Longer Shifts for First-Year Residents to Start in July

[Azete]

Yep. And as stated multiple other times: for many (most?) of us those of us that have done both (I was an intern in 2010-2011 and did 28-hour shifts and then switched to night float for junior residents in 2011), night float is way worse. Yes I am a surgery resident so I can only speak for surgery, and only at my institution, but I have heard from friends elsewhere in my specialty that they feel the same.

Being tired isn't fun but you know what? There are worse situations to be in. I'm inside, I'm warm, I can sit down in a chair sometimes to do my work, my socks are dry, I'm fed: I'm not in the military or other job out in the elements pulling long shifts or in an actual sweatshop. And on average I get a hell of a lot more respect than some of those people. I get that the idea of working an overnight shift sounds daunting to those of you who haven't actually done it, but there are those that HAVE who are telling you that 28 hours and going home to sleep/read/grocery shop postcall is far superior to being isolated on night float for a month at a time with a totally jacked up sleep schedule. Talk about losing your sanity. Those were the only months of residency that I honestly thought about quitting every day.

It's good to know $400k and 8 years of education will allow you the opportunity to work a job that's a little better than a sweatshop or freezing/starving outside. What a time to be alive.

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[SouthernSurgeon]

It's good to know $400k and 8 years of education will allow you the opportunity to work a job that's a little better than a sweatshop or freezing/starving outside. What a time to be alive.

Looked at another way - it allows you the opportunity to gain several years of highly valuable post-graduate training while being paid more than the average US household, then have a rapid increase in earning potential after those few years of training.

 

[radsisrad]

At least in my experience, the hell of having to do 28 hour shifts was trumped only by the hell of having to do 16 hour shifts as an intern day after day after day after day after day after day....

28 hour shifts suck, but you knock down a lot of your weekly hours with a couple of those and actually get a couple of real days off. As opposed to 16 hour shifts where you're working 5-6 days a week or worse yet 12 hour shifts where you're working 6 days a week all the time.

How many programs like this are there, apart from Gen Surg residencies? Most sign-outs on non-call days are at 5 or 6 - and that's really on the later side.

 

[Danbo1957]

Everything about medicine is easier now than thirty years-ago; especially imaging, drug development, advancements in treatment, advancements in the law, medical record keeping, electronic communications, the way humans treat each other in the workplace, and the hospital building itself. I did my Internal Medicine residency in the 1980's, the transition era between the Dark Ages of the 1970's and the Modern World. I did work those 120 hour weeks, and as I have stated previously, we worked for food and at times as an intern I would go several weeks not leaving the hospital grounds.

People died back then because there was nothing we could do for them, that has changed for the better. Patients are not "sicker" now versus then, with the exception that those who are beyond help from our treatments now are really sick (yes, they would have died 25 years ago). Fewer smokers in total numbers has made a huge difference in related morbidities.

Eighty hours a week is tough, but residency is infinitely easier today. We protect interns now, no longer do I see them sitting in the breakroom crying or sleeping on gurneys in the hallways... You're welcome.

 

[Azete]

Looked at another way - it allows you the opportunity to gain several years of highly valuable post-graduate training while being paid more than the average US household, then have a rapid increase in earning potential after those few years of training.

You're also working more hours than the average US household; the per hour compensation, accounting for overtime pay, is below minimum wage in some states.

 

[ProfMD]

People comparing residency to torture of POWs, sweat shops, etc need to get a grip.

 

[Light at end of tunnel]

People comparing residency to torture of POWs, sweat shops, etc need to get a grip.

In many ways, resident abuse is worse because it's perceived by many as a necessary evil to producing competent physicians.

Everyone would say POW torture is bad. But only some would say resident torture is bad' and therein lies the problem - it's the norm.

 

[ProfMD]

In many ways, resident abuse is worse because it's perceived by many as a necessary evil to producing competent physicians.

Everyone would say POW torture is bad. But only some would say resident torture is bad' and therein lies the problem - it's the norm.

Actually, the reason we get with saying residency is fine and POW torture is bad is because they are completely different.

 

[dr zaius]

People comparing residency to torture of POWs, sweat shops, etc need to get a grip.

Seriously.

