...I was just asking if the work hours and call schedule have become a big deciding factor.
However, I think there are few things that deserve more emphasis than the intern call schedule when searching for a training program:
- surgical training
- didactics
- research opportunities
- mentors
- residents pass the boards and match into fellowships
...
The fellowship matching and boards pass rates are actually numbers quite often published/obtainable (boards rate).
Surgical training regularly discussed at pre-interview dinners/etc... Programs usually hand you copies of current residents and recent grads logged cases. At interview time...attendings and residents "all" declare how well prepared you will be...
Research opportunities are another thing similarly more objectively identifiable.... publications, labs, lab tour, etc....
Mentors & didactics... well another subjective that can often be deceptive... Didactics are useless if your program is out of compliance, you are run down and sleep through the powerpoint in a dark room. You are left to infer based on reported ABSITE scores, board pass rate, and fellowship matching....
In the end, trying to get a feeling from "anonymous" folks with potentially first hand knowledge speaking to "reality" is probably as trustable data as asking at the interview about hours & on-call. The big difference is the anonymous component helping you ask the question without the repercussions.... But, the honesty/accuracy of the data still probably remains just as flawed as asking someone at the interview time....
As for what are or are not ACGME rules, I refer you to look at the ACGME site. They have descriptions and explanations and discuss the averages over four weeks, etc...
In the end, there are a great deal of things that require emphasis. However, probably most easily summed up as such:
The emphasis is to be well trained in an accredited program and properly prepared to pass your board examinations. This requires compliance with the rules/regulations to include working environment and/or expectations in conjunction with the appropriate academic/educational instruction. It is a package deal.
I understand how easy it is for numerous folks to try and argue against some of these components in favor of things they individually prefer or believe of more importance. To be blunt, that's too bad. I will not pressure any trainee to break the rules and train outside
the structure I have agreed to train them under because my great wisdom tells me it is all hogwash or whatever excuse one may conceive. The rules and requirements are what they are and a med-student that ignores their importance does so at their own peril. An attending that does not want to or is not capable of training a resident under these conditions should show enough decency and just leave the teaching environment.... until he/she is capable/willing to work within those boundaries or until said boundaries change to a degree that he/she can work under.
my 0.02
JAD
