Longer Shifts for First-Year Residents to Start in July

[Psai]

I'm doing it right now! I do it 1-2 times per week.

Ur being tortured man

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[Matthew9Thirtyfive]

Ur being tortured man

Feels like it sometimes. At least they pay me.


Jk. It's not that bad.

 

[WingedOx]

Jk. It's not that bad.

Wow. Poor bastard has Stockholm Syndrome too...

 

[Matthew9Thirtyfive]

Wow. Poor bastard has Stockholm Syndrome too...

 

[dr zaius]

I'm a urology resident and we have home call with no post call day. There are times when I show up at the hospital at 5AM, work a full day going home at 6-7PM, and get called in for the rest of the night. I then work a full day the next day until evening rounds which wrap up around 6-7PM. I have certainly gained medical knowledge seeing a difficult priapism in the ED, placing a difficult ureteral stent in a patient with a septic stone, or figuring out how to get a catheter in a patient with a terrible stricture and urinary retention at the tail end of that shift. To claim you can't learn after a certain number of hours is just false. You may not be able to study and retain information from a textbook, but you will certainly remember that hour 20/24 patient that was incredibly difficult and scary.

 

[Crayola227]

the issue is we keep having procedural specialties chiming in

there is a degradation of motor skills with lack of sleep, but I can understand why despite that still getting to do these procedures is adding a lot to learning

hour # IDEFK as the slowest intern that ever lived, busting work hours like you wouldn't believe, I was learning to put in a central line for the second time. I was clumsier than usual, had a harder time organizing my thoughts (than usual, lol) and the **** on the tray, but as Turk says, learn by doing, learn by doing. It took me a helluva lot longer to make sense of what I was seeing on U/S and angle my needle (I was typically OK with my U/S skills otherwise). I still feel that practice taught me something and I was in the black for having done it.

otherwise, stick a fork in me my brain was done

I'm actually too exhausted at the moment to get my brain to come up with the more cognitive scenario where you have to reason through a problem and it's mission ****ing fail during these sorts of scenarios

lol, how about some of our nightfloat accepts. Our nightfloat wasn't the sort of busy that could account for some of the ****ed up **** we got that was clearly poor judgement in someone that was a good doctor during other hours. I'm talking people half dead needing transfer to the ICU. Ridiculous ****.

Most interns are doing a lot of medicine and the overnights aren't about a lot more procedures. They're a lot more admits and putting out fires. Those aren't motor skills, they're judgement and critical thinking, the skills interns have the least of (and yes, need experience to develop) and the first to degrade with sleep deprivation per studies. Yes there's supervision, but as I just said, stuff goes through the cracks, when your tired supervisors are supervising tired inexperienced trainees.

I was drowning and sleep deprived enough already. I know my colleagues had their heads higher above the water than me. I think we all coped with the stress of intern year better COGNITIVELY and even emotionally as a result by going home at the end of every shift and getting a straight 6. At some point people seemed to get the sort of handle on things where I would trust them more doing complex COGNITIVE tasks at hour 27.

 

[Crayola227]

Right, cause the military never does anything that.

Or first responders.

my poor mother, who isn't in medicine but has been one helluva a patient, who has progressively watched me get physically and mentally totaled by training over the years, told me

"It's the war mentality. Medicine has a war mentality."

It was an interesting conversation we had. I find myself playing Devil's Advocate and there's a lot in the culture of medicine that makes total sense to me as being necessarily hard.

I explained that we gotta have that stiff upper lip, do whatever it ****ing takes, and take it as seriously as war, actually. The stakes are high, they're human lives, we're at war with disease and with ourselves to get. it. done. That's a lot of what drew me.

She pointed out that war mentality spills over to know we treat *one another*, as comrades-in-arms. Yeah, it's important we don't treat each other like the enemy.

Even there I get that we keep other tough and on our toes.

At the same time, this isn't war, our own lives are at stake in a different context, and we can just push each other right into a grave. That uber competitive mentality, perfectionism, pull to duty, that gets us where we are, can be maladaptive.

I'm always going to say we need to restructure our institutions and society for more sleep, rather than suggest the other way around.

