Human cost of being a physician

Discussion in 'Medical Students - MD' started by almost_there, May 16, 2008.

  1. almost_there

    almost_there Senior Member
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    I just finished my first clerkship on the wards in OB/GYN, and as I contemplate the next few years and my future career in medicine, I'm starting to realize the sacrifices I will need to make.

    Relationships -- I'll have to miss a good friend's wedding, because I can't take the time off the rotation (and I am discouraged to from the clerkship). If I can even pick up the phone when friends or family call, I am a worse listener and need to make it short and to the point. When my days are 4:30 AM - 7:30 PM, I'm not even interested in trying to engage with friends/family; I'm just trying to get a reasonable amount of sleep, and do a little reading to keep up.

    These are all "little" things, but I feel unavailable to the people in my life, and not maintaining/growing relationships. I feel somewhat alienated. I guess there is some light at the end of a LONG tunnel (i.e. after years of medical school, internship, residency, fellowship), but how much is sacrificed along the way?

    Anyone else feel/felt this way?
     
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  3. Law2Doc

    Law2Doc 5K+ Member
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    I think a lot of us researched med school enough to know about this far earlier than enrollment, let alone the first clerkship. (Odd that you are finishing your first clerkship in May, though). Face it, med school is demanding, residency will be more demanding. So it has to be among your top priorities for the next decade or so. And things like friendships will sometimes have be work around your insane schedule for the next few years. There was nothing hidden from you when you started down this path. That you didn't heed the warnings is a shame.
     
  4. nogolfinsnow

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    Today is the 3rd good friend's wedding that I'm missing just in my first year. My wife will miss the birth of our first nephew and I'm sure there will be plenty of other things we'll miss through school, residency, and beyond. It sucks, yeah, but I think everyone knows sacrifices have to be made to do this. I hope you can find a way to balance what little free time you have to maintain the relationships that are important to you.
     
  5. Dedikated2liftn

    Dedikated2liftn Bodybuilder
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    I think this a little harsh. I'm sure the OP knew to some degree what he was getting into; however, knowing it and actually living it are two very different things. But overall, Law2Doc is correct. Most likely though, you're going to find your niche in another specialty as you complete your 3rd and 4th years (clearly OB isn't your thing).
     
  6. Law2Doc

    Law2Doc 5K+ Member
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    The truth isn't harsh. It just is what it is. Regardless of the field OP chooses, at least some of residency is going to be years of a worse schedule than an OB clerkship, and more than a few weddings and family events will be missed even if OP gets into the cushiest of specialties.
     
  7. Moniker

    Moniker Member
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    i thought it was a little harsh too. as i understand it, she's not saying she wasn't aware of the sacrifices that would be required, she's just reflecting on how it makes her feel. i feel like that's fair game to bring up on an internet forum?
     
  8. HEADintheCLOUDS

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    Yeah way harsh. You shouldnt tell people the truth becasuse sometimes they cant handle it you meanie!:sleep:
     
  9. Moniker

    Moniker Member
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    dude what the hell. the OP was just asking if other people felt frustrated by the personal sacrifices.
     
  10. Instatewaiter

    Instatewaiter But... there's a troponin
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    Seriously

    I often feel a lot of the same things that the OP is going through. It is a daunting road. You cannot really understand the sacrifices you will be making from the outside- and I come from a family of doctors.
     
  11. Dedikated2liftn

    Dedikated2liftn Bodybuilder
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    The OP came here looking for advice (not to be reprimanded). Like I said earlier, I do agree with the majority of what you said; however, comments like the one I previously highlighted don't really do anyone any good.
     
  12. mjl1717

    mjl1717 Senior Member
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    Its Friday night:

    1)I thought this was harsh too! (my first gut thought)
    2)Agree with the other poster-Being IN it is far different from anticipating it.
    3)The human aspect or being conscientious---Never thought this was ANY lawyers strong point!!
    4) Hate to say it..But most of the time I agree with L2D..

    5)I know the truth can be rough at times
    6)To the O.P. I empathize and sympathize with you..
    a)Ive seen 13 year old girls in special summer medical programs somewhat disappointed about giving up an entire summer.. Or perhaps giving up almost every summer till med school!
    b)Sacrifice is a KEY word..
    c) Osler himself got married in his 40s
    d)I dont care what anyone says.. Giving up your youth "aint" no fun..
    e) at least a quarter million dollars, parents expectations, at least 4 or 5 meticulous medical board exams, bowing down in residency or people saying "are you a doc yet" is no joke.. To me it hard work, thats why I say and some will argue with me--One needs almost as much passion for this as one has for a spouse..
    7)But this is what we want and we will do it in one piece and intact..
    8) Good question.. Many think what you asked but have NOT the guts to articulate it because of the flack you get from certain "thoughtful" individuals..

