so how grueling is a peds residency, really?

[care bear]

day in the life of a peds resident. . .miserable? no time for yourself? or is it do-able after intern year?

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[iatrosB]

day in the life of a peds resident. . .miserable? no time for yourself? or is it do-able after intern year?

Phillipianes 4:13

Seriously though, it varies by program. I would say between 65 and 90 hours a week. Not as bad as the old days but still no picnic.

 

[care bear]

thanks dude. . . but you're not in med school yet! but honestly, thanks, especially for the verse.

looking for more firsthand-type experience, though. . ..

 

[fourthyearmed]

Well, it's not going to be more than 80 hours a week. A lot will depend on the rotation you're on that month. Most places say NICU and PICU are their hardest months. If you're at a big tertiary care center you'll probably have a bigger patient load than you would at a smaller program. But all in all from what I've seen at my own school and the schools I've done interviews and externships at, life is possible. Many peds residents are married with kids and those who aren't have free time to hang out together.

 

[KidDr]

Well, it's not going to be more than 80 hours a week.

Well...I wish that was the case but this unfortunately isn't true. Definitely depends on where you are training. When interviewing, make sure you get the real story from the residents about their work hours...

 

[iatrosB]

Well...I wish that was the case but this unfortunately isn't true. Definitely depends on where you are training. When interviewing, make sure you get the real story from the residents about their work hours...

Yeah, I've heard the 80 hour work week is an urban legend. I really wish programs would follow the rules!

 

[KidDr]

Yeah, I've heard the 80 hour work week is an urban legend. I really wish programs would follow the rules!

You and me both!!

 

[fourthyearmed]

Well, I recently did externships at 3 top programs and none of them seemed to be in violation of the 80 hr work week while on the wards where I was working. Maybe during PICU or NICU they ran over but no one complained of feeling overworked in general. Faculty seemed almost obsessed with getting people out on time and strict records of work hours were logged.

 

[J123]

Programs differ, and have become strict about the 80 hour rule. There's no urban legend, and there are big time penalties for not being in compliance. Nobody wants to lose their program or be put on probation for that. However, I will say that you have to figure out what kind of learner you are and look for a program to fit that. Some people learn best by seeing a lot of patients, so that you will see several diagnoses over, and over, and over so that there is a pattern recognition situation. Others can't do that and prefer to spend more time on fewer patients. Personally, I think bigger programs where you are exposed to a higher volume of patients is better. You simply see more things, and you tend to see more common things more often. One thing I would ask, however, is what your outpatient experience will be like. In other words, if you're doing your primary care clinic at the tertiary care hospital, you will tend have a higher percentage of "specialty" and special needs pts, which is not generally the mix in an office-based practice. So many programs that are based at tertiary centers have community-based general peds rotations which will give you the feel of what office-based peds is like. Finally, you only get a few months of ICU experience, make the most of it. You will work hard, and you may not enjoy it all the time, in fact you may hate it. But if you can learn the basics of the initial resuscitation of a critically ill patient, you can have a positive impact on the survival or overall outcome of that one really sick kid who may be booked into your "routine" clinic on any given day. (Sorry for the soapbox)
Oh, yes, as far a "having a life goes". Not a problem. Where there's a will there's a way. Hopefully your spouse/family will be understanding of the fact that there will be busy times during your training. It's only 3 years, and after that you can tailor your job to your lifestyle.

 

[Lara]

On that subject...would you advise me to take a PICU elective fourth year? I feel like I could use the advance training before residency, but that would mean another tough month on top of the sub-I.

btw - is it really soooo much worse in winter? The scutwork reviews for Pittsburgh Children's quoted a resident as saying it's bad enough to make you cry! I really regret doing peds block 2 since I feel as if I'm not exactly making an informed decision here (although I'm fairly confident I'd prefer it to medicine even during the worse times).

 

[KidDr]

Programs differ, and have become strict about the 80 hour rule. There's no urban legend, and there are big time penalties for not being in compliance.

