Do i have the wrong intepretation of ''on call''

[TooMuchResearch]

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So let's assume that you're on call on Monday. You get to the hospital at 5am as you proposed and stay until 12pm the next day. That means by Tuesday afternoon, you've worked 31 hours. Now, after working 5am - 5pm on Wednesday, as proposed, you will have worked 43 hours. So between thursday, friday, saturday and sunday, you can only work 37 hours. Correct? that means an average of just over 9 hours/day for the rest of the week (less than the "normal" 12hr shift you referenced)... So, I have to assume that under the type of schedule you're talking about, a resident would only be required to work 6 days per week and have one day entirely off, right?

Just trying to get my bearings here. Thanks so much.

Maybe I should leave this to the residents (or at least med students), but it seems I'm going to give it a shot anyway. The 80 hour per week rule is actually 80 hours per week averaged out over four weeks, so a resident might work more than 80 hours any given week. Of course, the interns I know work 100+ hour weeks pretty much every week...they do paperwork after officially signing out for the day.

 

[Law2Doc]

Maybe I should leave this to the residents (or at least med students), but it seems I'm going to give it a shot anyway. The 80 hour per week rule is actually 80 hours per week averaged out over four weeks, so a resident might work more than 80 hours any given week. Of course, the interns I know work 100+ hour weeks pretty much every week...they do paperwork after officially signing out for the day.

Right -- you aren't stuck at the 80 hour limit in a given week, just on average. And you technically aren't supposed to be there more than 30 hours in a row. Both of these rules are more theory than practice. All hospitals give lip service that they want residents to leave at X time each non-call day, and Y time each post-call day to the hospital stays within compliance. But at the same time since residents are both evaluated for getting their work done, are subject to pimping by attendings on all their patients, and also want to be around to see the cool cases, there is an incentive on the part of the resident to deflate their hours. Residents will thus "sign in" and "sign out" at designated times within the 80 hour limitation, but there isn't great policing to keep residents from coming in early or staying on after sign out if they aren't done with their work, and pretty significant incentive (self preservation) to fudge. So places are still working on this. It won't be the program or attendings making you stay beyond the 80 hour limitation for the most part, but it would be a lie to suggest that residents in all fields are staying in compliance. I don't think there's a rule about what residents can do at home, so certainly there will be plenty of people still doing paperwork, dictations, and remotely doing patient orders even after they go home.

As mentioned above there is no 80 hour limitation for med students. So there's nothing to stop a resident from asking a med student to pre-round before the resident gets in in the morning, and to take care of things after the resident leaves for the day. This is unusual, but not against the rules so there are people who have experienced this.

 

[Law2Doc]

...

But yes, most residents have one day a week off on average.

I would qualify this and say they more often get 4 days off a month on average. There will be weeks when you don't get a day off and weeks where you may get two.

 

[MagicDrumSticks]

This thread highly.. I repeat, HIGHLY makes me doubt that all you guys working these sleepless nights and 100 hour weeks are doing it because you like it or want to "help people"


Don't even try to glorify the profession because this is what it's become, why the hell else would someone want to suffer so much?

 

[majahops]

I've read this 5 times and I'm still lost. What are you saying here?

This thread highly.. I repeat, HIGHLY makes me doubt that all you guys working these sleepless nights and 100 hour weeks are doing it mainly for the pay.


Don't even try to glorify the profession because this is what it's become, why the hell else would someone want to suffer so much?

 

[BlueElmo]

I've read this 5 times and I'm still lost. What are you saying here?

Confused as well.

 

[stayclassy]

this thread is great. I am legitimately excited to challenge myself physically and emotionally during residency

 

[majahops]

I share your enthusiasm, but it's mixed with skepticism. Skepticism because I, for one, KNOW that I perform substantially worse in every respect if I'm working on less than 6 hours of uninterrupted sleep.

this thread is great. I am legitimately excited to challenge myself physically and emotionally during residency

 

[MagicDrumSticks]

I've read this 5 times and I'm still lost. What are you saying here?

My fault! I wasn't thinking straight

 

[majahops]

I get the first sentence, but still don't completely get what you're trying to say in the second one.

I'm choosing this profession because it gives me the best balance of intrinsic and extrinsic rewards. It's a profession in which I will be able to:

(a) reach out and establish meaningful connections with other human beings daily

(b) be cognitively stimulated and challenged both in training and practice

(c) make enough money to be able to raise my children and get them the braces they need and send them to college, without having to take out a second mortgage

and

(d) will get to make the study of human health and disease (currently my hobby) into my occupation, which to me in analogous in awesomeness to a street baller going to the NBA

There are other reasons, but I assume that these 4 (or at least 3/4 for each person) are pretty universal across the board for people who are secure in their decisions to go into medicine. No?

I should note, however, that I am in no way excited about the long, [literally] exhausting hours required in residency. If they make me a stronger doctor, then the challenge should be worth it. But if I don't come out of the experience believing that the sacrifice made me a better doctor than I would have been with reasonably sane working hours, then yeah, I expect I will be a tad bit bitter and jaded. But I think anticipating that is healthier than realizing it out of the blue when I'm entrenched in residency.

This thread highly.. I repeat, HIGHLY makes me doubt that all you guys working these sleepless nights and 100 hour weeks are doing it because you like it or want to "help people"


Don't even try to glorify the profession because this is what it's become, why the hell else would someone want to suffer so much?

 

[Law2Doc]

This thread highly.. I repeat, HIGHLY makes me doubt that all you guys working these sleepless nights and 100 hour weeks are doing it because you like it or want to "help people"


Don't even try to glorify the profession because this is what it's become, why the hell else would someone want to suffer so much?

You don't pick a field to "help people". You don't pick a field for the money. Those are happy fringe benefits if you can get them.
You pick a field because, after researching many options, you decide it's what you want to do for a living -- something you will enjoy, find interesting, and not hate going in each morning. In truth, your focus on "helping people" (something you can do in a 1000 other jobs) as the end all be all is misplaced IMHO.

As the prior poster suggests, you don't relish the long hours, you do it because it's part of the deal -- it's how you cram the most learning into the shortest period of time. If you are in the hospital most of the time, you see more.