I'm sorry you guys thought residency- the time where you actually learn how to be a doctor, practice your craft under supervision and guidance, and manage life/death/emotionally draining situations -was going to be a well rested cakewalk. And I'm sorry you may have to do a TY year and may be inconvenienced by a few 24 hour shifts before riding off into the derm/rad/whatever sunset. It's not what you signed up for (but really it is).

Working a 24+ shift with a post call day is far superior to 16 hour shifts. You get more sleep, and you have time to do life activities like grocery shopping. Mad because you don't get a set time for lunch? That's also part of the package, sorry. If this is all new to you then perhaps you didn't shadow enough. You're a doctor, not an investment banker.

 

[masaraksh]

Man I love this one too. Do you really think that there was a massive change in patient complexity in 2011 compared to 2010? Or 2002 compared to 2003?

I mean in "the good old days" one was able to choose from like 3 medicines - aspirin, heroin, or lasix and maybe 50 different herbs and tinctures, scribble the orders on some paper sheet, and get off in the call rooms. Seems like now with EMR, evidence based medicine, work compression, and like oversight we're like actually working hard and stuff

 

[Light at end of tunnel]

Seriously.

I'm sorry you guys thought residency- the time where you actually learn how to be a doctor, practice your craft under supervision and guidance, and manage life/death/emotionally draining situations -was going to be a well rested cakewalk. And I'm sorry you may have to do a TY year and may be inconvenienced by a few 24 hour shifts before riding off into the derm/rad/whatever sunset. It's not what you signed up for (but really it is).

Working a 24+ shift with a post call day is far superior to 16 hour shifts. You get more sleep, and you have time to do life activities like grocery shopping. Mad because you don't get a set time for lunch? That's also part of the package, sorry. If this is all new to you then perhaps you didn't shadow enough. You're a doctor, not an investment banker.

Investment bankers work like slaves, btw

 

[Goro femme]

In many ways, resident abuse is worse because it's perceived by many as a necessary evil to producing competent physicians.

Everyone would say POW torture is bad. But only some would say resident torture is bad' and therein lies the problem - it's the norm.

Torture-

1. the action or practice of inflicting severe pain on someone as a punishment or to force them to do or say something, or for the pleasure of the person inflicting the pain.
   
   Residency-grueling, inconvenient, demanding, at times distressing; NOT torture

 

[Astra]

People comparing residency to torture of POWs, sweat shops, etc need to get a grip.

In many ways, resident abuse is worse because it's perceived by many as a necessary evil to producing competent physicians.

Everyone would say POW torture is bad. But only some would say resident torture is bad' and therein lies the problem - it's the norm.

this is the stupidest thing I have ever read. In no way is residency worse than the torture of POWs.

 

[masaraksh]

As someone nearing the end of their medical internship, I'll say what's probably been said 1000x before: working overnight sucks, esp as part of a 24 hour shift. By the time the second half of the shift rolls around, I'm tired and can not function or learn, period. That plus having the constant schedule shifts would absolutely blow, and I don't see any convincing argument to the contrary.

I can see the argument of seeing a whole patient case get worked up and seeing it through w/ no gaps, but it's just not worth the detrimental effects on resident well-being, especially for years on end.

Hmmm that's weird. When I did my surg rotation and got to work at 5a, I was still fine come "second half" of the shift at 5p. Definitely still perfectly functional. The last bit at 1a-6a was hard... but 16hr shifts won't change the fact that working in the wee hours of the night can be tiring...

 

[Light at end of tunnel]

Just think about it for a bit before reacting to it. Maybe you'll see the point I'm trying to make.

 

[VA Hopeful Dr]

You're also working more hours than the average US household; the per hour compensation, accounting for overtime pay, is below minimum wage in some states.

With pretty much a guarantee of making 200k+ after 3-5 years. Yeah, that really blows

 

[Winged Scapula]

Have people forgotten how lucky we are?

Less than 1/3 of the US population has a college education. Many of them because they couldn't afford it or was told they weren't "college material". Some of them would literally give a body part (or eat a poop hotdog) to not only have a college degree but be able to go to medical school. Here we are talking about being mistreated. Some of you really need to see how the rest of the US and world lives.

