How early do you wake up?

[CANES2006]

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During my general surgery internship year I was up at 4-4:15 and at the hospital by about 5-5:15. The 80 hour work week was completely non-existent, as we were routinely at the hospital until late in the afternoon post-call, not to mention scrubbing in on cases post-call (also illegal). We were lucky if we got 2 days off a month.

Did this during my 3rd year surgery clerkship. I had to basically hop on my feet from time to time (without moving the protractors 😉 )to prevent from collapsing on the field when I had to scrub on a case post-call (was entering the 30th hour without sleep by the end of the case). I don't know how surgical residents do it. Of course, it isn't going to be much better for me in a month when I start my OB/GYN residency. 🙄

 

[trent05]

Another path guy.

I wake up at 6:30 when on Surgical path and 7 to 7:30 while on Clinical path. No one from my program is in before 7:30 AM, and the residents room is lights out before this time. If you can beleive it, I average 9 hours of sleep per night as a PGY-1 😴

 

[Mary Jane Watson]

When I rotated on gyn onc as a med student, we had to BE at the hospital at 3 a.m. So, I was up at 2 a.m. to get there and start pre-rounding at 3. Patients complained, so for a while they went in at 4. Then the residents complained they couldn't get everything done, so they moved it back to 3. We pre-rounded at 3, rounded again with the intern/2nd year resident at 4, with the 3rd year at 5:30, the fellow at 6:30 and the attendings between surgeries, usually at 8 a.m. You learn a lot, but it is the most inefficient system EVER. I LOATHE rounding - one reason I'm doing EM.

MJ

 

[needinformation]

I hate rounding too. What is the point to 'pre round' and walk from door to door, what a waste of time and energy?
I am a psychiatrist because we don't preround in psychiatry. Phew. Depending on rotation, I get to work around 8... I know, I have an enviable life. I have not taken call in...years.
However, do you know what is more demanding than early rounds? Newborns...

 

[angel80]

Pre-rounding is pretty important. You need to check-up on what's going on with the patient, check labs, test results, consultants' notes, and write your note for the day. That way when you round later on with the team, it will go more smoothly, and you will be able to accurately present the patient and answer questions. What I hate is when you have to round with various members of your team (ie first the intern, then again with the senior) before you round with the attending. To me, that's a waste of time. I think the most efficient way to do it is to pre-round on your own, then have the whole team sit down and do table rounds with the senior most member of the team in charge (or even one on one "table rounds" with just you telling the senior what's going on with your patient). Then finally, you round with the physician.

 

[drPLUM]

When I rotated on gyn onc as a med student, we had to BE at the hospital at 3 a.m. So, I was up at 2 a.m. to get there and start pre-rounding at 3. Patients complained, so for a while they went in at 4. Then the residents complained they couldn't get everything done, so they moved it back to 3. We pre-rounded at 3, rounded again with the intern/2nd year resident at 4, with the 3rd year at 5:30, the fellow at 6:30 and the attendings between surgeries, usually at 8 a.m. You learn a lot, but it is the most inefficient system EVER. I LOATHE rounding - one reason I'm doing EM.

MJ

Very similar to my experience as a med student. My alarm was set for 1:51am. Often I would be waking up when my wife would be going to bed.

 

[a_ditchdoc]

I have to say, my school has been humane. Even during surgery, we were not required to be there before 7:30, maybe 6:30 if we had to draw labs for the residents. Occasionally we would have a late evening or a 16 hour day, but it was not the rule. They believe in the humanistic approach and prefer that we are still human and like people when we are done.

I really loved surgery, and although I have already decided on EM, had I not, the decision would have been made the second I saw some of these schedules. There is NOTHING that I want to do so much that I would be willing to get up at 3:00 in the morning, every day, for five years. I am a night owl and generally do not get to bed until after 12-1am...if I try.

You guys have my sincerest sympathies....

 

[NoSz]

Tell me you are joking! 😱 Thinking of ever having to regularly set my alarm at 1.45 am makes me want to give back my residency position. That is sick and cruel.
Who would want to work at a hospital that starts before printing the newspaper begins?

I am not going to ask my hospital about the correct hours now, would like to live in fairy land until 6/26/2006.

But man, you scared me!

