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Eighty-hour work week

Nov 3, 2000
703
136
The Belt
  1. Attending Physician
    Hey everybody

    So, any thoughts on violations of the 80 hour work week in pathology? There are many prestigious programs out there that tacitly expect more than 80 hours during surg path....

    Do you agree with the philosophy that learning in pathology is by "doing" rather than by reading and having a less case load?

    And, does knowing that there are such expectations deter you from such prestigious programs or would you just accept the fact you'll be working more than your fellow medicine interns?

    Just wondering....
     
    B

    b&ierstiefel

      caffeinegirl said:
      Hey everybody

      So, any thoughts on violations of the 80 hour work week in pathology? There are many prestigious programs out there that tacitly expect more than 80 hours during surg path....

      Do you agree with the philosophy that learning in pathology is by "doing" rather than by reading and having a less case load?

      And, does knowing that there are such expectations deter you from such prestigious programs or would you just accept the fact you'll be working more than your fellow medicine interns?

      Just wondering....
      Long time no see.

      I certainly agree that there are a handful of programs where residents approach 80 hours/week or even go over that limit during surg path rotations. I haven't encountered too many residents who resent this. It seems like they do this because they enjoy surg path and choose to work those hours. The most variation in terms of hours spent at the hospital during surg path involves previewing time. Some residents seem very meticulous and adopt a perfectionistic attitude while previewing. This can lead to long nights which leads to your next point...the utility of "learning by doing" rather than "learning by reading." From working in basic science labs and even in the dreaded wards, I learned by being a part of the action and less by having my nose buried in a book or journal articles. Now reading does supplement knowledge gained during work activities but I think I do get more by doing. As I've reflected on this, I think one needs to find a good balance and cannot rely on solely one mode of learning.

      Now will the advance knowledge that I will have to work harder than other path residents affect my rank list? Well, I'd be lying if I said my answer was no because it's not that simple. For instance, it may make a certain program #3 instead of #2 or #4 instead of #3 etc etc etc. However, my attitude at this moment is that what really matters for me is the postdoc that I do after my 2 (or maybe 3 years) of AP training. Any surg path hardship will make me a better pathologist and will only be temporary--but I really don't see it as suffering because I really like surg path. Plus, I can unwind during autopsy months and to a lesser extent cytology months. I'll probably work even harder during my postdoc so I can get mah-self a jizzob.
       
      Nov 3, 2000
      703
      136
      The Belt
      1. Attending Physician
        Hey Andy
        I'm still around, checking out SDN all the time, more of a lurker now ;)

        I do agree with the philosophy that if you like what you do, then you won't mind working hard at it...heck, then I wouldn't be doing medicine, period! However, there is something to say about the amount of time spent on surg path, and what proportion is scut versus actual learning.

        Given this, however, I am quite apprehensive by the fact that, compared to our colleagues in other specialties, we will be in the hospital longer than them, albeit not overnight. This has got to be a surprise for many of those out there who think that we're in an "easy" field...

        But again, I also do feel...is it worth it?? Does seeing an extra slew of cases a day and previewing them into the late hours of the night actually help you learn this better?? In other words... does being an excellent diagnostic anatomic pathologist depend on the number or quality of cases you see during residency?? I guess it depends on your learning style, as you mentioned.

        Again, just wondering out loud here... because, as far as making your rank list goes, you would like a balance of having a life, being able to absorb what's thrown at you, and getting excellent training (with the stepping stone to a great career)...quite a difficult judgement to make
         
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        B

        b&ierstiefel

          caffeinegirl said:
          Hey Andy
          I'm still around, checking out SDN all the time, more of a lurker now ;)
          Yeah...you must be on invisible mode. That mode rocks. I might switch to that soon. Incognito :D
          caffeinegirl said:
          I do agree with the philosophy that if you like what you do, then you won't mind working hard at it...heck, then I wouldn't be doing medicine, period! However, there is something to say about the amount of time spent on surg path, and what proportion is scut versus actual learning.
          Totally. I don't mind working long hours if I enjoy what I'm doing but there comes a point when I will just space out due to overload.
          caffeinegirl said:
          Given this, however, I am quite apprehensive by the fact that, compared to our colleagues in other specialties, we will be in the hospital longer than them, albeit not overnight. This has got to be a surprise for many of those out there who think that we're in an "easy" field...
          Yeah...some people will be in for a rude awakening. But hopefully they'll adjust quickly and get used to it and still find the enjoyment in their work.
          caffeinegirl said:
          But again, I also do feel...is it worth it?? Does seeing an extra slew of cases a day and previewing them into the late hours of the night actually help you learn this better?? In other words... does being an excellent diagnostic anatomic pathologist depend on the number or quality of cases you see during residency?? I guess it depends on your learning style, as you mentioned.
          That is the million dollar question. Some feel that is the case. I, on the other hand, feel that this is worth it to an extent. However, one does not bud into a kickass anatomic pathologist overnight or in a few years! The legends of surg path honed their skills over decades by keeping at it...and we will have to do that too.