 

[VA Hopeful Dr]

my poor mother, who isn't in medicine but has been one helluva a patient, who has progressively watched me get physically and mentally totaled by training over the years, told me

"It's the war mentality. Medicine has a war mentality."

It was an interesting conversation we had. I find myself playing Devil's Advocate and there's a lot in the culture of medicine that makes total sense to me as being necessarily hard.

I explained that we gotta have that stiff upper lip, do whatever it ****ing takes, and take it as seriously as war, actually. The stakes are high, they're human lives, we're at war with disease and with ourselves to get. it. done. That's a lot of what drew me.

She pointed out that war mentality spills over to know we treat *one another*, as comrades-in-arms. Yeah, it's important we don't treat each other like the enemy.

Even there I get that we keep other tough and on our toes.

At the same time, this isn't war, our own lives are at stake in a different context, and we can just push each other right into a grave. That uber competitive mentality, perfectionism, pull to duty, that gets us where we are, can be maladaptive.

I'm always going to say we need to restructure our institutions and society for more sleep, rather than suggest the other way around.

And as has been pointed out many times before, we could make residency easier but it would have to be longer and that's not a deal most of us would take.

 

[Spectre of Ockham]

OK let me put it this way. This is bull, grade A certified bull.

After just 12 hours anyone becomes unmotivated, tiered , stinking mess. Unless you're sitting on your ass for about 4 hours you will be a mess. When you see 100 patients in 12 hours as a ER doc you become a mess. When you see 20 patients that need admission as a IM/Cardio/Neuro doc and you consult and chart for almost 12 hours non-stop your become a mess. When you operate almost non-stop for 12 hours as a general surgeon you become a mess. You can gargle any personal experiences about how you are made from indestructible bullsh*tium and how you float above the fold we all know it's bull simply because study after study shows a massive decay in performance , so you're killing and maiming more patients with your exhausted pompous ass.

I have pulled 72 hour shifts and I wanted to go on but I fell asleep after ingesting half a gallon of energy drinks. It took me 3 days of sleeping almost non-stop in order to recover. So please don't believe you know some kind of secret hand shake towards endurance.

Residency doesn't have to be longer , it has to be case based, how many procedures you performed and what were the outcomes. I don't believe you can remotely compare the training you get in the hellforge of a Level 1 trauma center with the training you get in sleepy town USA in the case of ER residency. Also most surgical residency are stupendously long since surgical residents to next to nothing most of the time as the attending just hogs the procedure. Maybe that should change.

 

[VA Hopeful Dr]

OK let me put it this way. This is bull, grade A certified bull.

After just 12 hours anyone becomes unmotivated, tiered , stinking mess. Unless you're sitting on your ass for about 4 hours you will be a mess. When you see 100 patients in 12 hours as a ER doc you become a mess. When you see 20 patients that need admission as a IM/Cardio/Neuro doc and you consult and chart for almost 12 hours non-stop your become a mess. When you operate almost non-stop for 12 hours as a general surgeon you become a mess. You can gargle any personal experiences about how you are made from indestructible bullsh*tium and how you float above the fold we all know it's bull simply because study after study shows a massive decay in performance , so you're killing and maiming more patients with your exhausted pompous ass.

I have pulled 72 hour shifts and I wanted to go on but I fell asleep after ingesting half a gallon of energy drinks. It took me 3 days of sleeping almost non-stop in order to recover. So please don't believe you know some kind of secret hand shake towards endurance.

Residency doesn't have to be longer , it has to be case based, how many procedures you performed and what were the outcomes. I don't believe you can remotely compare the training you get in the hellforge of a Level 1 trauma center with the training you get in sleepy town USA in the case of ER residency. Also most surgical residency are stupendously long since surgical residents to next to nothing most of the time as the attending just hogs the procedure. Maybe that should change.

Are you drunk? I mean this seriously because this post is utter nonsense


I don't know any ER doctor who sees 100 patients in 12 hours. The busiest I've ever heard of was 4 patients per hour, so 48.

Hospitalists routinely do 12 hours of constant work for several days in a row, and it's certainly hard but they aren't an "unmotivated tired stinking mess".

