Is this normal?

[Giovanotto]

Most of us were able to respond to this thread without being rude. Perhaps when you're actually you're a resident you'll understand the logic because I assure you, just because you're confused (as evidenced by your response) doesn't make it "nonsense."

No one said you need to work 26 days to get credit for a month of IM. What I said is that all programs have a minimum number of days you need to work to get credit for ALL rotations. There's just a standard minimum and if you don't reach it, you don't get credit. If you're scheduled for derm rotation for 12 shifts and you decide to take 7 days off, you don't get credit for that rotation and comparing it to a rotation where you're scheduled for 26 shifts and taking 7 days off is not comparable by any stretch of the imagination.

I mean it's the same at the medical school level (requirements for clerkships), and yet medical students take 1-week to 2-week long vacations in the middle of some podunk rotation and faculty turns a blind eye and everyone goes about their day and medical students somehow manage to make it to residency and succeed as doctors.

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[Mass Effect]

I mean it's the same at the medical school level (requirements for clerkships), and yet medical students take 1-week to 2-week long vacations in the middle of some podunk rotation and faculty turns a blind eye and everyone goes about their day and medical students somehow manage to make it to residency and succeed as doctors.

You're comparing med students to residents? Really?

 

[Piebaldi]

No way this is actually a thing. People put up with this? I stopped reading half way through this thread. You're getting shafted, is there anything else that needs to be said? Go ask for a refund on your vacation week and do your regular month.

in manyprograms including mine when i was a resident we would not be allowed to change vacations weeks

 

[mvenus929]

I mean it's the same at the medical school level (requirements for clerkships), and yet medical students take 1-week to 2-week long vacations in the middle of some podunk rotation and faculty turns a blind eye and everyone goes about their day and medical students somehow manage to make it to residency and succeed as doctors.

As an intern, we had a fourth year student on our rotation in like May (graduating in like 2 weeks) because they had taken an unauthorized vacation in November and needed to make up the time. As a fourth year at a different school, we had someone who wasn’t permitted to graduate (and thus match) because they took an unauthorized vacation and wouldn’t have completed the required number of weeks in fourth year. Not all schools are blasé about it.

 

[Piebaldi]

As an intern, we had a fourth year student on our rotation in like May (graduating in like 2 weeks) because they had taken an unauthorized vacation in November and needed to make up the time. As a fourth year at a different school, we had someone who wasn’t permitted to graduate (and thus match) because they took an unauthorized vacation and wouldn’t have completed the required number of weeks in fourth year. Not all schools are blasé about it.

Yes there are serious unfair issues at times. In my former program, some residents would be off like 2 weeks at a time or so when attendings would take off for vacations, conferences, etc. Some people got an extra 6 weeks or so of time off during residency. I believe I was the only person in my class who didn't have that experience.
I felt it was super unfair. I was put on night float as a 4th year, yet there were several other residents who were technically on rotations, but off during that time bc attending was off - and PD refused to have any of those residents to be placed on nightfloat -even the junior ones! Crap like this will stay with me for the rest of my life. So unfair.

 

[psychapp121]

You're comparing med students to residents? Really?

dude stop trying to be a hardass..if the guy took vacation he should be on vacation and not have to work a full months work..it’s really not a difficult concept..now obviously some residencies/med schools/jobs suck and will force you to work so just suck it up and move on but it def does suck especially if your off service and don’t even want to be there in the first place

 

[Mass Effect]

dude stop trying to be a hardass..if the guy took vacation he should be on vacation and not have to work a full months work..it’s really not a difficult concept..now obviously some residencies/med schools/jobs suck and will force you to work so just suck it up and move on but it def does suck especially if your off service and don’t even want to be there in the first place

I'm not being a hardass. I'm just a grown adult who realizes this is work. There are rules and there's a boss you answer to. This is precisely why I think med schools would be much better off accepting only students with real-world/employment experience. Without it, they always come across like the above.

 

[Giovanotto]

You're comparing med students to residents? Really?

Should we continue comparing till our deathbeds? When does it end?

 

[Giovanotto]

I'm not being a hardass. I'm just a grown adult who realizes this is work. There are rules and there's a boss you answer to. This is precisely why I think med schools would be much better off accepting only students with real-world/employment experience. Without it, they always come across like the above.

For a poster that on other subforums I've always agreed with, it amazes me to see just how far off base you are here.

 

[Mass Effect]

Should we continue comparing till our deathbeds? When does it end?