          BTW, just outta curiosity, are you AP only or AP/CP? You don't have to answer if you don't wanna.
           
          Nov 3, 2000
          703
          136
          The Belt
          1. Attending Physician
            Invisible mode rocks...! I actually forgot that I was still on it.. :cool:

            being a kick-ass pathologist of course doesn't happen after 2-3 years of AP...but going to a great program (as seen in the other "prestige" thread) will affect your future options

            I'm AP/CP, because I can't rule out private practice because I'm truly interested in diagnostics, and don't want to do basic research (I'll leave that to you braniacs) :D I'd rather do clinical/translational research..which isn't considered "real" research in several institutions
             
            B

            b&ierstiefel

              caffeinegirl said:
              being a kick-ass pathologist of course doesn't happen after 2-3 years of AP...but going to a great program (as seen in the other "prestige" thread) will affect your future options
              True dat...you're preaching to the choir :D
              Regardless of where you end up though, you are in essence starting over, turning over a new leaf, or whatever and you have to perform well. And that's where the happiness factor comes in...if you're unhappy, you ain't performing well.
              caffeinegirl said:
              I'm AP/CP, because I can't rule out private practice because I'm truly interested in diagnositcs, and don't want to do basic research (I'll leave that to you braniacs) :D
              Even the "braniacs" who wanna do basic science research in the long run are mostly doing AP/CP. I really feel left out here :(
               
              Nov 3, 2000
              703
              136
              The Belt
              1. Attending Physician
                AndyMilonakis said:
                Even the "braniacs" who wanna do basic science research in the long run are mostly doing AP/CP. I really feel left out here :(


                They may start AP/CP, but will choose one or the other...I don't think many people going towards the PI destination would go for AP/CP...at least that's what I've seen so far with my limited experience. AP/CP increases your marketability, traditionally, although I've heard this is changing as private practices become conglomerate behemoths.. I guess there's are two sides of the argument; AP and CP are becoming more integrated with the era of molecular diagnostics, and yet if you're going to do just do surg path in a large practice, you don't need CP.
                 

                PathOne

                Derminatrix
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                1. Attending Physician
                  All other things being equal, I do believe that there's a fairly close correlation between your skills and the number of slides you've looked at.
                  One of my most amazing mentors held down a attending job and a very large dermpath solo private practise, and thus was exposed to a huge number of slides. And he could basically come up with even the most bizarre diagnosis in a matter of seconds (and not only in derm).

                  So I DO think that working long hours can definitely make you a better pathologist. That being said, it's of course also important that you're exposed to a lot of different cases. Just looking at pap-smears for months on end doesn't exactly make you a well-rounded pathologist. But hard training in a diversified environment WILL make you better.
                  That's also one of the advantages of training in a high-powered academic environment, because they tend to get a lot of second-opinion stuff which can be very complex. Of course, you could just decide that you want to do community-stuff and send the weird slides to others, but in the long run there's definitely a personal satisfaction in recognizing something again and come up with a not-so-obvious diagnosis.
                  Just my USD 0.02
                   

                  yaah

                  Boring
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                  15+ Year Member
                  Aug 15, 2003
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                  Fixing in 10% neutral buffered formalin
                  1. Attending Physician
                    I haven't run into 80 hour week problems, but I have occasional days that run 14+ hours. Generally this doesn't happen on consecutive days but it is possible. And when you have long days, sometimes your reading will slack and you have to remind yourself. Going home and getting free doesn't always mean you can completely relax.

                    That being said though, there is definitely time for a life. Not having night call or standard weekend responsiblities (like full days on the wards in medicine, e.g.) is a huge plus.
                     

                    cytoborg

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                    1. Fellow [Any Field]
                      Guess it depends on what you want from life. If you've got a husband and/or kids, you might not want to go over 80 hrs on a regular basis. Single people with lots of hobbies might not either. Hell, single lazy people who like to stay home and watch "Cops" might not either. :D Regardless of how all of us personally feel about doing 80 hrs, I think it's another issue that there is a policy on hours and that some programs are violating it. It says something about a program that they are not abiding by the rules. You have to wonder how well they are really advocating for their residents, and if other rules are being bent as well. I'd rather be in an environment where I feel like the management is looking out for my well-being and has the integrity to keep things on the straight and narrow.

                      Beary, I'm sure this is more widespread than we think so I won't name individual places, but it's pretty easy to find out from the residents how many hours they are working. Some places will try to cover it up a bit in trying to "sell" the program, but I encountered more than one prisoner, I mean resident, who smiled obediently and said, "No, no trouble with the 80-hr week," but his eyes were saying, "Run, run like hell! We're workin' like dogs!"
                       
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