 

[ProfMD]

OK let me put it this way. This is bull, grade A certified bull.

After just 12 hours anyone becomes unmotivated, tiered , stinking mess. Unless you're sitting on your ass for about 4 hours you will be a mess. When you see 100 patients in 12 hours as a ER doc you become a mess. When you see 20 patients that need admission as a IM/Cardio/Neuro doc and you consult and chart for almost 12 hours non-stop your become a mess. When you operate almost non-stop for 12 hours as a general surgeon you become a mess. You can gargle any personal experiences about how you are made from indestructible bullsh*tium and how you float above the fold we all know it's bull simply because study after study shows a massive decay in performance , so you're killing and maiming more patients with your exhausted pompous ass.

I have pulled 72 hour shifts and I wanted to go on but I fell asleep after ingesting half a gallon of energy drinks. It took me 3 days of sleeping almost non-stop in order to recover. So please don't believe you know some kind of secret hand shake towards endurance.

Residency doesn't have to be longer , it has to be case based, how many procedures you performed and what were the outcomes. I don't believe you can remotely compare the training you get in the hellforge of a Level 1 trauma center with the training you get in sleepy town USA in the case of ER residency. Also most surgical residency are stupendously long since surgical residents to next to nothing most of the time as the attending just hogs the procedure. Maybe that should change.

There was a movement afoot in Canada to transition to competency based training. Ortho was to be the test case. Seemed like a good idea, but I'm not sure what happened to it.
http://www.royalcollege.ca/rcsite/documents/canmeds/canmeds-kraemer-orthopaedic-surgery-e.pdf

Your contention that surgical residencies are too long because all the resident does is watch the attending it just wrong. Maybe that happens at some programs, but it's not the norm.

 

[Mr Roboto]

All of his posts are senseless. He's posting from an Eastern European country and despite being an early year med student acts like his experience as a medic makes him an expert.

My favorite was the one where he said being a radiologist was a dangerous profession.

Mine was when he talked about having a "personal stash of medicine" that he gave to patients he diagnosed with HTN, arthritis, etc.

 

[Psai]

All of his posts are senseless. He's posting from an Eastern European country and despite being an early year med student acts like his experience as a medic makes him an expert.

My favorite was the one where he said being a radiologist was a dangerous profession.

No wonder, I was wondering why none of it made any sense.

 

[swamprat]

I honestly didnt read any of this thread but just to add m .02 cents on interns doing 24 hour shifts - I think its a bad idea for non-surgical specialties(at least).

One of my most recent 24 hour calls in the ICU where I am in charge over night (intensivist available via phone, sleeping at home). Had a code at 5AM (tail end of my call). I was exhausted, barely slept that night due to multiple other things going on. I ran it. It was a complicated code because this patient ended up bleeding from a line that was removed, she was coagulopathic and needed blood immediately. Obviously couldn't get blood bank on the phone, patient had poor access, etc etc. This was after a busy day and night and not my first code of my call. I was mentally exhausted. I ran it. I called the intensivist hoping that maybe he came in early since this was when we had bad weather up here in the NE and people came in early to avoid being late. Thankfully he was in house early and came and took over the cognitive load. That patient was way better off with a fresh mind running that resuscitation than myself. Now I am not saying no one should do 24 hour calls, I know that just is not possible. But as an intern who barely knows their head from their ass I think asking them to function at a high intellectual level when everything is a novel cognitive situation to them is not ideal for the patients.

 

[ProfMD]

I honestly didnt read any of this thread but just to add m .02 cents on interns doing 24 hour shifts - I think its a bad idea for non-surgical specialties(at least).

One of my most recent 24 hour calls in the ICU where I am in charge over night (intensivist available via phone, sleeping at home). Had a code at 5AM (tail end of my call). I was exhausted, barely slept that night due to multiple other things going on. I ran it. It was a complicated code because this patient ended up bleeding from a line that was removed, she was coagulopathic and needed blood immediately. Obviously couldn't get blood bank on the phone, patient had poor access, etc etc. This was after a busy day and night and not my first code of my call. I was mentally exhausted. I ran it. I called the intensivist hoping that maybe he came in early since this was when we had bad weather up here in the NE and people came in early to avoid being late. Thankfully he was in house early and came and took over the cognitive load. That patient was way better off with a fresh mind running that resuscitation than myself. Now I am not saying no one should do 24 hour calls, I know that just is not possible. But as an intern who barely knows their head from their ass I think asking them to function at a high intellectual level when everything is a novel cognitive situation to them is not ideal for the patients.

