Possible change in residency shift / sleep requirement

Excelsius

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That's a far better solution than trying to decrease the 80 hours per week thereby extending the length of already lengthy residency.
 
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Terpskins99

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Hey, here's a simple solution to reduce fatigue-related errors made by residents working 30 hour shifts...
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..............................DON'T HAVE RESIDENTS WORK 30 HOUR SHIFTS. :mad:
 

The South Face

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I was chatting with my boss (an MD) and he mentioned there was talk of reducing the 80 hr work week down to 56 to address this very problem. The catch is that they would lengthen residencies by a year or two on the back end to make up for the lost time.
 

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A lot of the old folks are not gonna like this. :smuggrin: I view residency like horrible pledging. You're hazed out of your mind and until its over, you're dirt. Then, when you get to the end, you want to rub others' faces in the grime. Yay.
 

rockydoc

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I agree that residents shouldnt have to work 30 hour shifts with no sleep....But Ill play devil's advocate here as well. This topic has come up while shadowing different doctors and they pointed out that a major advantage to residents being at the hospital for such long periods of time (virtually 24/7) is exposure. Residents learn by exposure to pretty much every possible patient encounter and every case (even the ones that arent as common). The only way that you can learn about all the different cases adequately is to be at the hospital when it happens. So in a sense, the 30 hr shifts suck, but at the same time, they are incredible from an educational standpoint. Plus, I have read somewhere that even with shorter shifts for doctors at different hospitals that there was no significant decrease in patient mortality and morbidity.
 

MrBurns10

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There are two things that will be hurt significantly by a decrease in the number of hours:

1) resident education
2) medical student education

First, there is no way a surgery or internal medicine resident can get everything done that they do now in a 56 hour week. It's impossible. If they really want to decrease the number of hours, they're going to have to start with decreasing the amount of paperwork/BS crap that is currently required. And there is A LOT.

Second, med students will be hurt significantly by a decrease in the hours a resident can be on service. 3rd year is great if you have a team that is willing to teach you, answer your questions, challenge you, etc. What happens when they're in an even bigger rush than they are now because they have to get what they used to get done in 80 hours done in 56? Those sit-down, "let's talk about diabetic ketoacidosis" discussions won't happen anymore.

And then you're talking about adding another year or two of working onto an already long process? It's just a bad, bad idea.
 

Excelsius

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There are two things that will be hurt significantly by a decrease in the number of hours:

1) resident education
2) medical student education

First, there is no way a surgery or internal medicine resident can get everything done that they do now in a 56 hour week. It's impossible. If they really want to decrease the number of hours, they're going to have to start with decreasing the amount of paperwork/BS crap that is currently required. And there is A LOT.

Second, med students will be hurt significantly by a decrease in the hours a resident can be on service. 3rd year is great if you have a team that is willing to teach you, answer your questions, challenge you, etc. What happens when they're in an even bigger rush than they are now because they have to get what they used to get done in 80 hours done in 56? Those sit-down, "let's talk about diabetic ketoacidosis" discussions won't happen anymore.

And then you're talking about adding another year or two of working onto an already long process? It's just a bad, bad idea.
I agree. Just because some students can't handle the long residency hours doesn't mean that the rest of us need to be punished with longer residency duration by decreasing the weekly hours. However, the article mentioned in this thread doesn't suggest decreasing the 80 hours. It seems to merely suggest regulations to ensure that the workload is more evenly distributed throughout the week.
 

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this is ******ed... i can't believe the AMA or whoever ******* running this organization is supporting longer residencies. We ALL knew what we were getting ourselves into beforehand. We all knew about the long ass hours.

I need a doctor who knows his stuff even in his sleep, i.e. that 31st hour of being awake. I want to be a resident who will graduate knowing that I know my stuff backwards and forwards.

Keep the 100+ hour weeks and kick out the people who are bitchin', and then we are good to go.
 

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Keep the 100+ hour weeks and kick out the people who are bitchin', and then we are good to go.
I'm certain you'll have the same attitude when you're a junior attending and your children start to wonder if they actually have a parent. :thumbup:

I love medicine and I love surgery but the idea of working an average of almost 17 hours a day, six days a week is pretty horrendous. And if you refer to the classic "gee if you love what you do it won't matter," consider that most people saying that are feeling tough and superior about working 60 hours a week, not 100.
 

Retsage

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this is ******ed... i can't believe the AMA or whoever ******* running this organization is supporting longer residencies. We ALL knew what we were getting ourselves into beforehand. We all knew about the long ass hours.

