Duty hours don't mean ****

[IRorBustguy]

Currently an intern at a general surgery program. The faculty are great, the chiefs are more than fair, and my co-residents are for the most part awesome. Couple of odd eggs, but that's at any program.

Unfortunately, logging duty hours is a complete farce, and everyone is complicit in turning a blind eye. Let me tell you about my ACTUAL DAY:
1) Wake up at 4:30/5 ---> shower --> hospital at 5:30, pre-round --> work --> home 7:30 on a good day. There will be atleast 1-2 days where I am there until 9 or later. So on average, that's 14 hours x 5 = 70 (MINIMUM).
2) We have to come in on the weekend and round atleast 1 day a week. I could either a) wake up around 3:30 to come in around 4 and prewrite my notes --> round 6 - 7 --> orders, notes, signout --> out by 10AM = 6 hours.
So right there, that is 76 hours MINIMUM.
3) We also have to take call 1-2x a week. Friday call, tack on another 15 hours to the "minimum" 70 hours = 85 (12 hours additional + you are rounding on your patients the next day). Saturday call, tack on 28 hours = 98 hours.
4) Duty hours is based on the average of 14 days ---> so AT MINUMUM, you are working average 79 hours a week IF YOU TAKE FRIDAY call. Calls are split 50/50 friday/saturday.

Imagine that...if you work absolutely minimum and only take friday call, you still log 79 hours a week. How often do you think we work the minimum required hours? In the past 4 months I've been here, not even once.

So how do people end up logging their hours? M-F 6-6PM + call days. Literally everyone logs it this way, even though it is completely a lie. What happens if you log accurately? I got an email from the program coordinator informing me that violating duty hours is a serious offense and that I should look over my log to make sure I am logging accurately. Lets say I stay headstrong..what happens next?
1) Chiefs get notified.
2) PD gets notified
3) PD probably has a word with the Chief
4) Chief and everyone else gets pissed off (especially if they end up having to cover for you) ---> you look like the trouble maker here.

Lastly, I am a prelim going into an advanced program. If logging duty hours puts me on bad terms with the PD and residents, I am already on extremely thin ice. If I get fired, there goes my advanced position and career.

So in summary, I have 0 leverage and absolutely everything to lose if I log accurately. Lastly, I realize I may be bitching, but the PGY2's and 3s in surg absolutely work past the 80 hours on a weekly basis given that they have to take consults AND operate. They've just given up on logging hours accurately and acknowledge that it is part of residency.

If the ACGME really wants to enforce duty hours, they should have residents clock in and out digitally. None of this manual logging bull****. Otherwise, the program has 0 incentive to ensure adequate staffing and ensure duty hours are protected. Sorry for the rant, just a little jaded at the moment.

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[LucidSplash]

This is probably not the place to seek sympathy on this issue.

 

[evilbooyaa]

Leave it in the ACGME survey at the end of the year that you were frequently asked to underlog your hours. If the program isn't serious about making sure duty hour violations aren't enforced, have the ACGME come down on them.

If you're going to make waves, I'd do it after you're out the door and comfortably at your advanced program, and still keep it anonymous.

 

[sinombre]

It could be worse, you could have to get to the hospital a couple of hours earlier. If I actually want to be thorough I have to get to the hospital at 3:30-4:00 each day. Waking up at 3am is probably the only thing I really dislike about residency so far. But yeah, I think I've only actually gone under 80 hours a week two times since July. I probably average 90 hours a week.

 

[balaguru]

Duty hour restrictions were established in 2003. If your program has not staffed services to be duty hour compliant by now they are either lazy or incompetent.

 

[TypeADissection]

Our program used to be notorious for work hour violations, but nobody here complained about it because this is exactly what we signed up for. It was a disgruntled prelim that said some things on a survey that incited a review by RRC. Long story short, we've since had major overhauls to our program towards the end of my 3rd year by instituting a night float system. Since then, we've had zero violations because the way we set things up, it's hard to go over. And before that, we were all top to bottom pulling 90-110 hours a week.

