Attendings who keep their medical school students until 5pm

[racerwad]

First of all, if you have an apartment near your medical school, you may still be forced to do a rotation or two that are close to an hour away and don't provide housing. When your apartment is close to the remainder of your rotations, it makes sense to rent for the whole year there. It does not make sense to rent an additional apartment for 6-12 weeks on top of that apartment. Your comment indicates that you really don't understand how rotations work for a lot of people.

Second of all, I didn't complain about 7-5 rotations. I complained about rotations that are 5-5 (and may be an hour away). I'm sorry but that leaves you 12 hours that you are not in the hospital. Subtract two for driving, an hour for showering/getting ready, an hour for cooking and eating dinner, you're at 8 hours of sleep. Now try factoring in studying, even just a 15 minute call with a significant other/parents, occasional food shopping/laundry/presentations, random school requirements not specifically tied to a rotation. It's just not enough time in the day to realistically not sleep deprive people. I don't think school should force unhealthy situations on people.

Do you know what else forces unhealthy situations on people? Life. Sometimes you just have to adapt, overcome, or accept that things may not be perfect all the time. What you are describing sounds like a normal job for a lot of people, both in medicine and the working world at large. It is not at all ideal, but it also is not insurmountable.

---

Members don't see this ad.

 

[kavorca]

FWIW I felt the same way during medical school (and still do even after finishing).

I would highly recommend doing a rotation at an low resource inner city hospital during 4th year.

The difference is like night and day. Instead of being treated like a burden and begging for procedures you're treated like a member of the team and expected to do everything for your patients. Your patient needs an ABG, blood work, urine dipstick, joint aspiration, lumbar puncture, etc...? You're doing the procedure, interpreting the results, and formulating a treatment plan (under appropriate supervision of course...most of the time). You learn by doing instead of sitting in the corner and going through U World questions on your cell phone while waiting for the next fake note to write.

I agree. My Med school had a hospital we could rotate at that was basically condemned. It was in the process of being shut down, which took like 10 years. It was a student's paradise, especially on surgery. Almost everyone who rotated there for surgery ended up going some kind of surgery. The students were 100% necessary to finish the work. That wasn't the case at our primary hospital.

 

[sloop]

Are you at an MD out of curiosity? I was at an MD with serious budget issues, but for rotations an hr+ away we were set up with free housing close to the facility. I think I've heard the commute thing is more frequently an issue for do

I'm at an MD school. We are also set up with housing for rotations an hour or more away, in theory. The issue is that the "hour away" rule appears kind of flexible and usually assumes best case scenario regarding road conditions, traffic, etc. Obviously these conditions are not always met in the winter or when your home commute involves going across bridges or into major city centers. It's complicated. My family medicine rotation was like 35 min away per google maps but involved a major bridge and rush hour traffic both ways. It was more manageable because it was family med hours, so not complaining about that, but it demonstrates the point.

But even if it's just 45 minutes away—you've bought yourself a half hour. I don't think this solves the problem.

 

[sloop]

Do you know what else forces unhealthy situations on people? Life. Sometimes you just have to adapt, overcome, or accept that things may not be perfect all the time. What you are describing sounds like a normal job for a lot of people, both in medicine and the working world at large. It is not at all ideal, but it also is not insurmountable.

I don't think this is a good defense. I really don't understand people who use this excuse regularly. The assumption seems to be that if there exist lots of problems or a problem exists in multiple arenas, the problem must not be worth fixing at all. How does this make sense?

 

[racerwad]

I don't think this is a good defense. I really don't understand people who use this excuse regularly. The assumption seems to be that if there exist lots of problems or a problem exists in multiple arenas, the problem must not be worth fixing at all. How does this make sense?

So how do you propose "fixing" the problem of commuting, traffic, weather, the logistics of getting thousands of medical students rotations with preceptors that actually value said students, or any other of the myriad things than can and do go into making life more frustrating and less efficient? Life is often a waste of time, energy and resources. Many of those can be fixed or are at least worth trying to do so. But complaining about not getting to leave before 5pm??? I think it is safe to presume that 5pm is either when the clinic closes or the relief comes in. Part of these rotations is to expose us as students to the good and bad of various clinical settings. I know when I was in a similar setting, this wasted time was one of the reasons I knew I couldn't go into that field.

