question about number of hours worked in residency

[Tardigrade101]

---

Members do not see this ad.

Hi!

I'm not sure if this is the right place to put this, but I'll be starting medical school in the fall and am trying to imagine my life for the next 10 years. I always hear horror stories about 3 day shifts and 120 hour work weeks from residents, and I was wondering if all time spent working is actually working, or whether you're just "on call" so to speak - like you're hanging out in a room somewhere until a patient needs something done?

In other words, are you on your feet doing stuff for the entire 12+ hour shift?

Thanks!

 

[DrMom]

You apparently aren't familiar with the residency work hour restrictions. Do a search or read through some of the residency forum threads on the topic. There's a max of 80 hrs/week averaged over 4 weeks and strict limitations on how many hours in a row. What you present is from years past.

 

[GTP]

How strict is this rule? Seems like many hospitals violate it

 

[ZagDoc]

I just completed a surgery intern year. I averaged 70 hours per week. My lightest week was 50 hours. My heaviest week was 102 hours. Most weeks were between 70 and 75 hours. I was only grossly over-hours 4 weeks out of the year, solely due to clinical volume and not due to any malignant unreasonable demands. The new work hour restrictions limit interns to 16 hours in the hospital. I only violated this 3 times (due to a non-PC intern call schedule by a surgical subspecialty department, which has now been addressed). PGY2s and beyond are limited to 24 hours on call with an additional 4 hours for cleaning up loose ends from patient care issues, rounds, sign out, etc.

Hope that gives you some perspective.

 

[Rothbard]

nm

 

[Tardigrade101]

I'm sorry, I don't think I phrased my question clearly. I wasn't exactly asking about number of hours worked. I more wanted to know about the nature of work. Obviously you spend the time taking care of patients, doctoring, so to speak, but are you on your feet the whole time, or do you wait until you're called to do something? How often do you take/how long are breaks?

Now that I think about it, it would probably be better to ask a current resident about these things, but I figured the current med student forums would know more about it than the pre-med people.

 

[ZagDoc]

Doesn't adherence vary by hospital? In some places it's a strict rule that's respected, in others it's more of a suggestion.

It's 100% a rule to be followed and respected. Repeated violation of the work hour rules can result in program suspension and withdrawal of federal funding for the residency program. This can and does happen to programs- including big-name academic ones.

Granted, programs can often be in frank violation for several years before suspension results. Programs are generally given the benefit of the doubt and given opportunity to make changes to call schedules/shifts/team structures to address work hours violations. That being said, once you're in the spotlight, you really need to demonstrate 100% compliance. This is not something that some programs "slide" on because they "want to."

 

[xf3rn4nd3sx]

I'm sorry, I don't think I phrased my question clearly. I wasn't exactly asking about number of hours worked. I more wanted to know about the nature of work. Obviously you spend the time taking care of patients, doctoring, so to speak, but are you on your feet the whole time, or do you wait until you're called to do something? How often do you take/how long are breaks?

Now that I think about it, it would probably be better to ask a current resident about these things, but I figured the current med student forums would know more about it than the pre-med people.

The hours include "on call" time, so you are not necessarily "doing" something every hour. That being said, you still could have a long period of time on your feet physically doing something like surgery, but to comply with hour regulations this means that you will have more lax periods for the rest of the week.

 

[RestoreSight]

I'm sorry, I don't think I phrased my question clearly. I wasn't exactly asking about number of hours worked. I more wanted to know about the nature of work. Obviously you spend the time taking care of patients, doctoring, so to speak, but are you on your feet the whole time, or do you wait until you're called to do something? How often do you take/how long are breaks?

Now that I think about it, it would probably be better to ask a current resident about these things, but I figured the current med student forums would know more about it than the pre-med people.

Very hospital and service dependent. Big hospitals = more patients and less time to rest. Most follow the basic routine though. You arrive between 4-7 am, depending what service you are on. You check in on your patients and update AM orders. You round with the attending for a couple hours (times vary considerably). Then you grab some food and make sure PM orders are in, then you have noon conference or some derivitive of that, then you put more orders in, then you (sometimes) do afternoon rounds, then you update sign out, discharge summaries, transfer orders, paperwork paperwork paperwork, dictations, etc. Then you sign out and go home.

The importance of the new system is nightfloat. If you are on nightfloat you come in between 7-9 pm and work overnight. Sometimes you can grab some sleep if things are quiet, othertimes you are up all night. Same routine as above, except you write less notes since your just covering.

You are not necessarily up and running all the time or at all. It depends on the service, i.e. ICU, wards, clinic, surgery, trauma, ED, etc.

 

[DrMom]

I just realized this was posted in the wrong forum. Moving to pre-allo as it is a pre-med question.

Yes, there are some programs (seems mostly surgical) that violate the hours, but most programs follow the hour rules as there are consequenses if they are caught violating them.

 

[mvenus929]

How strict is this rule? Seems like many hospitals violate it

As mentioned above, it's not a rule that is 'suggested'. Programs can lose accreditation by violating this rule.

I more wanted to know about the nature of work. Obviously you spend the time taking care of patients, doctoring, so to speak, but are you on your feet the whole time, or do you wait until you're called to do something? How often do you take/how long are breaks?

It varies. We do short call with the residents, where we admit on our on call day and stay until 8. My first call day, I didn't leave the hospital til 10 because 8 was the first chance I had to sit down and write my notes... we were running around and admitting patients from the ICU and ED all day (9 patients total, I think).

Yesterday I was on call again and left at about 8:30, and we only admitted 4 patients. The extra time after 8 was spent helping the intern update sign-out for the night float team (since we do cross-cover for 3 other teams from 5 til 8). My resident stayed a lot later because one of the patients we admitted wasn't doing so well and had to be transferred to the MICU.