Pre-Medical Simulation of Residency

Discussion in 'General Residency Issues' started by Excelsius, Jun 17, 2008.

  1. Excelsius

    Excelsius Carpe Noctem

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    It is after 3AM in CA now and I will likely not sleep today. I have been exercising the idea of emulating residency for some duration during this summer - maybe the entire summer. Could some of the residents describe their average day in detail? Ideally, it should include a complete schedule of a typical weekday as well as the weekends. Incorporation of exercise and even sexual habits, and how physically tiring residency is, would be helpful. It seems that the worst case scenarios are working 30 continuous hours. Essentially, that's what I am doing right now, except that I spent most of my day today writing a motion for my fourth ticket within the last year. So I was sitting most of the time, or pacing. Is residency very challenging and tiring physically? Are you standing up most of the time? What supplements, energy drinks, or pills (No Doz, etc) do you use when things get especially tough?

    I am particularly interested in schedules of neurosurgery residencies or residencies that are similarly demanding. I couldn't find a separate sub-forum for residents, so I am assuming this is the right place to post my question.
     
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  3. There are forums for interns, residents and surgery residents:

    Internship
    General Residency Issues
    Surgery and Surgical Subspecialties

    Please do a search in either of these forums as this question has been asked several times there.

    Edit: it's all well and good to read about the typical life of a resident to see if it's for you, and I certainly encourage you to collect as much information as possible. But rather than try to "simulate" a resident's life for the summer (because there's really no way you can do that, even if you're shadowing a physician), why not work on strengthening your credentials before applying to med school? Are you still in the process of transferring? Are you taking any summer courses? I remember your previous thread here: http://forums.studentdoctor.net/showthread.php?t=511889 .

    Best of luck.
     
    #2 Blade28, Jun 17, 2008
    Last edited by a moderator: Jun 17, 2008
  4. Excelsius

    Excelsius Carpe Noctem

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    That's exactly what I am trying to do. Simulating residency just for the sake of staying awake many hours every night is very imbecilic. I am fully utilizing my time, but I am also trying to push the limits and get more done while at the same time trying to approach a resident's schedule.

    I am in the middle of transferring this year and I spend a lot of time reading about where to go. The upcoming semester is going to be very challenging and getting used to squeezing maximum hours from a day will prove very useful.

    Thanks for the links.

    Edit: I searched several more keywords but was unable to find any threads about residency schedules. If you know of any threads, please post them.
     
  5. Excelsius

    Excelsius Carpe Noctem

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    Thanks, that was helpful, but many of those threads are not that detailed. Sure, I know that the standard is 80 hours a week, but what happens after you go home at 6PM? Just sleep? Study? Etc.
     
  6. Excelsius

    Excelsius Carpe Noctem

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    (Duplicate post after thread was moved.)
     
    #6 Excelsius, Jun 17, 2008
    Last edited: Jun 17, 2008
  7. yaah

    yaah Boring
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    Merging two identical threads.
     
  8. Excelsius

    Excelsius Carpe Noctem

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  9. Excelsius

    Excelsius Carpe Noctem

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    At least one thing I learned is that it seems most residents actually sleep at nights. The rest are either too busy to post or do not have access/are not allowed to go online while on rotations.
     
  10. Did you already read through all the threads I posted above?

    In general when most residents get home (between 6-8) they eat, try to read a little, relax, then go to bed at a reasonable hour. Most then have to wake up between 3-5 in the morning.

    Usually there's not much posting going on in the early mornings here - people are either asleep (West Coast), awake and on-call (too busy to post), or awake and at work (East Coast).

    I'm here because I don't sleep much most days.
     
  11. Excelsius

    Excelsius Carpe Noctem

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    Yep. A lot of posts are irrelevant to the to original or my topic. But yes, they are very helpful. I wonder if times have changed for residency since 2003-2006 (threads above).

    One of the guys who posted a detailed schedule for 2007 is banned now (Dr JHP). It is scary to think that someone may post almost 6000 messages before being identified a fake. Can you imagine how many people he would have mislead? Amazing.
     
