Unfair On Call Schedule

[DocInDub]

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Hello. I'm a frequent lurker but a very infrequent poster to this forum.

Brief background: I'm an American working in Ireland as a resident in a busy surgical specialty. The residencies are significantly longer here. I'm in my 4th year currently, which is about midway through the training scheme. We also rotate hospital every 6-12 months as opposed to the American scheme of staying put for the majority of training.

My issue: The last 6 months, I've been scheduled to do a significantly higher burden of on-call duty (which, in Ireland, are 24+ hours in hospital, completely run off our feet). I've counted the amount of call I've done in comparison to the other trainees of my level, and it's about 50% more. We've all had the exact same amount of holidays, etc.

The person in charge of our schedule is the equivalent of a chief resident. I've let them know that I notice the inconsistency and enquired as to how it will be dealt with. Their response was a vague "it should balance out over the next 6 months". What else should be done in this case?? I feel like others are getting the benefit of my being American and largely without family/commitments here in Ireland.

Any advice is appreciated!

 

[rokshana]

keep your head down and get through...if your chief resident says it will balance out over the next 6 months...then see if it balances out.

 

[Crayola227]

there must be balance between above two pieces of advice

I would document clearly the differences, give it 6 months, return to the issue
think carefully on whether you need to go above Chief's head if you can but be careful about politics/making enemies
getting in someone's face about how much work you are doing is never looked on well in medicine so you need to be diplomatic why you are taking issue with this and reaffirm you are all about helping out and work ethic but also want to catch if this is an oversight as we are all tired LOL

it would show maturity to acknowledge reasons they may have for doing this to you, or hopefully make them feel bad if the none of the following apply
"I accept if this is for the good of the program, that perhaps other residents have personal issues that shifting work is necessary... or I am wondering if this is because it is felt I need more hours compared to my peers. If it is the latter I would definitely appreciate feedback."

sometimes work is shifted to you because YOU are the weaker resident.... other times it is because you are the STRONGER resident and they need/forced to give other residents more space to improve and/or difficulty pulling weight safely

I also point this out to you if it makes you feel any better, there could be a reason and rhyme to this, maybe they are not sharing with you
could be lazy or favoritism but how does that view help you?
keep your head down bust ass don't make enemies is my mantra
it sucks but there it is

TLDR
advocate for self but be careful
give it a bit of time
document
maybe someone needs the work shifted to you
maybe you need the work shifted to you
residency sux so suck it up & bust ass with as little complaint as possible

 

[deleted245139]

As a chief I can speak to this: the goal is to even things out within a given block\month but sometimes, for one reason or another, it cant happen. Over a year it should even out completely. The above advice is spot on; stay on the chief, don't nag, and just encourage good dialogue. They should have your best interest in mind.

 

[Apollyon]

But this person is in Ireland. It's not the UK, but it is the British Isles, meaning, tradition goes further than talent, usually. That means that, if you graduate first in your class from Aga Khan, so what, b/c the consultant's brother, dragging a leg with a lazy eye, and drooling, gets the next consultant's spot, and the brown guy stays a registrar (resident). It is unjust, and inequitable, but is what it is. I wouldn't be surprised if the OP got "Irish diplomacy" while still getting worked to death. (With "Irish diplomacy" being: telling someone to go to hell, but having them look forward to the trip.) The American is the "odd man out".

 

[Law2Doc]

I don't know how much advice people in the US can offer in this foreign system scenario, but would suggest that residency in any country is a finite period of time and just like in the US there's usually some benefit to keeping your head down and pushing through.

Also, A lot of us lived through an era of 30 hour call here in the US so we can tell you with some confidence that 24+ shifts won't kill you. You'll learn a lot and probably still won't log the kind of hours many of your US counterparts log.

 

[bambi]

I had something similar in the UK, I was doing twice as much call as some of the other registrars. I emailed the senior registrar who is in charge of the rota who gave me the same line that it would even out. Our rota is done in blocks so I waited until the next block came out before saying anything again. When it did I was still doing more so I mentioned it again, he got annoyed and copied in our TPD to the emails. Pretty much the next day though he changed the rota to make it fair. The TPD was away and isn't very proactive so it wasn't his doing, the guy just realised it was unfair. I haven't had any problems with the guy since either. I think he just didn't really realise how big the difference was, I made it very clear, gave him all the numbers etc.

 

[j4pac]

Stay on him. When the next schedule comes out, if you continue to be treated unfairly, call him out directly. Publicly. Get in his face if need be. This comes up all the time, and if you don't advocate for your.own interests, no one else will either.

LOL. I would have loved to go to residency with you...we would have gotten together quite well! 🙂

 

[WingedOx]

As a chief I can speak to this: the goal is to even things out within a given block\month but sometimes, for one reason or another, it cant happen. Over a year it should even out completely. The above advice is spot on; stay on the chief, don't nag, and just encourage good dialogue. They should have your best interest in mind.

Yup, making the call schedule for 30+ residents is one of the biggest pains in the ass of being a chief resident. It basically involved 3 evenings of sitting in front of my TV used as a large monitor to view 3 spreadsheets and a flat screen. Any time someone noticed an error, that would require a change that would inevitably require 4 or 5 other changes, which would then compound the errors. Putting it together is like doing a damn Rubik's Cube.

Inevitably some people get somewhat screwed. I tried to make it as even as possible, but the discrepancies usually fell hardest on the interns because my priority for "evenness" was for the more senior residents.

 

[xyz34486]

At the end of the day, being lazy is the main culprit for chief residents having a bad schedule. Its easy for them to follow a set algorithm. To some extent, the squeaky wheel gets the grease so don't make the guy hate you (and punish you) but also stay on him and check in from time to time. My guess is from what you described in terms of rotations, waiting beyond 6 months might not make sense (cause you might be at a different hospital). Sometimes simply cc'ing a program director can get the ball moving.

 

[mppcc]

Quick warning, complaining more to the chief won't always help. You'll might put them into a mode of how do not change things only because I was confronted by a resident because it will set a bad precedent. I have no doubt that you have done more call shifts than your peers. Someone always draws the short straw when it comes to scheduling and often monthly schedules are made independent of prior months. If you keep your spirits up and don't let it get you down things will get better eventually.

 

[WingedOx]

At the end of the day, being lazy is the main culprit for chief residents having a bad schedule. Its easy for them to follow a set algorithm. To some extent, the squeaky wheel gets the grease so don't make the guy hate you (and punish you) but also stay on him and check in from time to time. My guess is from what you described in terms of rotations, waiting beyond 6 months might not make sense (cause you might be at a different hospital). Sometimes simply cc'ing a program director can get the ball moving.

...clearly a post from someone who's never been a chief resident.

 

[Winged Scapula]

...clearly a post from someone who's never been a chief resident.

Exactly.

Going to the program director is the last thing you would want to do.