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in 3rd (and 4th yr - although i've heard 4th yr is easy) yr, how much do u work? is it 80hrs/wk like the residents, with frequent 'stayupallnight' calls?
how busy are clinical yrs?
- Thread starter chef
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Depends on the rotation and the program, and to some extent your resident. Be aware that the RRC "rules" about the 80 hour workweek do NOT apply to students, so you may be expected to stay all day post-call when your fellow junior residents go home.
The frequency of "stay up all night" call will depend on the same above factors. Some places expect it and others do not.
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Im just still in my 1st rotation (surgery), but here's what it's like time-wise:
4 am: get up
4;30: leave
5-6:30: see my pts and write notes
6:30-7:30: rounds
7:30-9 (sometimes): Grand Rounds
9-5: Surgery and/or clinic
5-???: Evening rounds and any other stuff that comes up (ER cases, bedside procedures, etc)
Usually, I get home between 6:30-7, then I go to bed at 8, otherwise Im intolerably cranky.
This weekend, I have both days off, but I do have trauma call tonight, 6p-6a, plus conference in the am.
Ive heard that some rotations are cake (psych) and some are hellacious (medicine, except for the month of consult service).
Anyways, dont expect to be able to party too much.
Star
4 am: get up
4;30: leave
5-6:30: see my pts and write notes
6:30-7:30: rounds
7:30-9 (sometimes): Grand Rounds
9-5: Surgery and/or clinic
5-???: Evening rounds and any other stuff that comes up (ER cases, bedside procedures, etc)
Usually, I get home between 6:30-7, then I go to bed at 8, otherwise Im intolerably cranky.
This weekend, I have both days off, but I do have trauma call tonight, 6p-6a, plus conference in the am.
Ive heard that some rotations are cake (psych) and some are hellacious (medicine, except for the month of consult service).
Anyways, dont expect to be able to party too much.
Star
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Ditto what the previous poster said. It depends on what rotation you are on.
I am half-way through our eight-week third-year surgery block and find that I have to get up at around 4:45 in order to shower, shave, brush the fangs, and get to school early enough to write notes on the patients I am assigned before rounds. We round at about seven and then we either scrub in on a few surgeries or attend various clinics until at least 3:00PM. Most days we have some kind of lecture or professor's rounds in the afternoon. Then we do a "mini-round" with our residents and usually finish by around six.
We also have call about once a week.
As you can see, this is a lot of hours. The key is to go to bed early. Also, you have to find some "slack time" here and there. We have, for example, something called "Comprehensive Care Clinic" once a week which is scheduled, usually, from 1PM to 5PM. Even if I only have one patient scheduled or finish wicked early, I still try to "avoid" the wards until five. And I might "vanish" at 2 PM four times a week to lift weights for half an hour.
Point is, there is some "down-time" during the day. You just got to ask yourself how eager you are to do scut work. The first week of the rotation I didn't realize this and was running myself ragged.
Additionally, if things are slow, I will park myself in the conference room on the floor and study my surgery review book. I call this "hiding in plain sight." The residents know where to find me and if they need anything done I am at there disposal without being in their faces.
I can't say I've worked any 80 hour weeks. Mostly between sixty and seventy.
Some rotations are like nine-to-five jobs. Pediatrics and Psychiatry come to mind.
Just a note about the 80-hour limit. I find it laughable that the "old-school" think that 80 hours a week isn't enough time adequetly train residents. I think the real problem is that modern hospitals are so inefficient that much of the residents time is taken up wrestling with paperwork instead of training. I don't know the solution to this, of course, but seriously, I bet a study would find that lack of sleep makes learning impossible so anything over eighty hours is academic.
I am half-way through our eight-week third-year surgery block and find that I have to get up at around 4:45 in order to shower, shave, brush the fangs, and get to school early enough to write notes on the patients I am assigned before rounds. We round at about seven and then we either scrub in on a few surgeries or attend various clinics until at least 3:00PM. Most days we have some kind of lecture or professor's rounds in the afternoon. Then we do a "mini-round" with our residents and usually finish by around six.