Do interns run codes at your place?

 

[swamprat]

Do interns run codes at your place?

No they don't its always run by a pgy2 or 3 (I am EM). Our ICU is q4 24 hour call for residents and interns do 12-16 hour shifts with a night float.

 

[ProfMD]

No they don't its always run by a pgy2 or 3 (I am EM). Our ICU is q4 24 hour call for residents and interns do 12-16 hour shifts with a night float.

So an intern in hour 24 wouldn't be running that code. The rules change only affects interns.

Also, the whole point is to allow flexibility. Let the surgical fields do 24 hours. Let others do what they want.

 

[WingedOx]

So an intern in hour 24 wouldn't be running that code. The rules change only affects interns.

Also, the whole point is to allow flexibility. Let the surgical fields do 24 hours. Let others do what they want.

On top of that, if you ran a night float system, on paper it would make sense that the resident/intern would be more mentally sharp when needing to make a decision at 4-5AM, but in practice... not really.

 

[swamprat]

So an intern in hour 24 wouldn't be running that code. The rules change only affects interns.

Also, the whole point is to allow flexibility. Let the surgical fields do 24 hours. Let others do what they want.

True point taken.

 

[Spectre of Ockham]

Are you drunk? I mean this seriously because this post is utter nonsense


I don't know any ER doctor who sees 100 patients in 12 hours. The busiest I've ever heard of was 4 patients per hour, so 48.

Hospitalists routinely do 12 hours of constant work for several days in a row, and it's certainly hard but they aren't an "unmotivated tired stinking mess".

You obviously never had to work in an understaffed ER. Try being the one of the two ER docs in Level 1 trauma unit serving an area of about 1M people and see how things turn out, especially with many PCP sending patients for "a check-up" at the ER ; because screw scheduling going to a specialist. During a heatwave we had a record of 218 patients in 12 hours. That was one hell of a shift.
Anyway with the global shortage of medics this trend will continue to grow and the only question is how will we handle it.

There was a movement afoot in Canada to transition to competency based training. Ortho was to be the test case. Seemed like a good idea, but I'm not sure what happened to it.
http://www.royalcollege.ca/rcsite/documents/canmeds/canmeds-kraemer-orthopaedic-surgery-e.pdf

Your contention that surgical residencies are too long because all the resident does is watch the attending it just wrong. Maybe that happens at some programs, but it's not the norm.

It's not the norm but it happens too often and in too many places. A 28 hour shift can work but only if you get two or three 30 minutes breaks to eat and 4 hours in which you can sleep, otherwise it simply is torturous.

All of his posts are senseless. He's posting from an Eastern European country and despite being an early year med student acts like his experience as a medic makes him an expert.

My favorite was the one where he said being a radiologist was a dangerous profession.

Yes in Europe the human body is different and your 2-bit arrogance is perfectly justified. BTW it's Central Europe - feel free to google those word. #'Murica

 

[Matthew9Thirtyfive]

It's not the norm but it happens too often and in too many places. A 28 hour shift can work but only if you get two or three 30 minutes breaks to eat and 4 hours in which you can sleep, otherwise it simply is torturous.

Bro, I do 1-2 24-36 hour shifts a week, often with 0-4 hours of sleep (usually average around 3 hours) with two meal breaks, some of which are only 15 mins. And on deployment, I was doing that every day for weeks and months at a time. It is not "tortuous." Get a grip.

 

[Spectre of Ockham]

Bro, I do 1-2 24-36 hour shifts a week, often with 0-4 hours of sleep (usually average around 3 hours) with two meal breaks, some of which are only 15 mins. And on deployment, I was doing that every day for weeks and months at a time. It is not "tortuous." Get a grip.

With all do respect how exactly are you doing 1-2 24-36 hour shifts as a premed ? And what are you doing in those shifts ?