Edit: I suppose I should clarify, this isn't really a defense for how things are done, it is just reality. I hated having my time wasted as a medical student and I vowed to never let it happen when I was on the other side of the coin. I have decided that one of the things I want to do with my practice in the future is to focus on medical education and make sure that students don't have the same experiences with me that I had with other attendings/preceptors. I can't change how much they may have to commute or their weather patterns, but I will try and make their time high yield. As a student, I also made sure I always had study materials, FB, SDN, whatever, that would make wasted time less of a waste. A certain amount of the responsibility for making medical education worthwhile is the responsibility of the student.

 

[sloop]

So how do you propose "fixing" the problem of commuting, traffic, weather, the logistics of getting thousands of medical students rotations with preceptors that actually value said students, or any other of the myriad things than can and do go into making life more frustrating and less efficient? Life is often a waste of time, energy and resources. Many of those can be fixed or are at least worth trying to do so. But complaining about not getting to leave before 5pm??? I think it is safe to presume that 5pm is either when the clinic closes or the relief comes in. Part of these rotations is to expose us as students to the good and bad of various clinical settings. I know when I was in a similar setting, this wasted time was one of the reasons I knew I couldn't go into that field.

Edit: I suppose I should clarify, this isn't really a defense for how things are done, it is just reality. I hated having my time wasted as a medical student and I vowed to never let it happen when I was on the other side of the coin. I have decided that one of the things I want to do with my practice in the future is to focus on medical education and make sure that students don't have the same experiences with me that I had with other attendings/preceptors. I can't change how much they may have to commute or their weather patterns, but I will try and make their time high yield. As a student, I also made sure I always had study materials, FB, SDN, whatever, that would make wasted time less of a waste. A certain amount of the responsibility for making medical education worthwhile is the responsibility of the student.

As indicated by the thread we're discussing, the suggestion is not to have medical students work unnecessarily long hours. I think the statement "well this problem exists in residency too" is a poor reason not to fix it in medical school. On surgery for instance, if you're there at 5am, I think it's reasonable to let students go after cases are done or after clinic is done or by like 3 pm. I don't think only having a 10 hour work day would massively compromise the education of graduates.

Whatever though. I don't know why people seem to think that living a life with a terrible work life balance is necessary in medicine. It doesn't make sense to me.

 

[racerwad]

As indicated by the thread we're discussing, the suggestion is not to have medical students work unnecessarily long hours. I think the statement "well this problem exists in residency too" is a poor reason not to fix it in medical school. On surgery for instance, if you're there at 5am, I think it's reasonable to let students go after cases are done or after clinic is done or by like 3 pm. I don't think only having a 10 hour work day would massively compromise the education of graduates.

Whatever though. I don't know why people seem to think that living a life with a terrible work life balance is necessary in medicine. It doesn't make sense to me.

As others have alluded to here and in other threads regarding this same topic, part of the reason for the hours on certain rotations is so that students have a better understanding of what life as a resident and attending will be like. It would come as quite a shock for a student who experienced one version of life as a student to match into a specialty with a totally different pattern as a resident. Just because cases or patients in clinic are done doesn't necessarily mean that the work is done. Having an understanding of different practice environments can be really useful. And by useful, I don't always mean pleasant or enjoyable.

Work sucks, that's why we have to be paid to do it. Medicine, compared to many other jobs, can be fairly unpleasant due to the requirements the job has. Part of the clinical years is to expose students to those not-so-good spots so that you can make informed decisions about what you want to be doing in 30 years. Each month of your medical school training isn't always going to be great.

 

[themockjock]

Whatever though. I don't know why people seem to think that living a life with a terrible work life balance is necessary in medicine. It doesn't make sense to me.

It isn't. Even the CT surgeons I work with have relatively reasonable work-life balances (well, by my standards at least... I understand having to come in to the hospital at night once every month or two is, for you, the equivalent of a human rights violation). This is particularly true in later career private practice.

What you still can't fathom is that you are part of a team whose ultimate aim is to render care to patients. Your role on that team is primarily a learning one, so your primary job is to learn the basics of how to render care to said patients. You do so as part of a team. You are not a special snowflake. The hospital is not set up to serve pre-packaged patients with well defined chief complaints for you to evaluate between the hours of 9a and 5p. You need to accept (and make use of) downtime in order to reap the benefits of the 7pm Type A dissection or 3am ED thoracotomy because more than in most other specialties, surgery is unpredictable.

