Pre-Medical Simulation of Residency

[NotAProgDirector]

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... having someone pound you in the head repeatedly

I can't help but think that this might be a good way to prepare for internship.

 

[AwesomO]

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!

I think the OP is crazy but at least he/she is doing something remotely relevant to his future plans. It's better than the average premed harping about having a bake sale or backpacking through Europe and trying to pawn that off as demonstrating how that makes them better suited to be a doctor.

 

[Excelsius]

Every one of us who has chosen an arduous eight year educational plan followed by another 4-7 years of close-to-minimum-wage residency with 80 to 100 hour work weeks and many nights on call must face the reality - we are all at least a bit crazy.

I basically find that after an all-nighter followed by several nights of 4-6 hours of sleep can become draining after around the third or fourth day, but nothing unmanageable. That excludes the use of almost any caffeine (I don't like coffee), but if I were to add caffeine pills or energy drinks, I'd get a lot of extra stamina. I am not sure if you guys use any of these, but I am sure most of you drink a lot of coffee. If residents get the weekends (or at least one day/week) off, then it might be ok since it will allow time to recharge for the next week's cycle. One good thing about this hectic schedule is that it makes time fly and probably the seven or so years of residency might not be as noticeable as a result.

 

[bjolly]

I basically find that after an all-nighter followed by several nights of 4-6 hours of sleep can become draining after around the third or fourth day, but nothing unmanageable.

except that 3rd or 4th day is when you get to pull the NEXT allnighter.

If residents get the weekends (or at least one day/week) off, then it might be ok since it will allow time to recharge for the next week's cycle.

aw. premeds are so cute.

 

[Blade28]

I basically find that after an all-nighter followed by several nights of 4-6 hours of sleep can become draining after around the third or fourth day, but nothing unmanageable.

As stated above, often on that 3rd or 4th night after your all-nighter you're back on call, doing yet ANOTHER all-nighter. A few months of this can really take its toll on you (this is coming from someone who hasn't needed more than 4-6 hours of sleep a night, ever since freshman year of high school).

 

[Excelsius]

As stated above, often on that 3rd or 4th night after your all-nighter you're back on call, doing yet ANOTHER all-nighter. A few months of this can really take its toll on you (this is coming from someone who hasn't needed more than 4-6 hours of sleep a night, ever since freshman year of high school).

Wow, that's exactly why I originally asked for the detailed schedule. OK, so I'll try that as well.

One thing that's unclear: if you are on call on Monday and then the next time on Thursday (3-4 days later), do you get Saturday and Sunday off to recharge?

Also, don't you have the option to sleep for 8 hours or more between Monday and Thursday to make up for the all nighter?

 

[noentiendo]

why would anyone do this to themselves for no reason? it's like the person in another thread that said they were a first year and really stressed out about shoes. i just can't understand some of these people.

 

[chrisisinnocent]

Wow, that's exactly why I originally asked for the detailed schedule. OK, so I'll try that as well.

One thing that's unclear: if you are on call on Monday and then the next time on Thursday (3-4 days later), do you get Saturday and Sunday off to recharge?

Also, don't you have the option to sleep for 8 hours or more between Monday and Thursday to make up for the all nighter?

No you do not get days of to recharge. You work your usual schedule and on top of it you pull an all nighter every fourth night. You do get half a day off after your call so you start woorking at 6 am one day and you get out at noon the next day but you are expected to show up the next day after that at 6 Am again.

 

[Blade28]

Wow, that's exactly why I originally asked for the detailed schedule. OK, so I'll try that as well.

One thing that's unclear: if you are on call on Monday and then the next time on Thursday (3-4 days later), do you get Saturday and Sunday off to recharge?

Also, don't you have the option to sleep for 8 hours or more between Monday and Thursday to make up for the all nighter?

(1) Please check out some of those threads I linked (or the ones in my FAQ) - they explain the call schedules pretty well.

So hypothetically, if you're on Q3 call, your work schedule would be something like:

Work Monday 6 am - Tuesday 12 pm noon ("on call")
Rest of Tuesday off ("post-call")
Work Wednesday 6 am - 6 pm (regular day)
Work Thursday 6 am - Friday 12 pm noon
Rest of Friday off ("post-call")

Etc.

(2) You get one day off every week, on average. So no, just because you're on call, you don't necessarily get a weekend off. Remember that you may be on Q3 (every 3 days) or Q4 (every 4 days) call for most of your residency...so you can't get all these extra days off or your coresidents will suffer! Everyone should get one day off every week, on average.

