philic1013 said:
I'm currently an undergrad, and am trying to decide if I'm wasting all my time with the pre-med work.
I've always wanted to go into medicine, but recently, Dx'ed with Narcolepsy, which is covered under ADA laws. Its not that bad, no cataplexy, but I simply don't function if I cant get my 8-10 hours unbroken sleep.
How does this factor into a residency? I could never physically handle a 24/30 whatever hour shift, and my "sleep" is medicated so I couldn't do that when the going was slow.
Does anyone know if they make arrangements for people like this? Is it even possible? Anyone know of any success stories? I've been just telling myself I'll deal with it when I'm there, but the extra long shifts are unavoidable, I'm rethinking all the pre-med undergrad work I'm doing right now.
Opinions welcome,
Jason
Hi,
I can relate to your hesitation, but I don't think you're "wasting your time" with your pre-med work. I'm currently a resident and have delayed sleep-phase syndrome. Basically, my normal circadian rhythm is really shifted, so my natural "awake hours" are about 1 PM - 3 AM, and my "sleeping hours" are the opposite. Whenever I have an unregimented schedule (like when I was studying for boards), I fall into a schedule where I'm sleeping from about 4 AM to 2 PM the next day. I also have a long sleep requirement (ideally probably about 10-11 hours a night). Not a great match for med school or residency.
Here's how I've handled it. 1st and 2nd year are a lot like undergrad, except that you don't usually choose what time your classes start at. But you can still decide if you're going to go or not. My med school recorded all the lectures and put them online so I ended up watching many of them after they happened, something that worked great for me. I think most med schools do this.
3rd and 4th years, and then residency, are harder. But you and your sleep doctor should be able to come up with a med regimen that works for you. It won't be an ideal time of your life, and you're going to be more tired than you are now, but I think it's do-able. The majority of my months are q4 overnight call (so 30 hour shifts). It sucks, and I'm tired. But I make it work with meds (for me it's long and short-acting ritalin at different times depending on my schedule) on board. Do I like the fact that I need stimulants to do my job? No, but it works.
Here's some things to think about:
-Med students have some control over 3rd/4th year rotations. Required rotations are required rotations, but (at least at larger schools) you can pick amongst different sites, and you'll figure out which sites are more or less malignant
-There are definitly more and less demanding residencies, in regards to call schedule, average weekly hours, and so on
-Within each specialty, there are more and less demanding residency programs
-However, even if you end up at a less demanding residency program in a less demanding specialty, residency will still be hard. You will not be able to get 8-10 hours of unbroken sleep every night. I'm usually tired and I spend a lot of my time off sleeping. But it won't last forever
-Along those lines, residency is temporary, and after residency you can really choose your own schedule. Many people (esp in primary care) work part-time
-Some people choose to decelerate during med school and/or residency and take longer to complete. You might want to look at med schools/residency programs that offer this option
-There is a lot of research going on right now regarding residency work hours and the consequences acute sleep deprivation, chronic sleep deprivation, and disruption of normal circadian rhythms (all part of traditional residency programs). Change is slow in the medical world, but I anticipate that by the time you enter residency some of this new research will have positively affected the way residency education is carried out. I know not everyone agrees that limiting residency work hours is a good thing (especially those who aren't really affected by sleep deprivation) but for most of us it's a good thing.
I hope this helps. In the end you have to decide if it's worth it to you. If you can't picture yourself doing anything else with your life, then you'll find a way to make it work.