 

[Mass Effect]

Agreed, which is why it's too bad that medical students generally aren't allowed to do anything, at least in my experience. And I agree that my school is bad, but many others are bad in the same way. And things will only continue to get worse in this regard.

I still don't think medical students are a huge burden and I resent that sort of self important attitude. As I said, I don't like the way the system is currently set up, but it is set up that way, and people should accept the reality of the situation.

It isn't a self-important attitude and you're taking the whole thing completely out of context. Medical students make the day longer for most residents. This is not an opinion. It's a fact. Unless your resident is totally worthless, they should be teaching, giving guidance, giving feedback. This is their job and that takes time. Where do you think that time comes from? When I interview a patient on my own, I go in, ask the questions, steer the conversation to relevant matters, and get out. When I go in to observe my third-year, I watch as the patient goes wildly off-topic and the third year replies, asking totally irrelevant questions (when someone's been admitted for a heroin overdose, it doesn't matter why they once failed 9th grade, truly). I try to step in and steer the conversation back on topic until the next time it flies off the rails again. That takes time. Afterwards, I sit down with the student and give feedback. Again, it takes time. I'm happy to do it because I was once a third-year and I know it can help. But don't tell me it doesn't make the day longer. How could it not? And don't tell me that it's a "self-imposed burden" when I'm doing my job and what I'm required to do to HELP a student like you.

I made that distinction in my post. However, my point was, if it somehow came to the attention of lcme that students were routinely exceeding resident hours by a large margin for extremely dubious educational benefit, I'm not sure how it would be looked at. Im not familiar enough with the workings of lcme to say

That would never come to the attention of the LCME because it wouldn't happen.

We're generally limited to 1-2 patients, and often times you don't get to fully present because the resident will either preempt you or jump in midway through, or the attending will cut you off or just address the resident directly. You can write all the notes you want but the only feedback I've ever gotten is some variation of "this looks good." Presentations are rare. We watch procedures but generally never do them and after the fifth central line placement you observe it gets kind of tedious. That's been my experience of third year (6 weeks to go baby!).

This sounds like a problem with your hospital/residents. This is not the case at my program and as far as I can tell, my hospital in general.

 

[sliceofbread136]

I don't think you understand what that word means.

Please teach me great resident, I only hope I don't quadruple your work!

 

[IlDestriero]

You can leave whenever you want. It's your education.
Your evaluations will reflect your decisions.


--
Il Destriero

 

[kavorca]

You can check out any time you like, but you can never leave.

 

[Mass Effect]

Please teach me great resident, I only hope I don't quadruple your work!

You will, with your attitude.

 

[sliceofbread136]

You will, with your attitude.

Please accept this humble med student's apologies, he is not worthy of your resident greatness

 

[Mass Effect]

Showing some insight at last.

 

[Señor S]

Gonna work extra hard tomorrow so I only double the resident's work instead of tripling it.

#thirdyeargoals

 

[KnuxNole]

It's possible to have a good work-life balance, but sometimes, people spend too much time on certain things. For example: An hour to shower/get ready? I'm a male, so I don't understand that....it takes 5 minutes to shower, 2 minutes to do my hair, and 1-2 minutes to put on my clothes. I guess if you are putting on makeup/lipstick or doing your female hair, it might take some time. Also, 8 hours of sleep is more than what most people in their 20s and 30s sleep...

 

[Giovanotto]

As indicated by the thread we're discussing, the suggestion is not to have medical students work unnecessarily long hours. I think the statement "well this problem exists in residency too" is a poor reason not to fix it in medical school. On surgery for instance, if you're there at 5am, I think it's reasonable to let students go after cases are done or after clinic is done or by like 3 pm. I don't think only having a 10 hour work day would massively compromise the education of graduates.

Whatever though. I don't know why people seem to think that living a life with a terrible work life balance is necessary in medicine. It doesn't make sense to me.

I can already hear MadJack and his orderlies running to reply to me, but here it goes:

Americans never cease to amaze me. Truly a culture that lives to work. The best part is that with capitalism in place only a few benefit from all that work. So, while you could end up with a nation of people who work hard and everyone benefits, instead what we have now is a nation killing themselves with work, even past 65 (record high), in order to live while a few are benefiting.