(3) You try to get a full night's rest whenever you can - just trust me when I say that constantly being sleep-deprived is the norm, not the exception.

 

[elwademd]

(2) You get one day off every week, on average. So no, just because you're on call, you don't necessarily get a weekend off. Remember that you may be on Q3 (every 3 days) or Q4 (every 4 days) call for most of your residency...so you can't get all these extra days off or your coresidents will suffer! Everyone should get one day off every week, on average.

Wow, that's exactly why I originally asked for the detailed schedule.

- jun 30 (mon, week 1) - on call 7 am
- jul 1 finish call at 7 am, another 6 hours of "continuity of care" to end 30 hour shift at 1 pm
- 2 come in at 6 am, hope to leave by 4 pm... likely 6 pm
- 3 same
- 4 (friday) on call 7 am. happy 4th of july
- 5 finish call at 7 am, another 6 hours of "continuity of care". hope the attending comes in on time as he/she is post july 4th celebrations.
- 6 (sunday) day off
- 7 (mon, week 2) see july 2
- 8 on call at 7 am. again.
- 9 finish call at 7 am. again.
- 10 see july 2.
- 11 see july 2.
- 12 (saturday) the lovely saturday call.
- 13 finish call at 7 am. again.
- 14 (mon, week 3). see july 2
- 15 see july 2
- 16 on call at 7 am. yet again.
- 17 finish call at 7 am. hope to be out in 6 hours at 1pm.
- 18 see july 2
- 19. day off... first time in 12 days. 2 days off in the first 3 weeks!
- 20 on call again.
- 21 (mon, week 4) finish call at 7 am.
- 22 see july 2
- 23 see july 2
- 24 last call of the month. in at 7 am.
- 25 finish call at 7 am. hope to be out of the hospital at 1 pm.
- 26 day off
- 27 day off
- 28 (mon) new rotation begins


in this schedule (which is the schedule for the upcoming senior on icu at my program), there are 2 days off in the first 3 weeks, and then 2 days off in the last week... said another way, you get 3 days off in the last week, but only 1 in the 1st 3... any way you slice it, one day off a week averaged over a month isn't a thing of beauty. as was pointed out in another thread, it is ridiculous to call a weekend with 2 consecutive days off as a "golden weekend" what anyone else outside of medicine would consider a normal part of life.

as blade28 and other's have pointed out, you will be sleep deprived. even in a benign program, even if the call isn't heavy/hard. most people sleep better at home without a pager on, or the worry of codes/rapid responses, and other responsiblities that resident physicians have.

there's no way to simulate residency any way. after three years of residency, what i thought i was subjecting myself to in my most difficult medical school rotations wasn't even close to what residency actually was. i'd like to think that most interns/residents would feel the same way.

 

[gutonc]

I think we've forgotten the most important way to help the OP simulate residency and call. He should give everyone on SDN his cell phone # and we should put together a schedule to call him q5 min every 4th night and ask him to answer stupid questions and perform mundande tasks. Then, randomly, one of those calls needs to tell him that his dog just got run over or his dad just died, something to really get his adrenaline running. After a month of that I guarantee we will have minted another pre-law student.

 

[Winged Scapula]

I think we've forgotten the most important way to help the OP simulate residency and call. He should give everyone on SDN his cell phone # and we should put together a schedule to call him q5 min every 4th night and ask him to answer stupid questions and perform mundande tasks. Then, randomly, one of those calls needs to tell him that his dog just got run over or his dad just died, something to really get his adrenaline running. After a month of that I guarantee we will have minted another pre-law student.

Good idea. Don't forget to make about 1 in 10 calls a "no answer", followed in succession, just about the time he has fallen back to sleep, with another page complaining about him not answering his pages!

 

[smq123]

I think we've forgotten the most important way to help the OP simulate residency and call. He should give everyone on SDN his cell phone # and we should put together a schedule to call him q5 min every 4th night and ask him to answer stupid questions and perform mundande tasks. Then, randomly, one of those calls needs to tell him that his dog just got run over or his dad just died, something to really get his adrenaline running. After a month of that I guarantee we will have minted another pre-law student.

👍

In addition, the OP should walk down a busy street with a huge "kick me" sign on his back, at least a few times a day. Because no graduate medical education is complete without a little public humiliation, and ego-crushing moments.

 

[Jacobian78]

Just wondering, are these comments directed towards a certain type of residency, or is this just the resident experience overall? For example, would a pathology residency be this streneous, cause I always figured the on-call issue would be more minor for them. Of course I realize this is just an assumption though.