  12. Winged Scapula

    Winged Scapula Cougariffic!
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    Not really. 2003 was when the work hour regulations went into effect; while programs probably experienced some organizational troubles, there would not be significant differences between then and now and even if there were, it would be program dependent not residency-wide.

    JPH is not a fake. He is a very real and identifiable surgery resident (congrats on finishing intern year if you're reading JPH!) in Philly. Unfortunately, he also had a tendency to pick fights and generally destabilize the forums...despite having 6K posts, with multiple chances and failures to comply we didn't have a choice but to remove him.
     
  13. Winged Scapula

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    Depends on what they are doing and to some extent, luck of the draw. I had nights on call where I never saw the call room, never sat down, never ate. And I've had nights where I didn't get a single page (mind you, as a Chief resident).

    I don't think you will find what you are looking for as there are as many answers to your questions as there are residents. Some will go home post-call and immediately go to sleep; others will exercise, read, spend time the SO and/or family, etc. I used to try and not sleep because I felt worse and more groggy than if I just stayed up until an early bedtime. Some days I could do it and others I couldn't.
     
  14. Excelsius

    Excelsius Carpe Noctem

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    What would you say is the average number of hours your sleep per day? How does it fluctuate between internship to PGY7 or so? I guess if you don't have to do any work other than the rotations (like study) then the hours should be stable from year to year.
     
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  16. Winged Scapula

    Winged Scapula Cougariffic!
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    Again, it will depend on the program and specialty.

    In some, the Chief residents take in house call so will likely get less sleep than those who take call from home (and never get called). A PGY-7 fellow may be even busier in some training programs than he/she was as a resident.

    In general however, more senior residents take less in house call than do interns, at least in surgical services. Some ALWAYS have a Chief resident in house. But they may or may not work less hours. When I was a Chief, we were responsible for finishing up all the work that the interns who were over 80 hrs didn't get to, so I worked more than I did the year before. As for hours, it depends on the rotation (which will vary from year to year), the census (which can vary from day to day), the quality of your residents (ie, if you have someone who works hard, it can mean less work and hours for you), whether you have allied staff or night flight to take some of the load, etc.

    You are asking questions which are not answerable because there is no hard and fast rule about work hours. Expect to work the maximum allowable at least - some weeks you will work more and some less.

    As an attending I sleep more than I did as a resident, but its still only around 6 hrs per night because that's what I need. As a resident, some days I was up 42 hrs straight, some I got a full night's sleep and most it was somewhere in between.
     
  17. You can work anywhere from 70-90+ hours a week (or more, depending on the program, unfortunately). As you advance in level and become more senior, you take less in-house call and more home call. That means that anywhere from every second to every fourth night, you answer your pager all night long - and come into the hospital for sick patients, admissions, consults, etc. So even if you're at home your sleep can be extremely broken.

    I don't sleep much (never have) so I tend to average around 4-5 hours of sleep at night...but I've been like this since I was in junior high school and I would say most of my colleagues probably sleep around 6-7 hours a night. Surgery residents try to study at least a few days every week for the ABSITE, the annual exam given every January.
     
  18. AmoryBlaine

    AmoryBlaine the last tycoon

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    Dude, it's good that you are thinking about this but you can't agonize over it. It's so dependant on specialty and then again on training program and then again on rotation.

    As an EM resident there will be months (like Anesthesia) where I'll probably work 6a-11a M-F. There will also be MICU/SICU months where I'll probably do 80+ with call every third or fourth night.

    There will be Psych residents in the hospital who will likely rarely work as hard as me and Surg residents in the hospital with a much more grueling routine.
     
  19. sacrament

    sacrament somewhere east

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    Trying to simulate residency by limiting your sleep is like trying to simulate sex by dry-humping a pillow. I actually slept much less in grad school than I do in residency, but residency is rather more draining. It's one thing to try to keep yourself awake while running lab experiments or studying for an exam, it's another thing to pull an all-nighter with patients crashing all around you and your pager going off like mad. I don't spend much time contemplating how much sleep I do or don't get. It's an experience that cannot be simulated in anything but the most superficial manner.
     
