How many months of service do you do in your program 2nd/3rd yr?

[nope80]

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Just curious. I feel like we have a lot and i'm wondering how it compares to others. They say intern yr is the hardest year but that doesn't apply to all programs🙁

 

[gutonc]

Just curious. I feel like we have a lot and i'm wondering how it compares to others. They say intern yr is the hardest year but that doesn't apply to all programs🙁

All bets are off with the new work hours. Being super simplistic about it, since interns can now only work 2/3 the number of consecutive hours that an upper level resident can, I wouldn't be at all surprised if residents now do 1/3 more ward/ICU months than they did 3 or 4 years ago.

I would still argue that, hours and months of service aside, intern year is still the roughest just due to the whole "head up your arse" phenomenon.

To more specifically answer your question, when I was a resident (back in the days when interns could work longer than 45 minutes before getting a 6 hour nap break), our program had interns doing 7-8 ward/ICU months and residents doing the same number over the next two years. I know that the upper levels are doing more now (5 or 6) a year but I'm not sure what the interns are doing.

 

[surge55]

All bets are off with the new work hours. Being super simplistic about it, since interns can now only work 2/3 the number of consecutive hours that an upper level resident can, I wouldn't be at all surprised if residents now do 1/3 more ward/ICU months than they did 3 or 4 years ago.

I would still argue that, hours and months of service aside, intern year is still the roughest just due to the whole "head up your arse" phenomenon.

To more specifically answer your question, when I was a resident (back in the days when interns could work longer than 45 minutes before getting a 6 hour nap break), our program had interns doing 7-8 ward/ICU months and residents doing the same number over the next two years. I know that the upper levels are doing more now (5 or 6) a year but I'm not sure what the interns are doing.

my program has us do 4.5 months in the gen med wards, 1 month nightfloat, and 1 month ICU. the rest is ER and Cardio for 1 month each, neuro and gyn for .5 months, outpatient clinic for 2 months (with some study time and other stuff in there) and .5 as vacation.

 

[DOk1ng]

what about rules set up by RRC ( residency review committee) ?

 

[BolderNewfy]

All bets are off with the new work hours. Being super simplistic about it, since interns can now only work 2/3 the number of consecutive hours that an upper level resident can, I wouldn't be at all surprised if residents now do 1/3 more ward/ICU months than they did 3 or 4 years ago.

I would still argue that, hours and months of service aside, intern year is still the roughest just due to the whole "head up your arse" phenomenon.

To more specifically answer your question, when I was a resident (back in the days when interns could work longer than 45 minutes before getting a 6 hour nap break), our program had interns doing 7-8 ward/ICU months and residents doing the same number over the next two years. I know that the upper levels are doing more now (5 or 6) a year but I'm not sure what the interns are doing.

We have 10 (yes TEN) months of wards/ICU our first year. Only two electives the first year. Then second year, 4 wards, 2 ICU, 1 night float. 5 "electives" during 2nd year but have to do 6 calls on our weekends, and a month of Jeopardy as well. Also on wards we get Q4 call, and if call falls on friday or saturday (always get 2-3 per month) we have the delightful 30 hour shift. It effing blows and I am rocked.

I would say however that our program is run by bitter old people who love to talk about how hard they had it and how easy we have it. This despite the fact that when they did residency there was no such thing as genetic testing, or MRI's, and they often never saw patients anywhere near as complicated as we do. I have an old friend hospitalist who feels that around ten years ago, the patients really started changing in hospitals. Back in the day a patient came in with an MI and that was pretty much their only problem. Now we refer to the "Big 5" chronic illness that pretty much every patient comes in with, ie CAD, CHF, Afib, CKD, and COPD (and some acute exacerbation of these). Karma is a bitch and I cant wait till they are sick in the hospital, and see that what goes around comes around.....

 

[wyme84]

Ouch...

 

[gutonc]

When I wad interviewing, my 2nd interview was at BU where (at the time at.least), interns has 11 ward/ICU months. That place got booted off my list wicked fast.

 

[dd128]

We have 10 (yes TEN) months of wards/ICU our first year. Only two electives the first year. Then second year, 4 wards, 2 ICU, 1 night float. 5 "electives" during 2nd year but have to do 6 calls on our weekends, and a month of Jeopardy as well. Also on wards we get Q4 call, and if call falls on friday or saturday (always get 2-3 per month) we have the delightful 30 hour shift. It effing blows and I am rocked.

I would say however that our program is run by bitter old people who love to talk about how hard they had it and how easy we have it. This despite the fact that when they did residency there was no such thing as genetic testing, or MRI's, and they often never saw patients anywhere near as complicated as we do. I have an old friend hospitalist who feels that around ten years ago, the patients really started changing in hospitals. Back in the day a patient came in with an MI and that was pretty much their only problem. Now we refer to the "Big 5" chronic illness that pretty much every patient comes in with, ie CAD, CHF, Afib, CKD, and COPD (and some acute exacerbation of these). Karma is a bitch and I cant wait till they are sick in the hospital, and see that what goes around comes around.....

Wow that's rough.

I can never get over how these docs who, 'back in their day lived in the hospital' and diagnosed cancer with a stethoscope and a thumbtack seem to look down on us. We all get it, things were different back then. Part of medicine is that things change...all the time. And pimping gets old btw, I know that's how you did it in your day, but I'm sorry if I don't have every damn NEJM article from the last 40 years memorized.

...Coming off an ED shift where everyone in the hospital was griping at me, part of that may be coming out in this post.

 

[nope80]

bump

 

[michaelrack]

I have an old friend hospitalist who feels that around ten years ago, the patients really started changing in hospitals. Back in the day a patient came in with an MI and that was pretty much their only problem. Now we refer to the "Big 5" chronic illness that pretty much every patient comes in with, ie CAD, CHF, Afib, CKD, and COPD (and some acute exacerbation of these). ....

that's how patients were when I was doing residency 10-15 yrs ago- many came in with the big 5 combo. Patients are heavier today, however. 350 pounds was considered very obese when I was a resident, and seeing someone over 400 lbs only happened 1-2x per year. My understanding is that pts that heavy are much more common in hospitals these days.

 

[FutureInternist]

We have 10 (yes TEN) months of wards/ICU our first year. Only two electives the first year. Then second year, 4 wards, 2 ICU, 1 night float. 5 "electives" during 2nd year but have to do 6 calls on our weekends, and a month of Jeopardy as well. Also on wards we get Q4 call, and if call falls on friday or saturday (always get 2-3 per month) we have the delightful 30 hour shift. It effing blows and I am rocked.

I would say however that our program is run by bitter old people who love to talk about how hard they had it and how easy we have it. This despite the fact that when they did residency there was no such thing as genetic testing, or MRI's, and they often never saw patients anywhere near as complicated as we do. I have an old friend hospitalist who feels that around ten years ago, the patients really started changing in hospitals. Back in the day a patient came in with an MI and that was pretty much their only problem. Now we refer to the "Big 5" chronic illness that pretty much every patient comes in with, ie CAD, CHF, Afib, CKD, and COPD (and some acute exacerbation of these). Karma is a bitch and I cant wait till they are sick in the hospital, and see that what goes around comes around.....

I believe the new rules state that we can only do a total of 6 months of ICU in our 3 years.
Ofcourse some program can fudge it by having night ICU shifts labelled as "Night Float" etc
If you are being made to work more than that I would definitely say something the next time you do an ACGME evaluation