Duke hours / relieved time

[thracefish]

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I lost some of my interview notes and things are starting to blur. Naturally the time you go home each day at any program varies by rotation, but most places provided some kind of "usually you'll be out by X".

For Duke, the aim is to get you out/relieved daily around 5pm. Does that sound right? (I almost feel like one of the residents told me 4:15, but again, things are blending together and that may have been another program).

While I'm thinking about it, here are some other go-home times. Any feedback or corroboration appreciated.

UAB: ~3pm
Mayo: ~4pm
Stanford: ~5-6pm (no set time/CRNA relief)
Wake: ~4pm
UT (San Antonio): ~3pm
MUSC: ~3pm

 

[Southpaw]

I lost some of my interview notes and things are starting to blur. Naturally the time you go home each day at any program varies by rotation, but most places provided some kind of "usually you'll be out by X".

For Duke, the aim is to get you out/relieved daily around 5pm. Does that sound right? (I almost feel like one of the residents told me 4:15, but again, things are blending together and that may have been another program).

While I'm thinking about it, here are some other go-home times. Any feedback or corroboration appreciated.

UAB: ~3pm
Mayo: ~4pm
Stanford: ~5-6pm (no set time/CRNA relief)
Wake: ~4pm
UT (San Antonio): ~3pm
MUSC: ~3pm

The fact that medical students care about this infuriates me. You will not work 80 hours in all likelihood at the large majority of respectable anesthesiology programs. So just go out there and find the best training program in a place that you think you'll enjoy working. Having X o'clock as the time when all CRNAs come in and all residents go home might make your quality of life a tiny bit better for a few years, but it also makes our specialty look terrible and it may mean you'll have no job years down the road.

 

[Laryngophed]

The fact that medical students care about this infuriates me. You will not work 80 hours in all likelihood at the large majority of respectable anesthesiology programs. So just go out there and find the best training program in a place that you think you'll enjoy working. Having X o'clock as the time when all CRNAs come in and all residents go home might make your quality of life a tiny bit better for a few years, but it also makes our specialty look terrible and it may mean you'll have no job years down the road.

I can understand why someone would be concerned about it. There are people who want to practice anesthesiology for the hours and call commitment, not the practice itself. For me personally, I wouldn't care about getting out by '0x00' every day, but it would be nice to know that on didactic days that CRNA relief is coming so you can attend those lectures.

But watching the clock so you can be sure to get out at 1545 everyday instead of worrying about adequate training isn't something I'd be concerned about.

 

[Southpaw]

I can understand why someone would be concerned about it. There are people who want to practice anesthesiology for the hours and call commitment, not the practice itself. For me personally, I wouldn't care about getting out by '0x00' every day, but it would be nice to know that on didactic days that CRNA relief is coming so you can attend those lectures.

But watching the clock so you can be sure to get out at 1545 everyday instead of worrying about adequate training isn't something I'd be concerned about.

You're right, there are lots of people in our specialty for the wrong reasons. And we don't do ourselves a favor by applauding programs that get all residents home by X o'clock.

I understand your concern, and it's valid, and it's a great question to ask during your interview. However, again I strongly believe that most solid programs have a well organized system for getting residents out for didactics. If they didn't, they wouldn't be a 'solid program'.

 

[Laryngophed]

You're right, there are lots of people in our specialty for the wrong reasons. And we don't do ourselves a favor by applauding programs that get all residents home by X o'clock.

I understand your concern, and it's valid, and it's a great question to ask during your interview. However, again I strongly believe that most solid programs have a well organized system for getting residents out for didactics. If they didn't, they wouldn't be a 'solid program'.

I agree that the good programs are good for a reason, but I think that asking that question will help to further resolve whether or not you are there to solely be a workhorse or to be educated. I would imagine that at the really good programs, the distinction is clear for the word "go." And that also isn't to say that being at a workhorse program is a bad thing. I'm sure there are a lot of people who really benefit from bedside learning more so than didactics. But it could certainly be a launching point for discussion of the programs philosophy on education.

Me personally, I think I need a good mix of didactics and bedside learning. And I went to medical school to learn to be a doctor and my view of how my career will go is one that isn't consistently bound by a stop time in the afternoon. I see those few years of residency for what I think they are, my last (and very numbered) batch of protected learning time. They needed to be milked for all they are worth.