 

[cdql]

8am wakeup
9am classes

and even that is tricky at times 🙂

 

[shiro1]

You know this thread reminds me of a remark that was made to my husband as he was deciding on the area of medicine he was thinking of going into. When ENT was mentioned as a possibility he was told "Oh, that's a lifestyle field!" Being in ophtho, I guess I picked a nice lifestyle field which reflected in my residency hours. We usually needed to be present around 8 or 8:30 am, except when we had an early am lecture (sometimes at 6:45am!). Occaisionaly we had to work with a late working attending into the evening (some as late as 11:00pm) but generally were out by 5:00 or even as early as 3:30 if the clinics were slow. Usually we could get away with getting up at 7:00am. ( 15 - 30 minute commute) 🙂

I remember being chewed out once for being 30 minutes late to a glaucoma specialists clinic, though, due to fog on the bridge and traffic backed up unexpectedly for miles. I always checked the traffic reports, but they usually came too late to try for an alternate route. He told me if I had PLANNED on leaving 30 minutes earlier today I wouldn't be late. I had to bite my tongue not to say that that would leave me one hour early to his clinic 99% percent of the time. 😡 Oh well, all behind me now. 🙂

 

[Blade28]

Even during surgery, we were not required to be there before 7:30, maybe 6:30 if we had to draw labs for the residents.

But didn't cases begin at 7:30? If so, you wouldn't need to round at least before going to the OR?

 

[Nutmeg1621]

Silly question here but do any of you have a long cummute? ie more than 30 minutes

 

[mysophobe]

<~45 minutes if I drive fast.

 

[Nutmeg1621]

<~45 minutes if I drive fast.

Good. Then it is possible.

How early do you have to wake up and what time do you have to be there?

 

[mysophobe]

I wake up at 4:30, am in the car by 4:45, and get there by 5:30.

 

[Winged Scapula]

Wake up around 430, leave by 5, get to hospital at 515 for rounds at 530. Occasionally may shift if census is lower and get in for rounds at 6 am (busy Vascular Service).

I have come in as early as 300 am as an intern/medical student and as late as 7 am as Chief with a low census and no 730 cases.

 

[Lonestar]

Wake up about 5:30- 5:45. 25 min commute. get to OR at about 6:30 to set up room and get the drugs ready. Leave about 4-5:30 pm. Average about 65 hours/wk. Hours for General Anesthesia. If we are doing Hearts and Heads, get to the OR earlier.

 

[Blade28]

I've been arriving around 5 am this month, which is nice. Latest I've had to arrive was around 7...earliest was around 3:30.

 

[neuropower]

sorry for my ignorance, just an M2 here, but i really want to know...
why is it exactly that the workday has to start as early as 3, 4 or 5 am? is it that the attendings want to have more normal hours, but the residents have to do stuff before they get there? or does it just take that much time to get everything done? if the day starts at 3 am, then even if you work 14 hours, you'd be out at 5 pm. why not just start later and leave later? is this how they do things in europe? it just seems like there must be another way...
as a student interested in sleep medicine, it just makes me upset to see sleep schedules like this.

 

[Winged Scapula]

sorry for my ignorance, just an M2 here, but i really want to know...
why is it exactly that the workday has to start as early as 3, 4 or 5 am? is it that the attendings want to have more normal hours, but the residents have to do stuff before they get there? or does it just take that much time to get everything done? if the day starts at 3 am, then even if you work 14 hours, you'd be out at 5 pm. why not just start later and leave later? is this how they do things in europe? it just seems like there must be another way...
as a student interested in sleep medicine, it just makes me upset to see sleep schedules like this.

It obviously differs depending on patient census and other daily duties, but for surgical rotations, most OR cases start at 0700 or 0730. This means that the patients have to been seen and discussed with the attendings before that time. We round again at the end of the day, so it is not possible in this scheme to start later and end later - I have no control over OR start times. If I have 20 patients to see with the junior residents and most of them have dressings to be changed, etc. there is no way I can start rounds later than 5 or 530 and get it all done in time for OR cases.

Thus, it is expected that the medical students and residents get this work done before they meet with the attendings to "run the list" - ie, tell them how their patients are doing. A lot can change in 12 hrs (since the prior evening's rounds).

Medical services may have morning report by which time they have to have seen all the patients. However, not having ever been a medicine resident and never seeing them in as early as we are, I cannot comment fairly on what time they come in and what time they leave if not on call.

The system in the rest of the world is much more humane. When I trained in Australia, I was explicitly told by my attendings NOT to pre-round on patients and "wake them up in the middle of the night." We rounded at 0800 usually as a team; looking up labs on rounds, getting test results, then etc. Days are shorter in general, but the training periods are longer (ie, residency and the road to being an attending/consultant takes many more years than in the US). There is more shift work.