UT Southwestern Work-hours

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steveoflurane

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I'm wondering if anyone can shed light on the true work hours at UT Southwestern anesthesiology (before anyone posts about being tough and not afraid to work long hours...I get it. I'm not saying I can't work long hours, just want an accurate picture of what the program is before I rank it). At the interview day, they showed us supposedly real statistics how CA-1s average 54 hrs/wk and CA2/3s average 48 hrs/wk. This was initially encouraging, because I knew of their reputation. However, upon talking to others on the interview trail and reading SDN, I'm starting to question what the true work hours are like for a resident at UTSW. If anyone knows more about this, I'd appreciate sharing the info. Thanks!

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Common sense arithmetic: the resident workday in most programs starts at ~6 am, doesn't end before ~4 pm (I am counting hours spent in the hospital, including lectures, not just doing cases). That's ~10 hours/day. Plus call. ;)

48 hours/week is almost day attending level. I would expect more like 65-ish during OR months in residency.

Don't choose a program based on perceived cushiness. Just avoid the malignant ones.
 
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I wouldnt say "choose" a program, per se, on hours alone, but its definitely something to consider between two programs that are level in your mind.
 
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Just had this discussion with some classmates. Why work 70 hrs/wk when you can work 50 hrs/wk and get the same great training? Why work more for the same money? Why spend an extra 20 hrs/wk at the hospital when you can spend the time studying, or with family or significant other, or just breathing? Why work 70hrs/wk for free when you can get paid for those extra 20hrs at an equally reputable program?
I totally get your concern, OP.
 
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Just had this discussion with some classmates. Why work 70 hrs/wk when you can work 50 hrs/wk and get the same great training? Why work more for the same money? Why spend an extra 20 hrs/wk at the hospital when you can spend the time studying, or with family or significant other, or just breathing? Why work 70hrs/wk for free when you can get paid for those extra 20hrs at an equally reputable program?
I totally get your concern, OP.


Cause you won't. You can never predict when the learning opportunities come. All else being equal, those who train in 70hr/week programs will simply see and experience more than those training at 50hr/week programs. 70hrs/week with complex cases?......you will be a rockstar.
 
Are you serious? Some of the best programs have 50hr weeks. And by the time you are hitting hr 60, you're too daggone tired to appreciate and maybe even to take in, this extraordinary experience you can only get when working like a dog. If I were a patient, I sure as hell wouldn't want some exhausted resident falling asleep at my head. Sooo not cool. And I think everyone knows you learn better when rested. You take in more. Quality over quantity.

I should add: I know how I learn best. If I am exhausted, you might as well be talking to a tree. However, for those that need extra time and exposure and that might have the stamina of a young buck, I respect your decision to choose the workhorse programs thereby leaving more spots open at the less killer programs for me.

 
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Are you serious? Some of the best programs have 50hr weeks. And by the time you are hitting hr 60, you're too daggone tired to appreciate and maybe even to take in, this extraordinary experience you can only get when working like a dog. If I were a patient, I sure as hell wouldn't want some exhausted resident falling asleep at my head. Sooo not cool. And I think everyone knows you learn better when rested. You take in more. Quality over quantity.

I should add: I know how I learn best. If I am exhausted, you might as well be talking to a tree. However, for those that need extra time and exposure and that might have the stamina of a young buck, I respect your decision to choose the workhorse programs thereby leaving more spots open at the less killer programs for me.


Yeah I'm serious. All else being equal I think harder working programs are better.

You're more likely to see the middle of the night aortic dissection. You don't want your first one to be at your first pp gig. Or the penetrating chest trauma. If you only do 100 lap choles during residency, your less likely to see a catastrophic CO2 embolus than if you did 150. How many of each block does it take to become proficient? The list goes on and on.

All that said, I think a collegial supportive learning environment is very important. You can have 70 hrs of fun, camraderie, and a sense of common mission. Or you can have 70 hours of malignant lonely misery.
 
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Although I disagree, I respect your preference and your perspective. But that's why there are different programs with varying pros and cons, right? -- so each learner can choose best what works for them.
I am curious about UTSW as well so will be following this thread.
 