I need a doctor who knows his stuff even in his sleep, i.e. that 31st hour of being awake. I want to be a resident who will graduate knowing that I know my stuff backwards and forwards.

Keep the 100+ hour weeks and kick out the people who are bitchin', and then we are good to go.

What the hell, as a premed, do you actually know about this? A vague abstract idea that it's going to be hard? :laugh:
 

ChubbyChaser

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the way i read into it, we would still work 30 hour shifts, we would just have a 5 hour sleep break and could only treat 16 out of the 30 as opposed to 24................would they really have to lenghten residencies bc of this?
 
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phospho

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I'm certain you'll have the same attitude when you're a junior attending and your children start to wonder if they actually have a parent. :thumbup:

I love medicine and I love surgery but the idea of working an average of almost 17 hours a day, six days a week is pretty horrendous. And if you refer to the classic "gee if you love what you do it won't matter," consider that most people saying that are feeling tough and superior about working 60 hours a week, not 100.
but would you trade it for an extra two years on your residency?
 

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I'm certain you'll have the same attitude when you're a junior attending and your children start to wonder if they actually have a parent. :thumbup:

I love medicine and I love surgery but the idea of working an average of almost 17 hours a day, six days a week is pretty horrendous. And if you refer to the classic "gee if you love what you do it won't matter," consider that most people saying that are feeling tough and superior about working 60 hours a week, not 100.
True true true, QFT.
 

phospho

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What the hell, as a premed, do you actually know about this? A vague abstract idea that it's going to be hard? :laugh:
yes, i'm a premed...i'm not supposed to have an opinion...i know...i know...but still, would you rather have an extra 2 years on your 4 year residency just so you can have those hours reduced?
 

phospho

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I agree that residents shouldnt have to work 30 hour shifts with no sleep....But Ill play devil's advocate here as well. This topic has come up while shadowing different doctors and they pointed out that a major advantage to residents being at the hospital for such long periods of time (virtually 24/7) is exposure. Residents learn by exposure to pretty much every possible patient encounter and every case (even the ones that arent as common). The only way that you can learn about all the different cases adequately is to be at the hospital when it happens. So in a sense, the 30 hr shifts suck, but at the same time, they are incredible from an educational standpoint. Plus, I have read somewhere that even with shorter shifts for doctors at different hospitals that there was no significant decrease in patient mortality and morbidity.
:thumbup:
 

ChubbyChaser

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If it made having a family easier, absolutely.
wait I thought you wanted to roam the globe impregnating women performing your evolutionary duty. You mean, you actually wanna settle down and have a wife and take care of your little bacchus'?:eek:
 

teddybear

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I'm certain you'll have the same attitude when you're a junior attending and your children start to wonder if they actually have a parent. :thumbup:

I love medicine and I love surgery but the idea of working an average of almost 17 hours a day, six days a week is pretty horrendous. And if you refer to the classic "gee if you love what you do it won't matter," consider that most people saying that are feeling tough and superior about working 60 hours a week, not 100.
You'll have to decide what's more important to you. You can't have it all.
 

Bacchus

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wait I thought you wanted to roam the globe impregnating women performing your evolutionary duty. You mean, you actually wanna settle down and have a wife and take care of your little bacchus'?:eek:
White picket fence, 2 kids, a dog, swimming pool, moderately sized home, volvo in the driveway all in the 'burbs or rural America.
 

Chemist0157

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Why is this "adding more years to residency" issue coming up anyways? The article addresses how to make it easier on residents without prolonging their residency periods. Arguing just to argue?
 
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There is still the necessity for 24 hour or greater shifts for a resident in order to take ownership of a case while they learn the intricacies of how to track a sick patient. This incentives early symptom detection to prevent a crash during a night shift (which the resident would have to clean up later since they are working a full day's shift).

I just hope to God that whatever system is in place, it allows for the resident to get some sleep after this.
 

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I guess when I posted the link I assumed people posting would read it. As far as THIS article and THIS study goes, it was not talking about reducing the 80 hr. limit and extending residency. What it was talking about was on a 30 hr. shift, 16 hours could be spent treating patients and whatnot, there would be a 5 hour required break, and the other 9 hours would be spent on additional learning activities.
Now my rant :thumbup:. I know we picked a hard profession, I know the responsibility we have is huge. BUT, we are still human beings and need to be able to meet our sleep needs, the needs of our family, and really, to just have a freakin life. Reminds me of a SDN article where they interviewed the infection disease doc:

Q: Do you have a family and do you have enough time to spend with them?
A: I enjoy family life but it is, by my choice, secondary to work.