Coming from a family with a Vietnam POW I find the residency comparison to such insulting and infuriating. I grew up hearing about the torture and residency was nowhere close.

I hope that I never let a day go by where I don't appreciate a family that fed and clothed me, paid for my education and sat by patiently as I followed my dream; as @LucidSplash notes, she's warm, fed, has a bed to sleep in and is paid for her work. She's not being tortured. Right now in every city in the US there are people, some just as smart as all of us, who don't know where their next meal is coming from, where they'll sleep tonight. Those of you who are claiming human rights violations need to get a grip.

 

[Winged Scapula]

Everything about medicine is easier now than thirty years-ago; especially imaging, drug development, advancements in treatment, advancements in the law, medical record keeping, electronic communications, the way humans treat each other in the workplace, and the hospital building itself. I did my Internal Medicine residency in the 1980's, the transition era between the Dark Ages of the 1970's and the Modern World. I did work those 120 hour weeks, and as I have stated previously, we worked for food and at times as an intern I would go several weeks not leaving the hospital grounds.

People died back then because there was nothing we could do for them, that has changed for the better. Patients are not "sicker" now versus then, with the exception that those who are beyond help from our treatments now are really sick (yes, they would have died 25 years ago). Fewer smokers in total numbers has made a huge difference in related morbidities.

Eighty hours a week is tough, but residency is infinitely easier today. We protect interns now, no longer do I see them sitting in the breakroom crying or sleeping on gurneys in the hallways... You're welcome.

Thanks for peeling back the onion.

 

[Light at end of tunnel]

Since time immemorial, it's been expected that physicians will sacrifice themselves for the profession. Rightly or wrongly, this is the case. In reality, it means that once a med student/resident has attained status they can expect others to offer their bodies up at the front lines as well.

It's interesting to note that those with status in this thread seem to manifest similar expectations.

 

[Winged Scapula]

Since time immemorial, it's been expected that physicians will sacrifice themselves for the profession. Rightly or wrongly, this is the case. In reality, it means that once a med student/resident has attained status they can expect others to offer their bodies up at the front lines as well.

It's interesting to note that those with status in this thread seem to manifest similar expectations.

Because we see what it takes. You have made a commitment to take care of others and that commitment doesn't exist just between 0900 and 1700. This is not about, "I did it so you must as well", despite conventional beliefs.

Dancers, professional athletes, anyone working the night shift also "offer up their bodies" for their profession. Its not just medicine.

I don't want anyone to work 120 hours per week and frankly no one will. The vast majority of residents will not even work 80 hours per week, most weeks. So there should be no concern about physical injury resulting from training. Programs are no longer asking/insisting residents lie about their work hours. That DID happen in the early days of work hour restrictions (my program did it) but most programs, especially the well regarded/big name ones, have no interest in harming their programs. We have plenty of current residents here who have no reason to lie, yet medical students and pre-med students continue to claim they will be asked to lie about their hours.

 

[Danbo1957]

Thanks for peeling back the onion.

Well to be honest about it all, we IM residents didn't have it as hard as general surgery residents, even in your era. You have all my respect for what you went through...

 

[dr zaius]

Because we see what it takes. You have made a commitment to take care of others and that commitment doesn't exist just between 0900 and 1700. This is not about, "I did it so you must as well", despite conventional beliefs.

Dancers, professional athletes, anyone working the night shift also "offer up their bodies" for their profession. Its not just medicine.

I don't want anyone to work 120 hours per week and frankly no one will. The vast majority of residents will not even work 80 hours per week, most weeks. So there should be no concern about physical injury resulting from training. Programs are no longer asking/insisting residents lie about their work hours. That DID happen in the early days of work hour restrictions (my program did it) but most programs, especially the well regarded/big name ones, have no interest in harming their programs. We have plenty of current residents here who have no reason to lie, yet medical students and pre-med students continue to claim they will be asked to lie about their hours.

This is very true.

The only way to provide a "normal" work week in residency while still producing adequately trained physicians would be to extend the residency period, especially in surgical fields. I'm fairly certain that this would not be popular at all as it would increase the time to receiving an attending paycheck and would also be added years without autonomy.