  20. Excelsius

    Excelsius Carpe Noctem

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    I am not agonizing about work hours or lack of sleep at all. Since I am already pretty busy, I thought that I might as well multitask. Residencies differ, that's why I mentioned NS or any other surgical sub-specialties that are similar to the load of NS.

    Maybe a really great experience will be to shadow an NS Resident, Fellow, or even an Intern, especially on one of those 30 hour+ shifts. I am not sure med schools will care about this, but it sure will be a nice thing to bring up during an interview. I think that if I shadow a resident, I will get to shadow not one, but several doctors by default. Plus residents might be more open minded and honest about the process.

    Have you guys noticed that often when you get little to no sleep, you feel very energetic and sharp the next morning? I have heard of correlation in the amount of sleep you get vs the amount of sleep you still want to get - positive feedback - but I have not seen any studies into this. I don't know whether circadian rythms are covered in-depth in med school. Then there are those people with chronic hypomania that live their entire lives as a one large all-nighter without ever being affected by Da Vincian sleep. The most interesting aspect is that you can induce hypomania my brain damage. Maybe we'll have drugs in the future that will temporarily elicit that condition.
     
  21. AmoryBlaine

    AmoryBlaine the last tycoon

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    That's probably the hardest I've laughed reading an SDN post ever.
     
  22. Excelsius

    Excelsius Carpe Noctem

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    I am not familiar with that procedure since I haven't gone to medschool yet, but I wouldn't list it on AMCAS as an exctracurricular activity, although technically it is.
     
  23. Danbo1957

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    Our IM division went through six months of panic drawing up new schedules. Several well-known IM programs in the country almost lost accreditation (temporarily) for having residents work in excess of the new hour rules.

    As far as "differences between then and now", resident morale is up. :D We had to come up with the additional funds to pay for the hospitalists that were hired to cover the hours "lost". All in all, though, better patient care with less exhausted residents...
     
  24. smq123

    smq123 John William Waterhouse
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    1) The first time that you ever pull an all-nighter, then yes, this is true. The second time you pull an all-nighter, though, you feel like utter crap.

    2) You FEEL very energetic and sharp the next morning...but that is a very deceptive feeling. You're NOT actually any sharper...your poor, mixed up brain just thinks that you are.

    Go ahead. Stay up all night long multitasking. Then, tomorrow morning at 4 AM, write something...a journal entry, a post on SDN, a poem, whatever. Then, two days from now, go back and read it. See how much sense it actually makes when you're coherent. Not much, I'll bet.
     
  25. 8744

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    Dude. Let it be. It will happen. The only reason I could possibly think of for simulating residency would be to talk yourself out of a medical career. I bet if you had followed me around on my last medicine rotation last year, one week of easy night float with three weeks of Q3 call you would have thrown your application in the trash and laughed, yes laughed, that you ever yearned for this dysfunctional mother****er.

    With that being said, find a teaching hospital, present yourself to a residency program, and ask to shadow for a week.
     
  26. 8744

    8744 Guest

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    As someone noted, the sleep deprivation of residency is different from staying up all night eating pizza, surfing the internet, and waiting for the timer on your experiment to ring. It' not just eating Cheetos and drinking Dr. Pepper while lounging around in a ratty t-shirt.
     
  27. AmoryBlaine

    AmoryBlaine the last tycoon

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    But if you're going to do it, do it. Don't show up for 3 days, decide you've learned enough and go back to watching reruns on TBS.
     
  28. Sigh...if only call were like this, huh?
     
    #27 Blade28, Jun 17, 2008
    Last edited by a moderator: Jun 17, 2008
  29. Excelsius

    Excelsius Carpe Noctem

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    This is not the first time I have pulled an all-nighter. Sometimes I find myself dragging my arse to the gym at 3am. But I agree with you - what you are referring to is consecutive all-nighters. Correct me if I'm wrong, but I believe that over 48 hours of consecutive work is not something that happens often during residency. I guess if you did pull it off twice a week by choice, then you'd have the rest of the week for leisure since you'd meet the 80 hour clock.
     
