How much work AFTER work

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ideas

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Hello,

I am just curious as to how many hours an anesthesia doc and resident work at home after work is over? I know there is always reading to keep up on, but how much paperwork, charting, letters, etc would you say goes on after hours at home?

Thank you
 
Usually it depends on how much pre-op has to be done. If you have to start from scratch, 30 min-1 hour to get to know your patients, then 5-30 min on the phone with attending, and then reading up on the cases are person/case/training level dependent.
 
So on average as a resident, how many hours do you spend a night doing "prep" work or "studying"? I am sure it varies by program, but I am just trying to get a feel for residency in the field.
 
as far as the cases go, the work decreases as you start to see the same cases over and over again. Until then, i spent HOURS reading up on the surgery, anesthetic and comorbidities.
 
A new CA-1 is at the top of the work which is made up of pre-ops, basic knowledge, and new literature (and eventually boards). When you first start preops take longer, you're still trying to build your basic foundation with a text like Morgan and Mikhail and trying to finish baby Miller. If you want to be good, you'll spend about 3 hours working on the above. CA-2 year I spent reading specific parts of Barash (big Miller would be the other choice) and specialty specific texts based on rotation (peds, cardiac, pain, etc.). But at this phase you start to get into current literature. Anesthesia is great, really only 2 journals so keeping up is easy. Of course if you want to be informed you'll at least skim the NEJM and JAMA headlines. Most CA-3's that I know start to study for the boards pretty early. So add that in to the above.

So for paperwork, as a resident the only things I do are my own preops that are inpatients for the next day. If all of my patients are to be admitted after (and this happens quite a bit in the modern world, people just don't get admitted before surgery very often) then I grab whatever info I can get from the EMR or anesthesia clinic preop, call my attending, and make a plan. No calls, no letters, no nothing at home. If I do a regional anesthetic block on a patient in ambulatory surgery we follow them up with a phone call at home. Takes about 5 minutes and it's pretty cool.
 
Time spent at home doing work related tasks usually consists of preparation for upcoming cases or reading for knowledge base.

I think the amount of time residents devote to upcoming cases is highly variable. Some are simply better at finding relevant information from a patient's medical record, progress notes, diagnostic studies, and constructing a plan for an anesthetic. Often pre-op evaluation occurs when one is finished with his/her OR cases for the day. Efficient residents sometimes can accomplish this task during any schedule gaps or breaks during the day, so that when they finish their last case they are truly free to go home. Most CA-3 residents spend less time on pre-oping than CA-1's, eventhough they often have more complex cases/patients.

Reading is variable as well. After 4-6 months of training alot of anesthetic practice is routine/repetitious. It is possible to be a seemingly competent anesthesia resident without reading much of anything. I would advise against this. Nothing makes an anesthesiologist look like a mere technician ("drug pusher") than an inadequate knowledge base. The goal is to be a clutch performer, a clinician who can steer clear of danger well in advance and rescue him/herself from disaster when things go bad. Mere technicians can handle most routine situations but not the unexpected challenges that face us all from time to time. Encountering an evolving disaster they are often dependent on the availabilty of a sage clinician to save their butt. (Not that there is anything wrong with asking for help, but it may not always be immediately available.) The take home lesson is to keep reading, even when you think that you know enough to get you through your average day. Spending just a few minutes every day will contribute greatly to your training/career.
 
How about for practicing physicians? How does this vary by the type on anesthesia one practices?
 
How about for practicing physicians? How does this vary by the type on anesthesia one practices?

Except for a meeting a month, probably not any time at all. I do all my billing stuff during my cases, and enter them in the computer between cases or during in-house call. So when I leave the hospital, I don't have any work to do.
 
Except for a meeting a month, probably not any time at all. I do all my billing stuff during my cases, and enter them in the computer between cases or during in-house call. So when I leave the hospital, I don't have any work to do.

Ditto.
 
Laurel and Jet,
Do you find this pretty fullfilling, I know there are other topics in the forum on this, but since you responded, thought I would just ask. I am interested in anesthesia, but I honestly am not sure if it is for the right reasons. I am getting married soon and my husband and I would like to start a family after residency. I don't mind working hard, but I would like to spend after work with my family and not have charts and such to do.

