Any residents in hot spots being pulled out of the department?

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Krukenberg

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NY is really blowing up but Washington continues to worsen as well. In Italy they're literally pulling medical students into clinical care, so I assume something similar will eventually happen in the US.

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They’re discussing this locally now. It’s on the table and as we speak the PD is discussing this with the residents.
 
We're at times being pulled out of the department to go home to minimize exposure risk especially on academic days, but not being pulled to go do inpatient medicine stuff (which is what I imagine you were asking about)
 
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We're at times being pulled out of the department to go home to minimize exposure risk especially on academic days, but not being pulled to go do inpatient medicine stuff (which is what I imagine you were asking about)

Yea I'm talking about manning the guns on the front line
 
In PGY-2 year I would have been more than adequate to do inpatient stuff. I did a PGY1 prelim internal medicine year - ICU, night shift, central lines, DKA ICU admissions, you name it.

Now more than a decade removed from that I'm not sure how useful I would be.
 
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We're at times being pulled out of the department to go home to minimize exposure risk especially on academic days, but not being pulled to go do inpatient medicine stuff (which is what I imagine you were asking about)


What!? In my day, they would have had us all cover, cross-cover attendings, dictate notes on patients I never met before. Academic time was basically non-existent except on weekends. A nuclear war wouldn’t have kept us from covering somebody. Sounds like you have a nice residency!
 
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Multiple military sources telling me 14 day nationwide shutdown imminent. National guard to be deployed and announced over weekend.

This is really the only thing that has a chance of working, if true.

We will see.

Trump says fake news.
 
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If our patient load goes down, I've thought about locuming in the ICU to help pay the bills.
 
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In PGY-2 year I would have been more than adequate to do inpatient stuff. I did a PGY1 prelim internal medicine year - ICU, night shift, central lines, DKA ICU admissions, you name it.

Now more than a decade removed from that I'm not sure how useful I would be.

Highly doubt they'd put a rad onc in a situation where they'd have to be managing pressors or a vent, but not unreasonable to stick them in Covid triage in an ED or urgent care.
 
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Multiple military sources telling me 14 day nationwide shutdown imminent. National guard to be deployed and announced over weekend.

This is really the only thing that has a chance of working, if true.

We will see.

Trump says fake news.

Any other sources? National Guard on Twitter said it's not true (not that I trust them). But, I'm also hearing this...
 
This has been discussed at our large residency program. PD has so far refused to add our residents names to the general resident cross-cover pool. Rad onc makes up about 1% of residents in the system, so it's not like our residents would make a big impact.
 
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What!? In my day, they would have had us all cover, cross-cover attendings, dictate notes on patients I never met before. Academic time was basically non-existent except on weekends. A nuclear war wouldn’t have kept us from covering somebody. Sounds like you have a nice residency!

lol. I feel like I do, in response to bolded
 
Multiple military sources telling me 14 day nationwide shutdown imminent. National guard to be deployed and announced over weekend.

This is really the only thing that has a chance of working, if true.

We will see.

Trump says fake news.
I’ve been hearing this for a week. First it was Wednesday, then Thursday, then it was to be at the presser today, now it’s Sunday.....
 
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Multiple military sources telling me 14 day nationwide shutdown imminent. National guard to be deployed and announced over weekend.

This is really the only thing that has a chance of working, if true.

We will see.

Trump says fake news.

Huge if true
 
This has been discussed at our large residency program. PD has so far refused to add our residents names to the general resident cross-cover pool. Rad onc makes up about 1% of residents in the system, so it's not like our residents would make a big impact.
We've been added to that pool by our program. Our PD did not give us a choice or discuss with us, and there is certainly a lot of resident discontent about it. No indication that they are asking/requiring attendings to volunteer (though we have plenty of "non-essential" attendings as we would only need 1 on site for treatments to occur). Wondering if there is any recourse or even what the legality is in this situation? Many of us would be happy to volunteer to help if called upon, but being unwillingly thrown into the situation and mandated to work outside of our area of training just resonates the way in which we are looked at in the hospital (cheap, expendable labor).
 