  30. Excelsius

    Excelsius Carpe Noctem

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    I am not doing anything like that even during the day, but I think I know what you mean. I sometimes find myself completely exhausted when I am doing nothing but sitting with a book on quantum mechanics trying to understand what the math is really supposed to represent. This maybe not surprising because the brain requires a lot of energy (was it the third or so?) to operate. If your attending calls you an idiot, I bet that doesn't help you much either, especially if you are a Schopenhauerian.

    As for TV, the vast majority of the recent movies just suck. The tv shows are pretty lame as well. Have always been. That works out pretty well because if we discount the socialization aspect of the TV and some of the nicer science programs (Carl Sagan, et al), it has absolutely no value. An average person spends over three continuous YEARS just watching advertisements (assumed longevity: around 75). It's far better to discharge by popping in an occasional opera or stuff like the Life of Brian, 2001, etc.
     
  31. medicinesux

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  32. medicinesux

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    And no that is not me dry humping the pillow!
     
  33. NPR

    NPR

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    I would love to see what happens to the neurosurgery resident who tells his/her attending, "Sir/maam, I've already hit the 80 hour work week limit. I'm taking the rest of the week off for leisure. Catch you on the flip side."
     
  34. Excelsius

    Excelsius Carpe Noctem

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    Yeah, because I was going to say you are doing it all wrong!

    You might get honors. Someone posted here that programs are afraid to lose their accreditation if they fail to generally follow the mandated hour requirements. Maybe you could go to 90, but is there anyone here who works for over 100?
     
  35. It does happen - whether or not people report it (either here on SDN or to their program) is a whole 'nother issue.
     
  36. AmoryBlaine

    AmoryBlaine the last tycoon

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    Yeah but dude the issue with the whole 80 hour work week does not mean residents can just stay extra time at the hospital for the hell of it and then count it towards their 80 hours. The way you posted earlier it sounded like you thought you could pull some sort of voluntary 48 hour shift and then be over half done for the whole week -- it don't work that way.

    There are these things called "call schedules" and screwing them up is like punching all of your co-residents in the face.
     
  37. Excelsius

    Excelsius Carpe Noctem

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    True slavery. The long hours are not as disturbing as the lack of respect for residents reflected in the salary. Hard to imagine that after you get your MD you will make less money as someone flipping burgers - and this for seven years (NS). If you are also accumulating interest on a sizable debt, the interests alone can cut the value of the salary by half. No wonder that after so many years some doctors develop sociopathic syndromes and treat patients like objects, who in turn believe that doctors are heartless, soulless, careless pricks with distended hubris.

    Is there a way to accelerate residency? I read that in NS you can combine residency with fellowships. I'm not sure if that even affects the duration of the whole process. Saving even one year could make a difference of over 200K in lost income.
     
  38. AmoryBlaine

    AmoryBlaine the last tycoon

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    So we've established some already-proven truths..

    1. Medicine is hard
    2. You have to stay up all night
    3. Med school is expensive
    4. Debt accumulates during residency
    5. Residency is long
    6. So doctors hate their jobs

    It sounds like you are either a) trying to talk yourself out of medicine or b) looking for ways medical education might be altered to make it more convenient for you.

    If either one or both is true I would strongly reccomend you drop your ideas about going to medical school.
     
  39. 8744

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    Are you for real? There is a huge difference between pulling an all-nighter or two because you want to or have such poor self-discipline that you can't study during normal hours and being required to to go thirty hours without sleep every third or fourth day, and I mean thirty hours were you are working almost the whole time often harder than you during the normal day.

    And I like television...a lot. There is nothing wrong with it.
     
  40. 8744

    8744 Guest

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    This is absolutely untrue. If there are rude doctors it's because they were raised that way by their parents, not because medicine has turned them that way. Now, if you mean that there is a difference between some naive first-year medical student who will listen patiently to some drug-seeker trying to score some percocet and a seasoned resident who knows when smoke is being blown up his ass you may be right...but being cynical is not the same as being a sociopath.
     
  41. Strength&Speed

    Strength&Speed Need more speed......