Maybe this is totally selfish of me, but this is where my mind is at and I cannot envision myself being happy in primary care. . . anyways, just wondering what attracted you all originally and if the field has panned out to be what you have expected.
 
ideas

Dont take this the wrong way, it isnt personal. One of the reasons anesthesiology had a "bad rap" is because of how many "lifestyle" interested people enter it. Really, to move forward in the specialty we need more people who are passionate about it.

I would never assume to judge you for choices (especially putting family first) but that is how you would be judged by your peers. If you cant say why you are 'really' interested in anesthesia on your interview for the residency slot, then its probably not for you.
 
ideas

Dont take this the wrong way, it isnt personal. One of the reasons anesthesiology had a "bad rap" is because of how many "lifestyle" interested people enter it. Really, to move forward in the specialty we need more people who are passionate about it.

I would never assume to judge you for choices (especially putting family first) but that is how you would be judged by your peers. If you cant say why you are 'really' interested in anesthesia on your interview for the residency slot, then its probably not for you.


BINGO....this is why our specialty is turning into a laughing stock....

Being a physician is a FULL TIME committment...if you want to get pregnant and have kids then do THAT....don't become a doctor....at least NOT an anesthesiologist.

Go and become a GP, occupational health, or something like that...don't f uck up our specialty anymore than it is....
 
Ideas,

There is definately a misconception about anesthesiology being an "easy" job. Sure, it looks easy as a medstudent because you go into a case, intubate, hang around for a while and then leave. The real job is fairly brutal and you are usually busting your butt all day until the cases are done then have to go to preops, read up on cases, study, etc. Don't forget the ICU time in residency which can be an absolute beat down.

I'm just a resident so I can't speak from personal experience about private practice. From talking to my friends in private practice they paint a picture of you busting your butt all day long, working as fast as humanly possible with very little time for breaks or even lunch. They say there are many days that they feel lucky just to have enough time to wolf down a sandwich other days where they don't even have time to eat. In the real world time is money and your group will expect you to produce like a professional.

If you really want a good family friendly job I'd sugges Derm, Rads and even FP. You can work at your own pace, take an hour or so for lunch and not have to worry about being rushed all the time. I've met for than a few residents who were suprised that they are working harder now doing anesthsiology than they were during thier internal medicine internships.

Anyway, do some research and get a better idea of what the different specialties are really like. It's a big decision and you don't want to be stuck doing something you regret. Seriously, I would look into Rads. These guys have the true "lifestyle" job.

Burntcrispy, MD
 
My rads attending buddies tell me that private practice isn't as cush as you may think.

Dunno, personally.

Ideas,

There is definately a misconception about anesthesiology being an "easy" job. Sure, it looks easy as a medstudent because you go into a case, intubate, hang around for a while and then leave. The real job is fairly brutal and you are usually busting your butt all day until the cases are done then have to go to preops, read up on cases, study, etc. Don't forget the ICU time in residency which can be an absolute beat down.

I'm just a resident so I can't speak from personal experience about private practice. From talking to my friends in private practice they paint a picture of you busting your butt all day long, working as fast as humanly possible with very little time for breaks or even lunch. They say there are many days that they feel lucky just to have enough time to wolf down a sandwich other days where they don't even have time to eat. In the real world time is money and your group will expect you to produce like a professional.

If you really want a good family friendly job I'd sugges Derm, Rads and even FP. You can work at your own pace, take an hour or so for lunch and not have to worry about being rushed all the time. I've met for than a few residents who were suprised that they are working harder now doing anesthsiology than they were during thier internal medicine internships.

Anyway, do some research and get a better idea of what the different specialties are really like. It's a big decision and you don't want to be stuck doing something you regret. Seriously, I would look into Rads. These guys have the true "lifestyle" job.

Burntcrispy, MD
 
BINGO....this is why our specialty is turning into a laughing stock....

Being a physician is a FULL TIME committment...if you want to get pregnant and have kids then do THAT....don't become a doctor....at least NOT an anesthesiologist.

Go and become a GP, occupational health, or something like that...don't f uck up our specialty anymore than it is....
I agree a thousand percent! This isn't something unique to anesthesiology though Mil - its rampant and its f'ing ridiculous.
 
BINGO....this is why our specialty is turning into a laughing stock....

Being a physician is a FULL TIME committment...if you want to get pregnant and have kids then do THAT....don't become a doctor....at least NOT an anesthesiologist.