Just asking because there's a huge freaking difference when it comes to the labor you're doing. IMHO a shift as a EMT feels like a gentle breeze compared with a ER shift which feels like a sweet memory compared with a IM shift which is still a whole dam easier than a general or thoracic surgery shift.

 

[Matthew9Thirtyfive]

With all do respect how exactly are you doing 1-2 24-36 hour shifts as a premed ? And what are you doing in those shifts ?

Just asking because there's a huge freaking difference when it comes to the labor you're doing. IMHO a shift as a EMT feels like a gentle breeze compared with a ER shift which feels like a sweet memory compared with a IM shift which is still a whole dam easier than a general or thoracic surgery shift.

I'm in the military.

 

[ProfMD]

It's not the norm but it happens too often and in too many places. A 28 hour shift can work but only if you get two or three 30 minutes breaks to eat and 4 hours in which you can sleep, otherwise it simply is torturous.

As someone who has done 28 hour shifts, I disagree with your assumption.

 

[VA Hopeful Dr]

As someone who has done 28 hour shifts, I disagree with your assumption.

Seconded

 

[educ8r]

Seconded

Thirded. Not saying it is a cakewalk, but you don't need 4 hrs of sleep and 1-1.5 hours to eat. It is nice if you can get a bathroom break in once in a while though.

 

[Crayola227]

non-surgical field,

I did something approximating 72 hours as an intern, and I was one that got into a pattern of sleep deprivation --> loss of efficiency --> sleep deprivation --> LOE, I did plenty of overnights. Plus a few times I forgot to forward my pager, so I even got to do home call! I know what it is to get woke up to put an order in and work the next day.

so I can tell you that I find it quite easy to be wake for a lot of hours, I found it very difficult to be exhausted physically, mentally, emotionally, AND learn what you need to learn to function

I think overnights for an intern are a ridiculous idea

 

[Winged Scapula]

Thirded. Not saying it is a cakewalk, but you don't need 4 hrs of sleep and 1-1.5 hours to eat. It is nice if you can get a bathroom break in once in a while though.

Fourthed,

People really need to stop using the term "torture" to describe anything involving residency, medical training or practice in the US.

 

[Spectre of Ockham]

People really need to stop using the term "torture" to describe anything involving residency, medical training or practice in the US.

OK , how about cruel joke of a system ?

You work for 80+++ hours per week with only a day off to recover your wrecked system. You get no family leave because slaves have no rights (not US slavery , slavery in general) , you have no power to negotiate, your salary is a joke a bad one if you're going FM or PCP, you have no time off for half a decade maybe more and in exchange you learn oh so much by treating the same patient type most of the time. It's not enough that med school is a pointlessly long and weakly organized mess , let's waste more time on "training".

It may be just the effect of a chronically ill healthcare system that the US has which leads to such degrading work-to-no-life conditions forced upon the brightest members of society but let us not pretend that it is the only way . The much hated French and Danes have some sort of heretical system where one can finish medical school in 4 years and become a specialist in 4-6 years while working 48 hours per week and getting extra pay for working overtime.

I speak of these countries because their 5-year survival rates are close to the US for most procedures and in the case of some procedures slightly better. Yes the US still remains the king of innovation and patient care with legendary institutions like John Hopkins , Mayo and Mass General forging a better future for humanity . However the total medical scientific output of the EU is nearing that of the US so while this collective sacrifice yields better results than any other nation on Earth maybe just maybe such sacrifice should not be mandatory. Maybe then the US and other nations could avoid turning a sacrifice of time into a sacrifice of blood and lives.

Yes you can work a 24 hour shift if you want to but it should not be a mandatory sentence that one must pay in order to be a doctor. Also with the horrific cost of insurance it seems from my perspective that even as an attending you don't really have a much higher comfort , plus if you continue to work 80+ hours per week until the grave when do you have time to enjoy life ?

I mean no disrespect in my replies most of the time. I am honored to cross swords with you in this debate and I strongly believe that the only way to move forward is to have such debates since tip-toeing around issues has never yielded positive results.