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Just had this discussion with some classmates. Why work 70 hrs/wk when you can work 50 hrs/wk and get the same great training?
Because you just can't get the same training in 50 hrs/wk as in 65 hrs/week. Actually, I would argue that anything under 60 will not be great. Anesthesia is a practical specialty; one doesn't learn it while reading comfortably at home.
Why work more for the same money?
It's not really a salary, it's a stipend. It's peanuts compared to what an attending makes. It shouldn't even matter. Look at the big picture: you should want the best training, even if they pay you just enough to pay your loans and get by. You're not at work; you're at school. Focus on your education, not on making money. In a good program, more work should equal more opportunities to learn.
Why spend an extra 20 hrs/wk at the hospital when you can spend the time studying, or with family or significant other, or just breathing?
I agree that extra hours for the sake of extra hours are worthless. That's why you have to spend them learning something useful. Those 3 years pass fast and never come back. Get the best training and, as long as the hours and the salary are decent, stop worrying about them.
Why work 70hrs/wk for free when you can get paid for those extra 20hrs at an equally reputable program?
Stop focusing on the extra $10k/year, unless you depend on them. Focus on the quality of the training, especially 1-on-1 active teaching on the case, in the OR. Stuff you can't really learn from books. Pearls, personal experience, dos and don'ts.

I have been out for a few years, and I still learn new stuff in the OR every week. It never stops. But you cannot build on a poor residency foundation.
I totally get your concern, OP.
Then you are not looking at the big picture.

It should not be cushy, nor malignant. It should be uncomfortable enough to push your limits all the time, but nice enough so that you don't hate what you're doing. The middle way is usually golden in everything.
 
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And you know this because you trained in both a 50hr program as well as a 70hr program, compared them both and decided for everyone else to come that 70hrs is better than 50? I'll pass on that, kind sir. Again, it's quality over quantity for me. And apparently for the OP and many others before him/her.
Regarding pay: there are many residents with families. People they'd rather spend time with at home rather than doing lap chole #999. And if they do have to be apart from their family, wouldn't it be nice to say that at least you are making extra money so little Johnny can get new shoes or join the baseball team? That extra $10k/yr sure would be a help.
Your big picture and mine are obviously quite different, but that's okay. You (if you were a resident) work your 70, I'll work my 50 and guess what? We'll both end up great anesthesiologists. I'll just be a little more rested doing so. See? We all win!
Seriously though, I've worked with attendings that came from the two different work-hour programs, in both PP and academia. You can't tell them apart. People just have to do what makes them comfortable (less miserable). If there was a perfect program out there, all the others would try to copy that one. Instead, there's something out there for everybody. You just have to find what works best for you.
 
Let me ask you this: Among the famous "top" programs frequently mentioned on this forum, which one has less than 60 hour-workweeks while in the OR?

Assuming one 24-hour call/week with post-call day off, plus 3.5-4 ten-hour days/week (on average). That's pretty decent, actually less than what some PP attendings work. Don't forget that the average resident workweek is supposed to be 6 days, not 5.

There is a reason anesthesia residency takes 3 years. There is also a reason why it's not supposed to be just 50 hours weekly. ;)

It's not the hours that really matter. It's the atmosphere. It's the teaching. It's the attending involvement and help. It's the turnover rhythm. The breaks. The fairness level.

I don't remember the long days, or the short days with "lectures". But I remember the interesting cases, the near misses, the mistakes I made, the ones I avoided, the pearls of wisdom. Most of all, I remember all the things I had/will have to learn after residency, just because I didn't learn about them during well-focused overtime cases during residency.

There is a reason why the PGY-1 year is called internship. Interns used to live in dedicated wings of the hospitals. The idea was to not miss any educational opportunity, even in the middle of the night. Not a bad idea at all.
 
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I would like to see an answer to this question from someone who actually knows about UTSW. For me the real issue here is not the actual hours worked by the residents but if the program is misrepresenting themselves. If they are "leading on" potential applicants about hours then what else are they using this same tactic?
 
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Agree that generally tougher programs with more hours will improve training in the end. Having graduated recently I remember many occasions when I was forced to work longer hours than I would have liked, but I also distinctly remember several occasions where those cases done during the late night /early hours of the morning distinctly added to my knowledge base and made me a more experienced and better anesthesiologist. Bottom line: more hours equals more experience and better training. Things just tend to happen during those late add on cases that just don't happen when you are being relieved by 4pm to go read. Don't sell yourself short. Listen to the experienced people in this forum and don't worry too much about work hours when making your decision. (Disclaimer, I'm talking about working 60-70 hrs a week, not 100.) as long as the program attempts to be compliant with the acgme duty hours, you will have enough time to rest and study. Residency only happens once.
 
I trained at UTSW and those hours are wrong. I don't recall any single residency program at UTSW/Parkland that had those cush hours. Please see my original post in Yale vs UTSW vs UPMC. I averaged about 60 to 65 hours as a resident. A lot of rotations (especially CA1) are q4 which adds up to about 70 hour weeks. SICU was q3 and I did 3 of those as a resident. There are certain rotations where you are in the low 50s but they are rare. Acute and Chronic Pain have less hours.