 

[Strength&Speed]

Just wondering, are these comments directed towards a certain type of residency, or is this just the resident experience overall? For example, would a pathology residency be this streneous, cause I always figured the on-call issue would be more minor for them. Of course I realize this is just an assumption though.

no, path is probably one of the better ones. you will not be getting paged q 5 min as a path resident. however, the paging scenarios they presented are not uncommon for medicine and surgery residents.

 

[Strength&Speed]

Actually, maybe the OP is on to something. You know how they have patient simulators now? The mannikins and dummies? Why can't we have pre-medical simulation of residency. Like you said...I think we'd lose about 25% of our future applicants. at least.

 

[Excelsius]

I think we've forgotten the most important way to help the OP simulate residency and call. He should give everyone on SDN his cell phone # and we should put together a schedule to call him q5 min every 4th night and ask him to answer stupid questions and perform mundande tasks. Then, randomly, one of those calls needs to tell him that his dog just got run over or his dad just died, something to really get his adrenaline running. After a month of that I guarantee we will have minted another pre-law student.

That's pretty good. Call: 1-800-corn-the-premed. I do remember the thread where a guy was woken up at 2am for some stupid question about the blood pressure. Still, it seemed to me that a nurse would try to be so malicious mainly because you have established a bad rapport with her. I guess if you have the looks, it will help as well.

Maybe trying to sleep under pressure, on a gurney somewhere doesn't amount to much. I hope the pager is pretty loud because sometimes I sleep right through the alarm if I'm tired enough (that's why I am now getting a state-of-the art alarm).

Actually, maybe the OP is on to something. You know how they have patient simulators now? The mannikins and dummies? Why can't we have pre-medical simulation of residency. Like you said...I think we'd lose about 25% of our future applicants. at least.

Well, you wouldn't lose me. I always try to be proactive instead of reactive. I am going into medicine despite all the negativity because part of my goal is to contribute solutions to the field, rather than promulgate a sense of hopelessness and futility. If all of us went into the field proactively seeking leadership, we wouldn't have so many problems in the field now. The real question is when the time comes, how many of the closet residents will come out to join the movement? That's when you will have the opportunity to put your money where you mouth is. Every complaint you make should be considered an IOU towards the field. Regardless whether you are a pre-med or a resident, if you don't feel at least some responsibility in trying to fix the system, then you are the problem itself, or at least part of it. But I digress...

Thanks for those of you posting the detailed schedule. My late night SDN drive-by rotation is over for now. Since I have been awake since 5:30am, it puts me right on schedule to try what Blade said above, except that at 12PM I won't get time off, rather will have to go to my second job. I'll maintain about 4-6 hours of sleep for Tuesday and Wed. nights and simulate Q3 call by staying up Thursday from 6am till Friday 10 PM (have to work again). I think this simulation will be very real: Thursday morning I have to go to court present a 17 page motion against a $400 ticket and that's probably close to the pressure you feel during some of your rotations. Now if I feel that I am losing my sharpness before Thursday morning, I might have to succumb to a few extra hours of sleep this time simply because I wouldn't want to face a $400 bill as a result of my experiment, but this is going to be a an excellent challenge!

 

[Excelsius]

Quick reminder: effective today all drivers in California will be cited if they use the cell phone while driving. It will probably make your day to get a ticket while you're on your phone with the nurse trying to drag your tired ass home. This law is yet another example of political stupidity where correlation has been assumed to be a causation. My stat teacher was outraged at the data used to backup the new law.

 

[gutonc]

That's pretty good. Call: 1-800-corn-the-premed. I do remember the thread where a guy was woken up at 2am for some stupid question about the blood pressure. Still, it seemed to me that a nurse would try to be so malicious mainly because you have established a bad rapport with her.

See, the thing is, they don't always see it as malicious. They see it as their job. And since they're working shifts, they assume that you are too. It's even worse if you work in a place that has 3 shifts a day since that means a shift change around 11p. An hour or so after that, the graveyard shift has had time to go through the chart and orders and decides now is the time to call and ask why you don't need a liver panel on the morning labs.

 

[Excelsius]

See, the thing is, they don't always see it as malicious. They see it as their job. And since they're working shifts, they assume that you are too. It's even worse if you work in a place that has 3 shifts a day since that means a shift change around 11p. An hour or so after that, the graveyard shift has had time to go through the chart and orders and decides now is the time to call and ask why you don't need a liver panel on the morning labs.

But for that guy's case it sure seemed like malice on purpose. Maybe I am wrong, in which case we probably assume an unintelligent nurse.