My CNN.com article on resident work hours

[VardamanBundren]

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Great article! Thank you for posting!

 

[joonage]

Hi everyone,
Just wanted to post a link to an article I wrote for CNN.com on resident work hours. Medical school and residency is a bear, and the ACGME in 2011 instituted new work hour restrictions on interns. I'd love to hear your thoughts, as training to become doctors is ever-changing.

http://www.cnn.com/2012/06/26/health/youn-doctors-fall-asleep/index.html?hpt=hp_c2

Best wishes

People probably already said this, but woah?! Did not know you were on SDN. Your book was interesting and made me set up shadowing with a plastic surgeon to see how it is.

And great article. Random side note: Anyone else think the surgeon in the photo looks like Stephen Colbert ...

 

[celling]

So many of the residents post at this ungodly hour

Aren't you tired?

-On trauma night call this month. I was between a GSW to the head and an MVC. So, I was busy enough not to be tired.

 

[Law2Doc]

General surgery isn't one of those specialties that's very conducive to the "two days a week, no call" emeritus guy. We don't have anyone who does that, and while I have met one in the past, it's pretty uncommon....

The surgeons (plural) I know who work these hours more or less are old timers who now just do elective scheduled stuff, usually oncologic, and leave the acute stuff to the young guns in their group. There may not be many but their lower hours certainly help the averages.

 

[Hour30]

Is the only way to effectively train doctors is to work them to near death? The obvious solution is to extend residency that routinely works interns to the ground by one year, but I assume there are some serious complications to this or it would have been done already. What is the ideal solution?

In this same line of thought, I have heard that there may be a push to eliminate general intern years in fields such as mine (ENT), and do 5 straight years of ENT. This way residents wouldn't have to do 6 years, but would be more versed in otolaryngologic procedures.

 

[Hour30]

So, I have to ask - how do residents make any sort of life outside medicine work? I'm getting scared just reading the numbers here of how much interns are at the hospital for... and presumably doing this for 4 or more years during their 20's and 30's. Not to sound uncommitted to medicine, but how does any sort of personal relationship work when one person is barely home and when they ARE home, they want to do nothing but crash in bed? Or have any time for unwinding (hobbies) to stay sane?? And it sounds like all residents do this every week, for years and years...

If it is your passion it is doable! I have a wife, dog, and infant TWINS!

Having said that... the first 3 years of residency were as hard as they get under the law at the time. Q4 hour 30 shifts for 3 years... I wouldn't wish that on my worst enemy. However, you make it work and get through it. I'm glad that they beat me down and whipped me into a great surgeon. Now that I am chief, the hours are much better and approximate that of practice.

LIFE IS GOOD!

 

[mvenus929]

So, I have to ask - how do residents make any sort of life outside medicine work?

I dunno... the hours I've seen my residents work aren't horrendous. Hard, sure. But not horrendous. This was our team's schedule this past week.

Sunday - Off
Monday - Short call: 6:30 am - 9 pm
Tuesday - 6:30 am - 5 pm
Wednesday - 6:30 am - 5 pm
Thursday - Clinic day: 6:30 am - 6 pm
Friday - Long call: 6:30 am - 11 am Saturday morning
Saturday - Leave at 11 am
Sunday - Off

Our night float system is set up so the night floaters work Sunday night through Thursday night from 8ish til 9ish the next morning (they often go to morning conference at 8). On Friday and Saturday, the resident stays for 28 hour call, while the intern goes home and comes back the next morning to round and whatnot. When you're on call on Thursday, you get the whole weekend off. We pick up patients on our call days and our post post-call days (when our sister team is on call). And the more efficient you are, the later you can come in in the morning; prerounds just have to be done by 8 am.

Granted, this is one service (general medicine) in one hospital, so grain of salt and all that.

From what I've heard, students at the few schools that are on a 18-month pre-clinical curriculum still take step 1 around the same time as everyone else. They are allowed to start clinical w/o having completed it.

We have an abbreviated curriculum; we finish second year courses in December, and take Step 1 between then and the first week in February, then begin clerkships at the end of February.

So many of the residents post at this ungodly hour

Aren't you tired?

You'd be surprised how quickly you'll adjust to early morning hours if you have to do it 6 days out of the week.