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Sleep ???

Discussion in 'Clinical Rotations' started by QHamp, Nov 19, 2002.

  1. QHamp

    QHamp Armstrong Fan
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    I hope none of you mind a high school student nosing his way into your forum... If you do, just give me da' boot! :cool:

    I have heard that Med students on rotations tend to be sleep - deprived. So I wondered just how much sleep ya'll get per day. Is it worse in some schools than in others? Are some rotations worse?

    How much sleep did you get during your first two years? I have been interested in medicine for some time now, but want to get the skinny on all the "downsides".

    zzzzzzzzzzzzzz
     
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  3. Winged Scapula

    Winged Scapula Cougariffic!
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    It varies...

    from rotation to rotation, patient census, your Chief (who often decides when you come in and when you go home), whether you take call, and how hard you work - both in and out of the hospital.

    Some students are not satisfied with being any less than at the top of their class - assuming equality amongst intelligence (which isn't the case, I know but...bear with me), they *may* study more and sleep less. Others who care not as much for grades but more for a good social life may also sleep less.

    It is possible during 3rd and 4th years not to sleep at all for 36 or more hours straight. Since RRC work regulations don't affect medical students you could concievably be up all day, all night and all the next day before being allowed to leave and/or sleep. I see medical students around here try and sneak naps in during the day, but they often can't - being expected to be in the OR, at tutorials, etc. Truth is, at least here however, that we don't require all night call very often for the students, so most should be out of here not much later than 6-7:00 pm and back 10 hours or more later. If they can they sleep, but they'll often study as well.


    Guess there is no hard and fast rule, you'll find everyone will give you different answers to this question.
     
  4. AznTrojan

    AznTrojan Senior Member
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    what's sleep?? ;)
     
  5. southerndoc

    southerndoc life is good
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    Yea, I'm asking the same thing. I think I heard the word mentioned once before. I think the person was majoring in underwater basketweaving. I remember asking myself "what's this thing they are referring to as 'sleep'? How expensive is it? Where do you order it?"
     
  6. QHamp

    QHamp Armstrong Fan
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    Check on ebay :laugh:
     
  7. southerndoc

    southerndoc life is good
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    Is this gonna cost me an arm and a leg? I mean I've functioned for so long without this thing called sleep, and my other colleagues are functioning without it. One must really ask oneself if this thing called sleep is really, truly necessary to have. :laugh:
     
  8. QHamp

    QHamp Armstrong Fan
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    To tell you the truth, sleep itself isn't all that expensive. Some people get crazy, however, and think they need a bunch of accessories to go with it. Thing like Pajamas, and special sleep music. And then they spend a lot of money on things called alarm clocks to wake them up. Figure that!!

    I'd suggest that if you're getting along fine without this thing called sleep, it makes no sense to spend money on one. Med school is expensive enough as it is...
     
  9. fourthyear

    fourthyear Senior Member
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    quit scaring this person!!! Everyone tells you 3rd year is so hard, but i thought it was the most fun year of all (except 4th year of course) b/c you finally get to do what you came to med school to do!

    I'd say about 1/2 of the clinical rotations did not involve ANY overnight call at all - psych and family practice are pretty standard ones at most schools that are pretty much weekdays only. Only surgery and OB involved staying up all night for me - so that's 4-5 months max at most schools of really hard (but really fun) work. Many schools have students take call only till a certain time - say 11pm on services like medicine or peds - and I found both those rotations to also allow some afternoon study time at least a few days a week, since most of their work occurs in the morning unless they are on call for medicine and peds.

    With the exception of ob and surg, i got plenty of sleep, studying, working out, hanging out with friends time. Don't let people scare you - clinicals are super-fun and you will get enough sleep on most of them.
     
  10. fourthyear

    fourthyear Senior Member
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    oh, for the first two years - it's all about time management. if you're in high school - my best advice is get involved in sports or activities now and in college. Why? - it forces you to have to manage your time well in studying. Also, learn to study every day, not just right before the test. lots of smart kids can get by with cramming all the way up till med school and then it becomes hard to do it that way.

    In med school you have to efficiently memorize tons of stuff- especially in the first two years. If you are good at doing it efficiently, you will never have to stay up all night and cram the week of the exam - of course everyone does it at least once out of poor-planning or panic, but most of us learn it's better to use the slow-and-steady method of long-term learning. If you manage your time well, you should never have to go without sleep in the first two years.

    I will say my sleep standards have changed though. I like 8 hours a night, just like i liked in high school and college, but i've learned to function very well on about 5-6 through most of med school and much less when necessary. In most residencies you will have to stay up all night pretty often, so you might as well learn how. but everyone does it, people adapt well.
     