On one hand that's been a great thing. It's nice to get out of the hospital at a reasonable time and go to the gym, spend time with family and read/prepare for cases without feeling completely exhausted. On the other hand, as administrative chief, sometimes in a blue moon I have to place someone on q2 call (ex. Thurs-Sat) and it leads to some complaints. Every generation will claim that they've had it worse, and in many many ways, the previous generations truly did. However, there's a part of me that is concerned that this mindset of working "only" 80 hours a week will not prepare some of us for what awaits in the real world as attendings. Maybe I'm still too old school and maybe I'm part of the problem, and this is coming from a guy that loves spending time with his family and trying to keep the dad bod at bay. Confession: it's not going very well.

In regards to the OP, it sucks at times being an intern. You're tasked to do a lot of the busy work that keeps the services moving. It's not glorious. You're yearning for more operative time, but it's part of the process. It should teach you to be efficient and one day allow you to run a service because you understand all of the nitty gritty logistics to have appropriate dispo for your patients. Remember this, it'll never be easier than when you were an intern. All of this shall pass. Cheers.

 

[doc05]

Also keep in mind that as an intern you are probably very inefficient at everything. There's no reason to be in the hospital till 9pm unless you are in the OR. And since you're a prelim intern, you're not.

 

[Jolie South]

I logged accurately all the time as a prelim intern. Didn’t give AF. I might be going against the old guard but there really is no reason to work 100 hours a week especially if you are only doing floor work.

However, my program in residency from second year onward, I rarely broke unless I needed to stay to operate on someone really sick after call.

Juniors rarely went over and if they did seniors were encouraged to go over what was causing the overages. As someone else said, it’s inefficiency a lot of the time.

 

[vhawk]

It could be worse, you could have to get to the hospital a couple of hours earlier. If I actually want to be thorough I have to get to the hospital at 3:30-4:00 each day. Waking up at 3am is probably the only thing I really dislike about residency so far. But yeah, I think I've only actually gone under 80 hours a week two times since July. I probably average 90 hours a week.

This is a genuine question even though it may sound a little snarky, but if we want to be "fair" in a global sense, should you be logging the hours it ACTUALLY takes you to get your work done, or should you be logging the hours that, say, an average resident would take to get that work done? Obviously there is a range of efficiency for surgery residents but it doesn't seem correct to punish the other residents in the program if one resident takes longer to get things done.

I admittedly did not take work hours particularly seriously when I was in training, mostly because I find them to be extremely offensive and condescending, but to the extent that I did I mostly just logged the time I was actually REQUIRED to be there, not the time I spent doing work on my own time. Finishing up clinic noted, staying over to double scrub cases, etc. If an ideal resident wouldn't have logged those hours I wasn't willing to punish my program and co residents for my imperfections.

 

[vhawk]

Duty hour restrictions were established in 2003. If your program has not staffed services to be duty hour compliant by now they are either lazy or incompetent.

It would seem relevant whether the OP is uniquely exceeding hours or if it's a systemic problem. He implies the latter but is unlikely to have the perspective to notice.

But yeah as a general point I'd agree. The alternative is that they have had 14 years worth of residents who managed to not make duty hours enough of a problem that it required any sort of top down intervention. There are several programs like this.

 

[armybound]

I was also told to stop reporting my hours as-worked. I was sat down by the APD who told me that prelim interns are always causing problems with logging hours and to knock it off.

Oh well. It happens.

 

[mikeGR]

For better or for worse, the 80hr week is here to stay. Any prelim or categorical resident can file a complaint to the RRC anonymously, or just indicate the hour violations at the end-of-year survey. The programs that are still dishonest may continue for some time without being noticed, but eventually everyone will have to comply.

I agree with most of the comments above regarding efficiency, but that shouldn't make people consistently stay over 80hrs in 2017. Nowadays there are ways for hospital and services to be more efficient and reduce scut, including getting EMR and hiring APPs. If it has to take placing a program in probation to get there, so be it.

On the other hand, I have seen that the culture of some prelim interns, especially those with advanced positions who failed to match a transitional or medicine prelim, is to avoid doing too much work. Some interns literally logged minutes of work at a time (i.e. arrived at the hospital at 5:25, left at 6:35), which to many may sound ridiculous. Or, log the time they left home and got back home instead of actual work hours. Others take breaks during the day (breakfast, lunch, dinner, etc), which may contribute to them staying late. Should those be logged as work hours? Where do we draw the line?

To the OP: If the culture of the residency is that everyone is violating hours and they encouraged you to log dishonestly, then regardless of other factors, I would probably indicate it at the end of year survey. But in the meanwhile try to maximize your efficiency.