You compare things that are comparable. A med student on a random rotation is not in any way, shape, or form comparable to a resident learning his/her trade. Even off-service rotations have some utility to the chosen specialty and I think the only people here who miss that are those who are still in med school.

For a poster that on other subforums I've always agreed with, it amazes me to see just how far off base you are here.

Just because I disagree with you doesn't make me off-base. What I am saying is based on years of experience as a resident and a fellow and now an attending. It sucks that the OP loses a week of vacay for no reason, but that doesn't mean he/she should work less than 18 shifts when that's clearly the requirement. This isn't something they did to him/her. The OP even states that this has happened to others who've taken vacay this month as well. So that should have been conveyed by his seniors/colleagues. The fact that it wasn't isn't the fault of the rotation. When you're expected to work 18/30 shifts, asking for even less than that isn't going to fly 99% of the time. If you don't know that now, you will when you get to residency.

 

[Giovanotto]

You compare things that are comparable. A med student on a random rotation is not in any way, shape, or form comparable to a resident learning his/her trade. Even off-service rotations have some utility to the chosen specialty and I think the only people here who miss that are those who are still in med school.



Just because I disagree with you doesn't make me off-base. What I am saying is based on years of experience as a resident and a fellow and now an attending. It sucks that the OP loses a week of vacay for no reason, but that doesn't mean he/she should work less than 18 shifts when that's clearly the requirement. This isn't something they did to him/her. The OP even states that this has happened to others who've taken vacay this month as well. So that should have been conveyed by his seniors/colleagues. The fact that it wasn't isn't the fault of the rotation. When you're expected to work 18/30 shifts, asking for even less than that isn't going to fly 99% of the time. If you don't know that now, you will when you get to residency.

You make a decently reasoned argument, and I appreciate that, but I'll have to respectfully disagree with you on both points. Doesn't matter how you cut it, OP is not getting a vacation, he is simply having his schedule rearranged. If he was allowed to go on vacation, then he should get vacation.

 

[Piebaldi]

You make a decently reasoned argument, and I appreciate that, but I'll have to respectfully disagree with you on both points. Doesn't matter how you cut it, OP is not getting a vacation, he is simply having his schedule rearranged. If he was allowed to go on vacation, then he should get vacation.

Unfortunately some residents get screwed. I was the screwed resident in my program, the OP I guess is the screwed resident in his. It happens unfortunately. Not fair I agree. Adn I'd agree with you, OP is not getting a vacation if he's having to work the same number of shifts. But the schedule is already done and it won't be changed likely.

 

[GoSpursGo]

Should we continue comparing till our deathbeds? When does it end?

FWIW, as someone who agrees that this isn't particularly fair to the resident, I also agree that it makes little sense to compare residents and medical students. A resident is being paid a salary for a job which is vital at most academic medical centers. If you're being paid and not violating any work restrictions such as duty hours, then it sucks and may not be fair but there's also not much you can do other than advise other residents in the future to not take vacation in that block (or the program can remove that option entirely). Medicine is not the only field that sometimes screws its young professionals.

Med students are paying for the opportunity to learn, and the medical team isn't going to fall apart if they're not there. They have to show up enough to be evaluated, but in the end they're responsible for their own education.

 

[TraumaLlamaMD]

In my program a resident on vacation will almost always have to take the same amount of call in a given month (or close to it), concentrated into the non-vacation weeks, because if they don’t the others in the call pool will violate duty hour restrictions.

 

[Giovanotto]

FWIW, as someone who agrees that this isn't particularly fair to the resident, I also agree that it makes little sense to compare residents and medical students. A resident is being paid a salary for a job which is vital at most academic medical centers. If you're being paid and not violating any work restrictions such as duty hours, then it sucks and may not be fair but there's also not much you can do other than advise other residents in the future to not take vacation in that block (or the program can remove that option entirely). Medicine is not the only field that sometimes screws its young professionals.

Med students are paying for the opportunity to learn, and the medical team isn't going to fall apart if they're not there. They have to show up enough to be evaluated, but in the end they're responsible for their own education.

A hospital with a residency program that falls apart without its residents is a huge red flag. Residents should be there primarily to learn, not to "run" the hospital. SDN needs to make up its mind about whether or not residency is work or school. If it's work, then pay a fair wage and benefits (i.e. vacations). If it's school, then ask for money. This middle ground sucks.