We also have call about once a week.
As you can see, this is a lot of hours. The key is to go to bed early. Also, you have to find some "slack time" here and there. We have, for example, something called "Comprehensive Care Clinic" once a week which is scheduled, usually, from 1PM to 5PM. Even if I only have one patient scheduled or finish wicked early, I still try to "avoid" the wards until five. And I might "vanish" at 2 PM four times a week to lift weights for half an hour.
Point is, there is some "down-time" during the day. You just got to ask yourself how eager you are to do scut work. The first week of the rotation I didn't realize this and was running myself ragged.
Additionally, if things are slow, I will park myself in the conference room on the floor and study my surgery review book. I call this "hiding in plain sight." The residents know where to find me and if they need anything done I am at there disposal without being in their faces.
I can't say I've worked any 80 hour weeks. Mostly between sixty and seventy.
Some rotations are like nine-to-five jobs. Pediatrics and Psychiatry come to mind.
Just a note about the 80-hour limit. I find it laughable that the "old-school" think that 80 hours a week isn't enough time adequetly train residents. I think the real problem is that modern hospitals are so inefficient that much of the residents time is taken up wrestling with paperwork instead of training. I don't know the solution to this, of course, but seriously, I bet a study would find that lack of sleep makes learning impossible so anything over eighty hours is academic.
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Ask people at your school. It really varies by rotation and school.
As an example, my surgery rotation went like this:
2:30 or 3: get up and get ready
3:30 or 4: in the hospital rounding on patients before the intern
7-5: in surgery, rounding, lectures, etc.
5: usually go home unless you're on call or get a trauma page prior to 5 (trauma service gets to go home at 5 if no trauma comes in around that time)
The average hours per week I worked the different rotations were:
- peds: 70
- surgery: 100 (some weeks 130!)
- family medicine: 40 (yes that's right)
- psych: 30 (also not a joke)
- ob/gyn: 80-100 (depends on service; gyn-onc is like surgery)
- medicine: 50
Keep in mind that where I am, students do not take overnight call on peds, family medicine, psych, or medicine.
As an example, my surgery rotation went like this:
2:30 or 3: get up and get ready
3:30 or 4: in the hospital rounding on patients before the intern
7-5: in surgery, rounding, lectures, etc.
5: usually go home unless you're on call or get a trauma page prior to 5 (trauma service gets to go home at 5 if no trauma comes in around that time)
The average hours per week I worked the different rotations were:
- peds: 70
- surgery: 100 (some weeks 130!)
- family medicine: 40 (yes that's right)
- psych: 30 (also not a joke)
- ob/gyn: 80-100 (depends on service; gyn-onc is like surgery)
- medicine: 50
Keep in mind that where I am, students do not take overnight call on peds, family medicine, psych, or medicine.
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For all of you 3rd and 4th years. Everyone seems to be saying that they are going into patient's rooms in the middle of the night at 3-4 in the morning to pre-round.?! The lights completely out and the patient sleeping. Could someone explain to me the proper way to examine someone without turning on the lights and talking with the patient. do patient's generally appreciate being woke up in the middle of the night and having the lights turned on?
I'm just a 2nd year..................but very curious about how this works. Thanks,
later
I'm just a 2nd year..................but very curious about how this works. Thanks,
later
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Yeah, I am curious about this too. I am doing Psych right now, and we are not doing any prerounds - just rounds from 7:30-noon, and then we are done for the day. I remember at orientation that they said we are absolutely not to wake up patients before 5:30am.
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You just say, "Good Morning, Mr. Smith. I'm going to turn on the lights so you might want to close your eyes." Then do your examination, ask the appropriate questions, thank the patient, turn out the lights and move to the next room.
THe earliest I generally wake up somebody is around 5 AM, but that's only because I'm not in earlier. Remember, the nurses are waking them up several times a night for other things.
You can NOT examine the patient with the lights out. Period. I believe "feeling up" a sleeping patient in the dark is technically referred to as "groping."