  11. shag

    shag Supreme Procrastinator
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    Fourthyear,

    Where do you go to school? I just left the hospital after 38 hours of fun filled excitement on Medicine. I've done OB, Peds, and am about to finish medicine. Of 24 weeks, I've had 20 weeks of q4, 1 week of q2, 2 wks of 3am to 6pm with interns handling cross-cover, and 1 week of 6am to 6pm. I will have 8 wks of no call on family/rural and 8 wks of q7 on neuro/psyche. Surgery call at my school is q3. Until recently, I didn't even know there was such a thing as non-overnight call.

    Anyway, I don't want to scare the young guys and gals, but there will be times when you have to put in a lot of hours. For example, I was physically at the hospital or clinic 100 - 115 hrs/wk on peds.

    I hope I don't sound too negative (I'm usually not when I'm awake :)). Anyway, I still find time to jog, with my rest days being my call days. I get a golden weekend (2 weekend days off) once or twice a month, so I usually go out then, and reading be damned.

    Anyway, out of curiosity, does anyone have any insight into the average amount of call a third year medical student in the US takes?
     
  12. QHamp

    QHamp Armstrong Fan
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    Ah, Fourthyear. Quit spoiling all the fun!:laugh:

    Hey I am glad for all the pos, as well as the neg.

    I am curious as well as to which school you go to. I usually hear of the 115 hr/wk med schools -- maybe that's because they're the only ones who complain.


    I'm tacking the lil 'puter throwin' guy on for my "little brother's" sake. He's thinking of taking his A+ certification training, and thought this was the coolest thing he's ever seen.

    Here it is:
    +pissed+
     
  13. southerndoc

    southerndoc life is good
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    I'm on family medicine now... I'm putting in about 36-50 hours/week (yes, that's right). I get an afternoon off each week. Call isn't overnight. WOW
     
  14. hotbovie

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    To answer Qhamp's question,

    Some schools require overnight call for medical students. Others don't. My school does, and it wasn't until I was well into my 3rd year (and experienced at staying up all night) that I learned there are some schools where students don't take overnight call.

    My call schedule last year: Internal medicine overnight call was every 5th night, then you had to stay for the whole day after. Pediatrics was every 4th night, and again you had to stay the whole day after. It wasn't as bad as it sounds though, becuase there were 3-4 students per team, and we were assigned newly admitted patients in a rotating fashion. Most nights, we got 2-3 hours of sleep each. Some nights, though, it was busy enough that we never made it to bed. The primary duty of the student on these services was to write the H&P (=History and Physical, a document that each patient admitted must have on the chart, detaling the symptoms and physical exam findings, plus the plan for treating the patient). The residents we took call with also had to write a note on each patient, plus take care of whatever came up with patients already in the hospital (maybe they need tylenol, or maybe the have a heart attack in the middle of the night. All kinds of things must be addressed) Students were always welcome to tag along with a resident and see what was going on (but not required to). So generally we would go only if something sounded cool, or if there was a procedure that needed to be done.

    Psych had no overnight call. We had to go in on one weekend day per month to write H&P on patients who had been admitted overnight, but when we finished that, we went home

    OB/gyn had overnight call every 4th night on the OB month, but we got to go home after call was done. (Unless it was a day we had a lecture, then we had to go to the lecuture and then go home). OB call was much busier, much less sleep (often none), and when you did sleep you had to rotate and sleep one person at a time), and occured in an evaluation area (kind of like an ER) we took the inital information from the patient about why they were there. Then if the resident decided to admit to the hospital, we wrote the H&P. THis was interrupted regularly by calls to go deliver a baby (most students delivered a total of 10-15 babies during the month on OB. The gyn month had "call" but almost always the resident said there was nothing going on, go home.

    Surgery was every 4th nite on general surgery. THis was different from the other rotations as only one student and one resident stayed. The residents were pretty good about only calling the student for interesting stuff. Trauma call was every other night...24 hours on, 24 hours off. The whole team was usually up most of the night. If it wasn't too busy, you could rotate sleeping for an hour or two. But we have a pretty busy trauma center.

    And finally, family practice had "call" where you had to stay 2 days til 11pm. Often it wasn't busy, so we got to go home early.