Go and become a GP, occupational health, or something like that...don't f uck up our specialty anymore than it is....


I agree a thousand percent! This isn't something unique to anesthesiology though Mil - its rampant and its f'ing ridiculous.

I'm sorry that you misinterpreted my question as not wanting to work "hard" or commitment myself to whatever I am doing while at work. My question was how much of my patient load follows me home, with the exception of readings (which one should always do to keep up on the field). And, I can become a physician AND have children and I will pick the field that allows me that flexibility and from the physicians that I have spoken with about this, they have very positive things to say, actually these are the first "negative" comments I've heard.

Everyone initially is attracted to a field because of something (initial interest, pt care, continuity, lack of continuity, money, hours, procedures, intellectually challenging, etc) bottom line is I don't plan on doing anything that I can't stand to do, but if the possibility of not having to do tons of work at home around my family is the thing that initially attracts me, then so be it. This is why I will be doing a couple electives, to see if its something I like.

I also realize being a physicians is a "full time" commitment, but you still have a life outside of medicine no matter what your specialty is. Many physicians, including anesthesiologists, seem to find out how to do this. So I will continue to explore other options, but hate to disappoint you, anesthesia is still on my radar.
 
Ideas,

There is definately a misconception about anesthesiology being an "easy" job. Sure, it looks easy as a medstudent because you go into a case, intubate, hang around for a while and then leave. The real job is fairly brutal and you are usually busting your butt all day until the cases are done then have to go to preops, read up on cases, study, etc. Don't forget the ICU time in residency which can be an absolute beat down.

I'm just a resident so I can't speak from personal experience about private practice. From talking to my friends in private practice they paint a picture of you busting your butt all day long, working as fast as humanly possible with very little time for breaks or even lunch. They say there are many days that they feel lucky just to have enough time to wolf down a sandwich other days where they don't even have time to eat. In the real world time is money and your group will expect you to produce like a professional.

If you really want a good family friendly job I'd sugges Derm, Rads and even FP. You can work at your own pace, take an hour or so for lunch and not have to worry about being rushed all the time. I've met for than a few residents who were suprised that they are working harder now doing anesthsiology than they were during thier internal medicine internships.

Anyway, do some research and get a better idea of what the different specialties are really like. It's a big decision and you don't want to be stuck doing something you regret. Seriously, I would look into Rads. These guys have the true "lifestyle" job.

Burntcrispy, MD

Thank you, that was very helpful
 
I'm sorry that you misinterpreted my question as not wanting to work "hard" or commitment myself to whatever I am doing while at work. My question was how much of my patient load follows me home, with the exception of readings (which one should always do to keep up on the field). And, I can become a physician AND have children and I will pick the field that allows me that flexibility and from the physicians that I have spoken with about this, they have very positive things to say, actually these are the first "negative" comments I've heard.

Everyone initially is attracted to a field because of something (initial interest, pt care, continuity, lack of continuity, money, hours, procedures, intellectually challenging, etc) bottom line is I don't plan on doing anything that I can't stand to do, but if the possibility of not having to do tons of work at home around my family is the thing that initially attracts me, then so be it. This is why I will be doing a couple electives, to see if its something I like.

I also realize being a physicians is a "full time" commitment, but you still have a life outside of medicine no matter what your specialty is. Many physicians, including anesthesiologists, seem to find out how to do this. So I will continue to explore other options, but hate to disappoint you, anesthesia is still on my radar.

You just don't get it ...do you?

You are talking about becoming an EMPLOYEE...someone who comes to work punches the clock and goes home....and hopes that tomorrow you will still have a job to come back to as an EMPLOYEE....

You know what....As an employer, I would rather hire a CRNA...because you know why...as EMPLOYEEs, they are cheaper and can do essentially what you want to do.

Being a physician requires that you also are a businessman....with the business part of your practice done AFTER regular workhours....and the hours are unpredictable depending on what's going on with THE practice.

Look at all the other threads...about threats, reimbursements, and all the other crap that is going on....

All of these issues have become ISSUES because of people like YOU.....People who want to become EMPLOYEES and let other people (namely non-physicians) take over your financial/business obligations/responsiblities....the non-clinical stuff that goes along with the practice of medicine...