 

[vhawk]

I don't know how anyone could genuinely interpret the rules as how many hours you "should" work in an ideal world. That's a lot of intellectual twisting and turning for a pretty straightforward concept. Work hours = hours actually worked.

Further, the ACGME actually goes so far as to say it is the program's responsibility to make schedules reasonable, not the responsibility of the intern to be "efficient":

Clinically-Driven Standards | ACGME Common Program Requirements

I wasn't asking about the letter of the law, I fully understand that. I'm asking about what an adult should do.

Their statement doesn't really address what im asking though unless you take "reasonable" to mean "lowest common denominator." There is wide variability in intern efficiency. Any "reasonable" workload estimate will price out some laggards.

 

[RadOncDoc21]

I wasn't asking about the letter of the law, I fully understand that. I'm asking about what an adult should do.

Their statement doesn't really address what im asking though unless you take "reasonable" to mean "lowest common denominator." There is wide variability in intern efficiency. Any "reasonable" workload estimate will price out some laggards.

I reported my actual hrs once. I had to meet with the PD on my day off. Let’s just say I never “violated” duty hrs again.

 

[Psai]

I never understood why there was so much focus on this arbitrary number of hours worked. I just put whatever because I have better things to do than remember exactly when I left the hospital.

 

[deleted497653]

Are you complaining or what question are you trying to get answered here?

You should be doing whatever you can to learn as much as you can during residency including putting in the time. If working more than 80 hours occasionally is not something you’re willing to do, then quit. Nobody can guarantee 80 hr work week realistically unless it’s just a really chill program. And if that’s what you want, there is nothing wrong with that either but it might be hard to find (in your case, you should just be trying to finish and move on to your categorical program).

 

[pathslides]

Currently an intern at a general surgery program. The faculty are great, the chiefs are more than fair, and my co-residents are for the most part awesome. Couple of odd eggs, but that's at any program.

Unfortunately, logging duty hours is a complete farce, and everyone is complicit in turning a blind eye. Let me tell you about my ACTUAL DAY:
1) Wake up at 4:30/5 ---> shower --> hospital at 5:30, pre-round --> work --> home 7:30 on a good day. There will be atleast 1-2 days where I am there until 9 or later. So on average, that's 14 hours x 5 = 70 (MINIMUM).
2) We have to come in on the weekend and round atleast 1 day a week. I could either a) wake up around 3:30 to come in around 4 and prewrite my notes --> round 6 - 7 --> orders, notes, signout --> out by 10AM = 6 hours.
So right there, that is 76 hours MINIMUM.
3) We also have to take call 1-2x a week. Friday call, tack on another 15 hours to the "minimum" 70 hours = 85 (12 hours additional + you are rounding on your patients the next day). Saturday call, tack on 28 hours = 98 hours.
4) Duty hours is based on the average of 14 days ---> so AT MINUMUM, you are working average 79 hours a week IF YOU TAKE FRIDAY call. Calls are split 50/50 friday/saturday.

Imagine that...if you work absolutely minimum and only take friday call, you still log 79 hours a week. How often do you think we work the minimum required hours? In the past 4 months I've been here, not even once.

So how do people end up logging their hours? M-F 6-6PM + call days. Literally everyone logs it this way, even though it is completely a lie. What happens if you log accurately? I got an email from the program coordinator informing me that violating duty hours is a serious offense and that I should look over my log to make sure I am logging accurately. Lets say I stay headstrong..what happens next?
1) Chiefs get notified.
2) PD gets notified
3) PD probably has a word with the Chief
4) Chief and everyone else gets pissed off (especially if they end up having to cover for you) ---> you look like the trouble maker here.

Lastly, I am a prelim going into an advanced program. If logging duty hours puts me on bad terms with the PD and residents, I am already on extremely thin ice. If I get fired, there goes my advanced position and career.

So in summary, I have 0 leverage and absolutely everything to lose if I log accurately. Lastly, I realize I may be bitching, but the PGY2's and 3s in surg absolutely work past the 80 hours on a weekly basis given that they have to take consults AND operate. They've just given up on logging hours accurately and acknowledge that it is part of residency.

If the ACGME really wants to enforce duty hours, they should have residents clock in and out digitally. None of this manual logging bull****. Otherwise, the program has 0 incentive to ensure adequate staffing and ensure duty hours are protected. Sorry for the rant, just a little jaded at the moment.