 

[Raryn]

A hospital with a residency program that falls apart without its residents is a huge red flag. Residents should be there primarily to learn, not to "run" the hospital. SDN needs to make up its mind about whether or not residency is work or school. If it's work, then pay a fair wage. If it's school, then ask for money. This middle ground sucks.

It's both. Residency is basically the professional version of an apprenticeship.

 

[GoSpursGo]

A hospital with a residency program that falls apart without its residents is a huge red flag. Residents should be there primarily to learn, not to "run" the hospital. SDN needs to make up its mind about whether or not residency is work or school. If it's work, then pay a fair wage. If it's school, then ask for money. This middle ground sucks.

It’s both.

Come on, you don’t really want to pay tuition for residency. And the only way you learn is by taking real responsibility, but you need someone to ask for help from when you’re out of you’re depth. So it’s a mix of service and education.

 

[Giovanotto]

It’s both.

Come on, you don’t really want to pay tuition for residency. And the only way you learn is by taking real responsibility, but you need someone to ask for help from when you’re out of you’re depth. So it’s a mix of service and education.

Agreed, and it only further proves my point.

 

[GoSpursGo]

Agreed, and it only further proves my point.

I’m not trying to be obtuse, but I actually don’t know what your point is. This concept that a hospital with a residency program should be able to function without the residents is something I've seen a few times on SDN, and frankly it's entirely incorrect--you only learn with real responsibility, which you won't have if there are actually plenty of attendings and APPs around to do the work without you.

Clearly residents are still learners, but they know enough and contribute enough to be paid for the work they do. When you're being paid, you have to actually do the job.

 

[Dr.LeoSpaceman]

This concept that a hospital with a residency program should be able to function without the residents is something I've seen a few times on SDN, and frankly it's entirely incorrect--you only learn with real responsibility, which you won't have if there are actually plenty of attendings and APPs around to do the work without you.

I don't get this either. Who wants to work in a job where they feel they're expendable? No, obviously you should not feel like you have to be there at all times. But I'm unclear about why it's problematic that hospitals view residents as an integral part of the care team.

I'll also say this: It's getting a bit irksome to hear "work life balance" and "burnout" every time someone mentions a conflict between their personal life and professional obligations. Not just here, but it's something I dealt with in my own training programs. "Balance" doesn't mean that every time there is a conflict between the two, you should err on the side of protecting your own time. It means that each get equal consideration, and sometimes professional obligations trump personal obligations or vice versa. Yes, that means that sometimes your personal life is impacted by the responsibilities of being a resident. Saying that shouldn't invite contempt and pearl-clutching.

 

[calvnandhobbs68]

A hospital with a residency program that falls apart without its residents is a huge red flag. Residents should be there primarily to learn, not to "run" the hospital. SDN needs to make up its mind about whether or not residency is work or school. If it's work, then pay a fair wage. If it's school, then ask for money. This middle ground sucks.

lol dude you don’t know what you’re talking about. Most major academic hospitals would fall apart or have to double the amount of money they spend on faculty/NPs without their cheap resident labor.

 

[psychapp121]

lol dude you don’t know what you’re talking about. Most major academic hospitals would fall apart or have to double the amount of money they spend on faculty/NPs without their cheap resident labor.

there are also many hospitals that don’t require residents to function..that poster clearly prefers to work there

 

[Piebaldi]

there are also many hospitals that don’t require residents to function..that poster clearly prefers to work there

typical private type hospitals function without residents. county type hospitals need residents. it's all economics peeps.

 

[GoSpursGo]

there are also many hospitals that don’t require residents to function..that poster clearly prefers to work there

That’s not really what he was suggesting. He was specifically talking about hospitals with programs

 

[Raryn]

That’s not really what he was suggesting. He was specifically talking about hospitals with programs

I think it depends on the specialty.

Let's look at the typical IM service in the hospital - given that's what I know best. A team is usually structured as 1 attending, 1 senior, 1-2 interns, some number of medical students. There's lots of variants on this same structure, but I think that's most common. They can see (by ACGME mandate) a maximum of 16 (for 1 intern teams) to 20 patients (for 2 interns). Now, those are caps - I'd say a typical team probably averages 13-17 patients, with some days being more and others being less. Usually, but not always, the attending is *exclusively* on that inpatient service when he's on service. Some places do have an attending cover more than 1 team (particularly for weekends/holidays) or they may have a more traditional GIM practice where they have their own clinic schedule as well, but usually it's just 1 attending, 1 team, no other responsibilities.