Father of the year material right there folks. To those who want to work 110 hours a week, good luck finding time to take your wife/husband on an occasional date, time to get to the gym to stay in shape, time to just live a balanced life. I want to be a great doctor, but not at the expense of it being my only worthwhile accomplishment in life. Not at the expense of getting heart disease at age 55 due to failing to take time to exercise or get decent sleep on a regular basis. To those who put themselves through this, kudos. But I'm gonna fight to keep some balance in this bizarro world of my "lax" 80 hr. workweek.
 

Just Joshin

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I agree. Just because some students can't handle the long residency hours doesn't mean that the rest of us need to be punished with longer residency duration by decreasing the weekly hours.
Uh, I know we here on SDN like to believe that the whole wide world revolves around us, but I don't think the point is "punishment" for us as much as it is patient care.
 

Just Joshin

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this is ******ed... i can't believe the AMA or whoever ******* running this organization is supporting longer residencies. We ALL knew what we were getting ourselves into beforehand. We all knew about the long ass hours.

I need a doctor who knows his stuff even in his sleep, i.e. that 31st hour of being awake. I want to be a resident who will graduate knowing that I know my stuff backwards and forwards.

Keep the 100+ hour weeks and kick out the people who are bitchin', and then we are good to go.
I love when ignorance has a voice. Hey dude, there are no 100 hour work weeks. That went out five years ago and the reason was because of all the deaths caused by residents working those hours. If you want to have open-heart surgery with a doctor who's been awake and on-duty for 28 hours, that's your call. I for one, don't.
 

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I love when ignorance has a voice. Hey dude, there are no 100 hour work weeks. That went out five years ago and the reason was because of all the deaths caused by residents working those hours. If you want to have open-heart surgery with a doctor who's been awake and on-duty for 28 hours, that's your call. I for one, don't.
although the open heart surgery is much more likely to be performed by an attending who could have been awake and on-duty for more hours than that depending on the institution. there are no work hour limits for attending staff and they are ultimately responsible, not the housestaff.

don't get me wrong -- i'm not looking to extend resident work hours or residency period, but it's all essentially a game of shifting time around.
 

Excelsius

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Uh, I know we here on SDN like to believe that the whole wide world revolves around us, but I don't think the point is "punishment" for us as much as it is patient care.
There have been studies that have shown patient care is not affected by long hours. I think it was mentioned in this forum already.
 

Excelsius

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I love when ignorance has a voice. Hey dude, there are no 100 hour work weeks. That went out five years ago and the reason was because of all the deaths caused by residents working those hours. If you want to have open-heart surgery with a doctor who's been awake and on-duty for 28 hours, that's your call. I for one, don't.

Don't call someone ignorant, especially when you yourself are not an expert. While the mandate says 80 hours, there are some specialties where on some weeks residents do end up working around 100 hours. This is not the norm anymore, but it still exists.
 

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Don't call someone ignorant, especially when you yourself are not an expert. While the mandate says 80 hours, there are some specialties where on some weeks residents do end up working around 100 hours. This is not the norm anymore, but it still exists.
"Resident X, even though this surgery won't be done for another 4 hours, you are at your 80 hour max. I'm sorry, you don't get to learn anymore at this time. Go home."
 

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I myself always wondered about the benefit of 36hr shifts. Seems to me you could have residents at the hospital ALOT (so still rigorous and chock full of cases) by scheduling 16 hr shifts.

What I envision is 16 hr shifts of 7a-11p or 11p-5p. Residents could alternate these shifts week by week with their fellow residents so you get 24/7 coverage plus have the whole team together for 7a-5p rounds, etc.

You could alternate having five 16s one week and six 16s another.

That way you'd be alternating 80hr weeks w/ 96hr weeks.

You'd be getting the hours you need with cases & patients, eliminate the need for traditional "call", and no resident would ever be working more than 16 hrs in one stretch.

Am I just a naive pre-med in thinking this type of schedule could work?

I probably am and fully expect a current resident to hose me with a cold shower.

Just a thought from a know-nothing pre-med.
 

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Sixteen hours a day, five or six days per week?

Sounds like hell to me.
 
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this is ******ed... i can't believe the AMA or whoever ******* running this organization is supporting longer residencies. We ALL knew what we were getting ourselves into beforehand. We all knew about the long ass hours.