/rant

 

[jdh71]

If you're hawt I keep you around so I can leer at you.

Don't like it? Don't go to medical school.

 

[kavorca]

If you're hawt I keep you around so I can leer at you.

Don't like it? Don't go to medical school.

That's what she will say what happened to her therapist, but what will you say in the deposition?

 

[jdh71]

That's what she will say what happened to her therapist, but what will you say in the deposition?

I'll probably note that some students are just lazy and the mentally unstable to ones are paranoid. And I'll probably wax philosophical about how they don't pick students the way they used to. Will definitely toss the entire millennial generation way under the bus. It will be bullet proof. All of this after I completely tank her grade and make sure to mother**** her character to the rest of my colleagues.

 

[kavorca]

Not guilty!
Counter sue her for legal fees and your valuable time.

 

[Bobdabuilda14]

It's possible to have a good work-life balance, but sometimes, people spend too much time on certain things. For example: An hour to shower/get ready? I'm a male, so I don't understand that....it takes 5 minutes to shower, 2 minutes to do my hair, and 1-2 minutes to put on my clothes. I guess if you are putting on makeup/lipstick or doing your female hair, it might take some time. Also, 8 hours of sleep is more than what most people in their 20s and 30s sleep...

I am a guy and i cant take a shower less than 15 minutes. How can you clean your entire body in 5 mins? Its impossible. We're talking face, behind the ears, armpits, arms, back, chest and abdomen, butt, groin, balls, glans, butt crack, thighs, shins and feet. Impossible in 5 mins.

 

[jdh71]

I am a guy and i cant take a shower less than 15 minutes. How can you clean your entire body in 5 mins? Its impossible. We're talking face, behind the ears, armpits, arms, back, chest and abdomen, butt, groin, balls, glans, butt crack, thighs, shins and feet. Impossible in 5 mins.

Did you jump into a vat of feces prior or something?

You're probably a millennial.

 

[Cytarabine]

I am a guy and i cant take a shower less than 15 minutes. How can you clean your entire body in 5 mins? Its impossible. We're talking face, behind the ears, armpits, arms, back, chest and abdomen, butt, groin, balls, glans, butt crack, thighs, shins and feet. Impossible in 5 mins.

Soap in hair, gravity takes care of the rest. You think they make us take physics as a prereq for no reason?

 

[alpinism]

I am a guy and i cant take a shower less than 15 minutes. How can you clean your entire body in 5 mins? Its impossible. We're talking face, behind the ears, armpits, arms, back, chest and abdomen, butt, groin, balls, glans, butt crack, thighs, shins and feet. Impossible in 5 mins.

Oh its possible.

Enlist the military and go to basic training. You'll be crowded into open air showers with 45 other dudes. Everyone has 2 minutes max to wash from head to toe. After 2 minutes the water is shut off and you must exit the room. If you don't finish in time you'll be covered in soap for the next 24 hrs until your next scheduled shower. One way or another you'll learn how to quickly take a shower in less than 2 minutes.

Also, if I remember correctly we only had 30 seconds during the 1st week of basic training... The drill sergeant would basically line everyone up, hand out bars of soap, then spray us all down with an ice cold water hose. That being said, 30 seconds was definitely not enough time for a complete shower. You had to take turns washing different parts of your body every day. Fun times.

 

[sloop]

Lesson learned in this thread: far too many people in medicine pride themselves on how ****ty the existence they lead is and want to impose the same on others.

 

[jdh71]

Lesson learned in this thread: far too many people in medicine pride themselves on how ****ty the existence they lead is and want to impose the same on others.

cry about it

 

[sloop]

cry about it

Haha. Suck it. I won't play your misery poker. I'm better than that.

 

[jdh71]

Haha. Suck it. I won't play your misery poker. I'm better than that.

You already are.

Where is your god now??

 

[sloop]

You already are.

Where is your god now??

How am I? I don't like being miserable. I've been advocating changing the situations that make people miserable so that they're no longer miserable. I'm not doing this dumb thing, a la Nietzsche's On the Genealogy of Morals, where one proclaims (or implies) that they are powerful purely because they can endure suffering.