What would happen if all the residents disappeared for a day? Well... you'd be left with the attending and 13-17 patients. Guess how many patients a community hospitalist sees in a given workday by themselves? Hint: The average is usually around 15.

So if the residents disappeared for a day or two, the daytime inpatient medicine services would function just fine. The attendings would be stuck doing all of the work themselves - but they'd also have no education to do (for obvious reasons). Now, their schedules would be all kinds of messed up - academic attendings tend to have radically different schedules than community hospitalists - namely that they *typically* take fewer days off due to the less intense nature of their work (though likely more weekends). But it would work just fine. And the staff would be miserable. But the residents are only "necessary" to give the attendings the relatively cush life that allows them to accept the smaller salary (and lets them take time for teaching, QI, whatever else they like to do).

Nights gets a bit hinky, because most places just have residents operating semi-autonomously at night with home attending backup. So for facilities that don't have a night in house attending, they'd have to screw around with the schedules even more - but again, the attendings should be perfectly capable of triaging night calls and admissions on their own. At least for a few days before they all up and quit.

What about consult services? Same story, though there the schedules would be even more screwed up. The residents allow the subspecialists to likely see more patients than they otherwise would - or spend less time doing consultations and more time doing whatever procedures/clinic/whatever they would rather be doing.

The ICU would be a bit more touch and go, particularly at night - but even at the program where I did residency that had ridiculous ICU volume, I think the actual attendings could manage on their own for a few days before they all quit.

Clinics get more of a questionmark, because an attending is often supervising 4 individual residents with their individual schedules. Now, none of them is as busy as a full attending on their own - but even if they were only a third as busy as an attending, that's still 1.3X a clinic schedule.

I think it would be a lot less tenable for someone like a surgeon if the residents disappeared - because there's often no other built in mechanism for first assists and so much of the grunt work done by the residents saves the surgeons time and allows them to increase case volumes.

Basically, I'd say that most academic hospital services *could* function *briefly* if the residents up and disappeared, but that would require the attendings to work at full clinical volume on their own and that could not be sustainable due to the overall staffing not being built for that.

 

[dpmd]

I think it depends on the specialty.

Let's look at the typical IM service in the hospital - given that's what I know best. A team is usually structured as 1 attending, 1 senior, 1-2 interns, some number of medical students. There's lots of variants on this same structure, but I think that's most common. They can see (by ACGME mandate) a maximum of 16 (for 1 intern teams) to 20 patients (for 2 interns). Now, those are caps - I'd say a typical team probably averages 13-17 patients, with some days being more and others being less. Usually, but not always, the attending is *exclusively* on that inpatient service when he's on service. Some places do have an attending cover more than 1 team (particularly for weekends/holidays) or they may have a more traditional GIM practice where they have their own clinic schedule as well, but usually it's just 1 attending, 1 team, no other responsibilities.

What would happen if all the residents disappeared for a day? Well... you'd be left with the attending and 13-17 patients. Guess how many patients a community hospitalist sees in a given workday by themselves? Hint: The average is usually around 15.

So if the residents disappeared for a day or two, the daytime inpatient medicine services would function just fine. The attendings would be stuck doing all of the work themselves - but they'd also have no education to do (for obvious reasons). Now, their schedules would be all kinds of messed up - academic attendings tend to have radically different schedules than community hospitalists - namely that they *typically* take fewer days off due to the less intense nature of their work (though likely more weekends). But it would work just fine. And the staff would be miserable. But the residents are only "necessary" to give the attendings the relatively cush life that allows them to accept the smaller salary (and lets them take time for teaching, QI, whatever else they like to do).

Nights gets a bit hinky, because most places just have residents operating semi-autonomously at night with home attending backup. So for facilities that don't have a night in house attending, they'd have to screw around with the schedules even more - but again, the attendings should be perfectly capable of triaging night calls and admissions on their own. At least for a few days before they all up and quit.

What about consult services? Same story, though there the schedules would be even more screwed up. The residents allow the subspecialists to likely see more patients than they otherwise would - or spend less time doing consultations and more time doing whatever procedures/clinic/whatever they would rather be doing.

The ICU would be a bit more touch and go, particularly at night - but even at the program where I did residency that had ridiculous ICU volume, I think the actual attendings could manage on their own for a few days before they all quit.

