Longer Shifts for First-Year Residents to Start in July

[VA Hopeful Dr]

Why are you so obsessed with perceived injustice and persecution when you haven't even started yet? Between this thread and all your threads on how to report a residency program for violations its ridiculous.

You'd be much better served to go into residency with a positive attitude, rather than a presumption of persecution and a negative outlook.

But but but, slavery and torture...

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[Light at end of tunnel]

Why are you so obsessed with perceived injustice and persecution when you haven't even started yet? Between this thread and all your threads on how to report a residency program for violations its ridiculous.

You'd be much better served to go into residency with a positive attitude, rather than a presumption of persecution and a negative outlook.

Well I can certainly appreciate your perspective. I don't mean to be persecutory at all.

It is important to be optimistic, but it's also important to be informed. To that end, having both sides of the discussion is critical. We cant be pretending things are peachy kean if they aren't.

 

[ProfMD]

That's like telling cancer patients if they don't like chemo side effects, they can quit! But oh yeah, then they die!

Pure genius.

It's not like the rigors of training are any secret. If someone doesn't think they can or want to do it - don't got to medical school or choose a less rigorous speciality.

 

[Light at end of tunnel]

It's not like the rigors of training are any secret. If someone doesn't think they can or want to do it - don't got to medical school or choose a less rigorous speciality.

Completely agree here. Medicine isn't for everyone.

Regarding the rigors of training: sure folks may have a general sense of how tough things can be. But the SDN community can help fill in the devilish details.

I guess I'm just advocating for a more balanced discussion.

 

[SunsFun]

It's not like the rigors of training are any secret. If someone doesn't think they can or want to do it - don't got to medical school or choose a less rigorous speciality.

You know this line of reasoning is akin to "because I said so" parental reply. Saying "just quit" or "don't go to medical school if you are not okay with x, y, or z" just puts you at odds with those who have valid concerns or don't share your view of what effective medical education should look like.

We all come from different places in our lives and training. If we don't have some form of dialogue and reduce it all to ultimatums, medicine will go into crapper even faster.


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[Light at end of tunnel]

You know this line of reasoning is akin to "because I said so" parental reply. Saying "just quit" or "don't go to medical school if you are not okay with x, y, or z" just puts you at odds with those who have valid concerns or don't share your view of what effective medical education should look like.

We all come from different places in our lives and training. If we don't have some form of dialogue and reduce it all to ultimatums, medicine will go into crapper even faster.


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Exactly.

Folks around here would be wise to acknowledge and address the points raised rather than squash them by any means necessary, including ad hominem.

I think you would be surprised how easily leaves can be turned over if we actually listened to one another rather than dictated our opinions as biblical literature.

 

[ChEMD]

I can't believe this whole thread came about because of one rule change to increase the amount of time an intern can work by 8 (+4) hours. As far as I'm aware, nothing else has changed. PGY2s and above have been and will continue to work 24 hour shifts. No one ever said being a physician was easy, but please stop equating it to slave labor. There are plenty other of other professions, inside and outside of medicine, that work long shifts. Hard work is not unique to medicine.

 

[AcademicNeurosurgery]

I can't believe this whole thread came about because of one rule change to increase the amount of time an intern can work by 8 (+4) hours. As far as I'm aware, nothing else has changed. PGY2s and above have been and will continue to work 24 hour shifts. No one ever said being a physician was easy, but please stop equating it to slave labor. There are plenty other of other professions, inside and outside of medicine, that work long shifts. Hard work is not unique to medicine.

Yes, no one said being a physician is easy but that doesn't warrant dismissing a critical evaluation of the culture of medicine to see if there is room for improvement. If there's a way we can maintain or improve quality of care while providing a better quality of life for health care professionals, why should we just accept the status quo? I am not saying there is an easy solution but accepting past ways of medical practice as the status quo moving forward is a disservice to everyone in the field, including patients.