Dang dude. That is intense. If I had worked more than 60 hours a week in residency/fellowship in my field, that was a horrible/cruel week. I don't know how you peeps do this. Props.

 

[Thanatos]

Currently an intern at a general surgery program. The faculty are great, the chiefs are more than fair, and my co-residents are for the most part awesome. Couple of odd eggs, but that's at any program.

Unfortunately, logging duty hours is a complete farce, and everyone is complicit in turning a blind eye. Let me tell you about my ACTUAL DAY:
1) Wake up at 4:30/5 ---> shower --> hospital at 5:30, pre-round --> work --> home 7:30 on a good day. There will be atleast 1-2 days where I am there until 9 or later. So on average, that's 14 hours x 5 = 70 (MINIMUM).
2) We have to come in on the weekend and round atleast 1 day a week. I could either a) wake up around 3:30 to come in around 4 and prewrite my notes --> round 6 - 7 --> orders, notes, signout --> out by 10AM = 6 hours.
So right there, that is 76 hours MINIMUM.
3) We also have to take call 1-2x a week. Friday call, tack on another 15 hours to the "minimum" 70 hours = 85 (12 hours additional + you are rounding on your patients the next day). Saturday call, tack on 28 hours = 98 hours.
4) Duty hours is based on the average of 14 days ---> so AT MINUMUM, you are working average 79 hours a week IF YOU TAKE FRIDAY call. Calls are split 50/50 friday/saturday.

Imagine that...if you work absolutely minimum and only take friday call, you still log 79 hours a week. How often do you think we work the minimum required hours? In the past 4 months I've been here, not even once.

So how do people end up logging their hours? M-F 6-6PM + call days. Literally everyone logs it this way, even though it is completely a lie. What happens if you log accurately? I got an email from the program coordinator informing me that violating duty hours is a serious offense and that I should look over my log to make sure I am logging accurately. Lets say I stay headstrong..what happens next?
1) Chiefs get notified.
2) PD gets notified
3) PD probably has a word with the Chief
4) Chief and everyone else gets pissed off (especially if they end up having to cover for you) ---> you look like the trouble maker here.

Lastly, I am a prelim going into an advanced program. If logging duty hours puts me on bad terms with the PD and residents, I am already on extremely thin ice. If I get fired, there goes my advanced position and career.

So in summary, I have 0 leverage and absolutely everything to lose if I log accurately. Lastly, I realize I may be bitching, but the PGY2's and 3s in surg absolutely work past the 80 hours on a weekly basis given that they have to take consults AND operate. They've just given up on logging hours accurately and acknowledge that it is part of residency.

If the ACGME really wants to enforce duty hours, they should have residents clock in and out digitally. None of this manual logging bull****. Otherwise, the program has 0 incentive to ensure adequate staffing and ensure duty hours are protected. Sorry for the rant, just a little jaded at the moment.

This is always one of my favorite topics, i usually can't resist chiming in. I always took the duty hours for what they were, arbitrary rules made by random people (who probably don't even practice medicine anymore) without any evidence that they help anyone or anything. I'm comfortable saying that I lied my ass off for years and years logging hours and i'm okay with it. I also speed, jaywalk, steal coffee from cardiology and lie to people regularly (no I don't mind the room delay, that looks great on you, thanks anesthesia for all your help today, call me anytime if you have any questions i don't mind at all, i don't think your sister is annoying OR really attractive, i'm really glad we got the prelim intern home before it got busy, i love christmas music turn it up, yes i floss regularly and not just on the way to my dental appointment today). I'm just saying that i probably have some character flaws that makes this easy for me. Maybe that makes me part of the problem, and if only I cared with all my cold shriveled heart I could make the world a better sub 80 hour work week kind of place. But in the end I just don't believe in the magic 80.....for the record I don't think we should all work every minute of every week and I do think we should be able to take time for our families and etc, I just don't think there's anything special about 79, 80 or 81 hours a week that makes those things possible. At least not enough to shut down a program over and alter peoples entire careers.

In the end I've always just thought that if X= amount of work to be done and Y= amount of work that can be done by people available, that X will always be far greater than Y. That's just surgery. Attendings don't have hours rules, and somehow that's okay. I'm glad the first time i stay up all night doing some monster case won't be as an attending, i've been doing it for years already.