    Having detailed all my call for you, let me now say that things are very different this year. The reason for that is becuase the ACGME (a committee that puts out regulations for residency programs to follow) has now implemented regulations limiting the work hours for residents to no more than 80 hours a week. And you can't work for more than 24 hours, with no more than 6 hours after to allow you to turn over stuff to the oncoming call person (or to spend in lecture, etc). Also, there must be on day off every 7 and one full weekend off per month. THese rules take effect July 1, 2003. So most progams are experimenting with changes in the call schedule this year so that the are sure to be in compliance by the deadline (huge fines for violators). Many people in medicine think this is a bad idea, but the rules aren't going away. Some programs solve the problem by using a night float (people that are in the hospital from say 6pm-6am every day for a month, then you would rotate off night float) making it more like shift work. Other places are trying to avoid night float, and adjusting the call schedules so that overnight call occurs less frequently (no more call every other night!)

    So, the world of medicine will be very different by the time you start. You should still expect to have to be up all night sometimes, at least as a resident. But that might be in the context of simply working night shift for a month at a time.

    Rest assured, whatever call schdule you wind up with, you will quickly get used to it. It's not so hard to stay up when you are busy. YOu get used to sleeping for short times, in various call rooms, with various types and amounts of nosie around. You may even get to the point where you feel great when you've just gotten 2hours of sleep and function quite well the following day (until you get home, then it hits you)

    I think you are being very wise to consider all aspects of the career you are considering. I'd also follow the advice of a previous poster and start working now to refine your study habits. I was one of those crammers. Cramming got me through high school and undergrad. It doesn't work in med school. Learning to avoid it now will save you lots of pain in med school
     
  15. QHamp

    QHamp Armstrong Fan
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    Thanks, HotBovie. You can be certain I'll be taking a serious look at my study habits.
     
  16. Duke

    Duke Member
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    Actually I would worry more about the long road ahead of you. As you can see from the reply above, there is some time for sleep, but some people are busy helping others and don't have time to sleep or don't need to sleep.

    My girlfriend is a third year right now and she's busy, busy in her clinical rotations. She does really well and makes me look dumb sometimes, and somehow she manages to sleep 8 hrs a night. Even in the first two years, (Dude don't ask me how). But I would have to say that she is extremely organized and has incredible concentration.

    I, on the other hand was not blessed with the gift of organization, concentration or even staying awake in class. I manage to average 5-6 hrs of sleep. But I have a lot of hobbies and like to do stuff too. I guess comparatively, I guess I am the slacker, but I did really well on my rotations. What drove me to study was the fact that I would be in the same position in a couple of years and I would have to make the decisions and people would depend on me. I think that's incentive to make even the biggest slacker crack open a Harrison's..

    Q Hamp, if you're asking about how life is now.. I'm sure you'll do fine. You must be pretty organized!

    Duke
    Class of 2003, KCOM
     
  17. Starflyr

    Starflyr Manic Faerie
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    First 2 years, there's tons of time unless you are horrible at time-management and get yourself into messes. Our school this year does require 36 hours on for students in some rotations - and some rotations were requiring 100+ hours/week for students, but Ive heard that for our class, they're changing this. NOw, if you're on 24 hours, you get the next day off. A lot of services are changing to night float, which students do not participate in. We're also radically changing the curriculum and getting rid of the MAC (multidisiplinary ambulatory clerkship), which was 3 months spent away doing outpatient clinic stuff. SOOOO>....now there will be a lot more students to go around. We'll see.

    Star
     
  18. Delvonik

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    I love staying up late...but that's usually only when I'm watching tv and not doing med rotations,but they're pretty much the same...right ? :laugh:

    The thing I love the most is hurting people once I've become weak and irritable.....
     
  19. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD
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    I think I have a pretty lax med school...my third year went like this....Medicine Q4 on the wards, Q3 in the unit, surgery ~Q4, OB/GYN Q5, Peds Q4 for 3/6 weeks, Psych home call Q7, and no call on my surgical subspecialty for 2 weeks and for 4 weeks of family practice. And no, I didn't go home. My rule of thumb was at least 2-4 hours of sleep, and I almost always got it. I think an intern/resident that doesn't allow 2 hours of sleep for their students is depriving them of learning ability. There is no reason a student shouldn't be given 2 hours sleep per call. Call is a useful learning experience, but staying up all night and all the next day is not.
     
  20. shag

    shag Supreme Procrastinator
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    At my school on IM, its more like:

    "There is no reason an intern shouldn't take 2+ hours of sleep per call when he/she has a student to stay up all night and write H&Ps for her/him to "S&A with student note" and sign in the am" :)
     
  21. QHamp

    QHamp Armstrong Fan
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    I appreciate all of the replies. I kept hearing shag-type "horror stories", so I was curious what was really going on. Thankfully, I am a moderately organized person, so barring any crazy interns, I should get the sleep I need.