Not sure where you got those hours but they are wrong and it is disturbing if the program is advertising those hours. The work is manageable as is. I listed some cons about the program mainly that there are malignant parts of the program, but no program is perfect. CRNA's do a decent job of relieving you on pre-call days but when you get to advanced rotations you don't have CRNA relief. And with the new hospitals opening up, I am not sure if case load for sub-specialty rotations such as Neuro or CV will increase.

There has been changes in faculty and leadership at UTSW and whether that is for better or worse remains to be seen.
 
Thanks a lot, gaslife. That's really helpful. Exactly what I was looking for.
 
Some of the worst anesthesiologists I've seen and we even have had in our group trained at the top programs in this country.
No pain, no gain
 
Anesthesia is a practical specialty; one doesn't learn it while reading comfortably at home.

Agree with most of this, but this part is weak. We're procedural but our procedural breadth is limited compared to surgical specialties. With that said, I think that we see a much broader pathology and patient population than many surgeons.

How many people see MH, LAST requiring intralipid, AFE, etc during a 4 year residency? How many patients with dwarfism, weird congenital syndromes, or s/p heart transplants do folks see during training? By the way, if I recall right that was 3 years total for some of you ol' timers. Was the 1989 residency class 33% better than the 88 class?

I agree, you need to do cases. We train for low probability events, so you need some volume. Still, you gotta be ready to drop a knowledge bomb from the textbooks or forums on stuff folks rarely see.

FWIW, > 70h is associated with burnout in some studies but I'd have to look at you weird if you said you only worked 45h/w during an anesthesia residency.
 
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I trained at UTSW and those hours are wrong. I don't recall any single residency program at UTSW/Parkland that had those cush hours. Please see my original post in Yale vs UTSW vs UPMC. I averaged about 60 to 65 hours as a resident. A lot of rotations (especially CA1) are q4 which adds up to about 70 hour weeks. SICU was q3 and I did 3 of those as a resident. There are certain rotations where you are in the low 50s but they are rare. Acute and Chronic Pain have less hours.

Not sure where you got those hours but they are wrong and it is disturbing if the program is advertising those hours. The work is manageable as is. I listed some cons about the program mainly that there are malignant parts of the program, but no program is perfect. CRNA's do a decent job of relieving you on pre-call days but when you get to advanced rotations you don't have CRNA relief. And with the new hospitals opening up, I am not sure if case load for sub-specialty rotations such as Neuro or CV will increase.

There has been changes in faculty and leadership at UTSW and whether that is for better or worse remains to be seen.

Gaslife, how would you rank these programs-- Mount Sinai, NYU, Baylor, UTSW, and Miami. Leaning towards SW at #1 since I'm from TX (family from Dallas) and want to end up practicing in Dallas/Austin/Houston (plan to do fellowship out of state instead of leaving now). Any advice would be appreciated, thanks.
 
Just had this discussion with some classmates. Why work 70 hrs/wk when you can work 50 hrs/wk and get the same great training? Why work more for the same money? Why spend an extra 20 hrs/wk at the hospital when you can spend the time studying, or with family or significant other, or just breathing? Why work 70hrs/wk for free when you can get paid for those extra 20hrs at an equally reputable program?
I totally get your concern, OP.

I trained at a 70+ hour program and I'm now staff at a less hours intensive program. Ca2/3 are less than 50 most months. There is a difference. A lot of what we prepare for jn anesthesia is very rare events and unless you log the hours sitting on the stool, or sometimes just sitting in the hospital waiting for that rare event to happen, you don't get exposed to it. Some of the residents I work with now complain about this to me now, especially when they're getting close to graduation. I think it can be normal to be a little apprehensive about getting out on your own, but they rattle off a list of things they either haven't done or haven't done enough of and I think to myself, I was doing that every weekend as a resident. Residency should be uncomfortable. You can't schedule between 7 and 3 intubating someone with angioedema, or someone whose face has been blown off, or a construction worker who took a nail gun to the neck and has an expanding hematoma. You don't know if that emergency vascular case you do at 3 am is the one time in residency where you're going to see the real deal Holyfield protamine reaction. Or rapid deteriortion due to massive aspiration. Or inducing someone with cardiac tamponade. I could go on and on, those are all things that come to my head in residency that were valuable that I might or might not have seen if I worked less hours. Because none of those were during banker hours. Yes, I was tired. But you know what? Unless you take a mommy job as a staff you'll be tired then too. You have to be able to do your thing regardless. Can you be a very good anesthesiologist working less hours than I did as a resident? Yes of course. A lot of these shorter hours programs are very competitive and thus match very smart people. The program I'm at now graduates very good people. But they will find themselves in situations as attendings they haven't seen before. I don't think that's ideal. and I definately don't think its more important than a few hours sleep.
 