Clinics get more of a questionmark, because an attending is often supervising 4 individual residents with their individual schedules. Now, none of them is as busy as a full attending on their own - but even if they were only a third as busy as an attending, that's still 1.3X a clinic schedule.

I think it would be a lot less tenable for someone like a surgeon if the residents disappeared - because there's often no other built in mechanism for first assists and so much of the grunt work done by the residents saves the surgeons time and allows them to increase case volumes.

Basically, I'd say that most academic hospital services *could* function *briefly* if the residents up and disappeared, but that would require the attendings to work at full clinical volume on their own and that could not be sustainable due to the overall staffing not being built for that.

The hospitalists here don't take any calls at night (they sign out to the night hospitalist who covers calls and admissions. You are right about the up and quitting thing because I can't imagine the ones at a hospital with resident would be willing to do all the day work plus night work for less than the folks doing it in the community. For surgery, they would almost certainly balk at changing to in house call at night in addition to trying to juggle doing elective cases plus covering trauma plus seeing new consults. They would have to hire more people very quickly because either elective cases would be cancelled or trauma patient's outcomes would suffer (aside from those places where they have so little trauma that every low speed MVA and ground level fall gets activated, where I trained we got a lot of penetrating trauma where being there early matters). There actually was one night and day where the residents would not work (the night before and during the in training exam) but the trauma PA would take call that night (though she requested the attending stay in house too in case she needed help) and no elective cases were done the next day.

 

[Giovanotto]

I think it depends on the specialty.

Let's look at the typical IM service in the hospital - given that's what I know best. A team is usually structured as 1 attending, 1 senior, 1-2 interns, some number of medical students. There's lots of variants on this same structure, but I think that's most common. They can see (by ACGME mandate) a maximum of 16 (for 1 intern teams) to 20 patients (for 2 interns). Now, those are caps - I'd say a typical team probably averages 13-17 patients, with some days being more and others being less. Usually, but not always, the attending is *exclusively* on that inpatient service when he's on service. Some places do have an attending cover more than 1 team (particularly for weekends/holidays) or they may have a more traditional GIM practice where they have their own clinic schedule as well, but usually it's just 1 attending, 1 team, no other responsibilities.

What would happen if all the residents disappeared for a day? Well... you'd be left with the attending and 13-17 patients. Guess how many patients a community hospitalist sees in a given workday by themselves? Hint: The average is usually around 15.

So if the residents disappeared for a day or two, the daytime inpatient medicine services would function just fine. The attendings would be stuck doing all of the work themselves - but they'd also have no education to do (for obvious reasons). Now, their schedules would be all kinds of messed up - academic attendings tend to have radically different schedules than community hospitalists - namely that they *typically* take fewer days off due to the less intense nature of their work (though likely more weekends). But it would work just fine. And the staff would be miserable. But the residents are only "necessary" to give the attendings the relatively cush life that allows them to accept the smaller salary (and lets them take time for teaching, QI, whatever else they like to do).

Nights gets a bit hinky, because most places just have residents operating semi-autonomously at night with home attending backup. So for facilities that don't have a night in house attending, they'd have to screw around with the schedules even more - but again, the attendings should be perfectly capable of triaging night calls and admissions on their own. At least for a few days before they all up and quit.

What about consult services? Same story, though there the schedules would be even more screwed up. The residents allow the subspecialists to likely see more patients than they otherwise would - or spend less time doing consultations and more time doing whatever procedures/clinic/whatever they would rather be doing.

The ICU would be a bit more touch and go, particularly at night - but even at the program where I did residency that had ridiculous ICU volume, I think the actual attendings could manage on their own for a few days before they all quit.

Clinics get more of a questionmark, because an attending is often supervising 4 individual residents with their individual schedules. Now, none of them is as busy as a full attending on their own - but even if they were only a third as busy as an attending, that's still 1.3X a clinic schedule.

I think it would be a lot less tenable for someone like a surgeon if the residents disappeared - because there's often no other built in mechanism for first assists and so much of the grunt work done by the residents saves the surgeons time and allows them to increase case volumes.

Basically, I'd say that most academic hospital services *could* function *briefly* if the residents up and disappeared, but that would require the attendings to work at full clinical volume on their own and that could not be sustainable due to the overall staffing not being built for that.