The one place I think we can all sympathize, and this usually applies to interns, is if you have a program that won't staff services appropriately and you get stuck doing 80+ hours of scut. Sometimes a simple stroke of a pen could solve some of that misery, and they're usually aware of this but don't want to spend the money or whatever. Then by all means bag them on the survey, although I can tell you from considerable personal experience that whatever you put on there won't make too much of a difference.

That being said, even if its scut or poor service staffing or whatever that's causing you to violate the magic 80 you're still the doctor in charge of caring for these patients, and X is still greater than Y. Some weeks will be better than others, some weeks you'll go over the line but in the end someone has to do all the work.

 

[vhawk]

So I get that it is a cliche thing to say that "there is no such thing as scut" and that until you have mastered it, everything is a learning experience. I did and still do believe that to some extent, at least I believe that much of what residents complain about as "scut" is really just "things that I will need to learn how to do and that have educational value but that I just dont find interesting or sexy."

But now that I'm a few months into being an attending, I think there is even a further educational benefit to getting stuck doing all that "scut" in your residency years.


A ****ING TON OF WHAT I DO EVERY ****ING DAY IS SCUT.

If my residency training had fostered in me the idea that I am "above" scut work and that I do not need to do it, that all that I should be focusing on is operating and making critical decisions and helping patients and learning about surgery....I think I'd have lost my mind by now.

 

[DoctwoB]

Count me among those that don’t log hours accurately. I’m generally reasonably compliant with hours and always compliant with days off, though here are definitely rotations when I went over. In a program with a ton of home call though, duty hours don’t mean all that much.

Our GME system is so inflexible that even things that aren’t violations (e.g not having a day off one week even when it averages out to one day a week over 4 weeks, which is complaint) raise flags that get program directors called, which leads to emails being sent asking what the issue is, which leads to more work and hassle for me that just isn’t worth it. I’m reasonably happy that my program is complying with the intent, if not always the letter of the work hour restrictions and it’s a heck of a lot easier to just let it go.

 

[akwho]

Duty hours don't mean anything in surgery you're right. Count me in the group of surgeons who think duty hours shouldn't exist.

Patient care first, everything else after.

Who cares what hours you log, that's literally the 99th most important thing every day. Focus on being more efficient and your hours will take care of themselves.

 

[SLUser11]

Duty hours don't mean anything in surgery you're right. Count me in the group of surgeons who think duty hours shouldn't exist.

Patient care first, everything else after.

Who cares what hours you log, that's literally the 99th most important thing every day. Focus on being more efficient and your hours will take care of themselves.

As a community, surgeons and residents are not very good at governing themselves, i.e. if there were no rules, they would rarely or never have the self-awareness to say, "I have to go home, I've worked too much." Therefore, I'm not sure that a "patient care first" mentality is necessarily attached to limitless work hours.

Certainly compliance varies, but in general having some regulation on resident work hours has been beneficial to resident well-being, and it has not been significantly detrimental to their education. Grey-hairs will complain about today's product when they compare to how great they THOUGHT they were when they finished, but there are several other factors that contribute to this: Your Thoughts...

 

[deleted804629]

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[IRorBustguy]

Duty hours don't mean anything in surgery you're right. Count me in the group of surgeons who think duty hours shouldn't exist.

Patient care first, everything else after.

Who cares what hours you log, that's literally the 99th most important thing every day. Focus on being more efficient and your hours will take care of themselves.

It's this holier-than-thou mentality that really irks me. You're right. Patient care first. Hell, I would work 100 hours a week if it was straight clinical and I felt like my patients would suffer if I didn't work as hard. The problem is I spend what feels like 90% of my day doing scut work. Work that I feel could be done by mid-levels and allied health staff like social workers, etc. The other surgical specialties seem to have figured this out to some extent. For example my Ortho/ENT/CT-surg colleagues work equally long hours, but a spend a disproportionately higher % of time operating or in clinic. Those departments also employ and efficiently utilize mid-levels. I wonder why those residents also seem more satisfied with their day to day?

I respect the work ethic and commitment to clinical care that you have, but I would appreciate a bit of that dedicated towards improving the quality of resident work.