I need a doctor who knows his stuff even in his sleep, i.e. that 31st hour of being awake. I want to be a resident who will graduate knowing that I know my stuff backwards and forwards.

Keep the 100+ hour weeks and kick out the people who are bitchin', and then we are good to go.
Don't mean to be an eeevil senior student that's about to enjoy mexican style internship in a few weeks; but you have no idea how tough a night shift is on the body my friend, you just have NO idea. From what Pre-med sounds like, it's just nothing in comparison to med school.

You can be the smartest dude evar and look like you're drunk at 7:30 am after you stayed up all night stiching foreheads in the ER nonstop. At least the residents get to sleep after the change of shift at 7 am, the interns don't. Heck, the one time I had a night shift when I was still technically a lowly student and had classes that very morning as if nothing had happened were pretty gruelsome, all I can remember from that class was that my eyes were burning and the doctor teaching the class was glad I was coming home in a bus instead of driving because I looked real bad. There were a few other people that did the shift with me, but they took a 2 hour nap while I didn't. Note to all: when someone gives you permission to take a 1 hour nap on a night shift, DO IT.

Also, like already said, 100 workweeks don't exist in the US. I think Mexico is of the few countries in the world that still does some of those things (and us youngin's have been fighting hard to at least prohibit A-B shifts for interns, some residents in public hospitals still have these kinds of inhumane shifts. I'm surprised they haven't gone psycho after 2 years of such a sucky lifestyle). I'll still be expected to be fresh like a lettuce taking out blood samples after 30 hours of work in a few weeks. And yet people are still surprised by how many doctors get infected with HIV and Hepatitis C when they were interns, haha.

However, I've talked to some residents that had these very "special" internships and while they would never repeat the experience, they learned a lot (after your 200th birth you get the knack for it) and secretly enjoyed the torture. Luckily they didn't end up killing someone too. :smuggrin:

While they've done a lot to ease the workload off interns in Mexico (at least they got rid of a lot of the hazing stuff), residents still have to work a lot, though it also depends on which specialty they are doing. A dermatology residency is still an 8am-2pm job. Plus, if you were looking for an easy career, you wouldn't have chosen medicine in the first place. If you survived through med school, a coupe night shifts ain't so bad. At least they give you a free meal. :luck:
 

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Don't be fooled by the change in laws. The 100+ hour work week for residents is still alive and well. Violations don't get reported because it can bring consequences for the training program.
 

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this is ******ed... i can't believe the AMA or whoever ******* running this organization is supporting longer residencies. We ALL knew what we were getting ourselves into beforehand. We all knew about the long ass hours.

I need a doctor who knows his stuff even in his sleep, i.e. that 31st hour of being awake. I want to be a resident who will graduate knowing that I know my stuff backwards and forwards.

Keep the 100+ hour weeks and kick out the people who are bitchin', and then we are good to go.
Don't drink the KoolAid just yet. The Man wants you working as much as he can make you work for as little as he can pay and needs to keep you believing in the foolish dream that medicine is some kind of special calling that still justifies this kind of sacrifice. In fact, medicine is combination goat rodeo and cluster ****, a highly wasteful and inefficient enterprise the training for which is needlessly inhumane for the sole reason that your cheap labor, once even more plentiful than it is today, is absolutely vital to keep your teaching hospital functioning.

And you do not know what you are getting yourself into. You think you do but you really don't. I imagine that you have probably never had to go 30 hours without sleep three times a week for a month.
 

Excelsius

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I wanted to post this comment from that link to your blog:

"I graduated with an MD/PhD in neuroscience and I started my training in neurosurgery in Philadelphia in 1998 prior to the new policy limiting resident hours. At the time, I was 32yrs old with 2 young children (2yrs & 6mos old). I worked the 120hr weeks at a very active trauma center and spent all night up, every other night, caring for patients and often didn't sign out post-call until 10p (still no sleep) having to then go to medical records to dictate charts for a couple of more hours just to get unsuspended for the next day. I'd get home by midnight and have to be up at 4am to return for the next day. After a couple of months of that physical and pyschological torture, I became more and more depressed, angry all the time from being yelled at by nurses and attendings and myself yelling at nurses, patients, and med students. I increasingly found myself crying in the call room alone and feeling helpless and hopeless. By 6 months into my internship, I had hardly ever seen my children awake and my wife felt I was becoming more and more distant. One night during a particularly brutal call, I found myself facing a list of ~65 patients for whom I only had a name, room number and diagnosis and a beeper that wouldn't stop going off. That night I felt like there were 2 ways out — one was off the roof of the hospital and the other was out the front door. Thank God I had the strength to choose the front door. That day I quit and never returned and I have never regretted that decision which saved both my life and my family. I re-matched in Pediatrics and completed my medical training thankful for only having to work 80hr weeks (imagine that?!). I still get emotional recounting those difficult times. Was it necessary to make me work 80-120hrs in order for me to become a ‘good' physician — absolutely NOT. It dehumanized me and I can assure you that patients don't benefit from the care of dehumanized physicians. How can you care for someone else if you can't even care for yourself? Forget 24hrs, NOBODY should be expected to work longer than 12 continuous hours with full days off during each 7 day period. Anything else is INHUMANE and unecessary and benefits nobody. As dramatic as my story may sound, it is hardly unique. I'm glad there has been some progress with this very important issue, but there is much, much more to accomplish and I salute those making a stand."

Now 120 hours is indeed brutal. It explains why those surgeons, such as NS, appear so robot-like. If they are going to decrease the hours more, that's fine. But they should not extend the number of years it takes to finish residency. As you say, it is better to make the experience more efficient rather than more lengthy. At the same time, if this guy didn't have family and kids, he would probably be able to better handle his residency. But given the amount of time it takes to finish med school and residency, sometimes it is not as easy to postpone having a family. I think instead of decreasing the 80 hour shifts, they should cut the duration of residencies by a year or two. If the cut from 120 to 80 hours (that's 1/3) without having to increase residency durations didn't affect the quality of doctors being created, I think that we could do the same cut, but this time in years, rather than hours.
 
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phospho

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I wanted to post this comment from that link to your blog:

"I graduated with an MD/PhD in neuroscience and I started my training in neurosurgery in Philadelphia in 1998 prior to the new policy limiting resident hours. At the time, I was 32yrs old with 2 young children (2yrs & 6mos old). I worked the 120hr weeks at a very active trauma center and spent all night up, every other night, caring for patients and often didn’t sign out post-call until 10p (still no sleep) having to then go to medical records to dictate charts for a couple of more hours just to get unsuspended for the next day. I’d get home by midnight and have to be up at 4am to return for the next day. After a couple of months of that physical and pyschological torture, I became more and more depressed, angry all the time from being yelled at by nurses and attendings and myself yelling at nurses, patients, and med students. I increasingly found myself crying in the call room alone and feeling helpless and hopeless. By 6 months into my internship, I had hardly ever seen my children awake and my wife felt I was becoming more and more distant. One night during a particularly brutal call, I found myself facing a list of ~65 patients for whom I only had a name, room number and diagnosis and a beeper that wouldn’t stop going off. That night I felt like there were 2 ways out — one was off the roof of the hospital and the other was out the front door. Thank God I had the strength to choose the front door. That day I quit and never returned and I have never regretted that decision which saved both my life and my family. I re-matched in Pediatrics and completed my medical training thankful for only having to work 80hr weeks (imagine that?!). I still get emotional recounting those difficult times. Was it necessary to make me work 80-120hrs in order for me to become a ‘good’ physician — absolutely NOT. It dehumanized me and I can assure you that patients don’t benefit from the care of dehumanized physicians. How can you care for someone else if you can’t even care for yourself? Forget 24hrs, NOBODY should be expected to work longer than 12 continuous hours with full days off during each 7 day period. Anything else is INHUMANE and unecessary and benefits nobody. As dramatic as my story may sound, it is hardly unique. I’m glad there has been some progress with this very important issue, but there is much, much more to accomplish and I salute those making a stand."

Now 120 hours is indeed brutal. It explains why those surgeons, such as NS, appear so robot-like. If they are going to decrease the hours more, that's fine. But they should not extend the number of years it takes to finish residency. As you say, it is better to make the experience more efficient rather than more lengthy. At the same time, if this guy didn't have family and kids, he would probably be able to better handle his residency. But given the amount of time it takes to finish med school and residency, sometimes it is not as easy to postpone having a family. I think instead of decreasing the 80 hour shifts, they should cut the duration of residencies by a year or two. If the cut from 120 to 80 hours (that's 1/3) without having to increase residency durations didn't affect the quality of doctors being created, I think that we could do the same cut, but this time in years, rather than hours.
thank you for quoting that... very insightful. Everyone seems to be going off on me because they think I'm all for the 100+ hours a week. Yes, I am, if it means they're going to extend our residency. I would rather do those inhumane hours than waste another 2 years out of my dam life. Yes, the original article didn't mention the residency extension, but every other MD I've spoken with has heard the same rumor.

