To lie or not to lie, that is the question!

[eightyhours]

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Hi all,

I will tell you right now, I created a new login because I want to hide the identity of where I work for obvious reasons.

Anyway, as I'm sure a lot of programs do, ours have us log hours through new innovation which is an online tool that let's you do a lot of things and log your hours.

I'm an intern in trauma right now and my hours are way over 80 a week, more like 100.
I was told by some of my peers to log my real hours but then, I got an email from our coordinator that I was going to have to explain why I was over the 80 hour limit to the program director! My issue is that I'm a prelim and I want to be able to potentially stay at this institution.

Should I lie and report only 80 hours? or should I continue to put my real hours? I'm thinking that if I put my real hours, they will do something about it like adding more residents or telling my chief not to round at 5am and 8pm everyday!!!

FYI, my chief told me that she lies about the hours and that she cannot tell me to lie but that it would be less of a hassle for me to do the same!!!

Sorry for the long message! HELP!

 

[ACSurgeon]

Yes.

Duh.

You most have the best posts on SDN!

 

[Winged Scapula]

I'm thinking that if I put my real hours, they will do something about it like adding more residents or telling my chief not to round at 5am and 8pm everyday!!!

Read your comment below and tell me if you really think that your program is interested in how many hours you work. Clearly the residents have been inculcated to believe they have to lie and if you are honest you are "threatened" with a talk with the PD.

Such programs do not add more residents or in general tell the Chief how to run the service.

FYI, my chief told me that she lies about the hours and that she cannot tell me to lie but that it would be less of a hassle for me to do the same!!!

Is this the same Chief who makes you stay until she gets out of the OR at 8pm to round? If that's the case, she obviously doesn't care about how many hours you work. That's old school practice keeping everyone around until the Chief is done.

 

[Amy]

Yes, you should lie, because if you program goes on probation (or worse... loses accreditation), it's no good for anyone.

However...

This needs to be dealt with internally. You need to let your program director, administrative chief, or whomever else is "in charge" know about this, and that it has to be remedied before you (and your collegues in the same boat) report the problem to the ACGME. Obviously the chief on your service now isn't much help. I'll bet, though, that there are at least a few other residents in your program who are pissed off about the hours too. You need to band together and come up with a reasonable SOLUTION to the problem, and present it to the powers-that-be. This will be much more effective than simply complaining.

 

[Samoa]

I would simply ask your PD to help you figure out a way to comply with work hour rules while still rounding at 5am and 8pm everyday. That way you demonstrate a) willingness to seek help in a timely manner, b) desire to do your job thoroughly, and c) desire to follow the rules. All good things that no one can really criticize.

And you've brought it to his/her attention in a nonthreatening manner, which is also important, given your personal goals at that program.

It should be the PD's headache to make compliance possible, not yours. But once it's possible, then you need to figure out how to be efficient enough so that you do comply.

For the record, I never lied about my hours. And I never had more than a trivial 10 hour violation, either.

 

[Pilot Doc]

I'm an intern

Old surgical maxim ... "it's always a good time for an intern to keep his mouth shut."

The likelihood that you can change this program as an intern is about nil, although you have good chances of changing your career by trying. You have to decide if you are interested in staying in this program or not. If you are, take notes, don't make waves, and think about things that you could change later as a chief

 

[cchoukal]

Agree strongly with the above post. The faculty know the hours regulations are not being followed and I suspect they subtly encourage noncompliance. To make any mention of this risks being labelled a whiner and potential tattler, and this is particularly damaging for someone wanting a promotion from prelim to categorical.

Yes, yes, we should all stand up and demand to be treated fairly, and, no, we shouldn't tolerate abuse just because we were born later than our attendings, but, seriously, you have to let the next guy fight this one. Your job is to get promoted to categorical and the only way to do that is go balls to the wall (harder than the others) and hope it gets noticed. Do you want your concerns about working to long to be the thing that gets noticed instead?

 

[eightyhours]

Thanks a lot for your replies. Since then, I talked to more residents and surprisingly found upper levels that said they didn't go over 80 hours as interns.
Either he's lying or he had a chief that cared more about teir interns not going over 80 hours.

At any rate, I think this is a loose loose situation. Why doesn't ACGME or whoever is governing this 80 hour lie do a better job at catching programs violating the 80 hours??

For instance, they could easily figure out my hours by looking at my log from entering and exiting the parking structure at all hours of the day (and night).

 

[Pilot Doc]

Why doesn't ACGME or whoever is governing this 80 hour lie do a better job at catching programs violating the 80 hours??

The ACGME duty hours regs were put in place when congress started making noise about passing federal duty hour laws. That got attention real fast and the ACGME made the problem go away. For good measure, they revoked the accreditation (?sp) of a nationally prominent program that also happened to be in teh Washington Post's local coverage area.

As for now ... I don't think anyone, particularly in the surgery RRC, is planning to look very hard for work hour violations. If they really cracked down it would cause some fundamental changes in residency training that would probably not be good for residents (e.g. lots of programs probably closing)

 

[Pir8DeacDoc]

As for now ... I don't think anyone, particularly in the surgery RRC, is planning to look very hard for work hour violations. If they really cracked down it would cause some fundamental changes in residency training that would probably not be good for residents (e.g. lots of programs probably closing)

It's definitely an issue. A prominent Boston program is really struggling right now to remain compliant and not have the ax come down on their program. The surgery RRC knows that people lie about their hours so if it's still an issue that's documented you can bet it's a huge problem.

Things can get ugly fast so I'm told.

 

[Kubed]

Old surgical maxim ... "it's always a good time for an intern to keep his mouth shut."

(files that one away for later use.. much, MUCH later use 😉 )