I spoke to my PI who's an attending now and a colorectal surgeon on this matter, and he says that he would do 120 hr weeks easily and 36 hr call was the norm. When I stupidly asked him if he ever took a nap, he just looked at me with a straight face and said that you just power through it. And the 80 hrs/week restriction was in effect during his residency.
I always wondered, what does a 120-hour week look like? That's six 20-hour-long work days. Assuming you can fit the round-trip commute, shower, making/eating dinner into 1 hour, that leaves 3 hours for sleep each day?
I have many mixed emotions about the time constraints of surgical training.
First, I honestly think that you can train an effective, good surgeon in 5 years working 80 hours a week. It requires a good balance of service and education, but it is eminently doable. Based on this, I have always been a bit of an hours stickler with residents I've been in charge of. I expect them to be in the hospital when there is stuff going on, but I also expect and push them to get out quickly when they can. I also routinely chastise our more senior people for keeping junior residents/interns in the hospital unnecessarily. I am a firm believer that a junior resident's job is to make their senior's life easier and that it is a senior's job to take care of the education and well-being of their juniors. Sometimes, that does mean sending them home and doing part of 'the junior's job'. This is not a popular opinion in surgery. I often feel like I am on an island with it.
Second, I will get to my own personal hours in a sec, but 5 years feels like too short of training when you start getting toward the end. Even when you are well trained and saw tons, there is always more that you could have seen or learned. Everyone emphasizes about how when you go into practice you will need senior partners to continue to teach you and grow professionally. I know that in my last couple years of training hours really became meaningless. Either I was needed or I wasn't and either I was learning something or I wasn't. I logged 9-3 every day and just copy-forwarded my hours every week.
Personally...
Clinical duties, my weeks have ranged between 70-120/week. Median probably 80, mean probably 90ish. I only trained in the 80hour work week era. Now, I went to a fairly demanding program, I had weekly case presentations which required podium presentation level preparation (beyond powerpoint, video editing, figure drawing, etc). Many of my presentations became conference presentations, but the majority were just as a part of our program. Then there were journal club, M&M and then research. All told, my 'work' mean is closer to 100-105 hours/week. Lighter clinical weeks simply meant more time spent doing the other things.
All of that having been said, during my 7 years of residency...
Longest continuous time within the hospital, 114 hours. (natural disaster, no faculty in hospital, just myself and my intern in house, was on home call, saw it coming and ran back to hospital knowing that I may not be able to get back in. Then my chairman one upped me by coming in 24 hours after I did in the middle of the disaster giving new definition to 'like a boss'.
Longest continuous time within the hospital, excluding natural disaster, 54 hours.
Longest awake period ~48 hours.
Most days worked consecutively, 34. (amazingly not actually an ACGME violation btw)
You find that when you work as much as this that you need to save time where you can and also cut out things that aren't that important to you. I routinely sleep at the hospital, even when on home call if I end up getting called in. That gives me 30 minutes of extra sleep by itself. I have two lockers at the hospital full of everything that I would possibly need. Work out clothing, toiletries, etc. If I have a spare moment, I will get things done prior to going home if I am stuck at the hospital for something later. Of course, all of this is impossible if you do not have an understanding spouse. My wife's schedule revolves around mine. That doesn't mean that her life does, but it means that she gets up when I get up and we spend time together at really odd times for most people. We share interests and when I'm not in the hospital, she is either asleep or we are doing stuff together. You just make it work.