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We've been added to that pool by our program. Our PD did not give us a choice or discuss with us, and there is certainly a lot of resident discontent about it. No indication that they are asking/requiring attendings to volunteer (though we have plenty of "non-essential" attendings as we would only need 1 on site for treatments to occur). Wondering if there is any recourse or even what the legality is in this situation? Many of us would be happy to volunteer to help if called upon, but being unwillingly thrown into the situation and mandated to work outside of our area of training just resonates the way in which we are looked at in the hospital (cheap, expendable labor).
Is your program malignant to begin with? Food for thought for the newly matched and future med students going forward...
 
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We've been added to that pool by our program. Our PD did not give us a choice or discuss with us, and there is certainly a lot of resident discontent about it. No indication that they are asking/requiring attendings to volunteer (though we have plenty of "non-essential" attendings as we would only need 1 on site for treatments to occur). Wondering if there is any recourse or even what the legality is in this situation? Many of us would be happy to volunteer to help if called upon, but being unwillingly thrown into the situation and mandated to work outside of our area of training just resonates the way in which we are looked at in the hospital (cheap, expendable labor).

I've been looking into this myself and although I am no lawyer I did not find anything in my contract of employment or resident policy manual that mentioned the potential for interrupting my training to use me to cover labor shortages in other areas of the hospital. Doesn't seem legal to me, but that is just my opinion at this point. Anyone know if there is a legal basis for this?
 
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I'm pretty sure a pandemic would be considered an "act of god" similar to destruction wrought by an earthquake, hurricane or tornado. In that case, rules and legal protections are out of the window.

As Darth Sidious so eloquently put it:

B0FiHGY.png
 
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Is your program malignant to begin with? Food for thought for the newly matched and future med students going forward...
In fact, no - very "non-malignant" program, no double coverage, and typically treated very well - that's what is most disturbing.

And sure, pandemic should be considered "act of God" - but forcing us to work and excluding us from these discussions vs. asking for help/volunteers is a completely different conversation.
 
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It’s gonna hit double hard at a ****ty program like Bcm if residents are asked to go cover the ICU while also having to do contours on the side
 
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It’s gonna hit double hard at a ****ty program like Bcm if residents are asked to go cover the ICU while also having to do contours on the side

Don’t forget the dictations.
 
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Many of us would be happy to volunteer to help if called upon, but being unwillingly thrown into the situation and mandated to work outside of our area of training just resonates the way in which we are looked at in the hospital (cheap, expendable labor).

Us residents are just slaves and cannon fodder.

Anyone know if there is a legal basis for this?

Slaves!!
 
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We've been added to that pool by our program. Our PD did not give us a choice or discuss with us, and there is certainly a lot of resident discontent about it. No indication that they are asking/requiring attendings to volunteer (though we have plenty of "non-essential" attendings as we would only need 1 on site for treatments to occur). Wondering if there is any recourse or even what the legality is in this situation? Many of us would be happy to volunteer to help if called upon, but being unwillingly thrown into the situation and mandated to work outside of our area of training just resonates the way in which we are looked at in the hospital (cheap, expendable labor).
In fact, no - very "non-malignant" program, no double coverage, and typically treated very well - that's what is most disturbing.

And sure, pandemic should be considered "act of God" - but forcing us to work and excluding us from these discussions vs. asking for help/volunteers is a completely different conversation.

You better WAKE UP and get with the programme because you don’t mean a damn to your so called “non-malignant” programme. We are nothing but warm bodies and they will throw you to the fire before the attendings have to move a finger. You get sick? Eat up all your vacation and then go on unpaid leave and pay your own insurance through COBRA. Thats the Ponzi scheme modern medicine is built on.

this will be so bad at terrible no good programs. Everyone knows who you are, and they will throw the residents into the oven without any PPE.

i am not gonna get sick before any of these useless no good arseholes in academic departments get off their fat butts and get in the ICU with me, and pay for my lunch!!
 
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"
I'm pretty sure a pandemic would be considered an "act of god" similar to destruction wrought by an earthquake, hurricane or tornado. In that case, rules and legal protections are out of the window.

As Darth Sidious so eloquently put it:

View attachment 299385

"I am the Senate"
 
Anyone know if there is a legal basis for this?