Seems like it in my specialty, glad it's not the only one. And here we are talking about one off-service resident. And yet here I am made to appear lazy for stating that a likely already overworked resident should be able to take what in the real world people call vacation. To be clear, I understand the other perspective, but what OP is describing is simply not a vacation, so it would behoove programs to consider it one if they want to appear like an institution that actually cares about its residents. To go full circle, that's what I'm looking for in a program. Apparently, it's not as common as I'd have thought and even worse, it's considered entitled.

 

[GoSpursGo]

Seems like it in my specialty, glad it's not the only one. And here we are talking about one off-service resident. And yet here I am made to appear lazy for stating that a likely already overworked resident should be able to take what in the real world people call vacation. To be clear, I understand the other perspective, but what OP is describing is simply not a vacation, so it would behoove programs to consider it one if they want to appear like an institution that actually cares about its residents. To go full circle, that's what I'm looking for in a program. Apparently, it's not as common as I'd have thought and even worse, it's considered entitled.

Again, I’ve said multiple times the OP got a raw deal, and the program should explicitly advise residents against taking vacation in that block. But there’s likely no specific recourse for it.

Where you lost me was suggesting that residents are ONLY there to learn, or that a program should be able to function if all the residents disappeared. That’s a little over the top.

 

[NITRAS]

Residency programs exist to provide patient care and train residents to be doctors. 18 shifts (as long as reasonable times between shifts) in 30 days isn’t abuse.

What the OP is complaining about may seem unfair, but it doesn’t compare in the slightest to actual abuse of residents. It actually is more realistic representation of what happens real life.

 

[Piebaldi]

Residency programs exist to provide patient care and train residents to be doctors. 18 shifts (as long as reasonable times between shifts) in 30 days isn’t abuse.

What the OP is complaining about may seem unfair, but it doesn’t compare in the slightest to actual abuse of residents. It actually is more realistic representation of what happens real life.

It's not abuse per say but it's unfair. If someone takes vacation during a regular month for example, you wouldn't be expected to do anything residency related during that time. So if there was a week of call or whatever you wouldn't be expected to do it - bc u are on vacation. So it's unfair for OP to have to do all the shifts if he's off for 1 week. Abuse? no. Unfair?yes.

 

[dpmd]

It's not abuse per say but it's unfair. If someone takes vacation during a regular month for example, you wouldn't be expected to do anything residency related during that time. So if there was a week of call or whatever you wouldn't be expected to do it - bc u are on vacation. So it's unfair for OP to have to do all the shifts if he's off for 1 week. Abuse? no. Unfair?yes.

But he still gets a full week of not having any residency activities, something which he otherwise would not have gotten.

those that worked the entire month never had an entire week off straight

 

[Piebaldi]

But he still gets a full week of not having any residency activities, something which he otherwise would not have gotten.

Yes but he still has to do the same number of shifts - he should be doing LESS shifts if he's taking a week of vacation. Just as if he was on a service where there was call - he wouldn't do the call for the week he was off. Essentially the other residents are getting more days off.

 

[dpmd]

Yes but he still has to do the same number of shifts - he should be doing LESS shifts if he's taking a week of vacation. Just as if he was on a service where there was call - he wouldn't do the call for the week he was off. Essentially the other residents are getting more days off.

Because they didn't take vacation during an already light month. And if he was on a service with call he most likely would have had the same amount of call just compressed into three weeks. You are stuck with the idea of vacation meaning that you get to work less than other people. All it means is that you get to be free of duties for a set period. For a lot of jobs where you do work that isn't measured by how many hours you are there, you come back to find your projects still waiting for you and you work harder when you are there than the other people who didn't take time off that month. Fair or unfair is an opinion. But it certainly is quite normal (which was the original question)

 

[calvnandhobbs68]

Because they didn't take vacation during an already light month. And if he was on a service with call he most likely would have had the same amount of call just compressed into three weeks. You are stuck with the idea of vacation meaning that you get to work less than other people. All it means is that you get to be free of duties for a set period. For a lot of jobs where you do work that isn't measured by how many hours you are there, you come back to find your projects still waiting for you and you work harder when you are there than the other people who didn't take time off that month. Fair or unfair is an opinion. But it certainly is quite normal (which was the original question)

thats not necessarily a light month depending on the specialty. Since OP is talking in “shifts” I’m assuming this is an ED month where 18 shifts a month is pretty typical for all residents, including the ED residents.