 

[Winged Scapula]

Well to be honest about it all, we IM residents didn't have it as hard as general surgery residents, even in your era. You have all my respect for what you went through...

Note that @Danbo1957 doesn't say, "sympathy".

There was no reason to feel sorry for me or other residents because we did what we needed to do and it has brought us

This is very true.

The only way to provide a "normal" work week in residency while still producing adequately trained physicians would be to extend the residency period, especially in surgical fields. I'm fairly certain that this would not be popular at all as it would increase the time to receiving an attending paycheck and would also be added years without autonomy.

Its not.

When US students and residents were asked if they wanted training more akin to Commonwealth countries (shorter hours, longer training), they overwhelmingly said "no".

But enough of this discussion, off to my pedicure appointment.

 

[guitr25]

Investment bankers work like slaves, btw

And get paid handsomely. Also some survive with aid of various chemicals, Is that what we want residents to do?

 

[guitr25]

Long list of misadventures from lack of sleep by med residents: read and weep:
Today the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decisionto increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect):

“I did my internship in internal medicine and residency in neurology before laws existed to regulate resident hours. My first 2 years were extremely brutal, working 110 – 120 hours/week, and up to 40 hours straight. I got to witness colleagues collapse unconscious in the hallway during rounds, and I recall once falling asleep in the bed of an elderly comatose woman while trying to start an IV on her in the wee hours of the morning.”

“I ran a red light driving home in residency after a 36 hour shift. Got pulled over. It was sobering: I was not fit to use my driver’s license, but I had just been using my MEDICAL license for over a day non-stop!”

“I have made numerous medication errors from being over tired. I also more recently misread an EKG because I was so tired I literally couldn’t see straight. She actually had a subarachnoid hemorrhage and by misreading the EKG I spent too much time on her heart and didn’t whisk her back to CT when she came in code blue. She died.”

“I fell asleep multiple times at the light at the intersection right at my neighborhood after call. I would see home was close and relax just enough. I had a baby and I was so afraid of forgetting him in the back seat if I ever had him with me I would put his bag in the front with me and my stuff in the back with him. Luckily, nothing bad happened in either situation but I just got lucky.”

“As a resident in a surgical specialty, my program routinely violated work hours, yet our attending physicians kept talking about how lucky we are because we have “work hour restrictions.” To fool my brain into not stopping, I’d lie to myself. I’d tell myself that if I just got out of bed at 3:30 one more time I could go to bed early that night, or if I just got through a few more notes I could go home and finish the rest tomorrow. I thought I could just keep going at that pace and nothing terrible would happened until I woke up in the ICU and a doctor told me I had tried to kill myself.”

“In general surgery residency I had one week in which I worked 125 hour….I did a weekend of 72 hours in which I only got 4 hours of sleep. I would secretly hope to get in a car accident and maybe break a leg so that I would be forced to take off from work…just so I could get some rest.”

“I have fallen asleep at the wheel thousands of times since medical school. I literally would wake up the next day in my work clothes and not even remember leaving the hospital. I drive from 45 min to 4 hrs to rural hospitals now and in training, currently working up to 7 straight 24’s in a row.”

“I was post call after a 30-hour shift and rear ended a car while driving uphill. No one was hurt but I remember the guy saying ” you hit me driving up hill.”

“I was so sleep deprived that I’d fall asleep while writing patient notes and write my dreams into the notes. I’ve fallen asleep on a pile of charts only to have the nurses cover me with blankets. I woke panicked because I was hours behind in my work. I’ve fallen asleep standing up in surgery and witnessed my attending doctors fall asleep while doing surgery. I actually passed out at the end of a 36-hour shift and woke up on a stretcher in the recovery room.”

“A dear friend from med school died during her neurosurgery residency. Drove over a median into a tractor trailer after a 30+ hour shift. She left behind her family, including a twin sister and her fiance. She was 30.”

 

[guitr25]

"Dancers, professional athletes, anyone working the night shift also "offer up their bodies" for their profession. Its not just medicine."

Interesting note, esp about athletes. Years later, football players are ending up killing themselves from TBI's. Should med students accept offering up their mental health as a valid admission to the exclusive medical club? Why? Because others jump off cliffs? Time to rethink long-heralded traditions.