Basis no but precedent yes. Those of us who were in training in 2009 in places hard hit by the swine flu outbreak know first hand that you can be pulled to assist in other areas. I know I had to spend a couple days doing nasal swabs at an off-campus clinic. That oath you took is ambiguous and can be interpreted as rather far-reaching in your societal promises.

It’s ok to vent. There are a lot of people who unfortunately have taken a lot of you for granted over the years. But do try to keep in mind we are trying not to become the next Italy and some of the predicted responses require a massive work force and anyone with any medical training is on the hook. The alternative is scarier. To quote the late great George Carlin: “Think about how stupid the average person is. Now take in fact that half of them are stupider than that.” No one posting on this board is a “just a warm body.” You may be treated like one. But you are not. The reality is that a lot of this is going to have to get sorted out after the fact.
 
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Basis no but precedent yes. Those of us who were in training in 2009 in places hard hit by the swine flu outbreak know first hand that you can be pulled to assist in other areas. I know I had to spend a couple days doing nasal swabs at an off-campus clinic. That oath you took is ambiguous and can be interpreted as rather far-reaching in your societal promises.

It’s ok to vent. There are a lot of people who unfortunately have taken a lot of you for granted over the years. But do try to keep in mind we are trying not to become the next Italy and some of the predicted responses require a massive work force and anyone with any medical training is on the hook. The alternative is scarier. To quote the late great George Carlin: “Think about how stupid the average person is. Now take in fact that half of them are stupider than that.” No one posting on this board is a “just a warm body.” You may be treated like one. But you are not. The reality is that a lot of this is going to have to get sorted out after the fact.

Is this what you really think?

But we are treated just as warm bodies. This whole residency expansion and cannon fodder business only came to be because of one thing and one thing only: computers.

Think about it.

If the older attendings could still voice dictate and draw blocks with wax pencils instead of typing on EPIC and contouring do you think they would want/need this many rad onc residents?

But now they have them. Too many of them in fact. And other departments at a time of crisis know this. They have the numbers. So why not throw them into the fire?

My program (prestigious as this forum would call it and what not) is putting their residents directly at the front line in all aspects of this.
 
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I would be pissed but I don’t think anyone cares that much about residents. I mean yes some of the attendings will whine about not having coverage but it’s better that the residents cover the ICU then them.
 
Is this what you really think?

But we are treated just as warm bodies. This whole residency expansion and cannon fodder business only came to be because of one thing and one thing only: computers.

Think about it.

If the older attendings could still voice dictate and draw blocks with wax pencils instead of typing on EPIC and contouring do you think they would want/need this many rad onc residents?

But now they have them. Too many of them in fact. And other departments at a time o

I honestly have no idea what you are trying to convey. Too many residents? Yes, we can all agree there are too many residents. My post (and this thread for that matter) had nothing to do with residency numbers.

It also sounds like you are suggesting you feel slighted that residents are being thrown onto front lines before attendings. That feeling is understandable but naive. On some level all physicians are warm bodies to hospital administrators. But some warm bodies can bill and keep departmental operations going without any oversight whereas the other warm bodies really can't do anything but write notes and assist the other warm bodies. From a purely pragmatic perspective it is not a difficult choice for them.

The only thing I tried to convey (beyond the fact that being thrown in has happened to some of us before and it will happen again) was that you shouldn't forget you are still skilled warm bodies no matter how you are treated.
 
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Guys, with all due respect... I believe the US is going to hit 100k by the end of week with the current rates of infection (36-49% daily increase in the past days).
I think you should stop arguing about who is sending who to the "frontlines".
We are all already or are all going to be on the frontlines very soon.
Either that or sick; hopefully only mildly & quarantined and not in a hospital bed or on the ventilator.
 
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If you are asked to help, it's because you are needed. There are too many sick patients. If they run out of inpatient doctors, then next up is outpatient doctor's with recent inpatient experience (i.e. residents). Next it will be outpatient attendings and so on. They are asking for retired healthcare workers in NY state to volunteer. I know that everyone wants everything to be about the evil academic PD/Chairs and their plot to destroy the job market... this is not that.