 

[Piebaldi]

Because they didn't take vacation during an already light month. And if he was on a service with call he most likely would have had the same amount of call just compressed into three weeks. You are stuck with the idea of vacation meaning that you get to work less than other people. All it means is that you get to be free of duties for a set period. For a lot of jobs where you do work that isn't measured by how many hours you are there, you come back to find your projects still waiting for you and you work harder when you are there than the other people who didn't take time off that month. Fair or unfair is an opinion. But it certainly is quite normal (which was the original question)

I disagree. And no, for a resident on vacation, if call happens to be on the week they are on vacation, they will not have to take call - so they will do LESS call for that month.
Everyone is supposed to get about the same amount of time off. In my opinion this resident should be having less shifts. Clearly I'm not making the schedule for this resident so it doens't matter what I think but thats my opinion.

 

[rokshana]

It's not abuse per say but it's unfair. If someone takes vacation during a regular month for example, you wouldn't be expected to do anything residency related during that time. So if there was a week of call or whatever you wouldn't be expected to do it - bc u are on vacation. So it's unfair for OP to have to do all the shifts if he's off for 1 week. Abuse? no. Unfair?yes.

And guess what? Life is unfair.

 

[rokshana]

Yes but he still has to do the same number of shifts - he should be doing LESS shifts if he's taking a week of vacation. Just as if he was on a service where there was call - he wouldn't do the call for the week he was off. Essentially the other residents are getting more days off.

Well frankly, if it is known that you have to do all 18 shifts regardless and you still ask for vacation during that month, you get what you deserve...common sense says you just ask for the shifts to be concentrated and then have a stretch of off days...or don’t do that rotation when you need vacation.

 

[GoSpursGo]

Because they didn't take vacation during an already light month. And if he was on a service with call he most likely would have had the same amount of call just compressed into three weeks. You are stuck with the idea of vacation meaning that you get to work less than other people. All it means is that you get to be free of duties for a set period. For a lot of jobs where you do work that isn't measured by how many hours you are there, you come back to find your projects still waiting for you and you work harder when you are there than the other people who didn't take time off that month. Fair or unfair is an opinion. But it certainly is quite normal (which was the original question)

Agree with this--for this reason, we weren't even allowed to take vacation except during our elective months. It makes total sense to me that if you're taking vacation during a block of service, the remainder of your month is going to be awful.

I disagree. And no, for a resident on vacation, if call happens to be on the week they are on vacation, they will not have to take call - so they will do LESS call for that month.
Everyone is supposed to get about the same amount of time off. In my opinion this resident should be having less shifts. Clearly I'm not making the schedule for this resident so it doens't matter what I think but thats my opinion.

Everyone DID get the same amount of time off--everyone who takes vacation during that month got the exact same treatment. So it may suck, but it's not "unfair." And frankly, if you get caught up trying to make sure that you have exactly the same amount of shifts/calls/whatever to ensure that you're being treated "fairly," then residency is going to be a very long 3-7 year slog.

And keep in mind, it's a zero sum game. If the program decided that people who are on vacation get to do fewer shifts/calls, then when you're working you're going to be working a lot harder and have more shifts/calls to cover the people who are on vacation. You're still going to wind up with the same amount of work no matter how you try to cut the pie.

 

[rokshana]

I disagree. And no, for a resident on vacation, if call happens to be on the week they are on vacation, they will not have to take call - so they will do LESS call for that month.
Everyone is supposed to get about the same amount of time off. In my opinion this resident should be having less shifts. Clearly I'm not making the schedule for this resident so it doens't matter what I think but thats my opinion.

Not in IM...Because you don’t get to take vacation on months that you are on call...and when you are on an elective and you are back up...you don’t get to take vacation when you are on back up....and it’s not like you get to skip being on back up.

In IM , the ACGME says you get 2weeks if vacation...if you are getting extra weeks, the the program has decided to give you extra weeks...and the ACGME doesn’t mandated that you as the resident gets to choose when you get to take the weeks off...heck there are programs out there that just schedule your weeks off and that’s all you get.

 

[Piebaldi]

Agree with this--for this reason, we weren't even allowed to take vacation except during our elective months. It makes total sense to me that if you're taking vacation during a block of service, the remainder of your month is going to be awful.

Everyone DID get the same amount of time off--everyone who takes vacation during that month got the exact same treatment. So it may suck, but it's not "unfair." And frankly, if you get caught up trying to make sure that you have exactly the same amount of shifts/calls/whatever to ensure that you're being treated "fairly," then residency is going to be a very long 3-7 year slog.