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To the OP. I trained at UTSW and graduated in 2013. Things may be different in the last two years with the new University Hospital. My CA-1 year I had 7 months of q4h in-house call at Parkland. Sounds like a lot. However, 5 of those months were main OR call and 2 were OB. OB call as a CA-1 was pretty easy given that during the day there were residents and CRNA that took turns doing C-sections. Usually people were milling about. During the night things could be busy or not. Some nights I slept 4-6 hours sometimes less. Main OR call as a CA-1 could be busy, however the call team consisted of a senior resident running the board and doing preops/getting consents and 4 stool monkeys (2 crna + 2 CA-1 or 3 crna +1 CA-1). By 7pm only 2 ORs were open all night and 1 room open for traumas. In my recollection, I had only one call as a CA-1 where I was up the entire 24 hours and that was for a hand re-implant. On my main OR call I typically got 4 hours of sleep. So it worked out to be about 57-66hrs/w depending if you had two 24 hr calls in a week. Post call days were guaranteed off, and non-call days I was relieved by 3pm. Some of my classmates had less in-house call because they did their general OR months at the VA or the University hospital where there is no in-house call. So it was possible to work less than 60 hrs/week.

CA 2/3 hours were markedly less because I took less frequent in-house call. Neuro and cardiac call were home call. OB was q4 in-house call. However, if it was a week day call you came in at 3pm-7am. If it was a weekend then 24hrs. The same if you did main OR call at Parkland. Over all, I have to agree that my average work hour came out to be mid-50s. The hours on cardiac were pretty long and unpredictable. Some calls were easy some I was up all night. This is due to the fact that the CT surgeons kept operating and the transplant volume increased. At its worse, probably bump mid 70s, other times on my cardiac rotation I probably worked 50s. The cardiac anesthesia attendings and fellows were good about make sure we didn't violate work hours. However, post-call was always off on Cardiac but not for neuro. On neuro I averaged around mid-40 hrs consistently. As a CA-3 there were months that were really light, for instance ambulatory anesthesia, no call or weekends and done the latest by 3pm.

The hours on ICU could be long given that it was q4h in-house call with no post-call day off. The average work hour was in the mid-70s/ week. There were times where we were q3h call because a resident got sick or took vacation.

Over all, I will say that as of 2 years ago, the average weekly hours at UTSW were in-line with the average quoted by the OP. Some weeks could be busier, some really light. In-house call could be busy, but I usually got sleep.

Overall, I believe I got solid training with great experience and at the same time had enough free time to do other things like travel and pick up new hobbies. There was usually enough time for studying. However, I will also say it wasn't always sunshine and rainbows either. Rank it if you like the program and don't if you didn't. Where ever you train you'll learn to push the same drugs, learn to dial in similar vaporizers, stick needles and catheters in the same anatomic structures, and volume resuscitate.
 
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There is a lot of misinformation here, but what lazypanda said above is absolutely correct. Actually, the CA-1s have less Q4 call these days (and definitely no Q3 business).

First of all, this program has had an ugly reputation of being malignant. I have not found a single malignant attending, even if there are a couple I do not like. The hours are not bad. You do sleep a lot during call. During pre-op clinic (8a-4p 5 days a week with no call), I was yearning for Parkland OR, because I love being in the OR, not clinic.

Second of all, Kpride, aka "Professional Gas Passer," if you feel like you need a cush program to become a great anesthesia attending, please do not come to UTSW. I do not like people who complain about work hours, especially in a field like anesthesia. Please find a surgery/medicine resident colleague and tell them about all your problems regarding getting worked hard.

Finally, if you want to see some crazy trauma (gunshot to inner groin, aortic dissection from MVA, etc) please come to UTSW. The attendings I admire the most are the ones that stay calm when s*** hits the fan, because they have seen even crazier things. They will even let me struggle for a while so I can learn on my own, but they are still in the room to bail me out when things are going south. You have three years to learn all this stuff while on someone else's license. The attending that does research all the time (and came from a "cush" program) and is really nervous (takes over the case) for a semi-routine case just bugs the crap out of me. If you think you can become a great attending doing routine lap choles and GYNectomies, please do not come to UTSW.

With that said, after seeing all this I would love to go into PP and do boob jobs and lap choles all day. But some measly patient with DM or previous MI will not scare me :)
 
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You do see more exotic cases on call, but the majority of time you are doing bs lap chole, appy, gyn, washout and i and d..oh yeah don't forget ortho.

In regards to attendings they act nice and friendly but trash residents at parkland ready room as well as zale ready room. Sources? Crna, surgical residents, and I even heard it myself. Again residency is tough but an attending is doing no one a benefit by trashing someone while acting like everything is Ok.