 

[Azete]

I don't think there's a single medical student or doctor that doesn't work hard relative to the societal norm. We all should take pride in our work and commitment to learning, and kudos to those that work 100+ hours a week for their entire lives, but there's a disturbing stigma in this community towards those that want to have a life outside of medicine. As if not subjecting yourself to chronic exhaustion and misery somehow makes you an inferior physician.

 

[jdh71]

How am I? I don't like being miserable. I've been advocating changing the situations that make people miserable so that they're no longer miserable. I'm not doing this dumb thing, a la Nietzsche's On the Genealogy of Morals, where one proclaims (or implies) that they are powerful purely because they can endure suffering.

You've already signed up kid. Maybe you didn't notice? It's funny how you're refusing to play poker and don't realize you've already been dealt a hand. Good luck.

 

[IlDestriero]

How am I? I don't like being miserable. I've been advocating changing the situations that make people miserable so that they're no longer miserable. I'm not doing this dumb thing, a la Nietzsche's On the Genealogy of Morals, where one proclaims (or implies) that they are powerful purely because they can endure suffering.

If you think working until 5 is miserable. Oh man. You're so ****ed!


--
Il Destriero

 

[sloop]

If you think working until 5 is miserable. Oh man. You're so ****ed!


--
Il Destriero

Haha. So instead of responding to my cultural criticisms, you decide to mock me and tell me I'll make a terrible resident? What is this, high school?

I think people in medicine fetishize long hours and ****, consequently burn themselves out and occasionally blow their brains out. But whatever, you're right. That's far less important than swinging your dick and asserting your dominance over a medical student on the Internet.

And you passively imply that I am somehow immature or lack perspective? You make me laugh, dude.

 

[ewax]

Leaving early (without getting in trouble) as a medical student is an art you obviously haven't learned yet.

 

[IslandStyle808]

I am a guy and i cant take a shower less than 15 minutes. How can you clean your entire body in 5 mins? Its impossible. We're talking face, behind the ears, armpits, arms, back, chest and abdomen, butt, groin, balls, glans, butt crack, thighs, shins and feet. Impossible in 5 mins.

Did you jump into a vat of feces prior or something?

You're probably a millennial.

Soap in hair, gravity takes care of the rest. You think they make us take physics as a prereq for no reason?

We all knew it was coming to this clip...

 

[MediCane2006]

This thread is validating my despair regarding the millenial generation.

On the bright side, I think I have *liked* about a dozen posts in here....

 

[BusinessAndMedicine]

This thread is validating my despair regarding the millenial generation.

On the bright side, I think I have *liked* about a dozen posts in here....

Sorry to break it to you MediCane2006 but unless you had a career before medicine you are a millenial.

https://en.wikipedia.org/wiki/Millennials

 

[MediCane2006]

Sorry to break it to you MediCane2006 but unless you had a career before medicine you are a millenial.

https://en.wikipedia.org/wiki/Millennials

Please point out where I said I wasn't.

 

[FindMeOnTheLinks]

I can already hear MadJack and his orderlies running to reply to me, but here it goes:

Americans never cease to amaze me. Truly a culture that lives to work. The best part is that with capitalism in place only a few benefit from all that work. So, while you could end up with a nation of people who work hard and everyone benefits, instead what we have now is a nation killing themselves with work, even past 65 (record high), in order to live while a few are benefiting.

/rant

I can't even with this

 

[kavorca]

GenX ftw!

 

[VA Hopeful Dr]

Haha. So instead of responding to my cultural criticisms, you decide to mock me and tell me I'll make a terrible resident? What is this, high school?

I think people in medicine fetishize long hours and ****, consequently burn themselves out and occasionally blow their brains out. But whatever, you're right. That's far less important than swinging your dick and asserting your dominance over a medical student on the Internet.

And you passively imply that I am somehow immature or lack perspective? You make me laugh, dude.

You are thoroughly missing the point. We're not fetishizing long hours, we just have the perspective to realize that you can't learn medicine purely from books. A) Patients don't read the books (cliched, I know, but true) B) Its one thing to read about physical finding X and quite another to see it. We've all had rotations that seemed to be kind of a waste of time, but there is value to be found from almost anything in medicine as you'll end up interacting with pretty much everyone else over a career.