If I hire someone like you....I will SCREW you like you wouldn't believe because that's what you and all others like you deserve...because you are the ones who get hired my AMC's (get screwed by AMCs)and than allow the AMC's to screw with good practices.

I hope you NEVER get into anesthesia, because people like you are the cause of our downfall.
 
Hopefully with the new crop of seemingly stronger and more motivated residents coming up, we'll all be better off. With more emphasis on research to advance the field as well as expanding our scope of practice, we'll solidify our positions within healthcare of the future...


You just don't get it ...do you?

You are talking about becoming an EMPLOYEE...someone who comes to work punches the clock and goes home....and hopes that tomorrow you will still have a job to come back to as an EMPLOYEE....

You know what....As an employer, I would rather hire a CRNA...because you know why...as EMPLOYEEs, they are cheaper and can do essentially what you want to do.

Being a physician requires that you also are a businessman....with the business part of your practice done AFTER regular workhours....and the hours are unpredictable depending on what's going on with THE practice.

Look at all the other threads...about threats, reimbursements, and all the other crap that is going on....

All of these issues have become ISSUES because of people like YOU.....People who want to become EMPLOYEES and let other people (namely non-physicians) take over your financial/business obligations/responsiblities....the non-clinical stuff that goes along with the practice of medicine...

If I hire someone like you....I will SCREW you like you wouldn't believe because that's what you and all others like you deserve...because you are the ones who get hired my AMC's (get screwed by AMCs)and than allow the AMC's to screw with good practices.

I hope you NEVER get into anesthesia, because people like you are the cause of our downfall.
 
Laurel and Jet,
Do you find this pretty fullfilling, I know there are other topics in the forum on this, but since you responded, thought I would just ask. I am interested in anesthesia, but I honestly am not sure if it is for the right reasons. I am getting married soon and my husband and I would like to start a family after residency. I don't mind working hard, but I would like to spend after work with my family and not have charts and such to do.

Maybe this is totally selfish of me, but this is where my mind is at and I cannot envision myself being happy in primary care. . . anyways, just wondering what attracted you all originally and if the field has panned out to be what you have expected.

Well, I'm a woman in private practice and I am married and will eventually start a family. I can tell you that out of about 35 people in our practice, there are five women. I really like my job - it is interesting and challenging. And it is hard work. But somehow, despite the 50-60 hours a week I work, I feel like I have a lot of free time. When I am in-house call, I do all my paperwork and read journals and I am often still doing literature searches for cases that stump me. My colleauges are very supportive and we often discuss cases. The in house call person deals with all the pain rounds and PACU. So once I leave the hospital, I leave all my work there and I actually feel like I have plenty of time to spend with my family and friends and time to take care of myself.

I do have an extemely supportive husband who has a flexible job. If the dogs need to go the vet, he can take them. He is there to deal with repairman, problems with neighbors etc.

So I work hard. When I am at work, I am rushing around with little down time. But once I get home, I relax, work out, watch TV, eat dinner, hang out with my husband and rarely have to do any work.
 
You just don't get it ...do you?

You are talking about becoming an EMPLOYEE...someone who comes to work punches the clock and goes home....and hopes that tomorrow you will still have a job to come back to as an EMPLOYEE....

You know what....As an employer, I would rather hire a CRNA...because you know why...as EMPLOYEEs, they are cheaper and can do essentially what you want to do.

Being a physician requires that you also are a businessman....with the business part of your practice done AFTER regular workhours....and the hours are unpredictable depending on what's going on with THE practice.

Look at all the other threads...about threats, reimbursements, and all the other crap that is going on....

All of these issues have become ISSUES because of people like YOU.....People who want to become EMPLOYEES and let other people (namely non-physicians) take over your financial/business obligations/responsiblities....the non-clinical stuff that goes along with the practice of medicine...

If I hire someone like you....I will SCREW you like you wouldn't believe because that's what you and all others like you deserve...because you are the ones who get hired my AMC's (get screwed by AMCs)and than allow the AMC's to screw with good practices.

I hope you NEVER get into anesthesia, because people like you are the cause of our downfall.

That is definitely an important point. The anesthesia hours are very unpredictable. I can't what time I will be home until I actually leave the hospital. I don't know where the myth originates that anesthesia has nice regular hours. My hours are actually very irregular. Which is good and bad. So if you are the 'mom' in your family and have a lot of inflexible family obligations, I would think anesthesia would be hard.
 