 

[akwho]

It's this holier-than-thou mentality that really irks me. You're right. Patient care first. Hell, I would work 100 hours a week if it was straight clinical and I felt like my patients would suffer if I didn't work as hard. The problem is I spend what feels like 90% of my day doing scut work. Work that I feel could be done by mid-levels and allied health staff like social workers, etc. The other surgical specialties seem to have figured this out to some extent. For example my Ortho/ENT/CT-surg colleagues work equally long hours, but a spend a disproportionately higher % of time operating or in clinic. Those departments also employ and efficiently utilize mid-levels. I wonder why those residents also seem more satisfied with their day to day?

I respect the work ethic and commitment to clinical care that you have, but I would appreciate a bit of that dedicated towards improving the quality of resident work.

It's not a holier than thou mentality. It's an acknowledgement that we as surgeons aren't shift workers and we stay until the work is done. That means some days we go home late.

I'm all for residents fighting for more mid-level support with scut work. I'm in a county system and have done more than my fair share of scut work and absolutely agree with you on that point.

 

[IRorBustguy]

It's an acknowledgement that we as surgeons aren't shift workers and we stay until the work is done.

I think if you are a good clinician, this point holds true for whatever field, regardless of speciality, so I agree with you 100% and my mindset is relatively the same.

However, I would argue that if the work is largely non-clinical, it shouldn't fall on the intern to get it done. Too often I feel my program relying on interns as sources of cheap labor for relatively unskilled things, which really frustrates me.

 

[SLUser11]

I think if you are a good clinician, this point holds true for whatever field, regardless of speciality, so I agree with you 100% and my mindset is relatively the same.

However, I would argue that if the work is largely non-clinical, it shouldn't fall on the intern to get it done. Too often I feel my program relying on interns as sources of cheap labor for relatively unskilled things, which really frustrates me.

I don't disagree with you, as I believe all members of the team should carry their weight with the less educational tasks.

To frame it better, could you create a list of the tasks that you classify as "non-clinical," and what percentage of your time is spent doing these tasks? I think we all agree interns shouldn't be used as "cheap labor" but I prefer specifics.

 

[STATGJ]

Is it a farce? Yes

Were you being naive to assume people followed the 80 hour work week? Yes

Is it your own fault for not fully understanding what was involved in surgical training? Yes

The good news is that it's only a year. My concern is whether your type of personality will ultimately be happy as an IR attending. The hours can be brutal, especially in high end practices. You really need to be honest with yourself before you end up in a specialty that makes you miserable.

Good luck.

 

[filter07]

FWIW I lied every single timesheet every year for 7 years. Logging hours accurately was a massive waste of my limited free time. I'm not saying I worked 100 hrs a week. I probably did 85-90 on the busier rotations and 75 on the lighter ones, which averages out to 80ish. That's good enough for me. Now if I was pulling 95-100 regularly I would have been more inclined to report that, but there were only a few rotations in 7 years where I thought things were outright abusive or the work hours were egregious. I mean, I could have easily done 80 hours a week but I'd be an uncaring douche that piles work on for other people. Gotta learn to play in the sandbox.

I really do empathize with the interns though. They are all told massive lies during interviews about how everyone hangs out and drinks beer all the time after work, operate a ton, and have great work-life balance. We should all be more honest with the trainees and let them know that surgery is hard, surgery is demanding, surgery is humbling, and it will challenge your endurance/perseverance/strength. Instead we make it seem like a joining a cool frat. That is one thing that always irritated the hell out of me during training, and it disgusted me how we all used to lie through our teeth to the M4s when what they really should be doing is peds.

 

[rock1234]

Exactly in the same situation. Doing a surg prelim before radiology and I hate it. My duty hours are more >100h per week... 100h at best. I log 5am-6pm instead... What's worse really is the mentality of the program and surgeons. Can't wait to be done.

 

[rock1234]

Agreed. Everything I was told during interviews at my current program unfortunately was a big lie. When I started and asked about the things they had promised the senionrs just laughed and said "That's what they say every year..."

 

[rock1234]

I think if you are a good clinician, this point holds true for whatever field, regardless of speciality, so I agree with you 100% and my mindset is relatively the same.

However, I would argue that if the work is largely non-clinical, it shouldn't fall on the intern to get it done. Too often I feel my program relying on interns as sources of cheap labor for relatively unskilled things, which really frustrates me.