    Addendum:
    1)** One of the BIG things about the arena.. What you find out while IN the field can be completely different from what you knew when you were not in the field..

    2) And just to add the icing to the cake .. There is ALWAYS at least one wise guy who will say something like " "Its cake to me" or "Oh before I came into the field I was doing research with Debakey at Baylor"
     
  13. roja

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    1-it gets worse before it gets better
    2-it gets better.
    3-only you can decide if these sacrifices are worth it. They are sacrifices. It is hard. But for many, it is also worth it.
    4- try and find a balance. (do you really have to be first in your class? get the highest score? [not that you are doing this, just a general statement] decide how competitive the field is you want to go into. weigh the costs and if you think its worth it. I personally loved trauma and vascular surgery. However, I *KNEW* the sacrifices I would have to make would never be worth it. I didn't love it THAT much. )
    5-take breaks when you can. Even if its just to step outside the hospital.
    6- recognize your own needs. (this includes *alone* time... its hard to take care of people all day, then come home and try and take care of your friends/family) make sure you also take care of yourself.
    7-realize you aren't alone
     
  14. mjl1717

    mjl1717 Senior Member
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    Agree 110%---Some make like its a cake walk...
     
  15. cpants

    cpants Member
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    I know there are a lot of sacrifices that I will make, but there is almost nothing that would make me miss a good friend's wedding. Even if it is the weekend before a final or a shelf, manage your time and get a lot of studying in before and after. How long does a wedding/reception last? 8 hours max. You can find that time.
     
  16. cpants

    cpants Member
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    The same goes for staying in touch with family and friends, by the way. It's not that hard to find a few hours every week to talk/visit with friends and loved ones. Make it happen.
     
  17. sunflwr85

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    Not to speak for the OP, but I think the problem here arrises when the wedding isn't in a convenient location. Sure, you can give 8 hours for a wedding and reception, but can you give the time for the drive/flight there and back too, plus the exhaustion from a whirlwind trip? In many cases, that's just not possible, as much as you'd like for it to be. I'm not disagreeing with you entirely, as I completely agree with the notion that you can, and must make time for the people and things that are truly important to you. Just wanted to point out (from personal experience) that it's not always as simple as giving up 1 day, or 8 hours.
     
  18. I've missed the weddings of a few good friends while I've been in residency - sometimes it's just not possible to take a day off here and there. But the worst was during undergrad when I missed my brother's high school graduation (since I had finals that day and the next, and couldn't reschedule). :thumbdown:
     
  19. smq123

    smq123 John William Waterhouse
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    My sister's a doctor.

    When she wanted to get married, she decided (initially) on an informal ceremony. But because of her work schedule, she could only do it on a weekday - a Tuesday. So, of course, none of her friends or co-workers could come. The only people who came were family members.

    However, because I was on my surgery rotation, and too busy to ask for 2 days off (plus I was so exhausted I couldn't remember what day of the week it was), I couldn't go to my own sister's wedding.

    Yes, it sucks sometimes. Thank God for fourth year, because now I can go to the "real" ceremony that she's going to have next year.
     
  20. cpants

    cpants Member
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    I hear you, it's a lot harder if the wedding is hundreds of miles away. But even if you have to leave for a couple of days the weekend before a final, you should still do it. When you look back at your life, you will never remember what you got on that test or how you scored on that rotation, but you will always regret not making it to a friend's wedding.
     
  21. AmoryBlaine

    AmoryBlaine the last tycoon
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    Wading in on the side of Law2Doc, I don't think it's unreasonable to say what he said (I'm 95% sure L2D is a dude - if not sorry).

    Venting on the internet is fine, healthy, and one of the best things about SDN. But I too kind of roll my eyes when the new M3 (finishing 1st rot in May?) says, "wow, this is really hard."

    All through college people said, "are you sure, it's pretty hard to become a doctor..." and the bright-eyed pre-meds said "yes, yes, yes!"

    I think humans have a tendancy to be pretty cognitively dissonant about the concepts of "hard work" and "sacrifice." If you would have asked me 5 years ago (as a senior in college) if I was ready for this I would have said, "100%." Working hard and sacrificing seems noble and glamorous.

    But on hour 27 of trauma call or hour 6 standing in the OR or admission H+P #3 on IM the concept of "hard work" is less cool. I once read on here that the best shadowing experience for a pre-med would be to follow an IM/GSurg resident through a call -- all of it. I tend to agree with that.
     