With regards to your last point - while hard work is not unique to medicine, you'll be hard-pressed to find a field outside of medicine where every decision you make has a direct impact on someone's health and life.

 

[Light at end of tunnel]

But but but, slavery and torture...

We spent hours trying to move away from these inflammatory analogies, yet you flippantly allude to them once more for no reason other than the possibility that you have run out of all other gaslight fuel material.

Very disheartening.

Might I suggest you weigh in with meaningful substance instead?

 

[ProfMD]

You know this line of reasoning is akin to "because I said so" parental reply. Saying "just quit" or "don't go to medical school if you are not okay with x, y, or z" just puts you at odds with those who have valid concerns or don't share your view of what effective medical education should look like.

We all come from different places in our lives and training. If we don't have some form of dialogue and reduce it all to ultimatums, medicine will go into crapper even faster.


Sent from my iPhone using SDN mobile app

Exactly.

Folks around here would be wise to acknowledge and address the points raised rather than squash them by any means necessary, including ad hominem.

I think you would be surprised how easily leaves can be turned over if we actually listened to one another rather than dictated our opinions as biblical literature.

There has been ample dialogue. Just look at the pages and pages and pages of numerous threads on this topic. If you don't think there has been ample dialogue - use the search function.

If you do that, you will see that by and large people who have been there support the rule change. We have given our reasoning and nauseum. By and large, the people who oppose the rule change and want further work hour restrictions have not been there and done that. (Of course there are exceptions.)

Beyond our own personal experiences as trainees and now attendings, we have posted links to the studies that have been done on the rules. These studies show no improvement in patient safety and serious concern for inadequate training with further reductions in work hours.

Yet, despite all this open dialogue, people still start new threads or jump into the middle of old ones acting like the sky is falling, equating residency training to torture of POWs, etc. Yet, if you step back, you will see that the only thing that is changing is that interns will be able to work 24 hour shifts like every other resident who is R2 and above. Nothing else changes. No one is suggesting that we repeal the 2003 rules. No one is even saying that interns must work 24 hour shifts - it is still up to each program.

So, pardon me if my last post was a bit short.

 

[ProfMD]

Yes, no one said being a physician is easy but that doesn't warrant dismissing a critical evaluation of the culture of medicine to see if there is room for improvement. If there's a way we can maintain or improve quality of care while providing a better quality of life for health care professionals, why should we just accept the status quo? I am not saying there is an easy solution but accepting past ways of medical practice as the status quo moving forward is a disservice to everyone in the field, including patients.

With regards to your last point - while hard work is not unique to medicine, you'll be hard-pressed to find a field outside of medicine where every decision you make has a direct impact on someone's health and life.

By your screen name I am going to assume you are interested in neurosurgery. If that is the case, I hope you understand that neurosurgery residents and attendings have some of the most grueling work hours out there. This is not likely to change anytime soon.

 

[SunsFun]

There has been ample dialogue. Just look at the pages and pages and pages of numerous threads on this topic. If you don't think there has been ample dialogue - use the search function.

If you do that, you will see that by and large people who have been there support the rule change. We have given our reasoning and nauseum. By and large, the people who oppose the rule change and want further work hour restrictions have not been there and done that. (Of course there are exceptions.)

Beyond our own personal experiences as trainees and now attendings, we have posted links to the studies that have been done on the rules. These studies show no improvement in patient safety and serious concern for inadequate training with further reductions in work hours.

Yet, despite all this open dialogue, people still start new threads or jump into the middle of old ones acting like the sky is falling, equating residency training to torture of POWs, etc. Yet, if you step back, you will see that the only thing that is changing is that interns will be able to work 24 hour shifts like every other resident who is R2 and above. Nothing else changes. No one is suggesting that we repeal the 2003 rules. No one is even saying that interns must work 24 hour shifts - it is still up to each program.

So, pardon me if my last post was a bit short.