With that being said, there are some awesome attendings. The guys who ran sim lab were excellent teachers.

Overall it is a solid program and will be well trained but just know its not easy and can even be a headache if you piss off the wrong people. I'm just happy to never have to be at parkland again. The ancillary staff was terrible and there were always stupid rules every single week that made it a witch hunt
 
There is a lot of misinformation here, but what lazypanda said above is absolutely correct. Actually, the CA-1s have less Q4 call these days (and definitely no Q3 business).

First of all, this program has had an ugly reputation of being malignant. I have not found a single malignant attending, even if there are a couple I do not like. The hours are not bad. You do sleep a lot during call. During pre-op clinic (8a-4p 5 days a week with no call), I was yearning for Parkland OR, because I love being in the OR, not clinic.

Second of all, Kpride, aka "Professional Gas Passer," if you feel like you need a cush program to become a great anesthesia attending, please do not come to UTSW. I do not like people who complain about work hours, especially in a field like anesthesia. Please find a surgery/medicine resident colleague and tell them about all your problems regarding getting worked hard.

Finally, if you want to see some crazy trauma (gunshot to inner groin, aortic dissection from MVA, etc) please come to UTSW. The attendings I admire the most are the ones that stay calm when s*** hits the fan, because they have seen even crazier things. They will even let me struggle for a while so I can learn on my own, but they are still in the room to bail me out when things are going south. You have three years to learn all this stuff while on someone else's license. The attending that does research all the time (and came from a "cush" program) and is really nervous (takes over the case) for a semi-routine case just bugs the crap out of me. If you think you can become a great attending doing routine lap choles and GYNectomies, please do not come to UTSW.

With that said, after seeing all this I would love to go into PP and do boob jobs and lap choles all day. But some measly patient with DM or previous MI will not scare me :)

Sir/ma'am, I said nothing about cush. What I did say is 70+ hours is not necessary to make a great anesthesiologist. As I personally know outstanding anesthesiologists that came from programs with 50-60hr weeks, nothing you say will change my mind. What I also said was if I am working longer hours, I would like to receive moonlighting pay. Call me money hungry or whatever but I am a business woman and a parent. If you want to work for free, go right on ahead. But if I am going to be away from my family, I'd like to be able to pay the nanny. Feel me? No? Oh well.
 
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Sir/ma'am, I said nothing about cush. What I did say is 70+ hours is not necessary to make a great anesthesiologist. As I personally know outstanding anesthesiologists that came from programs with 50-60hr weeks, nothing you say will change my mind. What I also said was if I am working longer hours, I would like to receive moonlighting pay. Call me money hungry or whatever but I am a business woman and a parent. If you want to work for free, go right on ahead. But if I am going to be away from my family, I'd like to be able to pay the nanny. Feel me? No? Oh well.

You're very sure of yourself for someone who has never done a residency. Do you think you'll have a hard time in residency with your notion that you don't want to work for free?
 
You're very sure of yourself for someone who has never done a residency. Do you think you'll have a hard time in residency with your notion that you don't want to work for free?

No I do not think I will have a hard time. I will take the time to research programs and find one that meets my needs. I don't know what your personal situation was when you went through residency and you don't know mine. Some residents have responsibilities outside of residency (spouses, children, medications, ill parents, alimony, child support, etc etc). Until you have walked in my shoes, don't judge me.
If your program works their residents 70+ hours and doesn't compensate for the extra hours, I won't be applying there anyway.
That's no slight to your program; it just doesn't fit with what I need. I am able to recognize that and choose accordingly.
 
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Until you have walked in my shoes, don't judge me.
Perhaps until you've done a residency and walked in those shoes, judging the adequacy of 50 vs 70 hours/week should be done carefully? :)

It's true that the 1 AM appendectomy or c-section or emergency butt pus cases have less educational value than an airway tumor causing dyspnea in the ER, but there's value to every single minute spent in the OR, especially when you're working on someone else's license in residency. Even when you're tired.

Orin said it well above:

We train for low probability events, so you need some volume.

And it's not just the crises we train for, it's efficiency and smoothness. Waking up a patient brisk and clear, without pain, as the drapes come down, setting up the PACU for a fast discharge is hard. It's a skill that is acquired over a long time and refined for the rest of your career. I'm better now than I was when I finished residency, and I expect to be better 5 more years down the road. It's not the exciting and thrilling cases that make you efficient and smooth, it's hundreds and thousands of those little ditzel cases done during hours that you're already declaring aren't necessary.

By all means, find a 50-hour program that's a good fit for you, but be honest with yourself and don't pretend that there's no cost to finishing residency with a few thousand fewer hours in the hospital than the chumps slaving away in the 70-hour salt mines.
 