 

[VA Hopeful Dr]

I'd rather have a rough schedule and finish faster than the other way around

 

[WingedOx]

I speak of these countries because their 5-year survival rates are close to the US for most procedures and in the case of some procedures slightly better. Yes the US still remains the king of innovation and patient care with legendary institutions like John Hopkins , Mayo and Mass General forging a better future for humanity . However the total medical scientific output of the EU is nearing that of the US so while this collective sacrifice yields better results than any other nation on Earth maybe just maybe such sacrifice should not be mandatory. Maybe then the US and other nations could avoid turning a sacrifice of time into a sacrifice of blood and lives.

It's almost as if there are other public health variables involved in outcomes besides just the surgeon.

Yes you can work a 24 hour shift if you want to but it should not be a mandatory sentence that one must pay in order to be a doctor. Also with the horrific cost of insurance it seems from my perspective that even as an attending you don't really have a much higher comfort , plus if you continue to work 80+ hours per week until the grave when do you have time to enjoy life ?
.

It's true man. The sleep deprivation never ends. I've got a 9:30 PM hockey game tonight. Probably won't be in bed until after midnight. Gonna be draggin' it at work like mad tomorrow. Attending life is strenuous.

 

[NeuResurgens]

The sad matter is that medicine is a hard profession to learn and you need to put in a s*** ton of hours to get good at it. No easy way of getting through this. I hope residents aren't pressured beyond what they really need for education purposes, but that's a more vague matter and probably varies by program

 

[username456789]

You guys whining about "torture" are free to apply to PA school if you're not cut out to be a doctor.

 

[Psai]

OK , how about cruel joke of a system ?

You work for 80+++ hours per week with only a day off to recover your wrecked system. You get no family leave because slaves have no rights (not US slavery , slavery in general) , you have no power to negotiate, your salary is a joke a bad one if you're going FM or PCP, you have no time off for half a decade maybe more and in exchange you learn oh so much by treating the same patient type most of the time. It's not enough that med school is a pointlessly long and weakly organized mess , let's waste more time on "training".

It may be just the effect of a chronically ill healthcare system that the US has which leads to such degrading work-to-no-life conditions forced upon the brightest members of society but let us not pretend that it is the only way . The much hated French and Danes have some sort of heretical system where one can finish medical school in 4 years and become a specialist in 4-6 years while working 48 hours per week and getting extra pay for working overtime.

I speak of these countries because their 5-year survival rates are close to the US for most procedures and in the case of some procedures slightly better. Yes the US still remains the king of innovation and patient care with legendary institutions like John Hopkins , Mayo and Mass General forging a better future for humanity . However the total medical scientific output of the EU is nearing that of the US so while this collective sacrifice yields better results than any other nation on Earth maybe just maybe such sacrifice should not be mandatory. Maybe then the US and other nations could avoid turning a sacrifice of time into a sacrifice of blood and lives.

Yes you can work a 24 hour shift if you want to but it should not be a mandatory sentence that one must pay in order to be a doctor. Also with the horrific cost of insurance it seems from my perspective that even as an attending you don't really have a much higher comfort , plus if you continue to work 80+ hours per week until the grave when do you have time to enjoy life ?

I mean no disrespect in my replies most of the time. I am honored to cross swords with you in this debate and I strongly believe that the only way to move forward is to have such debates since tip-toeing around issues has never yielded positive results.

Just quit med school so we don't have to hear you complaining
Haven't even done a single 24 hour call yet but you're still writing anna karenina over here

 

[LucidSplash]

Make sure you don't post in the threads about trying to figure out how to moonlight since you'll be too exhausted from your regular workweek.

 

[cbrons]

What do you expect?

They have their "studies" which show that patient safety is not impacted by longer vs. shorter shifts. Therefore, you'll work longer shifts. How you feel about the matter is of absolutely no relevance.

 

[ProfMD]

What do you expect?

They have their "studies" which show that patient safety is not impacted by longer vs. shorter shifts. Therefore, you'll work longer shifts. How you feel about the matter is of absolutely no relevance.

Your feelings are relevant. Don't want to work 24 hour shifts? Look for specialities / programs that use night float.