 

[Light at end of tunnel]

And get paid handsomely. Also some survive with aid of various chemicals, Is that what we want residents to do?

That's not what I said, nor what I meant.

Investment bankers make WAY more money than residents, and attending physicians. They also work a ton of hours and their field isn't regulated by the likes of an ACGME-equivalent. So instead of apppealing to higher level authorities (which don't exist in their fields), they often do resort to what is available to them (a significant portion of which comes in the way of medication/stimulants).

There are always grave consequences for subjecting residents/med students to the conditions under which we function: more divorces, more depression, lower levels of subjective happiness, etc., not to mention the harm by way of mistake to our patients.

Prospectively, it feels terrible for those going through it. Retrospectively, it feels like a right of passage. I'm not sure there is a right or wrong...

 

[Light at end of tunnel]

Long list of misadventures from lack of sleep by med residents: read and weep:
Today the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decisionto increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect):

“I did my internship in internal medicine and residency in neurology before laws existed to regulate resident hours. My first 2 years were extremely brutal, working 110 – 120 hours/week, and up to 40 hours straight. I got to witness colleagues collapse unconscious in the hallway during rounds, and I recall once falling asleep in the bed of an elderly comatose woman while trying to start an IV on her in the wee hours of the morning.”

“I ran a red light driving home in residency after a 36 hour shift. Got pulled over. It was sobering: I was not fit to use my driver’s license, but I had just been using my MEDICAL license for over a day non-stop!”

“I have made numerous medication errors from being over tired. I also more recently misread an EKG because I was so tired I literally couldn’t see straight. She actually had a subarachnoid hemorrhage and by misreading the EKG I spent too much time on her heart and didn’t whisk her back to CT when she came in code blue. She died.”

“I fell asleep multiple times at the light at the intersection right at my neighborhood after call. I would see home was close and relax just enough. I had a baby and I was so afraid of forgetting him in the back seat if I ever had him with me I would put his bag in the front with me and my stuff in the back with him. Luckily, nothing bad happened in either situation but I just got lucky.”

“As a resident in a surgical specialty, my program routinely violated work hours, yet our attending physicians kept talking about how lucky we are because we have “work hour restrictions.” To fool my brain into not stopping, I’d lie to myself. I’d tell myself that if I just got out of bed at 3:30 one more time I could go to bed early that night, or if I just got through a few more notes I could go home and finish the rest tomorrow. I thought I could just keep going at that pace and nothing terrible would happened until I woke up in the ICU and a doctor told me I had tried to kill myself.”

“In general surgery residency I had one week in which I worked 125 hour….I did a weekend of 72 hours in which I only got 4 hours of sleep. I would secretly hope to get in a car accident and maybe break a leg so that I would be forced to take off from work…just so I could get some rest.”

“I have fallen asleep at the wheel thousands of times since medical school. I literally would wake up the next day in my work clothes and not even remember leaving the hospital. I drive from 45 min to 4 hrs to rural hospitals now and in training, currently working up to 7 straight 24’s in a row.”

“I was post call after a 30-hour shift and rear ended a car while driving uphill. No one was hurt but I remember the guy saying ” you hit me driving up hill.”

“I was so sleep deprived that I’d fall asleep while writing patient notes and write my dreams into the notes. I’ve fallen asleep on a pile of charts only to have the nurses cover me with blankets. I woke panicked because I was hours behind in my work. I’ve fallen asleep standing up in surgery and witnessed my attending doctors fall asleep while doing surgery. I actually passed out at the end of a 36-hour shift and woke up on a stretcher in the recovery room.”

“A dear friend from med school died during her neurosurgery residency. Drove over a median into a tractor trailer after a 30+ hour shift. She left behind her family, including a twin sister and her fiance. She was 30.”

---------

This is in fact the bitter truth.

 

[SouthernSurgeon]

---------

This is in fact the bitter truth.