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I agree with PGG. The more practice/cases you do, the better you get.I know guys who do Pain who lost a lot of their OR skills after a year out of the OR. After proficiency, comes efficacy and speed. Of course I would argue that a good amount of the weird exotic cases I learned about in residency did not come from being on call but in the simulation lab. Wasn't the same as having the shock value of seeing it in a real life patient but nevertheless better than just reading about it.

At the same time, those residents working 70+ hours a week have no time to study and learn on their own. I'll go ahead and say it ,I was told not to go to Mayo Jacksonville or one of those small cush programs where you work close to 50 hours a week or less. I was told by my medical school advisor that, I wouldn't be well trained. Looking back on it, I'm glad I went to SW, despite all the bull**** that festers there..I hit my numbers easily by latter part of CA2 year.
 
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The program is still about the same in terms of work hours and environment. lazypanda's post is fairly accurate. The program has made a lot of recent changes in response to resident feedback/complaints, and the program continues to evolve which is a good thing in my opinion. Responding to past residents' input:

I trained at UTSW and those hours are wrong. I don't recall any single residency program at UTSW/Parkland that had those cush hours. Please see my original post in Yale vs UTSW vs UPMC. I averaged about 60 to 65 hours as a resident. A lot of rotations (especially CA1) are q4 which adds up to about 70 hour weeks. SICU was q3 and I did 3 of those as a resident. There are certain rotations where you are in the low 50s but they are rare. Acute and Chronic Pain have less hours.

Not sure where you got those hours but they are wrong and it is disturbing if the program is advertising those hours. The work is manageable as is. I listed some cons about the program mainly that there are malignant parts of the program, but no program is perfect. CRNA's do a decent job of relieving you on pre-call days but when you get to advanced rotations you don't have CRNA relief. And with the new hospitals opening up, I am not sure if case load for sub-specialty rotations such as Neuro or CV will increase.

There has been changes in faculty and leadership at UTSW and whether that is for better or worse remains to be seen.

SICU has gone away for us due to resident feedback about the nature of that rotation and breaking hours. Agree about the malignant parts of the program (a few bad eggs) but still happy to be training here. Volume has increased with the opening of NPH, but the work hours for the residents are probably still around 60-65 hrs/week, decreasing with seniority and certain rotations and increased for ICU rotations (never above 80). Hours aren't bad, but CA-1 year is still tough with the q4 24h call at Parkland. That being said, CA-1s get to see a lot and do a lot overnight. The big cases will usually go to CA-1s unless there are weaker/less confident faculty on call overnight (very rare). You quickly gain confidence, knowledge, and skill if being thrown into things is your style of learning. If your hand needs to be held throughout residency, this is definitely not the program for you.

To the OP. I trained at UTSW and graduated in 2013. Things may be different in the last two years with the new University Hospital. My CA-1 year I had 7 months of q4h in-house call at Parkland. Sounds like a lot. However, 5 of those months were main OR call and 2 were OB. OB call as a CA-1 was pretty easy given that during the day there were residents and CRNA that took turns doing C-sections. Usually people were milling about. During the night things could be busy or not. Some nights I slept 4-6 hours sometimes less. Main OR call as a CA-1 could be busy, however the call team consisted of a senior resident running the board and doing preops/getting consents and 4 stool monkeys (2 crna + 2 CA-1 or 3 crna +1 CA-1). By 7pm only 2 ORs were open all night and 1 room open for traumas. In my recollection, I had only one call as a CA-1 where I was up the entire 24 hours and that was for a hand re-implant. On my main OR call I typically got 4 hours of sleep. So it worked out to be about 57-66hrs/w depending if you had two 24 hr calls in a week. Post call days were guaranteed off, and non-call days I was relieved by 3pm. Some of my classmates had less in-house call because they did their general OR months at the VA or the University hospital where there is no in-house call. So it was possible to work less than 60 hrs/week.

CA 2/3 hours were markedly less because I took less frequent in-house call. Neuro and cardiac call were home call. OB was q4 in-house call. However, if it was a week day call you came in at 3pm-7am. If it was a weekend then 24hrs. The same if you did main OR call at Parkland. Over all, I have to agree that my average work hour came out to be mid-50s. The hours on cardiac were pretty long and unpredictable. Some calls were easy some I was up all night. This is due to the fact that the CT surgeons kept operating and the transplant volume increased. At its worse, probably bump mid 70s, other times on my cardiac rotation I probably worked 50s. The cardiac anesthesia attendings and fellows were good about make sure we didn't violate work hours. However, post-call was always off on Cardiac but not for neuro. On neuro I averaged around mid-40 hrs consistently. As a CA-3 there were months that were really light, for instance ambulatory anesthesia, no call or weekends and done the latest by 3pm.