 

[SunsFun]

I'd rather have a rough schedule and finish faster than the other way around

Would you be okay with giving others more options in terms of length of training and intensity tradeoff.


Sent from my iPhone using SDN mobile app

 

[VA Hopeful Dr]

Would you be okay with giving others more options in terms of length of training and intensity tradeoff.


Sent from my iPhone using SDN mobile app

Probably not intra-program as that would screw up schedules but if a whole program wanted to I don't see why not.

Funding would be an issue as I wouldn't want CMS to pay more money than is currently allotted for training a resident, but the program in question could make up the difference if they wanted to do this.

 

[Spectre of Ockham]

I'd rather have a rough schedule and finish faster than the other way around

But you don't ever finish , if you want to stay relevant , get tenure and advance your career you still have to publish like a dog and if you actually want not to eat ramen from the garbage you do need to run your own business / investment portfolio or moonlight. Kind of hard to do any of those if you are glued to the OR floor 100 hour per week every other day. Not to mention stupid stuff like working out and spending time with your family.

You guys whining about "torture" are free to apply to PA school if you're not cut out to be a doctor.

Just quit med school so we don't have to hear you complaining
Haven't even done a single 24 hour call yet but you're still writing anna karenina over here

And risk not seeing the tears flow from bitter attendings that we might not get worked to death like in the ye old days ? Not a chance. The river of Stockholm syndrome tears is an amazing site to see.

Make sure you don't post in the threads about trying to figure out how to moonlight since you'll be too exhausted from your regular workweek.

Fortunately I got nice business already making me cash so that's not a problem.

What do you expect?

They have their "studies" which show that patient safety is not impacted by longer vs. shorter shifts. Therefore, you'll work longer shifts. How you feel about the matter is of absolutely no relevance.

Studies ? You mean study in which they cherry picked the data to suit their ye old purpose. I mean in every other profession on Earth performance starts to degrade if you're working insane hours but surely one study will prove the world wrong. Alternative facts FTW.

Also you're working 80 hours per week / 363 days per year . Since when has accelerated cerebral atrophy led to better professionals ?

 

[username456789]

But you don't ever finish , if you want to stay relevant , get tenure and advance your career you still have to publish like a dog and if you actually want not to eat ramen from the garbage you do need to run your own business / investment portfolio or moonlight. Kind of hard to do any of those if you are glued to the OR floor 100 hour per week every other day. Not to mention stupid stuff like working out and spending time with your family.





And risk not seeing the tears flow from bitter attendings that we might not get worked to death like in the ye old days ? Not a chance. The river of Stockholm syndrome tears is an amazing site to see.



Fortunately I got nice business already making me cash so that's not a problem.



Studies ? You mean study in which they cherry picked the data to suit their ye old purpose. I mean in every other profession on Earth performance starts to degrade if you're working insane hours but surely one study will prove the world wrong. Alternative facts FTW.

Also you're working 80 hours per week / 363 days per year . Since when has accelerated cerebral atrophy led to better professionals ?

Aside from hearing yourself whine, what is it you hope to accomplish here? If I recall, you are a student in a European country. Complaining that you know best about US residency training is ineffective.

Short of repeating yourself ad nauseum for the sake of repeating yourself ad nauseum, what is your goal? Throwing out childish phrases like "Stockholm Syndrome tears" does nothing to strengthen your position.

If it's any consolation, it's unlikely you'll ever have the pleasure of training on one of our horrible slave plantations here in the US.

 

[Spectre of Ockham]

*salty gargle*

What did you expect ? That you can silence people with childish insults ?

Here's one for you , if you're an attending - allegedly - why do you waste your time trying to troll med students on a forum ?

 

[Psai]

What did you expect ? That you can silence people with childish insults ?

Here's one for you , if you're an attending - allegedly - why do you waste your time trying to troll med students on a forum ?

If you can't handle the heat, get out of the kitchen

 

[username456789]

What did you expect ? That you can silence people with childish insults ?

This is the kind of childish stuff I'm talking about.

Good luck with whatever it is you're doing over there. I'm sure "salty gargle" means something to someone somewhere.