If they're going to make my medical education 10 years (4+6) instead of 8 years (4+4), I will do whatever I have to keep it minimal. I need to get my life back at some point.

To the people who say that I don't know what I'm talking about: I'm a premed, how the hell am I supposed to know what I'm talking about? However, many others have done it before me; why should I be any different? I'll do it just like they did.
 

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I love when ignorance has a voice. Hey dude, there are no 100 hour work weeks. That went out five years ago and the reason was because of all the deaths caused by residents working those hours. If you want to have open-heart surgery with a doctor who's been awake and on-duty for 28 hours, that's your call. I for one, don't.
You can make your point without being an ass. You're not 10 years old. I gave you my opinion, and you can give me yours.
 

Just Joshin

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You can make your point without being an ass. You're not 10 years old. I gave you my opinion, and you can give me yours.
Oh and your first post on this topic wasn't screaming "look at me, I'm 10 years old?" I think I let go of the word "******ed" when I was in elementary school. I'd suggest you do the same.
 

linguini

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Oh and your first post on this topic wasn't screaming "look at me, I'm 10 years old?" I think I let go of the word "******ed" when I was in elementary school. I'd suggest you do the same.
So glad we're not personally attacking each other...:rolleyes: Can you guys stop doing that so that others can actually benefit from a useful and interesting thread?
 

phospho

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Oh and your first post on this topic wasn't screaming "look at me, I'm 10 years old?" I think I let go of the word "******ed" when I was in elementary school. I'd suggest you do the same.
I was saying that the fact that our "residencies were going to be extended" was ******ed. It was a figure of speech (albeit a bad one). I would never call anyone on this forum ******ed for their opinions, or for any other matter.

Either way, sorry to have gone off topic, and my apologies if I offended you or anyone else.

:luck:
 

armybound

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There have been studies that have shown patient care is not affected by long hours. I think it was mentioned in this forum already.
The very article we're supposed to be discussing here comments on that:
The study confirms that scientific evidence shows acute and chronically fatigued residents are more likely to make mistakes.
 

phospho

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The very article we're supposed to be discussing here comments on that:
I think what Excelius is referring to is another study that found out that there wasn't an increase in the amount of "fatalities" with chronically fatigued residents. I'm pretty sure I read about this somewhere, but I could definitely be wrong.

The study referenced in this thread is talking about "mistakes". I'm not sure if the respective authors are deliberately trying to make a distinction between the two concepts.
 

armybound

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I think what Excelius is referring to is another study that found out that there wasn't an increase in the amount of "fatalities" with chronically fatigued residents. I'm pretty sure I read about this somewhere, but I could definitely be wrong.

The study referenced in this thread is talking about "mistakes". I'm not sure if the respective authors are deliberately trying to make a distinction between the two concepts.
"Mistakes" can lead to extended hospital stays, further procedures, and who knows what other kind of unnecessary/expensive care. From a hospital's perspective, killing people shouldn't be your main concern, since fatal mistakes are undoubtedly far less likely than some costly smaller mistake.

People have laid it out straight in many ways, and I don't know what's difficult to understand about it. I cannot study when I'm tired, I can't perform well on a test when I'm tired, and I have no idea why I would be expected to give someone medical care when I cannot function. Attendings get reasonable hours of sleep for a reason, and it's not because they don't care about patients.

I believe that residents need to work late hours. I think it's good to have an attending on call at 3am when something happens. I don't think that person needs to be deprived of sleep and on a 20+ hour shift in order to experience that. If sleep deprivation was the key to memorization and performance, no one would ever sleep. College would have been spent sleepless, and so would medical school. I've never read an article saying sleeplessness improves performance on anything, and I think it's downright scary that we expect medical professionals to make sound judgments while sleep-deprived. It goes against all logic to assume your skill will be satisfactory or improve while you're too tired to function properly.
 
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Nemuri

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If they're going to make my medical education 10 years (4+6) instead of 8 years (4+4), I will do whatever I have to keep it minimal. I need to get my life back at some point.
My thoughts exactly. I can see where a doctor with a wife and kids can have conflicting interests when completing such a grueling residency. But what about the young, single, and no kids crowd? It's still going to be a challenging experience but with less responsibilities to juggle and no guilt for jeapordizing a marriage or a child's upbringing.
 
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