UCLA Residency Hour Discrepency

[sniderwes]

Does anyone have first or second-hand experience with resident work hours at UCLA? Half of online sources claim 50s while the other half is claiming 70-80 hour weeks on average which is a huge difference. Somebody's lying

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[DrOwnage]

Current UCLA resident here. It varies by year, but is nowhere near 70. For intern year it is in the low 50's, CA1-CA3 year are usually around the same in the mid 50's. Schedule is not bad and we definitely have it pretty good compared to other programs. The patients are sick though, and in house calls can be very busy at the main hospital. But my average hours (looking at the simulated report from my duty hours) over the past 3 years have been 49 (however that includes vacation). Any other questions?

 

[IMGASMD]

Could it be the difference between ca-1 to ca-3? Could it be the difference between I don’t count my set up time in cardiac case, but that you do? If it makes a difference in your decision making as to which program you want to choose, go with the higher number. You will be unhappy and eventually find something else wrong in the program when the thought of 1.5 hour/day extra during residency is making you this uncomfortable.

 

[samwise gamgee]

Your residency training is supposed to prepare you for your future independent practice. Being afraid of putting in the reps and the hours is a potentially detrimental mindset going into the next four years of your life. In the departments that provide incentive pay for working late, the money hungry residents that end up logging the most hours consistently become the most competent clinicians by the end of their training. If you are looking for the lightest schedule, you will end up getting out of your training exactly what you put in to it. Programs will lure you with a light schedule in order to attract good candidates, but this does their future trainees (you) a disservice.

 

[DrOwnage]

Give the guy a break, no reason to question his work ethic. He's merely trying to find out a discrepancy in 30 hours he's been researching... You can always argue more hours = better training. However, I'm one to argue for the fact that staying another 1.5 hours in a breast flap case or relieving CRNAs has very little to do with making you a more competent anesthesiologist in the end. When you're pushing 70 hours on average in anesthesia there's a good chance you are being overworked with end of the day cases with little educational merit.

 

[sniderwes]

Current UCLA resident here. It varies by year, but is nowhere near 70. For intern year it is in the low 50's, CA1-CA3 year are usually around the same in the mid 50's. Schedule is not bad and we definitely have it pretty good compared to other programs. The patients are sick though, and in house calls can be very busy at the main hospital. But my average hours (looking at the simulated report from my duty hours) over the past 3 years have been 49 (however that includes vacation). Any other questions?

Thanks for the clearcut response! How happy are the residents, how is there relationship with attendings/CRNAs, and how would you describe your work life balance? Sorry for the barrage of questions...it's not everyday I can actually ask them to a UCLA resident

Your residency training is supposed to prepare you for your future independent practice. Being afraid of putting in the reps and the hours is a potentially detrimental mindset going into the next four years of your life. In the departments that provide incentive pay for working late, the money hungry residents that end up logging the most hours consistently become the most competent clinicians by the end of their training. If you are looking for the lightest schedule, you will end up getting out of your training exactly what you put in to it. Programs will lure you with a light schedule in order to attract good candidates, but this does their future trainees (you) a disservice.

Did you average 80 hours a week during your training? The average these days is 50-60 hours a week, and the consensus is that the majority of programs train you very adequately. Nearing 70 hours is considered "workhorse" where the focus is on using the residents to cover rooms, and not on teaching. Even my oldschool attending who I work with closely (the man works weekends and puts in 80+ hours a week and has a family) says I will be well trained no matter where I go, and to choose a place where I would fit in and be happy.

 

[samwise gamgee]

Thanks for the clearcut response! How happy are the residents, how is there relationship with attendings/CRNAs, and how would you describe your work life balance? Sorry for the barrage of questions...it's not everyday I can actually ask them to a UCLA resident



Did you average 80 hours a week during your training? The average these days is 50-60 hours a week, and the consensus is that the majority of programs train you very adequately. Nearing 70 hours is considered "workhorse" where the focus is on using the residents to cover rooms, and not on teaching. Even my oldschool attending who I work with closely (the man works weekends and puts in 80+ hours a week and has a family) says I will be well trained no matter where I go, and to choose a place where I would fit in and be happy.

I am suggesting, earnestly and in good faith, that avoiding working in excess of an average of 50 hours per week in residency would be doing yourself a disservice. Consider this a single data point among all of the advice you are receiving. As you interview, make your intentions clear to the programs at which you interview so you can avoid landing into a situation that will make you unhappy. They may sugar coat their hours, but if you make it clear you don't want to work more than an average of 50 hours weekly, you should be able to effectively self-select yourself out of most programs that exceed your limit.

 

[Twiggidy]

Thanks for the clearcut response! How happy are the residents, how is there relationship with attendings/CRNAs, and how would you describe your work life balance? Sorry for the barrage of questions...it's not everyday I can actually ask them to a UCLA resident



Did you average 80 hours a week during your training? The average these days is 50-60 hours a week, and the consensus is that the majority of programs train you very adequately. Nearing 70 hours is considered "workhorse" where the focus is on using the residents to cover rooms, and not on teaching. Even my oldschool attending who I work with closely (the man works weekends and puts in 80+ hours a week and has a family) says I will be well trained no matter where I go, and to choose a place where I would fit in and be happy.

