Please tell how much hours in General Surgery now?

[AndreyE]

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Hey!
I dropped my idea of coming to the USA to work since I think so many hours are life killing and not enough to spend any money gained.
So I'm an intern in russia now. Here it works this way: one year as an intern and here you go - you can work as a general surgeon (if any hospital accepts you with this lack of exp which is not that rare).

QUESTION
Today I told my attending (who apparently used to have a dream of coming to the USA because he told me he was preparing for the USMLE) that working hours in general surgery for residents are more than 80 hours a week and attendings might do even more. He said no way you're nuts.
So please write him here a sample schedule for a week or just say a few words.
I think he will be happy to find out he haven't lost much when not coming to the USA.

 

[Winged Scapula]

Residency programs in the US restrict working hours to an average of 80 hours, averaged over a 4 week period.

From the ACGME: "Duty hours must be limited to 80 hours per week, averaged over a four- week period, inclusive of all in-house call activities and all moonlighting." Here is the source document (see page 16): http://www.acgme.org/acWebsite/home/Common_Program_Requirements_07012011.pdf

Some programs, most notably Neurosurgery, have gotten permission for 88 hours per week.

I will leave the discussion as to whether or not programs violate these work hours to other threads as it has been discussed ad nauseum and cannot be predicted on a large scale basis, as it is program, census, Chief resident and rotation specific.

There are no work hour restrictions for Attending physicians, including General Surgeons. Depending on how your practice is set up, you can be up all night in the ED/OR and then expected to see patients the next day in the office, and there are currently no rules preventing that.

Moving to the Surgery Forum..

 

[AndreyE]

And how many hours per week an average attending does? I bet it's 90-100hrs

 

[Winged Scapula]

That is going to vary considerably from community, hospital census, whether you have residents who take first call, the call schedule and luck. You are asking for something that cannot be accurately predicted but I would say that 90-100 hours per week as an Attending is too high...it can be that high but the average would probably be less than resident work hours. You can tell your friend it is not a 40 hour per week job.

 

[jubb]

Clinical hours are probably more like 60-70 hrs/wk on average. I guess a lot will depend on whether or not there are in-house call requirements, and what subspecialty they are in, academic vs. private and many other factors.

 

[Khaos]

Residency programs in the US restrict working hours to an average of 80 hours, averaged over a 4 week period.

From the ACGME: "Duty hours must be limited to 80 hours per week, averaged over a four- week period, inclusive of all in-house call activities and all moonlighting." Here is the source document (see page 16): http://www.acgme.org/acWebsite/home/Common_Program_Requirements_07012011.pdf

Moving to the Surgery Forum..

Hahaha...I remember my rotations in surgery, orthopedics, and ICU. This was all after the 80 hour restriction. I can tell you without a doubt that everybody in the other fields were going over that restriction often, especially the surgeons. I remember being on call with one of the ortho residents, doing rounds until 10am (hitting 28hours straight) and then he went into the OR to "gain more experience" until 3 to 4 pm. He easily went over his hours. Same for the surgery residents. The IM guys tried to get me to stay past my 80 hours and my 30 hours straight. It didn't work out for them. I explained that my director was very strict with the rules and if they wanted they could ask him if I could stay past the restrictions. They left me alone after the first time in the middle of rounds I handed the senior resident my notes and told him I hit 30 hours and then walked out after the attending asked me where I was going and I explained that I hit my 30 hours and I had to leave.

The problem with these restrictions is that most residencies record hours given to them by the residents. It is very easy to write down that you only did 80 hours and I've seen it done so many times. Luckily, as an EM resident I never came close to that while on EM, only on off rotations.

 

[Docbeme]

Hahaha...I remember my rotations in surgery, orthopedics, and ICU. This was all after the 80 hour restriction. I can tell you without a doubt that everybody in the other fields were going over that restriction often, especially the surgeons. I remember being on call with one of the ortho residents, doing rounds until 10am (hitting 28hours straight) and then he went into the OR to "gain more experience" until 3 to 4 pm. He easily went over his hours. Same for the surgery residents. The IM guys tried to get me to stay past my 80 hours and my 30 hours straight. It didn't work out for them. I explained that my director was very strict with the rules and if they wanted they could ask him if I could stay past the restrictions. They left me alone after the first time in the middle of rounds I handed the senior resident my notes and told him I hit 30 hours and then walked out after the attending asked me where I was going and I explained that I hit my 30 hours and I had to leave.

The problem with these restrictions is that most residencies record hours given to them by the residents. It is very easy to write down that you only did 80 hours and I've seen it done so many times. Luckily, as an EM resident I never came close to that while on EM, only on off rotations.

I'm an M2 and have a question about hours. How would you get around your system logon and logoff times? I have heard stories about residents in programs going "over the limit" and requests being made for residents' work hours as shown on the facility's computer system. If you are filing paperwork showing compliance and a disparity shows up, wouldn't that be an easy ticket out of a program?

 

[Ski2Doc]

I'm an M2 and have a question about hours. How would you get around your system logon and logoff times? I have heard stories about residents in programs going "over the limit" and requests being made for residents' work hours as shown on the facility's computer system. If you are filing paperwork showing compliance and a disparity shows up, wouldn't that be an easy ticket out of a program?

You are right, with electronic systems its definitely possible to pin your exact hours more easily, but who the heck will waste that time.

From what i hear the penalties are stiff to the program, hopkins got severly penalized for violoating the rules, and so the PD's are pretty strict on telling residents to go home.

BTW, didnt a medscape study this year come up with an average workweek of a surgeon is 51hours?
Around 20K responded to the survey i think. However, it includes all surgical specialties. and all hours worked - OR, office, and paperwork.