  22. soeagerun2or

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    I'm starting to wonder why we put up with the notion that we have to sacrifice so much? No one else in the world sacrifices so much of their life and it is not as though, as a student, it makes a difference if we are there or not. Given that when in practice we will be able to make arrangements to be covered I don't see why, as students, we get the shaft on such a frequent and consistent basis.
     
  23. nogolfinsnow

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    Well, if your friend's weddings are all taking place 3k miles away because you weren't lucky enough to stay near home for school and a trip out and back w/ spouse would run over $1k, the ones you miss start adding up.
     
  24. sunflwr85

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    Agreed... I knew what I was getting into when I started, but that doesn't mean I have to accept it as fair, or the way it should be. Why does being a doctor mean that I have to (or am expected to, anyway) give up everything in my life for 4-10 years? I'm not saying I'm going to revolt or anything, and I'm sure there's little I can do about it... I just don't quite understand why it's so necessary to overtake every aspect of our lives. I can tell you right now that I'm not going to be one of those physicians who puts medicine above everything else. I refuse to believe that that's what makes a good doctor, and, well, I have too many blessings in my life to let my career become all consuming. So why am I being forced to do it now?

    In the interest of perspective, I guess I should say that I haven't started clerkships yet. I'll start next May. But I think I've gotten a pretty accurate picture from older students, and it's already becoming an issue when it comes to weddings and other long term plans. I truly wouldn't change what I'm doing, it just sometimes gets very, very frustrating....
     
  25. MrBurns10

    MrBurns10 Excellent, Smithers
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    OP, it's important to go through what you're going through but also to realize that not every specialty is like OB or surgery (and not every rotation is like them either). You're going to be working hard in residency no matter what you go into, but there are many specialties that after you're finished aren't so bad on the hours. You have to weigh the costs and benefits of each field you're interested in and make your decision accordingly. I've already heard many of my classmates who were gung ho surgeons coming into med school and after finishing their surgery rotation decided to go into something else and I really respect that...it's not always easy for a early-mid 20 year old to think what will make them happy in 10, 20 years once they have a family.
     
  26. OncoCaP

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    I think it's a cool thread and I didn't get the impression the OP was somehow blindsided by this ... just wanted to talk about it, which is fine. Looks like several people gave some good insight about specialty selection and the situation changing with time either way.
     
  27. ZagDoc

    ZagDoc Ears, Noses, and Throats
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    I think a lot of that stems from the tension between the historical tradition of physicians as clergy, healers, and leaders who made sacrifices for their communities and the concept of medicine as simply a "profession." The predominant mindset these days is of medicine as a profession, but a lot of the protocol of training is rooted in tradition.
     
  28. sunflwr85

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    You know, I hadn't really thought about it quite like that, in the broader historical perspective... Makes a lot of sense though. I wonder if we'll ever really be able to reconcile our training methods with the more modern idea of what a physician is. And I certainly don't mean to say that medical training should be a cake walk - there's an incredible amount to learn, much of which is of immense importance when dealing with people's lives and health. I just think there's a lot of work to be done in refining the medical education system as a whole.
     
  29. IcedTea

    IcedTea Nuthin But A G Thang Baby
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    Yeah man I feel ya. But it all pays off in the end though. You gotta do what you gotta do.
     
  30. smq123

    smq123 John William Waterhouse
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    I mean no offense, but you're a 1st year.

    Your time is still (mostly) your own. You can rearrange it as you wish. If you need to go to a wedding over the weekend, you can make up the lost study time a few days later, if you carefully manage your time.

    When you're a third year, or a fourth year in the middle of residency applications and interviews, or a resident, it's a totally different story.

    Some rotation sites won't let you switch call nights with other students - the call schedule is set in stone, and not showing up when it's your turn to be on call is not acceptable.

    One of my interns had to rotate through another service. She needed a weekend off to go be a bridesmaid in her best friend's wedding...but arranging things in order to do that was very nerve wracking. She had to email many, many people in order to get another intern to cover for her. If one of her co-interns had not come through for her, she would have been SOL.
     
  31. AmoryBlaine

    AmoryBlaine the last tycoon
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    Because you have to learn/see/read/do a million different things before you can be good. Once you get put in a position where you have some actual responsibility (even if it is just a Sub-I) you will see that you can't learn medicine part time.

    The sooner you drop this idea that you can be a good doctor and still have time to do everything you want to do as well you want to do it the better off you will be. If you don't work crazy hard at some point (at least residency) and make these sacrifices you are going to hurt people. Plain and simple.
     