This crisis is unique in that it sucks pretty hard for EVERYONE in this country (albeit in different ways). We are in the uncommon position of being able to help... and it is a privilege to do so.
 
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We are entering a time of crisis. I'm ready and willing to help however I can. If I save a life that wouldn't otherwise be saved, that's more important than any financial reward.

I can't imagine how anyone else could feel otherwise.
 
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Resident in one of the hot spot cities. I have been hearing from my contacts on the front line (e.g. ED, ICU, inpatient) and they are getting absolutely demolished. Apparently much worse than they have ever seen it and multiple providers are calling out sick due to lack of adequate PPE.

Our PD was required by GME to submit a list of residents who were available to be pulled as needed. Our program is trying to protect us as best as possible. Those with reason to be especially concerned, including those with underlying health issues, were not included on this list. Additionally, all residents on research have been given some clinical responsibility as the rumor is those residents non-essential to the functioning of their respective departments will be the first pulled. All work is being done remotely via telemedicine with only 1 resident and a handful of attendings physically present in the department each day.

Word has it that at the most recent faculty meeting our chair told the attendings that they should expect to be pulled for front line service at some point. The residents assume the same. That said no one to my knowledge has been pulled yet and the fact that oncology care waits for no virus may in fact help insulate us to some degree -- certainly more so than some of our surgical colleagues who are now sitting on their hands.

In short: I expect to be called soon. I expect that the attendings will as well. With the lack of adequate PPE this has lead to A LOT of anxiety but I know everyone will do their part. Our institution has repeatedly called this an "all hands on deck" moment.
 
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Here's another perspective:
You are helping out your fellow co-residents in other acute care specialties that are getting slammed with this virus.
 
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I’m happy to be my own employer currently.
 
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If you are asked to help, it's because you are needed. There are too many sick patients. If they run out of inpatient doctors, then next up is outpatient doctor's with recent inpatient experience (i.e. residents). Next it will be outpatient attendings and so on. They are asking for retired healthcare workers in NY state to volunteer. I know that everyone wants everything to be about the evil academic PD/Chairs and their plot to destroy the job market... this is not that.

This crisis is unique in that it sucks pretty hard for EVERYONE in this country (albeit in different ways). We are in the uncommon position of being able to help... and it is a privilege to do so.

I'm the OP but in no way meant for my post to sound like whining. I actually strongly disagree with anyone who knocks a residency program for its residents being "cannon fodder." This is an unprecedented crisis and if we can help take care of patients while others run the rad onc department, then so be it.

That said, I doubt that rad onc residents will be needed to work in an ICU. They will pull other specialties with ICU care as a substantial proportion of their training first, and I think that could stem the losses in the ICU (e.g. general surgery, neurosurgery, neurology, medicine fellows, etc). At most institutions with rad onc programs that would constitute hundreds of backup trainees. Many institutions cancelled all elective surgeries so that probably leaves a pool of surgery residents with little to do.

I think it's much more likely rad onc residents would be deployed at testing sites, triaging fevers and coughs in the ED, triaging hotlines of patients calling with fever and cough, or maybe being an intern again on a medicine ward.
 
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Most hospitals do not even have required PPE, some are giving you one OR mask and asking you to indefinitely re-use, totally useless. This reminds me of the WWI/WWII, korean war accounts of soldiers seeing Chinese, russian, korean soldiers running toward them without any shoes, without any guns, without anything but a rock or a stick, not even a kitchen knife and having to mow them down. Hero instinct to run toward the fire must be tempered by reason, lets not kill a bunch of doctors because once they are gone, we cannot replace them, decades of education. The thing that worries me the most is the PPE crisis and depts volunteering people to “front lines” without the most basic necessary things, plus the continuation of the power dynamic where residents are defenseless and thrown in, while the officers are behind the trenches, no general in the front in the white horse, heading the risk response. Today i walked into hospital, they are out of masks, saw an admin in a suit with an N95 mask. This is sickening. So excuse us that when we think about being thrown Into it by our depts, we feel anxious, angry, disappointed, scared, etc etc
 
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Most hospitals do not even have required PPE, some are giving you one OR mask and asking you to indefinitely re-use, totally useless. This reminds me of the WWI/WWII, korean war accounts of soldiers seeing Chinese, russian, korean soldiers running toward them without any shoes, without any guns, without anything but a rock or a stick, not even a kitchen knife and having to mow them down. Hero instinct to run toward the fire must be tempered by reason, lets not kill a bunch of doctors because once they are gone, we cannot replace them, decades of education. The thing that worries me the most is the PPE crisis and depts volunteering people to “front lines” without the most basic necessary things.