Sorry. Don't expect to not push long hours at big name academic programs. Also yes, they will tell you to "fudge" your hours. Lastly I disagree that "workhorse" programs do you no merit. You can look at it as "I'm just covering rooms" but there is something to take away from every case, even if it is an appy.

 

[bellevueperson]

Thanks for the clearcut response! How happy are the residents, how is there relationship with attendings/CRNAs, and how would you describe your work life balance? Sorry for the barrage of questions...it's not everyday I can actually ask them to a UCLA resident



Did you average 80 hours a week during your training? The average these days is 50-60 hours a week, and the consensus is that the majority of programs train you very adequately. Nearing 70 hours is considered "workhorse" where the focus is on using the residents to cover rooms, and not on teaching. Even my oldschool attending who I work with closely (the man works weekends and puts in 80+ hours a week and has a family) says I will be well trained no matter where I go, and to choose a place where I would fit in and be happy.

Recent UCLA grad, and I can also attest to averaging 50s a week and great training dealing with sick patients. Only went over 70 hours a handful of weeks during residency, mainly ICU rotations. Overall good work/life balance, happy residents, and collegial/friendly relationship with attendings and CRNAs (you'll find a few exceptions at any program). Feel free to PM me with additional questions.

 

[DrOwnage]

Agree with everything Bellevue said above. I would also add that CRNAs don't have a huge role at UCLA, although they are adding a couple more. They do not take any educational cases away from residents and we do not have an SRNA program. Our current PD is pro-resident and against CRNA milling. We have a LOT of attendings and I haven't even worked with all of them over the past 2 years. Majority of them are awesome, with a couple of bad apples (however I figure that's how it is everywhere). I've never fudged my hours or been asked to. All my co-residents are overall happy and would choose UCLA again. Hope it helps, good luck. PM me with any other questions bro.

 

[MetaPhysicianBlog]

Let's say you are on a 24 hour home call and you never get called in. Technically, you worked zero hours. However, you can't go out and have a life. Someone familiar with the UCLA program can chime in on how they count the hours.

Also, as others have said (@bellevueperson and @DrOwnage ) X hours taking care of healthy patients is much much different than sick patients. That cannot be stressed enough. Usually quality programs have sick patients and big cases.

And I'm with @Twiggidy - every case has something to teach. Some cases have more to teach you. Sometimes attendings teach you explicitly. Other times the patient on the table teaches you. And sometimes the surgeon teaches you.

It is up to you how you fill the hours with recognition of educational moments.

 

[DM27]

Regarding hours and the resultant quality of training, a lot of it depends on what kind of person you are.

There are good programs out there that are focused on more "academic" cases and supervisory roles and they will really let you coast. These kinds of programs are probably the best examples of you get out what you put in. A friend of mine graduated from one of these programs and he was describing how many of the people who took advantage of the ability to essentially decline cases and let a CRNA do it etc. ended up entering practice very unprepared or ended up going into pain. Whereas people who took advantage of all the opportunities came out fairly strong.

On the other hand there are good programs that will work you fairly hard (defining this as routine 60+ hour weeks) which may really hurt your quality of life, but will add a bit of "insurance" that by virtue of working more overall you have a higher likelihood of leaving with a decent degree of comfort and competence.

There is honestly nothing wrong with either approach, it is human nature and nature in general to not expend more energy than you need to. A lot of it is knowing yourself and being able to make a decision that you know is best for your future. I am someone who does not personally seek out more work than I need to, so when it came time to decide on residency programs I picked a program where I was 100% hands on as a first year and gained supervisory experience on call as a CA-2 and CA-3 supervising other residents on the call team. I chose this because I knew that being in a situation where I was working more on average and had more clinical exposure that I would have a greater opportunity of graduating competent than a program where I had the ability to sleep through my entire call and then go home and play video games all day (not that bad either).

 

[nimbus]

Let's say you are on a 24 hour home call and you never get called in. Technically, you worked zero hours. However, you can't go out and have a life.

Sure you can. As long as you don’t drink or do drugs and are within a reasonable distance to work. If I count home call time, I’m frequently hitting 100hrs per week as an attending.

 

[vector2]

Best training program ranking (imo)

1. ~50+ hr program with minimal fellows and strong complexity (tertiary OB, transplant, neuro, cardio thoracic, ICU) where you actually spend a fair share of your downtime reading voraciously (my experience)

2. 60+ hr program with strong complexity but not as much reading time because you're burnt out

3. 60+ hr program with moderate complexity but you have to relieve CRNAs after hours for ASA 1/2 gen surg

4. ~50 hr community program with weak complexity and you spend your downtime getting drunk and playing xbox

 

[dchz]

Best training program ranking (imo)

1. ~50+ hr program with minimal fellows and strong complexity (tertiary OB, transplant, neuro, cardio thoracic, ICU) where you actually spend a fair share of your downtime reading voraciously (my experience)

2. 60+ hr program with strong complexity but not as much reading time because you're burnt out

3. 60+ hr program with moderate complexity but you have to relieve CRNAs after hours for ASA 1/2 gen surg

4. ~50 hr community program with weak complexity and you spend your downtime getting drunk and playing xbox

This is pretty spot on. except PC gaming is where it's at.