The hours on ICU could be long given that it was q4h in-house call with no post-call day off. The average work hour was in the mid-70s/ week. There were times where we were q3h call because a resident got sick or took vacation.

Over all, I will say that as of 2 years ago, the average weekly hours at UTSW were in-line with the average quoted by the OP. Some weeks could be busier, some really light. In-house call could be busy, but I usually got sleep.

Overall, I believe I got solid training with great experience and at the same time had enough free time to do other things like travel and pick up new hobbies. There was usually enough time for studying. However, I will also say it wasn't always sunshine and rainbows either. Rank it if you like the program and don't if you didn't. Where ever you train you'll learn to push the same drugs, learn to dial in similar vaporizers, stick needles and catheters in the same anatomic structures, and volume resuscitate.

This is a very accurate post in terms of hours, workload, and overall flow. OB is no longer q4 in-house call for CA-1s, so the hours are slightly better. We don't do q3 calls whatsoever. Upper level residents are still generally pre-op monkeys overnight, but the rotation is slowly evolving and will take some effort to transition the upper levels from pre-op monkey to actual boardrunning. There are a few "bad egg" CRNAs, but for the most part, they are generally professional and collegial if you also put in the work yourself. There are lazy residents in this program who unfortunately take advantage of the CRNAs and do very little work in comparison.

There is a lot of misinformation here, but what lazypanda said above is absolutely correct. Actually, the CA-1s have less Q4 call these days (and definitely no Q3 business).

First of all, this program has had an ugly reputation of being malignant. I have not found a single malignant attending, even if there are a couple I do not like. The hours are not bad. You do sleep a lot during call. During pre-op clinic (8a-4p 5 days a week with no call), I was yearning for Parkland OR, because I love being in the OR, not clinic.

Second of all, Kpride, aka "Professional Gas Passer," if you feel like you need a cush program to become a great anesthesia attending, please do not come to UTSW. I do not like people who complain about work hours, especially in a field like anesthesia. Please find a surgery/medicine resident colleague and tell them about all your problems regarding getting worked hard.

Finally, if you want to see some crazy trauma (gunshot to inner groin, aortic dissection from MVA, etc) please come to UTSW. The attendings I admire the most are the ones that stay calm when s*** hits the fan, because they have seen even crazier things. They will even let me struggle for a while so I can learn on my own, but they are still in the room to bail me out when things are going south. You have three years to learn all this stuff while on someone else's license. The attending that does research all the time (and came from a "cush" program) and is really nervous (takes over the case) for a semi-routine case just bugs the crap out of me. If you think you can become a great attending doing routine lap choles and GYNectomies, please do not come to UTSW.

With that said, after seeing all this I would love to go into PP and do boob jobs and lap choles all day. But some measly patient with DM or previous MI will not scare me :)

I generally agree with this post. If you need to feel better about yourself, say bye to the surgery resident who's been up longer than you have and will stay in the hospital longer than you will as you're walking out of the OR. Hours aren't bad, and the overnight call allows you to see some crazy, rare things--rare enough that it is potentially identifying if I talk about them here. We see everything.

You do see more exotic cases on call, but the majority of time you are doing bs lap chole, appy, gyn, washout and i and d..oh yeah don't forget ortho.

In regards to attendings they act nice and friendly but trash residents at parkland ready room as well as zale ready room. Sources? Crna, surgical residents, and I even heard it myself. Again residency is tough but an attending is doing no one a benefit by trashing someone while acting like everything is Ok.

With that being said, there are some awesome attendings. The guys who ran sim lab were excellent teachers.

Overall it is a solid program and will be well trained but just know its not easy and can even be a headache if you piss off the wrong people. I'm just happy to never have to be at parkland again. The ancillary staff was terrible and there were always stupid rules every single week that made it a witch hunt

I also agree with this post. Generally, we try to put the CA-1s in "better" cases if one comes up, but it's a lot of overnight choles, appys, GYNs, and I&Ds distributed among the 3 CRNAs and resident. Parkland surgeons have gotten a lot better at not operating throughout the night for what it's worth.

Some attendings still trash talk residents. I agree that it used to piss me off, and I think it's pretty unfair to air out the dirty laundry in front of other attendings. It does affect how you are perceived as a resident in this program. That being said, I don't know that I have been or will be any different, although I try to be. We all talk amongst ourselves about which attendings are the "bad" ones who freeze up in dire situations and teach us completely wrong things, and we all know who the lazier or weaker residents are. Also, we all know who the awesome attendings are, and there are a great number of amazing faculty who excel at letting you figure things out on your own while teaching you their way of doing things.