And keep in mind, it's a zero sum game. If the program decided that people who are on vacation get to do fewer shifts/calls, then when you're working you're going to be working a lot harder and have more shifts/calls to cover the people who are on vacation. You're still going to wind up with the same amount of work no matter how you try to cut the pie.

It has to be roughly equal - ie - you can't like it happened at my program have some people working all the same holidays, and others getting off on all holidays. Or you can't have people having like 4-6 extra weeks of time off during residency when attendings take off. There has to be some fairness.

 

[Piebaldi]

Well frankly, if it is known that you have to do all 18 shifts regardless and you still ask for vacation during that month, you get what you deserve...common sense says you just ask for the shifts to be concentrated and then have a stretch of off days...or don’t do that rotation when you need vacation.

If it works the same for everyone involved, and everyone knows that that's a different issue. In my program we coudln't take vacation in certain months - ICU, IM, rehab months. But otherwise you could do so. When you did, you didn't take call or whatever for that time that you were off.

 

[Piebaldi]

And guess what? Life is unfair.

Residency has to be somewhat fair. Sure it's not feasible to have the exact same number of everything - but if one or two people end up with all the calls, holidays, crappy rotations, and the others end up with no holidays, easier scheduling, etc. problems arise.

Residency scheduling can to a large extent be controlled. Life not so much. And that is a discussion that is outside the scope of this thread really.

A scheduling chief can say hey I like resident x who is my buddy. I'll give them Thanksgiving, Christmas, and New Year's off, and resident B, well they kind of rub me the wrong way or I don't know them well so let's have them take all those holidays.

That cna't work well.

 

[GoSpursGo]

It has to be roughly equal - ie - you can't like it happened at my program have some people working all the same holidays, and others getting off on all holidays. Or you can't have people having like 4-6 extra weeks of time off during residency when attendings take off. There has to be some fairness.

I think your opinion of how things were run at your program is well-documented, but perhaps not relevant to the OP's situation.

 

[dpmd]

I disagree. And no, for a resident on vacation, if call happens to be on the week they are on vacation, they will not have to take call - so they will do LESS call for that month.
Everyone is supposed to get about the same amount of time off. In my opinion this resident should be having less shifts. Clearly I'm not making the schedule for this resident so it doens't matter what I think but thats my opinion.

In most places I have knowledge of if a resident is on a service with call and is out for a week the total number of calls taken remains the same, they are just not scheduled during that week they are gone. If not done that way, then the other residents would have to take more call instead of everyone being equal (and then they would complain that isn't fair, basically no strategy will make everyone happy)

 

[dpmd]

thats not necessarily a light month depending on the specialty. Since OP is talking in “shifts” I’m assuming this is an ED month where 18 shifts a month is pretty typical for all residents, including the ED residents.

As a surgeon I am obligated to call all ed service months light

 

[Dr.LeoSpaceman]

A scheduling chief can say hey I like resident x who is my buddy. I'll give them Thanksgiving, Christmas, and New Year's off, and resident B, well they kind of rub me the wrong way or I don't know them well so let's have them take all those holidays.

You're arguing against a position to which no one in this thread has taken. Yes, being targeted to take more call or shifts than another resident based on personal preference is inappropriate and should not be tolerated. But there is no evidence that happened in this case, so the argument is irrelevant.

As others have mentioned, what about the other residents who have to take more shifts in a month because they had the bad luck of one person taking vacation when they are on service? What if they start complaining things are unfair? How will you reconcile who gets preference?

When every perceived inconvenience is bemoaned as "unfair", then it becomes a lot harder for residents to be taken seriously when there are real problems.

 

[VA Hopeful Dr]

Not in IM...Because you don’t get to take vacation on months that you are on call...and when you are on an elective and you are back up...you don’t get to take vacation when you are on back up....and it’s not like you get to skip being on back up.

In IM , the ACGME says you get 2weeks if vacation...if you are getting extra weeks, the the program has decided to give you extra weeks...and the ACGME doesn’t mandated that you as the resident gets to choose when you get to take the weeks off...heck there are programs out there that just schedule your weeks off and that’s all you get.

FM was the same - no vacation during call months, period.

 

[Giovanotto]

If they had a dislike button on this forum I'd be making it rain.

 

[Dr.LeoSpaceman]

If they had a dislike button on this forum I'd be making it rain.

MD aware.

 

[Raryn]

If they had a dislike button on this forum I'd be making it rain.

There's an angry button