. On the other hand, on most of our subspecialty months and electives, we get a couple of golden weekends.