Completely agree. Hopefully, the PPE shortage is going to be addressed soon as companies are ramping up their production and some are retrofitting their factories to shift their production to making PPE.

The manpower shortage is going to be much longer lasting and more difficult to solve.
 
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I am a resident in one of the harder hit areas. Most of the residents come in 1-2 days per week and work from home. My service is still relatively busy but after this week all numbers fall off a cliff. I fully expect to be called to the front lines, don't mind what the task is. Don't care for admin, but feel responsible for helping out other physicians and the patients who need it.
 
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@ramsesthenice @Palex80 @Neuronix @Lamount

Serious question. Would you personally be willing to work in an inpatient or ICU environment without proper PPE?

That's the driver of much anxiety. A lack of proper PPE to provide protection, and leadership (national & institutional) at all levels downplaying the need for proper PPE to protect healthcare providers (attendings, residents, nurses, etc.).
 
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Serious question. Would you personally be willing to work in an inpatient or ICU environment without proper PPE?

No. We all fear this happening, but to my knowledge it has not actually happened.

I'm not going to refuse to be available just based on a hypothetical situation.
 
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Sent my resident home. Too risky for amount of help he can give me today. On the other hand, hospital situation is not dire enough to pull them onto IV teams and such.
 
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@ramsesthenice @Palex80 @Neuronix @Lamount

Serious question. Would you personally be willing to work in an inpatient or ICU environment without proper PPE?

That's the driver of much anxiety. A lack of proper PPE to provide protection, and leadership (national & institutional) at all levels downplaying the need for proper PPE to protect healthcare providers (attendings, residents, nurses, etc.).

I agree with Neuronix. No, I would not want to do this. Hopefully none of us have to do this. Right now it is more likely we will be asked to staff the drive-up testing centers. If the sh@t completely hit the fan and it came down to it, yes I would be willing work in an ICU or inpatient environment without proper PPE. Someone will have to and I am not inherently more important than my colleagues. It may not be explicitly written into my contract but I signed on to be ready to step in for extreme circumstances. This is looking like it is moving that way very quickly.

That being said, I agree with above. It would take a lot to get to that point. Fortunately in the US we are not seeing hospitals becoming so overwhelmed people are dying in the halls waiting on care.
 
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I wouldn’t just jump into the situation without proper PPE. It’s equivalent to going to war without a gun. I applaud you all who are more willing to be on the front lines.
 
I would not be OK with any situation without proper PPE, doubly so for any ICU care.

I'm all for helping folks but not at the risk of my own personal health. I think the bandanas and scarves bit is ridiculous, but I also think people have an unrealistic expectation of what PPE to expect. No, you will not get a daily N95 if you are not seeing symptomatic patients. Be OK with a surgical mask.

If they wanted me to swab symptomatic patients, better give me a N95 and eye shield.

Rad Onc residents are closer to general medicine than attendings. If I was a patient I would want general medical care from a rad onc resident over a rad onc attending. You think your 65 year old attending that has had 24/7 resident coverage for a decade plus who can't handle doing outpatient notes in EPIC is going to be anything but a liability and a risk to himself/herself and others on the medicine floors?
 
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Rad Onc residents are closer to general medicine than attendings. If I was a patient I would want general medical care from a rad onc resident over a rad onc attending. You think your 65 year old attending that has had 24/7 resident coverage for a decade plus who can't handle doing outpatient notes in EPIC is going to be anything but a liability and a risk to himself/herself and others on the medicine floors?

This. I bet most attending physicians who have had resident coverage for >5 years wouldn't be able to manage a COVID order set...
 
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