Being a physician is a FULL TIME committment...if you want to get pregnant and have kids then do THAT....don't become a doctor....at least NOT an anesthesiologist.


This is ridiculous. You would never tell a male MS4 not to go into anesthesiology because he wants to have children at some point. I've seen female attendings back at work full time 4 weeks after delivery. Given most families have 2 children, I think those 8 weeks of maternity leave over an entire career can be reasonably handled and are certainly not adequate justification to tell any women who wants to get pregnant and have kids at some point NOT to become a doctor.
 
You've gotta admit that it's tougher on a woman in res to have kids than a man to have a wife who has them...


This is ridiculous. You would never tell a male MS4 not to go into anesthesiology because he wants to have children at some point. I've seen female attendings back at work full time 4 weeks after delivery. Given most families have 2 children, I think those 8 weeks of maternity leave over an entire career can be reasonably handled and are certainly not adequate justification to tell any women who wants to get pregnant and have kids at some point NOT to become a doctor.
 
I am wondering where the evidence for "all the motivated residents coming out now" is? From what ive seen (which is limited to 4 institutions) is that MORE people are interested in the 'lifestyle' part of anesthesiology than not.

Do others see this or am I just seeing a disproportionate amount?
 
I am wondering where the evidence for "all the motivated residents coming out now" is? From what ive seen (which is limited to 4 institutions) is that MORE people are interested in the 'lifestyle' part of anesthesiology than not.

Do others see this or am I just seeing a disproportionate amount?

My experiences are very limited at this point. But, of all the people I know as an MS1 (now MS2)that are interested in anes, all of them are top notch candidates that excel on exams and seem to be hard workers and professional. Alpha males that want to EXCEL (don't know any females personaly).

I get inspired by the PASSION (so damn important) I sense on this forum. That's what it takes to succeed in anything (truly succeed, not just "make it").
 
You've gotta admit that it's tougher on a woman in res to have kids than a man to have a wife who has them...

I'm sure that is true, but folks do it all the time. However, I don't "plan" on getting pregnant during residency.

Laurel,

Your post was very helpful. I don't need "regular" hours, but I do need to have some spare time outside of work, so I'll take some of the things I'm hearing on the board into consideration (while completely blocking out others 🙂 and continue to talk with those at my institution to see what will be best for ME in the long run! Thanks again!
 
I am wondering where the evidence for "all the motivated residents coming out now" is?

One metric that ought to be readily available are average ITE scores.

Would be interesting to see what the 25th, 50th, 75th percentile scores have been for CA-0/1/2/3 residents over the last few years. Presumably if we're getting better people, those scores would be going up.

My guess is that we're probably getting more of a bimodal distribution like medicine allegedly does.

Medicine - big lump of slackers at the low end who couldn't get a competitive residency, and a big group of motivated people who are only enduring medicine because it's the path to a fellowship like GI, cards, etc.

Anesthesia? - big lump of lifestyle slackers at the low end, and a growing (?) group of motivated people who have that passion
 
You've gotta admit that it's tougher on a woman in res to have kids than a man to have a wife who has them...

No doubt it's harder on a woman to have kids in residency than a man. But what militarymd said is:

if you want to get pregnant and have kids then do THAT....don't become a doctor....at least NOT an anesthesiologist.

As if being a doctor/anesthesiologist is incompatible with having kids for a woman. That's complete crap as evidenced by the myriad of females in all specialties who manage to practice, even excel in their practices, and have children.
 
It seems that taking pride (and striving for excellence) need not be mutually exclusive to wanting a good lifestyle, income, etc.

It's possible that BECAUSE of historic compensation levels in anesthesiology, that this may have brought talent to the field that perhaps may not have given it a second look. Who knows. Then again, I'm sympathetic to the private practice people that feel as if there are (in their real world experience versus my theoretical arguement) too many "lifestylers" in anes these days. So, there must be some legitimacy to it.
 
I'm sure that is true, but folks do it all the time. However, I don't "plan" on getting pregnant during residency.

Laurel,

Your post was very helpful. I don't need "regular" hours, but I do need to have some spare time outside of work, so I'll take some of the things I'm hearing on the board into consideration (while completely blocking out others 🙂 and continue to talk with those at my institution to see what will be best for ME in the long run! Thanks again!