 

[ProfMD]

But you don't ever finish , if you want to stay relevant , get tenure and advance your career you still have to publish like a dog and if you actually want not to eat ramen from the garbage you do need to run your own business / investment portfolio or moonlight. Kind of hard to do any of those if you are glued to the OR floor 100 hour per week every other day. Not to mention stupid stuff like working out and spending time with your family.

You really have no idea what the life of an academic surgeon is, do you? Hint: it's nothing like you describe.

Studies ? You mean study in which they cherry picked the data to suit their ye old purpose. I mean in every other profession on Earth performance starts to degrade if you're working insane hours but surely one study will prove the world wrong. Alternative facts FTW.

Show me your counter-studies. At the very least, show me the cherry picked data you claim exists.

Also you're working 80 hours per week / 363 days per year . Since when has accelerated cerebral atrophy led to better professionals ?

I know of no residencies that work 363 days a year. Everyone I am aware of gets 3-4 weeks of vacation a year. And trust me, the residents use it. Also, in most residencies, you will not be 80 hours per week. That's mostly surgeons.

 

[Mr Roboto]

Lol everyone finished says it's great (doesn't affect them) and everyone who it will affect says it's ****e.

K /thread.

 

[ProfMD]

Lol everyone finished says it's great (doesn't affect them) and everyone who it will affect says it's ****e.

K /thread.

What you mean to say is that the people with experience (who have lived it, in some cases under both systems) think going back to 24 hour shifts is fine and the people without experience (who don't know what they are talking about) are opposed.

 

[mimelim]

But you don't ever finish , if you want to stay relevant , get tenure and advance your career you still have to publish like a dog and if you actually want not to eat ramen from the garbage you do need to run your own business / investment portfolio or moonlight. Kind of hard to do any of those if you are glued to the OR floor 100 hour per week every other day. Not to mention stupid stuff like working out and spending time with your family.





And risk not seeing the tears flow from bitter attendings that we might not get worked to death like in the ye old days ? Not a chance. The river of Stockholm syndrome tears is an amazing site to see.



Fortunately I got nice business already making me cash so that's not a problem.



Studies ? You mean study in which they cherry picked the data to suit their ye old purpose. I mean in every other profession on Earth performance starts to degrade if you're working insane hours but surely one study will prove the world wrong. Alternative facts FTW.

Also you're working 80 hours per week / 363 days per year . Since when has accelerated cerebral atrophy led to better professionals ?

It is sad how little you know about clinical medicine, but how strong your opinions are about safety and how to teach it. There are practical realities of training. There are more than one variable at play here, it is unclear if you are being intentionally obtuse or really just that woefully ignorant of the topic.

Lol everyone finished says it's great (doesn't affect them) and everyone who it will affect says it's ****e.

K /thread.

This affects me, a lot. I have been a resident for 5 years. I have 2 more to go. I work with our GME and the NRMP. Short story: I know a **** load more residents than you. I can't recall a single resident that thinks that the intern work hours are a good idea.

 

[motu]

General question here, just curious. Not trying to protest the system because its obviously worked well, but as a soon to be med student, just want to know the reasoning behind why there are such long shifts for residents? What is it trying to achieve? Pros/cons?

 

[Ismet]

Lol everyone finished says it's great (doesn't affect them) and everyone who it will affect says it's ****e.

K /thread.

Not really. The majority of the people complaining are people who have never set foot in residency in the US. I'll be a PGY-2 next year and I'll be doing 24's, the rule isn't new for us, only incoming interns. And looking back on my inpatient service months in intern year, I would have preferred having some 24's. Would have had much more time off. And my first 24 would have been as an intern with a senior there to have my back. Now my first 24 will be as the senior making the decisions.

General question here, just curious. Not trying to protest the system because its obviously worked well, but as a soon to be med student, just want to know the reasoning behind why there are such long shifts for residents? What is it trying to achieve? Pros/cons?

Because you're learning how to be a doctor and doctors don't get to go home when the clock strikes 5 and there are still patients to be taken care of. There's a lot to learn in residency. You learn a lot more by admitting a patient and seeing them through rather than admitting them at 6pm and handing them off to a night team. You reduce harm to patients by reducing the number of times patient information has to be handed off to other residents.