High school students

[urgewrx]

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I had a high school student in the OR today. After the circulator introduced him, he came up to me and the first thing he asks me is: How much do you work? "What does that mean?" crossed my mind. Anyway, I replied 50 to 60 hrs/week. He then asked me how long do surgeons work? I told him probably more.

Boy, oh, boy. That kid was bummed out. After a few minutes left the OR not to be seen again. We had some fun talking about how important spare time was to kids nowadays.

My guess is residencies will have to reduce work hours to 40hrs/week in a few years if they want to attract candidates.


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[rmh149]

I thought residents were already restricted on how many hours they can work....or am I wrong?

 

[epidural man]

I thought residents were already restricted on how many hours they can work....or am I wrong?

We are not restricted in our work hours, however, we are restricted to NOT TELL THE TRUTH about our works hours, so the bottom line is, we must report 80 hrs/week, which has no bearing on how many hours we actually work.

 

[amyl]

Technically residents and interns are restricted to 80h/week. However, at some programs you go over. At my home program (I am third year med student) they go over.... and we usually pity the intern who complains about it. for us lowly med students all bets are off...there is no restriction on how many hours per week we can work. You gotta pay your dues. Not everyone can be a doctor.

 

[VolatileAgent]

we are limited to 80-hours a week and four days off per month on average. this means you can have some brutal weeks. i've had a few in my training where i've worked 12 days straight and, in that time, pulled some 20 hour days. this has been mostly my outside-the-OR rotations. overall, though, i work about 55-65 hours per week on average when in the OR.

but, i know in PP there are times when you are supposedly "post-call" and still have to work the next day. there are no acgme rules in pp to protect physicians. i briefly looked at one extremely high-paying practice during interview season, but it became clear that this was an understaffed place and, while i would've made bank, it wasn't worth it to me and my family.

 

[jwk]

I had a high school student in the OR today. After the circulator introduced him, he came up to me and the first thing he asks me is: How much do you work? "What does that mean?" crossed my mind. Anyway, I replied 50 to 60 hrs/week. He then asked me how long do surgeons work? I told him probably more.

Boy, oh, boy. That kid was bummed out. After a few minutes left the OR not to be seen again. We had some fun talking about how important spare time was to kids nowadays.

My guess is residencies will have to reduce work hours to 40hrs/week in a few years if they want to attract candidates.


​

I doubt the average high school student has a concept of working even a 40-hr week, much less 50-60. But hey - as my favorite radio guy Neil Boortz points out, "...someone's got to cook the french fries..."

 

[Noyac]

I thought residents were already restricted on how many hours they can work....or am I wrong?

Nice try.

Keep it up!

 

[rmh149]

Nice try.

Keep it up!

What are you talking about? It was a legitimate question. Sorry if it offended you?

As I understood it, the limitation in work hours for residents was intended to maintain patient safety and quality of care.

 

[Stimulate]

Technically residents and interns are restricted to 80h/week. However, at some programs you go over. At my home program (I am third year med student) they go over.... and we usually pity the intern who complains about it. for us lowly med students all bets are off...there is no restriction on how many hours per week we can work. You gotta pay your dues. Not everyone can be a doctor.

The enforcement of work hours rules is very much program-dependent. At my program there are rotations that occasionally violate hours rules, which may result in a changing of the call schedule for the following YEAR. Bottom-line is that nothing moves quickly and residents/interns still occasionally work over 80 hours/week. However, I do think it seems better than the past.

As an aside I have to completely disagree with those residents/interns who file falsely low hours reports. They think they are doing their program a favor but really they are hurting the system and especially patients. The hardliner attendings/program directors are forgetting that these rules were put in place to protect patients. If you cannot resolve hours violations with your program director and GME office, you can always file a report with ACGME, or just wait for your annual program ACGME survey. You can nail the program on this survey and if the scores are striking enough it will trigger a site visit. Site visits tend to effect change.

I had heard at one time that there was a push for the ACGME hours rules to apply for medical students as well. Couldn't medical students work with their rotation directors and try to get the rules instituted for them as well?

 

[epidural man]

The enforcement of work hours rules is very much program-dependent. At my program there are rotations that occasionally violate hours rules, which may result in a changing of the call schedule for the following YEAR. Bottom-line is that nothing moves quickly and residents/interns still occasionally work over 80 hours/week. However, I do think it seems better than the past.

As an aside I have to completely disagree with those residents/interns who file falsely low hours reports. They think they are doing their program a favor but really they are hurting the system and especially patients. The hardliner attendings/program directors are forgetting that these rules were put in place to protect patients. If you cannot resolve hours violations with your program director and GME office, you can always file a report with ACGME, or just wait for your annual program ACGME survey. You can nail the program on this survey and if the scores are striking enough it will trigger a site visit. Site visits tend to effect change.

I had heard at one time that there was a push for the ACGME hours rules to apply for medical students as well. Couldn't medical students work with their rotation directors and try to get the rules instituted for them as well?

I agree with this, and disagree. The problem is - if you complain to ACGME, you might get the program into deep water - even to a point of losing accredidation. Do you really want to graduate from a program that is not accredited? You hurt yourself either way. I think what a resident should do is when they reach 80 hrs, go up to the chairman or director and say "I am at my 80 hours, what do you want me to do?"

As you said, things change slowly, but are speeding up because there have been large settlement lawsuites where lawyers have found that the interns/residents on the team that had a bad outcome lied about work hours and the hospital was nailed hard for it. I imagine this is what is going to get programs to actually change behavior, rather than just yell at residents to not go over work hours, yet do nothing to change the system.

 

[nimbus]

I think we need to give the kids a break.

Don't know where you folks live but around here in metropolitan SoCal the HS students work their *sses off. It is not unusual for them to take 4 or 5 AP classes as juniors in addition to multiple sports and extracurricular activities. They probably average 5 hours sleep a night on weekdays.

They definitely have more on their plate than me in private practice.