How is my small program going to comply with the new rules?...

[MDGKS]

We have 7 interns, and 12 upper-levels in my IM program. Call is Q4.

Does anyone have a blueprint for compliance with the new regs?

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[docB]

Have everyone keep working as they are and carefully prepare a batch of sham schedules and logs to show the RRC when they come nosing around. No one really expects this to work which is clear by the fact that it is totally unfunded. The RRCs will yell and threaten. The programs will cower and say they'll have to close and in a year or two it'll all blow over. Then we can get back to working 180 hrs per week like our attendings did when they saw patients in 5 feet of snow and no one complained.
docB
BTW- If you can't work 180 hrs per week then you better hire someone or have a spouse to work the extra twelve.

 

[The White Coat Investor]

Two words: Night floats

Now while on easy outpatient rotations, you'll have the blessing of taking call as a night float.

I think the main theory everyone is using is to work harder while you're on. I.E. instead of signing out post-call at 5 pm, you sign out at 10 am, and the on-call team gets slaughtered. At least that's the way it goes around here. Of course, things do get more complicated the smaller the program.

When it gets right down to it, the attendings will have to do more work.

 

[Apollyon]

Originally posted by Desperado
Two words: Night floats

Now while on easy outpatient rotations, you'll have the blessing of taking call as a night float.

I think the main theory everyone is using is to work harder while you're on. I.E. instead of signing out post-call at 5 pm, you sign out at 10 am, and the on-call team gets slaughtered. At least that's the way it goes around here. Of course, things do get more complicated the smaller the program.

When it gets right down to it, the attendings will have to do more work.

Desperado....as I under my breath MF you for your getting pick of the litter EM positions (where, unless you are a complete tool, you will match at one - and you are not a tool (MF #2), so you will)....

Right now, in my program, I am doing my second month of day float (in ours, the prelims do 2 1/2 months (there's 5, so one prelim does 2 weeks of floor extra), whereas the categoricals only do 1 month), and it is HELL. HELL HELL HELL. I am at one of the busiest hospitals in New York City (and one of the only ones that makes a profit), and, when the team signs out in the AM (24 hours max, with max 3 hours for paperwork), I get to pick up the pieces...earliest out - 3:45. Latest, 11pm (several times). You appreciate two people on the team (or, even better with 3 - 1 R and 2 I), when you have notes to write, a single lumen to change to a triple, drop an NG tube in, and argue with XR to do that AXR from the morning.

Not to take anything away, but, from some of the better schools, that are more theoretical, an intern being dropped in July 1 into float is easily overwhelmed. That is one single advantage I had being an FMG - I know my way left and right around a hospital. Unfortunately, with 405 style (Bell Commission) regulations, this will become an unwelcome sight all around. All I can offer is my weak condolences.

 

[The White Coat Investor]

I think there was a veiled compliment in there somewhere. Thanks for reminding me why I didn't want to go into IM, Apollyon. Don't MF me too fast, you may be my fellow EM1 next year yet. So far I haven't been as impressed with the "big name" places as I thought I would be.