  32. dilated

    dilated Fought Law; Law Won
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    I think it should only be that bad if you're gunning for AOA or you did badly on step 1 so you need to make up for it.

    A graduating friend gave me the brilliant advice to decide if you care about honoring the rotation before starting. If not, treat it like an employee treats a job. Go in, do your work and when your work is done ask if you can leave. I've been getting out every day at 3:30 on Family Medicine with this strategy. :p

    I'll probably high pass instead of honor. Oh noes!
     
  33. Moniker

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    I'm kind of torn on this. On one hand, in some ways the public is clearly saying, "you're overeducated and someone with lesser training can do your job" (NPs, PAs in primary care, for example), and even the ACGME finally had enough of overworking residents and capped the work week. On the other hand, if we compromise our training by dropping it to less work, less time in the hospital, less cases, and less experience, we'd be agreeing that lesser trained professionals can indeed replace us seamlessly. And there were certainly issues with "are our residents going to be as well trained with less hours in the hospital as those who went before them?" with the 80 hour work week.

    I think another issue is women in medicine. Women are more likely to want lifestyle accomodations (or to put it in a less inflammatory way: they want better balance to their lives) than men and are less likely to be the primary breadwinner, thus putting less pressure to maximize their performance and income, and I think when they push for maternity leave, time off for mothering, to be a wife, etc., the men tend to think, "well I'd like that time too..."

    So I guess we've got to constantly assess: how much time, how many cases, how many patients, are enough?

    Personally, I'm pretty much in favor of working the hell out of trainees. I don't know about ya'll, but I want a doctor who was trained to perform with a heavy workload, on little sleep, in the face of pressures both personal and professional, to get the job done. This is no joke, they should train us to handle it.
     
  34. mjl1717

    mjl1717 Senior Member
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    True, its ok to vent.. Especially about something so encompassing.. Its interesting how some folks struggle with the human side of that..:sleep:
     
  35. gostudy

    gostudy Black covfefe. No sugar, no cream
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    As a first year? Life is short, tests come and go. Weddings/big get togethers last a lifetime. Enjoy your pre-clinical years while they last when you can make your own time and (gasp!) fly accross the country to a wedding a few days before a subject test. Trust me, you'll be fine. If you can't get in some of these important things now, just think about how hard it will be 3/4 yr or residency when you have no control over your time.
     
  36. cpants

    cpants Member
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    No offense taken. I understand that it will be more difficult M3/M4 and beyond, but I still know that there are few circumstances that would make me miss one of my best friend's, or one of my sibling's weddings--as other people have mentioned here. Of course, you probably can't go to every wedding you get invited to, but if it is someone you really care about, you will find a way.

    Your example proves my point. It was "nerve wracking" for your friend, but she still found a way.
     
  37. smq123

    smq123 John William Waterhouse
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    Sometimes, there isn't much of a way to make these things work. I agree that you work to attend the things that matter to you, but if you don't have enough advance notice to plan ahead, or you can't find someone to replace you (it happens), or you're denied permission to leave (ALSO happens!), then, well....

    It's tough as a third year med student, because some clerkship directors are really strict about missing days from rotations except for serious illnesses. And, as a third year, you can't just "find a replacement" - despite your relative lack of responsibility and lack of importance, your presence is still somehow "required."

    I love my non-med school friends, but they've had a really hard time understanding the lack of spontaneity in my life. For instance, if you call me on a Friday evening in August and say, "Hey! Let's' go to the beach!", I probably can't just get up and go. I need a couple weeks notice in order to swap weekends with someone, sometimes. :(
     
  38. nogolfinsnow

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    But I ain't got no $$$$$$!!!!!! I know I'd be fine school wise, it's the lack of money, not time, that stops us. I'm also an older first year, so I understand the importance of not giving up all of your life during the preclinical years. We're just a bit isolated where we live now .
     
  39. Ashers

    Ashers Bacteria? Don't exist.
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    Oh junk!

    I missed my one of my brother's college graduations M1 year because of finals, and I missed my other brother's college graduation yesterday because i had to work. It's way too difficult to fly to where they are (not HI), but my parents did bring leis out to the grads for me.

    With a day of traveling each way, it makes it hard to go anywhere other than staying in the immediate vicinity.

    Exactly. I haven't asked for a day off yet. I finally had to ask for part of a day off for an official school function (in my last rotation), and I was afraid to do that.

    My parents usually end up calling me to ask if I'm still alive, especially during really busy rotations when all I have time to do when I come home is shower then go to bed.