    Sometime in the middle of last year I read something about the AMA beginning to force med schools to lower the hours students were forced to put in. Has this had any effect on you yet?
     
  22. shag

    shag Supreme Procrastinator
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    Don't let me scare you... It really isn't that bad...

    I'm just being the sterotypical "whiney medical student" :)

    Putting up with the BS is par for the course, and things like sleep deprivation are annoying, but managable.
     
  23. beezar

    beezar Senior Member
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    Anyone develop insomnia during med school? And how the heck do I get over it? I mean it pretty much sucks that when you have the time to sleep, you can't fall asleep. Logging on to studentdoctor.net at 2:30 in the morning doesn't seem to help much either... ;)
     
  24. QHamp

    QHamp Armstrong Fan
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    We're going to have to creat a "SDNer's Anonymous" for all of us SDN addicts! :laugh: :laugh:
     
  25. OwlMyste

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    I am a HS senior and I am considering becoming an orthopaedic surgeon, the only problem is, I have epilepsy. It's controlled by medications and everything, but I am concerned. Lack of sleep has been known to trigger a seizure in the past. I have petit mal seizures, I'm just wondering if they would take that into consideration and give me good hours? I don't know, thats why I am asking. I mean, I don't want to be near someone's Artery with a scalpel in my hand, and have a seizure because of the lack of sleep that Doctors get. any Ideas or suggestions? I really want to be a surgeon, so I hope my having epilepsy won't hinder that. Also, do you know of any Doctors or surgeons in particular that have epilepsy? How do they deal? Also, how do ortho surgeons balance work and family? :confused: :eek:
     
  26. OwlMyste

    OwlMyste Membership Revoked
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    lLOL...you and me both, Q-Hamp...you and me BOTH!! Hell, procrastinator is my middle name! Geez! :laugh: :p :D :cool: :)
     
  27. sleep deprived

    sleep deprived Senior Member
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    funny you ask. :)
     
  28. soon2bdoc2003

    soon2bdoc2003 Senior Member
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    What kind of med schools are you people going to..

    Medicine - no call
    Peds - Q4 short call (10pm)
    OB - Q4 overnight (slept 6 hours every call) go home 6:30am
    Surgery - 4 weeks of Q2 overnight call (hell), no call for 8 weeks
    Psych - no call

    4th year - the only rotation with call was Peds sub-i with Q5-6 overnight and the residents would send me home at midnight. My medicine Sub-i was 8am-11am every day and I probably spent a total of 4 hours in the hospital during my entire 2 week path rotation.
     
  29. Vlade

    Vlade Junior Member

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    medicine - q4 call till about midnight (3mos)

    ob - q4 overnight call x 6 weeks; first call night - 0 sleep; avg 3-5 hrs; go home 5 pm post call

    peds - q4 overnight call x 6 wks avg sleep 4 hrs

    surgery - q 4 overnight x 6 weeks; home 6-7pm post call (sometimes later)

    smalls - no overnight call; neuro "call" till like 10 pm
     
  30. Cube

    Cube New Member

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    Owlmyst - that is a very good question and I wouldn't know how to answer it. I would suggest contacting a local surgeon or medical school for answers. As far as Ortho goes, they are one of the best compensated specialties, but they work long hours. But, if it is what you want to do, go for it. I would offer you this piece of advice though, think thoroughly about why you want to do medicine and explore the field. Explore other fields too. You will see on this site and in medical schools all across the nation students that regret their decision. Medicine is not how it is portrayed on TV. I am lucky because I had no rationale for entering medicine, but found that I love it.

    As far as studying and sleep go, I believe that learning "how" to study is the key to med school time management. When I first got to school I had no idea what was important, or what the expectations were. Once I figured out what was important, I cut out the other crap and managed my time better. In addition, each student has to understand "YOU CAN'T KNOW EVERYTHING", which is a tough concept to get, especially for gunners. Learn those two principles and your stress level drops and free time increases

    Call schedule

    Surgery - no call but several nights I was up until the wee hours on cases, only to return to round 90 min later.

    Peds - "Call" q 3. Most days let out by 8 pm.

    Fam Med - q 3. I was in a small town doing rural health. I slept unless an ER came in, which happened freqently. I still got about 6 hrs/night

    IM - q 6 or so. My residents wouldn't wake me up unless something cool came in. I was at the VA so I never got up.

    OB - Each student does one week of nights, no sleep (which is why I am on this site in the first place).

    Psych - I don't know yet.
     

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