 

[thracefish]

Don't worry, it's not the primary factor. This reminds me of the managers mentioned in a recent HBR post that felt employees that stayed at work longer were more dedicated and more responsible (passive face time = hard-working, regardless of actual productivity). The same post mentioned the "crazy" 50-60 hr weeks people often work in industry. While people in business strive to maintain the 40-hr week, I know I'm entering a field where I'll probably never see hours like that, and that's fine with me.

I need a lot of training to be where I want to be professionally, and that's going to take hours and effort on my part. Part of that is learning on my own, so if a program is well-managed and can get me home at 4 rather than 5 or some indeterminate time, it's worth considering. Learning's fine, but being stuck in a chair doing something routine to close out another case isn't ideal.

 

[PonyUp]

I lost some of my interview notes and things are starting to blur. Naturally the time you go home each day at any program varies by rotation, but most places provided some kind of "usually you'll be out by X".

For Duke, the aim is to get you out/relieved daily around 5pm. Does that sound right? (I almost feel like one of the residents told me 4:15, but again, things are blending together and that may have been another program).

While I'm thinking about it, here are some other go-home times. Any feedback or corroboration appreciated.

UAB: ~3pm
Mayo: ~4pm
Stanford: ~5-6pm (no set time/CRNA relief)
Wake: ~4pm
UT (San Antonio): ~3pm
MUSC: ~3pm

Didactics can only teach you so much... you learn by doing cases and more specifically finishing your own cases. With the exception of UAB [or UPMC which you didnt list] where you are expected to use that time to get an MBA, MPH or moonlight [as in, you're seeing cases after 3 and getting experience], there better be a damn good reason they're letting you out early.

Don't get me wrong, I don't believe that one must be miserable and over-worked to graduate as a competent resident, but I'm trying to avoid matching to a program that attracts clock-watching stool-sitters. The reputation of any given program hinges on the work ethic of their laziest resident - in a way - a chain is only as strong as its weakest link.

I know that your original intent was not to appear lazy, but unless you're a single parent with a special needs child or some other aberration that requires you're out the door at 3 everyday, I would focus on the details of a program that matter.

 

[Doctor4Life1769]

lol @ this thread and all the responses generated.

 

[Laryngophed]

lol @ non-substantive responses

 

[Agast]

They can aim to get you out all they want, but you shouldn't be surprised when they misfire. There's no such thing as "oh we can't book your case, we have to send our residents home" if they need a warm body in a room. I wouldn't factor that into your rank list because it's in the program's best interest to lie about how successful they are at sending you home by 4pm.

 

[imfrankie]

This is part of the reason many surgeons have little respect for anesthesiologists. You want to be dispensable.

 

[Noegrus]

This is part of the reason many surgeons have little respect for anesthesiologists. You want to be dispensable.

This. Ladies and gentlemen. Wise words.

 

[Laryngophed]

This is part of the reason many surgeons have little respect for anesthesiologists. You want to be dispensable.

Oddly enough, I heard these words come straight from the mouth of a surgeon. Needless to say, he doesn't have a lot of respect for clock watching.

 

[foley12]

Oddly enough, I heard these words come straight from the mouth of a surgeon. Needless to say, he doesn't have a lot of respect for clock watching.

Please. The surgeon eats what he kills, If he was salaried (like many anesthesiologist's) you had better believe that he'd be watching the clock.

 

[thracefish]

it's in the program's best interest to lie about how successful they are at sending you home by 4pm.

Thanks, I'm sure this happens and it's one of the reasons I wanted to hear others' experiences.

This is part of the reason many surgeons have little respect for anesthesiologists. You want to be dispensable.

I want to be indispensable while I'm there, not only because I'm there.

Residents I met while interviewing didn't mind volunteering their typical schedule (in addition to whatever the program might have to say about it). It seemed to matter to them - maybe they're not well-represented here.

A couple of the programs listed above are at least somewhat respectable. Assuming they can train competent anesthesiologists, I'd be interested in the one that does it and leaves residents with an extra hour most days. There's only so much you can plan for in surgery, granted, but some places seem to squander the time they are able to manage, turning one-hour tasks into two-hour ones

 

[Laryngophed]

Please. The surgeon eats what he kills, If he was salaried (like many anesthesiologist's) you had better believe that he'd be watching the clock.

I am pretty sure this surgeon is salaried.

 

[imfrankie]

Please. The surgeon eats what he kills, If he was salaried (like many anesthesiologist's) you had better believe that he'd be watching the clock.

Maybe I've not been doing this long enough, but I've never seen a second surgeon (nor NP) come relieve the first at 4 pm.