No worries. I actually enjoy reading your comments and find myself agreeing with most of your stances. My reply was meant to get us back to the issues. I've read enough of this thread and SDN to know that pretty much every new topic is beating a dead horse but despite my initial urge to dismiss it, I try (not always successfully) to reexplain things and defend my points as long as necessary. The new commenters barging in regurgitating same old mantra that has been discussed just a page earlier can get quite annoying but I think we are doing everyone a disservice who reads this thread when we chose the blunt "just quit, etc" replies.

Sorry, I didn't mean to single you out. Just wanted to see less dismissive tone on both sides.


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[Light at end of tunnel]

There has been ample dialogue. Just look at the pages and pages and pages of numerous threads on this topic. If you don't think there has been ample dialogue - use the search function.

If you do that, you will see that by and large people who have been there support the rule change. We have given our reasoning and nauseum. By and large, the people who oppose the rule change and want further work hour restrictions have not been there and done that. (Of course there are exceptions.)

Beyond our own personal experiences as trainees and now attendings, we have posted links to the studies that have been done on the rules. These studies show no improvement in patient safety and serious concern for inadequate training with further reductions in work hours.

Yet, despite all this open dialogue, people still start new threads or jump into the middle of old ones acting like the sky is falling, equating residency training to torture of POWs, etc. Yet, if you step back, you will see that the only thing that is changing is that interns will be able to work 24 hour shifts like every other resident who is R2 and above. Nothing else changes. No one is suggesting that we repeal the 2003 rules. No one is even saying that interns must work 24 hour shifts - it is still up to each program.

So, pardon me if my last post was a bit short.

Fair enough.

I would second the need to be less dismissive overall, from both sides. I'm sure we can bridge the gap with respectful discussion.

 

[Psai]

Completely agree here. Medicine isn't for everyone.

Regarding the rigors of training: sure folks may have a general sense of how tough things can be. But the SDN community can help fill in the devilish details.

I guess I'm just advocating for a more balanced discussion.

You don't have a general sense of anything. We do. Because we've lived it. All you've done is sit in a library for a few hours a day if even that

 

[Light at end of tunnel]

You don't have a general sense of anything. We do. Because we've lived it. All you've done is sit in a library for a few hours a day if even that

I guess we'll have to take your perfectly timed post as the poster child for dismissiveness.

I'm not sure it's possible to offer a better non-example, strong work.

 

[AcademicNeurosurgery]

By your screen name I am going to assume you are interested in neurosurgery. If that is the case, I hope you understand that neurosurgery residents and attendings have some of the most grueling work hours out there. This is not likely to change anytime soon.

I certainly do understand that and the grueling nature is one of the things that drew me to the field. Again, my point is about not accepting the way things are done just because they have always been done this way. Yes, there is often a method to the madness and I value perspectives from attendings who have been through it all (it certainly helps when they explain why things are the way they are, we aren't stupid so a simple explanation can go a long way). At the same time, you have to admit that there are some things in medicine that have no logical explanation for their being other than "I had to do it, so you do too". These are the areas we can work on and you don't have to be an attending to discuss how we may be able to improve both medical education and delivery of care.

 

[AcademicNeurosurgery]

I guess we'll have to take your perfectly timed post as the poster child for dismissiveness.

I'm not sure it's possible to offer a better non-example, strong work.

Psai has a knack for finding the least communicable/most inflammatory way to make a point. It's generally a good idea to ignore and move on.

 

[Light at end of tunnel]

Psai has a knack for finding the least communicable/most inflammatory way to make a point. It's generally a good idea to ignore and move on.

Indeed, any other time I wouldn't have bothered to engage.

But, let's give some credit, psai's post really captures the quintessential essence of dismissiveness.

We can even throw them a bone and pretend it was their intention all along.

 

[Winged Scapula]

Congrats you managed to put everyone down in just one short paragraph.

Nobody cares how much you worked back in the day. It's irrelevant to discussion at hand. Also "your patients" survival less than they do now with advent of evidence-based medicine.