Well good luck - three of the other five women in my group have kids. They manage. But we all have supportive spouses. Because there will still be in house night call and long days. But like today is Friday and I am post call. So from the time I came home today at 7am to 7 am on Monday morning, I am totally free to do what I want. There is no pager, no paperwork, no charts, no patients.
 
Seems a little harsh Mil...

Yes, I am......but ask Jet about his experience with his job recently......having my "harsh" attitudes will likely protect ALL of our futures.

Go ahead and close your eyes....encourage this "I want it all" and "I deserve it all" attitude is what's causing the problems that everyone on this board is complaining about.

It doesn't work both ways....it never has....It never will.....
 
Go ahead and close your eyes....encourage this "I want it all" and "I deserve it all" attitude is what's causing the problems that everyone on this board is complaining about.

It doesn't work both ways....it never has....It never will.....

ooooooh those uppity women who want it all--career and family. Clearly they can't have both. No one ever has. No one ever will.

Oh wait, men have both all the time. Scratch that.
 
ooooooh those uppity women who want it all--career and family. Clearly they can't have both. No one ever has. No one ever will.

Oh wait, men have both all the time. Scratch that.


The poster just happens to be a woman, but my attitudes applies to anyone who wants to have "good hours"..."free time"..AND the rewards of a good practice.

"Lifestylers" ....the ones who are ruining this specialty.

A specialty filled with people who aren't committed becomes a specialty that will be pillaged by non-physicians.

Ever hear a surgeon whine about "losing their turf" to non-physicians? Nope...you know why? I do...it's because anyone who choses to become a surgeon knows that the road is hard and long.

Go ahead ...encourage "lifestylers" into our specialty...because you know what? In the end, it won't matter for me....I will have made my pile off you "lifestylers" with your "limited work hours"....and retire to the Bahamas and leave you all with what's left of anesthesiology....a bunch of babies crying about why their reimbursement is the same as a nurses.
 
The poster just happens to be a woman, but my attitudes applies to anyone who wants to have "good hours"..."free time"..AND the rewards of a good practice.

"Lifestylers" ....the ones who are ruining this specialty.

A specialty filled with people who aren't committed becomes a specialty that will be pillaged by non-physicians.

Ever hear a surgeon whine about "losing their turf" to non-physicians? Nope...you know why? I do...it's because anyone who choses to become a surgeon knows that the road is hard and long.

Go ahead ...encourage "lifestylers" into our specialty...because you know what? In the end, it won't matter for me....I will have made my pile off you "lifestylers" with your "limited work hours"....and retire to the Bahamas and leave you all with what's left of anesthesiology....a bunch of babies crying about why their reimbursement is the same as a nurses.

The irony of your post is that you talk about making your "pile" of money, which sounds like a "lifestyler" to me 🙂 Just you are concerned with money and my first priority is not that. Have fun in the Bahamas, I'm sure you'll see me there also👍 At the end of the day, its the patient first no matter what you are practicing, just some physicians follow their patients throughout their entire lives, while others follow them for just a few days.
 
The irony of your post is that you talk about making your "pile" of money, which sounds like a "lifestyler" to me 🙂 Just you are concerned with money and my first priority is not that. Have fun in the Bahamas, I'm sure you'll see me there also👍 At the end of the day, its the patient first no matter what you are practicing, just some physicians follow their patients throughout their entire lives, while others follow them for just a few days.

A good point. Militarymd just sounds pissed because the "lifestylers" are ruining things for the "moneyworshippers." The "lifestylers" could just as easily accuse the other "moneyworshippers" of causing the downfall of anesthesiology and the huge influx of midlevels. I mean, isn't the idea that by supervising CRNAs, you can make more money than by doing cases on your own? And now that's coming back to bite you in the butt? Seriously, I think the problems anesthesiology is facing right now has WAY more to do with just working moms (or "lifestylers" which is really just a more politically correct way of putting it.)
 
During my last call, the fellow I was working with asked me if I would consider switching "to a more exciting field" rather than just sitting behing the curtain doing long cases.

He proceeded to say that many of the anesthesia people he's been exposed to are just lazy and not motivated at all to work hard. Obviously his comment was a generalization but there's something to be said about it.
 
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