    I did get to take a mini-vacation over Labor day because it counted as a weekend, and on OB/gyn we got to make our own schedule, but that also meant I got a really crappy call schedule for the rest of the month (2 Saturday calls and the last day on call before the shelf in exchange for 3 days off in a row).
     
  40. doc20

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    no one is mentioning that lot of doctors remain unmarried or worse divorced. and its not a choice but it comes with the profession,
    My dad is a doctor , he is a great father but he really didnt have much time to spend with his kids. and I am assuming all the doctor parents are in some kind of same situation.
    and ofcourse the HIGHEST SUICIDE rate among all the professions is there to remind us how sad our lives can be. But no one gives a damn about the people who sacrifice their lives to save others
     
  41. Ashers

    Ashers Bacteria? Don't exist.
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    Ok, I'll add to that. My dad got tired of leaving the house as we were getting ready for school and briefly seeing us, and getting home after we were in bed. We moved to HI because he wanted to see us grow up and he was working 80hrs/week in private practice, hospital politics and his specialty politics.

    He's also older because my parents postponed having kids until after residency.
     
  42. gostudy

    gostudy Black covfefe. No sugar, no cream
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    Ah, I see now.
     
  43. 45408

    45408 aw buddy
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    As a student, I agree, but when you're a resident or an attending, sh!t happens at all hours of the night. The baby is going to be born, someone's coding at 3am, the Knife & Gun Club have a meeting at 4th and Clark, etc. You also need some continuity of care, so when the patient you operated on has complications 10-50 hours later, you're going to get a call.


    But yeah, they should give med students off for things like weddings and such. The attending is getting paid to miss the wedding - the student is PAYING to miss the wedding.
     
  44. 45408

    45408 aw buddy
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    There's no way I'd miss one of my sibling's weddings. Period.
     
  45. JC Denton

    JC Denton Burned Out
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    Your dad must have been pretty damn stressed working so many hours while rarely seeing his own family. I thought that sort of schedule ended with residency? :confused:
    There goes the light at the end of the tunnel.... getting farther and farther away...

    It was cool that your dad finally sacrificed work for family, though. I wonder what it's like to practice in Hawaii? (been stuck in an urban metropolis my whole life) I've been there countless times for vacations, but never got to see any hospitals.
     
  46. Ashers

    Ashers Bacteria? Don't exist.
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    In residency he was old school like 120hr/week or something like that (and sleeping in the ortho clinics when he got a chance), so he did have a better life than residency.

    Now he works about 60-70hrs/week depending on ER busy-ness. When we first moved to HI it was about 50-60, but now there's an ortho shortage and a bigger population. He's retiring soon, so he's happy.
     
  47. JC Denton

    JC Denton Burned Out
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    120hours... Talk about brutal... :scared:
    Good to hear he's happy now, though.;)

    And I should really worry about graduating first, instead of fantasizing about places to practice in! :smuggrin:
     
  48. ZagDoc

    ZagDoc Ears, Noses, and Throats
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    Well the term "resident" is derived from the fact that in the past interns, during their training, lived in hospital housing while often taking call every other night in order to maximize their training. Only 168 hours in a week, y'know :)
     
  49. smq123

    smq123 John William Waterhouse
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    Some med students have reported having difficulty getting off for RELIGIOUS HOLIDAYS (particularly if you're Jewish). Some clerkship directors have "recommended" at least a month's advance notice if you need any days off from the rotation. :eek:

    Welcome to the crappy part of third year. :(
     
  50. Ashers

    Ashers Bacteria? Don't exist.
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    Prowler won't be happy, our school is usually required 1 month's notice before the start of the clerkship, even if it's a 2 month clerkship (except for unusual circumstances -- death in family or person's own illness).
     
  51. Law2Doc

    Law2Doc 5K+ Member
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    Exactly. I've missed quite a few friend and family events precisely because they were out of town and there was simply no one you could trade with, and if you were on call you were on call -- no ability to trade because the people on your team all had the same schedule you did. If you miss several days of obligations on the rotation, you may be asked to repeat the entire rotation. I've seen this happen. There's simply no wedding that's worth delaying graduation.

    Unless you are hospitalized or have explosive diarrhea, you are expected to show up for certain things in third year -- no ifs ands or buts. Some rotations have fewer obligations than others, but don't expect to be able to go missing for a couple of days in most things and be able to reschedule or make things up. The first two years of med school are pretty much the opposite of the kind of lack of control over your schedule you will have in third year. In first year you can skip things, you can juggle. In third year, your time is out of your control and the school may schedule obligations for you 13-24 hours per day, regardless of family and friend obligations. You go through life telling your friends and family not to count on you for things in that year. Moreso in residency.
     

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