I got a bright idea. Why don't you and people like you quit instead of telling others to quit. That way we could actually attempt to attract non-malignant individuals who you'd actually want to be around for longer.


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C'mon guys...you missed that kineticdeux was posting as part of an April Fool's day SDN prank. Stop taking what he/she wrote so seriously; we had several trolls going around the site yesterday.

BTW, IRT Libby Zion let's not forget that she neglected to tell the staff about the phenelzine, Percodan and cocaine she was using and died from fatal serotonin syndrome. Even the courts didn't believe that work hours killed her.

 

[SunsFun]

C'mon guys...you missed that kineticdeux was posting as part of an April Fool's day SDN prank. Stop taking what he/she wrote so seriously; we had several trolls going around the site yesterday.

BTW, IRT Libby Zion let's not forget that she neglected to tell the staff about the phenelzine, Percodan and cocaine she was using and died from fatal serotonin syndrome. Even the courts didn't believe that work hours killed her.

He definitely got me


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[ProfMD]

I certainly do understand that and the grueling nature is one of the things that drew me to the field. Again, my point is about not accepting the way things are done just because they have always been done this way. Yes, there is often a method to the madness and I value perspectives from attendings who have been through it all (it certainly helps when they explain why things are the way they are, we aren't stupid so a simple explanation can go a long way). At the same time, you have to admit that there are some things in medicine that have no logical explanation for their being other than "I had to do it, so you do too". These are the areas we can work on and you don't have to be an attending to discuss how we may be able to improve both medical education and delivery of care.

If you read all these threads you will see that none of us are using the "I had to do it, so you do too" argument with regards to work hours.

 

[VA Hopeful Dr]

We spent hours trying to move away from these inflammatory analogies, yet you flippantly allude to them once more for no reason other than the possibility that you have run out of all other gaslight fuel material.

Very disheartening.

Might I suggest you weigh in with meaningful substance instead?

You mean like the literally dozens or posts I have on this topic that, combined with the other attending school and residents who have posted as well, get ignored and the same types of posts get put up again and again, even within the same thread, despite our points to the contrary?

 

[Goro]

Millenials.

Why are you so obsessed with perceived injustice and persecution when you haven't even started yet? Between this thread and all your threads on how to report a residency program for violations its ridiculous.

You'd be much better served to go into residency with a positive attitude, rather than a presumption of persecution and a negative outlook.

 

[AcademicNeurosurgery]

Millenials.

Classic old fart comment.

Edit: Given the nature of this thread, I feel the need to clarify that this comment is in jest.

 

[Goro]

Go back and re-read SouthernSurgeon 's post.

Classic old fart comment.

 

[bannie22]

I wonder how many more sacrifices are needed before work hours are completely revamped to respect the health and dignity of fellow human beings.
Nobody wants to be taken care of by someone 24hours into their work, and neither does anyone want to work 24hours continuous, except for those tempted by the "postcall day".

 

[VA Hopeful Dr]

I wonder how many more sacrifices are needed before work hours are completely revamped to respect the health and dignity of fellow human beings.
Nobody wants to be taken care of by someone 24hours into their work, and neither does anyone want to work 24hours continuous, except for those tempted by the "postcall day".

Well no ****. I don't really want to work at all most days. Sadly, its hard to earn money otherwise.

I also don't want longer training. If I had to do it over again, I'd rather 3 years at 80 hours than 5 at 50.

Beyond that, who is going to pay for all these extra doctors? 24 hour calls don't end once you leave residency for most specialties - in fact that often get worse. If we break shifts up we have to start paying all the extra doctors who are picking up the slack.

 

[ProfMD]

I wonder how many more sacrifices are needed before work hours are completely revamped to respect the health and dignity of fellow human beings.
Nobody wants to be taken care of by someone 24hours into their work, and neither does anyone want to work 24hours continuous, except for those tempted by the "postcall day".

Which sacrifices are you referring to?

Beyond anecdotes and assumptions, there have been no reports of sacrifices on a systemic scale beyond one's time.