Hate it so much. I'm a transporter, phlebotomist, foley inserter, m&m write up person, dressing changer, random person to decompress on, room cleaner, IT, pharmacy runner to get meds, supplies stocker, etc etc, basically the stuff I do could have been done by anyone. Good thing surg prelim actually uses your MD training.
In short, never do prelim surgery. You wont be a doctor, you're a slave.

 

[rock1234]

Hate it so much. I'm a transporter, phlebotomist, foley inserter, m&m write up person, dressing changer, random person to decompress on, room cleaner, IT, pharmacy runner to get meds, supplies stocker, etc etc, basically the stuff I do could have been done by anyone. Good thing surg prelim actually uses your MD training.
In short, never do prelim surgery. You wont be a doctor, you're a slave.

Also our nurses don't push meds here, so q1 I receive phone calls about a medication I need to push...

 

[evilbooyaa]

Hate it so much. I'm a transporter, phlebotomist, foley inserter, m&m write up person, dressing changer, random person to decompress on, room cleaner, IT, pharmacy runner to get meds, supplies stocker, etc etc, basically the stuff I do could have been done by anyone. Good thing surg prelim actually uses your MD training.
In short, never do prelim surgery. You wont be a doctor, you're a slave.

Surg prelim in NYC sounds like

 

[rock1234]

Surg prelim in NYC sounds like

Surg prelim in NYC sounds like

yep

 

[evilbooyaa]

yep

After all the horror stories of interns in NYC (surg, medicine, peds, whatever) have with the lack of ancillary support, I wonder why anybody signs up for residency in NYC anymore.

 

[rock1234]

After all the horror stories of interns in NYC (surg, medicine, peds, whatever) have with the lack of ancillary support, I wonder why anybody signs up for residency in NYC anymore.

Yes so do I. Family reasons I guess

 

[Psai]

After all the horror stories of interns in NYC (surg, medicine, peds, whatever) have with the lack of ancillary support, I wonder why anybody signs up for residency in NYC anymore.

Some hospitals are balling with the ancillary staff - northwell is amazing.

The education is pretty damn good. Everyone at my place gets a ton of autonomy so our graduates are top notch. It's probably the kind of thing where it sucks when you're in it but you appreciate it when you look back 5 years later.

But it's not really the lack of ancillary staff as their lack of will to do anything useful. I see transporters sitting around all the time doing jack. I don't know how they aren't fired, but it probably has to do with low pay.

 

[evilbooyaa]

Some hospitals are balling with the ancillary staff - northwell is amazing.

The education is pretty damn good. Everyone at my place gets a ton of autonomy so our graduates are top notch. It's probably the kind of thing where it sucks when you're in it but you appreciate it when you look back 5 years later.

But it's not really the lack of ancillary staff as their lack of will to do anything useful. I see transporters sitting around all the time doing jack. I don't know how they aren't fired, but it probably has to do with low pay.

Yeah I'm aware that they're present physically, just that they don't seem to be mentally or in any other useful manner.

IM residents generally do get a fair amount of autonomy. IV draws and transporting patients does not make for a good doctor, IMO.

 

[swoopyswoop]

Hate it so much. I'm a transporter, phlebotomist, foley inserter, m&m write up person, dressing changer, random person to decompress on, room cleaner, IT, pharmacy runner to get meds, supplies stocker, etc etc, basically the stuff I do could have been done by anyone. Good thing surg prelim actually uses your MD training.
In short, never do prelim surgery. You wont be a doctor, you're a slave.

Literally what do the nurses do?

 

[Apollyon]

After all the horror stories of interns in NYC (surg, medicine, peds, whatever) have with the lack of ancillary support, I wonder why anybody signs up for residency in NYC anymore.

Because, isn't it something like 80% of all residency programs/residents are in NYC?

 

[AdmiralChz]

Literally what do the nurses do?

It’s hard work going on that union-enforced break every two hours!

 

[rock1234]

Literally what do the nurses do?

Call our phones q1minute to bother with stupid things, sit and surf on amazon, watch movies, listen to loud music, talk to each other, go on breaks that last an entire shift. They do everything but work. And worst part, their hourly salary is double or perhaps triple that of ours. I hate our nurses.
And I have friends at Northwell, sure they may have the staff, but the staff sure isn't doing anything that's part of their work duties.