Most of those are either blatant violations of ANY duty hour standards or complete fabrications (e.g. The one complaining about being scheduled for 7 consecutive 24 hr shifts)

 

[guitr25]

@Light at end of tunnel: As you note, you are not sure if there is a right or wrong. The irony in medicine is the thesis is health. Yet med students are taught from day one to expect to suffer, be insulted, abused physically & emotionally, cursed at, humiliated, etc. to prove themselves. I and many others argue this is not the only way to learn. Nor does it promote health. I agree caring for deathly ill patients is not 9-5. It is not for the faint of heart. But the health & well-being of others is also at stake when trainees are made to deprive themselves for years. Time for medical training programs to re-examine their methods.

 

[Light at end of tunnel]

Most of those are either blatant violations of ANY duty hour standards or complete fabrications (e.g. The one complaining about being scheduled for 7 consecutive 24 hr shifts)

Well, I'm just gonna put this out there for what's its worth: if we did feel that reporting violations to ACGME/LCME would change things positively (and also not get us fired/expelled by way of retribution), I think more ms/residents would actually report violations.

Personally, those examples can represent any one of us. I recall on my on/gym overnight rotation, we were expected to be at morning lecture the morning following a shift (so I would have been at work for about 20 hours or so). I was having double vision driving back to the lecture hall, so I called the coordinator to let them know I couldn't safely drive 40 minutes under that condition.

What doesn't kill us does make us stronger, but damn if it kills us it sure will.

 

[guitr25]

---------

This is in fact the bitter truth.

And you're ok with that?

 

[Light at end of tunnel]

And you're ok with that?

Like I said, I think the answer to that is one I don't have.

But to put one's head in the sand pretending that these things don't happen because of our conditions is reckless and inconsistent with how we are supposed to treat our fellow humans as physicians to begin with.

Sadly, medical school doesn't prepare you for the real world, only real tests.

 

[guitr25]

Well, I'm just gonna put this out there for what's its worth: if we did feel that reporting violations to ACGME would change things positively (and also not get us fired by way of retribution), I think more residents would actually report violations.

Personally, those examples can represent any one of us. I recall on my on/gym overnight rotation, we were expected to be at morning lecture the morning following a shift (so I would have been at work for about 20 hours or so). I was having double vision driving back to the lecture hall, so I called the coordinator to let them know I couldn't safely drive 40 minutes under that condition.

What doesn't kill us does make us stronger, but damn if it kills us it sure will.

This is where, at least under any other administration, OSHA would normally be pertinent. But to say that ACGME is allowed to continue the abuse, because how else do you pay off >$300,000 in loans, is the serious problem. That's why NP's and PA's will take over. When MD's and DO's give up.

 

[Light at end of tunnel]

This is where, at least under any other administration, OSHA would normally be pertinent. But to say that ACGME is allowed to continue the abuse, because how else do you pay off >$300,000 in loans, is the serious problem. That's why NP's and PA's will take over. When MD's and DO's give up.

I'm gonna go cry now. Ttyl.

 

[VA Hopeful Dr]

Most of those are either blatant violations of ANY duty hour standards or complete fabrications (e.g. The one complaining about being scheduled for 7 consecutive 24 hr shifts)

No kidding. I have never heard of anything like those stories and I'm married to an internist and have a cousin who's ortho. Stuff like that just doesn't happen.

 

[Light at end of tunnel]

No kidding. I have never heard of anything like those stories and I'm married to an internist and have a cousin who's ortho. Stuff like that just doesn't happen.

Most are afraid to speak up as I was right before calling in. But I realized that not doing so would be selfish of me as I would be subjecting other drivers to my technically illegal driving condition simply because I didn't want to be "that medical student."

No way I could justify running a red light and potentially taking an innocent life.

 

[VA Hopeful Dr]

Most are afraid to speak up as I was right before calling in. But I realized that not doing so would be selfish of me as I would be subjecting other drivers to my technically illegal driving condition simply because I didn't want to be "that medical student."

No way I could justify running a red light and potentially taking an innocent life.

So don't run red lights.

 

[Light at end of tunnel]

So don't run red lights.

@ThoracicGuy @gutonc; this one's for you

I finally understand; I think I've finally seen the light

 

[GUH]

You're not being honest if you think anyone is really learning a lot after working for 24 hours.
And 6X16 is still against the regulations.