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    I disagree. I dry humped a pillow once and it felt terrific.

    About residency, yes I agree about that.
     
  42. Excelsius

    Excelsius Carpe Noctem

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    Number six doesn't apply to all doctors. And if it is possible to make residency shorter by combining programs, hell yes I am going to do it. That has nothing to do with choosing a medical career, but you could apply Burnett's law. Every one of us tries to make the smartest financial choices possible.

    As I said, I don't stay up because I have to, but because that's how it works out. This is the summer between the transfer year and I don't have any classes right now, but I am studying for MCAT, working full time, volunteering, and doing the rest of the pre-med requirements, some of which are just crap because they don't necessarily add any values that will make me a better doctor. They just chip away at your well-roundedness until there isn't as much left.
     
  43. AmoryBlaine

    AmoryBlaine the last tycoon

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    Whoops, the list was supposed to read....

    1. Medicine is hard
    2. You have to stay up all night
    3. Med school is expensive
    4. Debt accumulates during residency
    5. Residency is long
    6. SOME doctors hate their jobs

    Whether or not the slip was Freudian, well ...
     
  44. IndyXRT

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    It would be very difficult to simulate residency by doing anything voluntary. Even medical school does a poor job of simulating residency. What makes the biggest difference is the responsibility: you are responsible for the care of your patients (this is especially true while on call) and to your fellow residents. You cannot just walk away when things get difficult; you have to keep going whether you like it or not. This can be physically and/or emotially demanding, which makes sleep deprivation that much more of a problem. While shadowing a doctor certainly wouldn't hurt, it will not give you real insight into what it is like being a resident (in my opinion).
     
  45. Excelsius

    Excelsius Carpe Noctem

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    That's why I want to shadow a resident. Just found out that our hospital does have a residency program. However, since there is a volunteer placement office, I am not sure if they have any policies restricting the shadowing of "students" by other students.

    Except the people who think they went into medicine only for money, would the rest of you say that you love your job so much that it allows you to overcome some of the hardest aspects of residency? Are there weeks when you work a lot of hours, but you feel as if you have barely worked because that particular week involved many interesting cases? This is in relation to the adage that if you love what you do, you never really work.
     
  46. Strength&Speed

    Strength&Speed Need more speed......

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    Yes to the last part. I actually sort of enjoyed intern year, despite having 10 months of call, because I was learning so much. After that, it kind of became more like work. That's because I'm high on novelty. Other people probably liked the more mundane, less stressful stuff more than I did. So, certainly, if you love it, it wont be terrible. I find this more amongst the rads/anesthesia/derm/ophtho/and actually quite a few surgery people. if you love surgery, it just isn't quite as painful to some. That said, it sucks for everybody sometimes. Because dealing with some idiot patient will always be your responsibility sometime, or the bullshyt admit, or whatever. Nobody loves total BS work, no matter how absurdly happy you are.
     
  47. (1) Check with the volunteer office and see if they routinely take college students in their program. Some places have policies in place only for med students; some take college seniors; some take anyone interested.

    (2) I'm one of those people who truly loves what I do, so the pain of residency isn't so bad. Some of my colleagues don't quite feel this way, though.

    But don't be misled - there are some days (or nights, or weeks, or months) that are truly VERY painful. Pain that you can get through if you buckle down, but that you absolutely wouldn't want to repeat.
     
  48. Excelsius

    Excelsius Carpe Noctem

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    It seems that just like every profession, there are bad days. The important thing is that general feeling. If you're always feeling like crap, that must be pretty taxing on the morale.
     
  49. I think there's also a big difference between specialties and programs. I can only speak from experience being in General Surgery...other fields may have morale that's much better (or much worse).
     
  50. fakin' the funk

    fakin' the funk ASA Member

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    Why hasn't anyone taken Excelsius to task for posting obsessively in this thread about his/her masochistic "residency experiment" even though he/she is a PREMED? Chill out, bro!
     
  51. Strength&Speed

    Strength&Speed Need more speed......

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    i think we were more intrigued that someone was actually trying to do it. its like preparing for a boxing match by having someone pound you in the head repeatedly
     

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