Also, no one is saying you'll be a terrible resident. The previous 2 posters are merely saying that if you think staying at work til 5pm is bad then residency will be a rude awakening for you. Heck, I'm FM (so a fairly easy residency compared to many) but I once had to stay in the hospital for 50 straight hours - had 4 continuity OB patients come in back to back.

 

[WingedOx]

Leaving early (without getting in trouble) as a medical student is an art you obviously haven't learned yet.

Learning the art of when to completely stop showing up is also key. I swear my evaluations got a hell of a lot better once I stopped giving a sh-t.

 

[jl lin]

My friends in the "real world" also stay at their 8/9-5 jobs until the end of the day even if they have downtime. I don't think it's really any different. Like someone else said, it's not like they are violating hours (stuff like >80hr/week and not having the 10hr break between shifts still apply to med students I think... we get asked about that on every evaluation).

ETA: I've been there and I understand the frustration but if you've asked/hinted to leave and they said no you just have to deal with it.

The "You have to do it, b/c I had to do it as a med student" notion is disrespectful, wasteful, and well may be a dysfunctional attitude/approach. Yes. If the student leaves early s/he may miss some good stuff that may come through the doors. You can't plan this stuff. There are a number of times where it may be feast or famine anywhere w/in the hospital. But if this is a consistent theme, where there is no benefit, and you are getting the feeling that it's someone's idea of making you "pay the same dues they had to," that is nonsense, period. There will be more than enough of this in residency--and probably a LOT more opportunities.

Defying common sense isn't a good quality in this profession. At the same time, the other poster @kavorca is right. Some people are SET in their thinking and are completely inflexible, and so, I have seen where MSs have had to suck it up and do the best they can. If it's unnecessary and it's impairing your ability to keep up w/ coursework and prep, then you have to decide if it is worth the potential fall out of pissing a stubborn, inflexible person off. C'est la vie!

 

[jl lin]

Did you jump into a vat of feces prior or something?

You're probably a millennial.

Metrosexual.

 

[jl lin]

It isn't a self-important attitude and you're taking the whole thing completely out of context. Medical students make the day longer for most residents. This is not an opinion. It's a fact. Unless your resident is totally worthless, they should be teaching, giving guidance, giving feedback. This is their job and that takes time. Where do you think that time comes from? When I interview a patient on my own, I go in, ask the questions, steer the conversation to relevant matters, and get out. When I go in to observe my third-year, I watch as the patient goes wildly off-topic and the third year replies, asking totally irrelevant questions (when someone's been admitted for a heroin overdose, it doesn't matter why they once failed 9th grade, truly). I try to step in and steer the conversation back on topic until the next time it flies off the rails again. That takes time. Afterwards, I sit down with the student and give feedback. Again, it takes time. I'm happy to do it because I was once a third-year and I know it can help. But don't tell me it doesn't make the day longer. How could it not? And don't tell me that it's a "self-imposed burden" when I'm doing my job and what I'm required to do to HELP a student like you.



That would never come to the attention of the LCME because it wouldn't happen.



This sounds like a problem with your hospital/residents. This is not the case at my program and as far as I can tell, my hospital in general.

Well to you @Mass Effect , I would like to say thank you for going the extra mile in teaching. Not every resident, fellow, or attending does this. There are many that do, but there are some that don't.

 

[jl lin]

Professionalism: Be respectful of others’ time. Being sensitive to others’ schedules and time limits shows respect. Perhaps that's the issue. There is a difference between teaching and giving people opportunities to learn vs. making someone your b!tch just b/c you can and b/c it was done to you. People need to be better than that.

At the same time, if you work to help the resident, making the most of the opportunities, he or she will see you are sincere, reliable, you care, and when things get slow, they may cut you a break.

It's balancing act.

 

[ThoracicGuy]

I am really frustrated with this. If we aren't doing anything, why make us stay? Opinions?

There's nothing I hated more as a resident than having students ask me if they can leave early. If you asked, the answer was no. If you didn't ask, acted like you wanted to be there, and showed at least a passing interest in what was going on? If the day was light, I'd tell you to go study or something.

 

[mimelim]

If there is something going on, I expect students, interns, residents etc to be here. If there isn't, I expect them to get the **** out of the hospital. Life is too short to hang out in the hospital for no reason. That having been said, if something is going on and you can't be found, you are not going to like your eval. It isn't exactly hard.