 

[guitr25]

No kidding. I have never heard of anything like those stories and I'm married to an internist and have a cousin who's ortho. Stuff like that just doesn't happen.

My husband trained in the late 80's and I lived through his horrors. Thankfully no major incidents, but definitely falling asleep often when working. I now live in a.community where 2 families lost their medical student sons to suicide. Both managed to hide their distresses. Just like medical education taught them to. The stories are nationwide. The deaths are reported as "sudden" and hidden by whatever hospital or school they were from. So this is my other great concern. Medical education must be modified. The career should not be this dangerous.

 

[guitr25]

I'm gonna go cry now. Ttyl.

snowflaking? I do still keep a sense of humor, believe it or not.

 

[guitr25]

Well, I'm just gonna put this out there for what's its worth: if we did feel that reporting violations to ACGME/LCME would change things positively (and also not get us fired/expelled by way of retribution), I think more ms/residents would actually report violations.

Personally, those examples can represent any one of us. I recall on my on/gym overnight rotation, we were expected to be at morning lecture the morning following a shift (so I would have been at work for about 20 hours or so). I was having double vision driving back to the lecture hall, so I called the coordinator to let them know I couldn't safely drive 40 minutes under that condition.

What doesn't kill us does make us stronger, but damn if it kills us it sure will.

Now we at least have Uber. Maybe Residents should make that demand. Think I'll patent my idea.

 

[Winged Scapula]

Long list of misadventures from lack of sleep by med residents: read and weep:

If you're going to cut and paste someone else's work, you should cite them.

BTW, ask Dr. Wible how long ago these things happened and whether she verified them before stating them as fact.

 

[Light at end of tunnel]

WS,

To your knowledge, have any of those incidents been verified?

 

[VA Hopeful Dr]

View attachment 216090

@ThoracicGuy @gutonc; this one's for you

I finally understand; I think I've finally seen the light

I sincerely doubt they'll disagree with me.

Moving on though, I'm confused: does fatigue make you color blind? Why did you run the red light?

 

[Winged Scapula]

You're not being honest if you think anyone is really learning a lot after working for 24 hours.

Is someone saying that?

And 6X16 is still against the regulations.

No its not.

The rules are (from the ACGME press release yesterday):

80 hours per week averaged over 4 weeks; so you can work 6 x 16 as long as the average doesn't go over 80
8 hours between shifts
1 day off per week

6 x 16 meets those requirements

WS,

To your knowledge, have any of those incidents been verified?

No but I don't doubt that many of them occurred especially before 2003.

As @SouthernSurgeon notes, the veracity of some of them is doubtful. Even back in the cruel days, no one was on call for 72 hours straight.

This is such an emotional topic that I suspect the students aren't seeing the whole picture. None of us nor the ACGME is advocating going back to the pre-2003 hours.

I don't know where the sweet spot is for hours worked. Accidents do happen when people are tired. But there is stuff to be learned so either the hours are long and the years short, or vice versa. Maybe the answer is to go for a skill and knowledge based advancement system rather than a year/time based but that's ripe for abuse and subjectivity.

It doesn't help to accuse others of being ignorant or cruel nor to make comparisons to slavery or POWs.

 

[GUH]

Is someone saying that?

So are you admitting that learning may be diminished towards the tail end of a 24h+ shift?

And you can't work 6X16 two weeks in a row without breaking the rules. Using your same logic you could work 6X24's with 8 hour breaks in a row - which is possible but disallowed for extended periods.

 

[Light at end of tunnel]

I sincerely doubt they'll disagree with me.

Moving on though, I'm confused: does fatigue make you color blind? Why did you run the red light?

Not sure if you're being serious, but Ill offer the benefit of the doubt here:

Fatigue --> double vision --> impaired driving skills ---> reflection --> maybe I shouldn't drive --> call coordinator --> everybody lives --> great success

 

[VA Hopeful Dr]

So are you admitting that learning may be diminished towards the tail end of a 24h+ shift?

And you can't work 6X16 two weeks in a row without breaking the rules. Using your same logic you could work 6X24's with 8 hour breaks in a row - which is possible but disallowed for extended periods.

Yes, obviously you don't learn as well when tired.

And no, you must have 14 hours off after a 24 hour shift.