I agree with your last line. You do not want to be labeled the "lazy" or "bad" resident here because it will likely stick with you for a long time. I don't know that it is any different at other programs, but it is especially true here. Some residents are not happy here, and it's understandable. There have been some recent tragedies in this department and with that, a lot of emotions and questionable actions by the leadership. Sometimes we feel like our voices are not being heard, but I think the people in charge have good intentions at least and are constantly trying to improve the program. I do think most of them (not all) care about us. They have made a lot of changes in the recent years based on resident feedback, and that's probably more than you can say for some other programs.

Overall, I think the training is great, the hours are reasonable, the residents look out for each other, and you will come out very confident and well-trained if you work hard and take advantage of the short 3-4 years you have here.
 
The program is still about the same in terms of work hours and environment. lazypanda's post is fairly accurate. The program has made a lot of recent changes in response to resident feedback/complaints, and the program continues to evolve which is a good thing in my opinion. Responding to past residents' input:



SICU has gone away for us due to resident feedback about the nature of that rotation and breaking hours. Agree about the malignant parts of the program (a few bad eggs) but still happy to be training here. Volume has increased with the opening of NPH, but the work hours for the residents are probably still around 60-65 hrs/week, decreasing with seniority and certain rotations and increased for ICU rotations (never above 80). Hours aren't bad, but CA-1 year is still tough with the q4 24h call at Parkland. That being said, CA-1s get to see a lot and do a lot overnight. The big cases will usually go to CA-1s unless there are weaker/less confident faculty on call overnight (very rare). You quickly gain confidence, knowledge, and skill if being thrown into things is your style of learning. If your hand needs to be held throughout residency, this is definitely not the program for you.



This is a very accurate post in terms of hours, workload, and overall flow. OB is no longer q4 in-house call for CA-1s, so the hours are slightly better. We don't do q3 calls whatsoever. Upper level residents are still generally pre-op monkeys overnight, but the rotation is slowly evolving and will take some effort to transition the upper levels from pre-op monkey to actual boardrunning. There are a few "bad egg" CRNAs, but for the most part, they are generally professional and collegial if you also put in the work yourself. There are lazy residents in this program who unfortunately take advantage of the CRNAs and do very little work in comparison.



I generally agree with this post. If you need to feel better about yourself, say bye to the surgery resident who's been up longer than you have and will stay in the hospital longer than you will as you're walking out of the OR. Hours aren't bad, and the overnight call allows you to see some crazy, rare things--rare enough that it is potentially identifying if I talk about them here. We see everything.



I also agree with this post. Generally, we try to put the CA-1s in "better" cases if one comes up, but it's a lot of overnight choles, appys, GYNs, and I&Ds distributed among the 3 CRNAs and resident. Parkland surgeons have gotten a lot better at not operating throughout the night for what it's worth.

Some attendings still trash talk residents. I agree that it used to piss me off, and I think it's pretty unfair to air out the dirty laundry in front of other attendings. It does affect how you are perceived as a resident in this program. That being said, I don't know that I have been or will be any different, although I try to be. We all talk amongst ourselves about which attendings are the "bad" ones who freeze up in dire situations and teach us completely wrong things, and we all know who the lazier or weaker residents are. Also, we all know who the awesome attendings are, and there are a great number of amazing faculty who excel at letting you figure things out on your own while teaching you their way of doing things.

I agree with your last line. You do not want to be labeled the "lazy" or "bad" resident here because it will likely stick with you for a long time. I don't know that it is any different at other programs, but it is especially true here. Some residents are not happy here, and it's understandable. There have been some recent tragedies in this department and with that, a lot of emotions and questionable actions by the leadership. Sometimes we feel like our voices are not being heard, but I think the people in charge have good intentions at least and are constantly trying to improve the program. I do think most of them (not all) care about us. They have made a lot of changes in the recent years based on resident feedback, and that's probably more than you can say for some other programs.

Overall, I think the training is great, the hours are reasonable, the residents look out for each other, and you will come out very confident and well-trained if you work hard and take advantage of the short 3-4 years you have here.

q4h call goddamn
"Work" is right
 
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Just a little math based on the 10,000 hours concept:

if it takes 10,000 hours to truly master something, and you spend 3 years doing anesthesia (not counting an intern year towards this and not factoring in possible fellowship) than at 50 weeks per year, you need about 65 hours a week.
 
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Just a little math based on the 10,000 hours concept:

if it takes 10,000 hours to truly master something, and you spend 3 years doing anesthesia (not counting an intern year towards this and not factoring in possible fellowship) than at 50 weeks per year, you need about 65 hours a week.
Programs using a light work load to lure applicants are doing harm to our profession. Students finding this attractive are doing themselves great harm in their quest to become competent clinicians. ho hum.......
 
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