You just have to get over your natural revulsion towards waking people up at zero dark thirty. But then, you have to get over your natural revulsion to a lot of things in the medical profession.
I just want to add that we have a whole sub-population of patients at our hospital who for whatever reason don't want to leave. Some are homeless and literally have no other place to go. Some like the thought of "three hots and a cot or are exxagerating symptoms to score some more pain-killers. God loves these people, but if we didn't wake them up six times a night they might never leave.
Most patients don't really mind being woken up and appreciate the amount of attention paid to them by medical students. The attending might spend thirty seconds with a patient if that. The resident might spend two minutes. It is not unusual for a medical student to spend forty-five minutes per day with his patients and even get to know and like them.
I like several of our long-term patients and look in on them several times a day, even if I don't have to, to see how they are doing.
THe earliest I generally wake up somebody is around 5 AM, but that's only because I'm not in earlier. Remember, the nurses are waking them up several times a night for other things.
You can NOT examine the patient with the lights out. Period. I believe "feeling up" a sleeping patient in the dark is technically referred to as "groping."
You just have to get over your natural revulsion towards waking people up at zero dark thirty. But then, you have to get over your natural revulsion to a lot of things in the medical profession.
I just want to add that we have a whole sub-population of patients at our hospital who for whatever reason don't want to leave. Some are homeless and literally have no other place to go. Some like the thought of "three hots and a cot or are exxagerating symptoms to score some more pain-killers. God loves these people, but if we didn't wake them up six times a night they might never leave.
Most patients don't really mind being woken up and appreciate the amount of attention paid to them by medical students. The attending might spend thirty seconds with a patient if that. The resident might spend two minutes. It is not unusual for a medical student to spend forty-five minutes per day with his patients and even get to know and like them.
I like several of our long-term patients and look in on them several times a day, even if I don't have to, to see how they are doing.
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Agree with year three as described. The only thing I'll add is that if you are concerned about "me time" for whatever reason, here's some advice:
1. Work Efficiently - Get everything done that you need in a timely fashion and try to avoid (although this is not always possible) getting into a boondoggle chasing X-rays and such. This will be less effective on the busier services like surgery.
2. Go means GO - When a resident or attending tells you that you can leave, then by all means, LEAVE. If you ask for more to do, you will almost always get it. My experience is that doing this is not rewarded, although efficiency is (see #1).
3. Wait for 4th Year - Don't take blocks off in the 3rd year if you can manage it. If you must, then take the missed block first in the 4th year. The reasons pertain to things like applications, honors, letters of reference, etc. You want your core rotations done ASAP, no matter what they tell you. As an added bonus, you can have a pretty fun 4th year taking things you enjoy and the occasional sleeper (radiology).
No way to sugar coat it, though, some times you will be suffering from chronic fatigue and still wondering why you can't find time to make it to the bathroom...
1. Work Efficiently - Get everything done that you need in a timely fashion and try to avoid (although this is not always possible) getting into a boondoggle chasing X-rays and such. This will be less effective on the busier services like surgery.
2. Go means GO - When a resident or attending tells you that you can leave, then by all means, LEAVE. If you ask for more to do, you will almost always get it. My experience is that doing this is not rewarded, although efficiency is (see #1).
3. Wait for 4th Year - Don't take blocks off in the 3rd year if you can manage it. If you must, then take the missed block first in the 4th year. The reasons pertain to things like applications, honors, letters of reference, etc. You want your core rotations done ASAP, no matter what they tell you. As an added bonus, you can have a pretty fun 4th year taking things you enjoy and the occasional sleeper (radiology).
No way to sugar coat it, though, some times you will be suffering from chronic fatigue and still wondering why you can't find time to make it to the bathroom...
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You can't examine your patient without waking him/her up.
Unfortunately, patients in a teaching hospital get very little sleep at all. Lab techs coming to draw blood, techs coming to take vital signs, nurses coming to administer meds, medical students coming to do their thing, residents coming to do theirs, etc. It sucks being a patient on a teaching service.
Remember that when your patients start getting antsy, confused, or slightly delirious. It might just be from lack of sleep.