 

[pgg]

We train to handle rare events. If you'd like to see some of them while you're in training, you have got to be present. There is no substitute for time in an OR.

 

[jthedestroyr]

DC what are you playing ? Overwatch, etc? 😛

 

[deleted162650]

As a resident, there’s always something you can be working on even in B&B cases whether it’s efficiency, smooth wake up, etc. Don’t slack. Continually try to improve your Anesthesia game so day 1 of PP you can hit the ground running.

 

[jthedestroyr]

As a resident, there’s always something you can be working on even in B&B cases whether it’s efficiency, smooth wake up, etc. Don’t slack. Continually try to improve your Anesthesia game so day 1 of PP you can hit the ground running.

Agree, I like having those easy days where you can work on using a different blade, try faster wake ups etc.

 

[okayplayer]

As a resident, there’s always something you can be working on even in B&B cases whether it’s efficiency, smooth wake up, etc. Don’t slack. Continually try to improve your Anesthesia game so day 1 of PP you can hit the ground running.

Also hustle for every bread and butter block (not the weird shi$ nobody does in PP), labor epidural and thoracic epidural. Get efficient and become self-sufficient.

Try to do spinals in as many geriatric folks as possible (total knees, hips, turps). You are going to have 2-4 min to get these SABs in the community before the ortho starts getting antsy. There is a learning curve to quickly and proficiently placing spinals in this population.

Just my 2 cents after 5 years out of residency....

 

[dchz]

DC what are you playing ? Overwatch, etc? 😛

Overwatch, pubg, LOL.... I must be at a 1 or 4 program.

 

[DM27]

Overwatch is one of the main reasons I care about when I get out. Gotta grind these Halloween skins.

 

[Status Sciaticus]

Overwatch, pubg, LOL.... I must be at a 1 or 4 program.

Overwatch is one of the main reasons I care about when I get out. Gotta grind these Halloween skins.

PC or PS4?

 

[jthedestroyr]

PC or PS4?

PC, PM me if you want to join the fun.

 

[Twiggidy]

For me it’s the Forza series. Drive a bunch of cars I’ll never be able to afford on tracks I’ll probably never see.

 

[dchz]

For me it’s the Forza series. Drive a bunch of cars I’ll never be able to afford on tracks I’ll probably never see.

You can literally afford to rent any car in the world to drive on a track with a CRNA salary if you really wanted to. Last I checked ~$2k is about the cost of renting even the most expensive car to take out on the track.

 

[DM27]

I used to play on XBox but I switched over to PC...it's so much better. Now though I am mostly sinking into Red Dead Redemption 2.

 

[MetaPhysicianBlog]

Sure you can. As long as you don’t drink or do drugs and are within a reasonable distance to work. If I count home call time, I’m frequently hitting 100hrs per week as an attending.

I personally find it much more enjoyable to be completely off. If I can't go running, biking, hiking, out with friends for dinner, turn off my phone before bed or heaven forbid travel somewhere nearby or far away then I consider the time not completely mine. I thought that was one of the big perks of anesthesia- when we are off, we are off. That may be just me, though.

I said the comment in order for prospective residents to not be duped in 'oh we only work x hours' when in reality this is not the same as saying you'll have x amount of hours free per week. I want them to be informed and ask 'how many days of call are there per week?' or 'how hard do you work when you are there?' to get a better idea.

All hours are not the same.

 

[rakotomazoto]

Just graduated from UCLA, average hours were in the 50's, never felt pressured to fudge. I would always show applicants my actual hours log and case logs, if you go someplace legit there is no need to fudge. The training was solid and I have felt very comfortable out in private practice land. I am getting a lot of compliments for being fast and efficient and I feel like that is directly due to my focus on those things during residency and having the good fortune to being exposed to wide variety of complex cases and environments. That is something you can work on no matter where you train and no matter what cases you do.

We don't take much home call, I only ever counted when I was called in. Only time I hit high 70's was CTICU as a CA3 and on medicine wards as an intern at UCLA, which we all do one month of, most of the intern year is actually at the West LA VA and hours there are much more chill. Every now and again if I did two 24 hour shifts in a single week, I would get close to 80, but that didn't happen too often. Maybe the people who quoted 70-80 were reviewing their cases for the next day at the hospital or something. I always went home and did that remotely and didn't spend my valuable free time on things that could be done during stool sitting time in the OR like studying for boards. My point is that some of the variation is a reflection of efficiency or a lack thereof, in addition to the usual factors that have already been described on this thread.

FWIW, we did relieve CRNA's from time to time, but no SRNAs and no competition for interesting cases. I picked UCLA because their presence was minimal, no regrets about that decision.

If anyone has UCLA questions, I am happy to answer on here or PM me if more appropriate. It may already be obvious, but I loved residency there and would rank it #1 again without hesitation.