Again, I'll just reinterate that not all peds programs are in compliance (to say nothing of other specialties). The only reason I'm harping on this is because I think applicants have a right to know this when considering residency positions, but programs not completely in compliance may not be the most forthcoming with this info.

It's my sense that most peds program have taken the 80 hr workweek seriously, track resident's hours, and are making it work. But there are still at least a few programs that, despite the threat of penalties, are not. If this is something that's important to you, you need to talk to the residents at the programs you're interviewing at and get the real story, because there's plenty of places out there where you can get a great education without working >80 hrs/week!

 

[J123]

On that subject...would you advise me to take a PICU elective fourth year? I feel like I could use the advance training before residency, but that would mean another tough month on top of the sub-I.

btw - is it really soooo much worse in winter? The scutwork reviews for Pittsburgh Children's quoted a resident as saying it's bad enough to make you cry! I really regret doing peds block 2 since I feel as if I'm not exactly making an informed decision here (although I'm fairly confident I'd prefer it to medicine even during the worse times).

I'd agree that an elective in PICU would be another tough month, but I think you'd be better prepared for that rotation when you get there in residency. Not all programs have interns rotating in PICU, so you'd actually have prior PICU experience that would help you with your ward rotations. Others may disagree, and I will admit I'm biased towards PICU (PICU in training), but having done general peds in a prior life in a community hospital, I can't tell you how often I used my critical care "skills", esp in the ED.

Yes, it is worse in winter no matter where you go. And when there are more patients, there's more scutwork...and the scut never goes away, someone's got to do it, a fair portion is non-educational, and it continues to fall on those who are lowest in the food chain. That being said, if a busy rotation like that can help you become more efficient at gathering data, prioritizing tasks, etc, then I would do it. I used those types of skills every day in clinic!!
Best of luck to you!
PS-I felt the same way about my medicine rotations...

 

[Doc-Hollywood]

You and me both!!

I will say only one thng to you guys

1. the "80 hour rule" is very new , and a lot of us that trained without it , regard you training with it as somehow below par.
As an intern ,when I thought I had it rough, I was doing a month as in the after hours outpatient clinic, working with a different private medical staff each night.
One night I worked with a real old timer who did his residency in the 50's
He told me that they didn't even get paid as a resident. They got a stipend for room and board. He took call every other night, and on his "night off" ( you newbies will call this post-call ) he worked as an insurance adjuster to make ends meet

as an attending , I often go over 80 hrs in some weeks. there is no chicken-**** ACGME group complaining on my behalf. I just do my time and function. that's life ( I trained like that so I am used to it. It's become second nature )

many of you might work some rough hours once OUT of residency. You will certainly run across a grey-haired attending that will pull all weekend in-house on service, while he goes through 2 fellows and 4 residents
Frankly, I am pretty embarrassed at the sudden onset of ***** wimp attitude with you folks training in my profession. I hope you can hack it once you are done if God forbid you must put in an 81 hr week and have no agency to fight on your behalf.

I think the whole 80 hr garbage ought to be scrapped. It's a joke to the rest of american physicians that trained in the old system and regard the new bunch of whiners as people that don't deserve yo be admitted into the club

Just one time I would like to not see new residents whining about some work hour restrictions! Get some cajones !

 

[tkrohn]

Sounds like someone's jealous of the new work hour regulations! So sorry you old-timers didn't have the good sense to establish them yourselves, but please get over your bitterness and stop bitching.

 

[fourthyearmed]

Again, I'll just reinterate that not all peds programs are in compliance (to say nothing of other specialties). The only reason I'm harping on this is because I think applicants have a right to know this when considering residency positions, but programs not completely in compliance may not be the most forthcoming with this info.

It's my sense that most peds program have taken the 80 hr workweek seriously, track resident's hours, and are making it work. But there are still at least a few programs that, despite the threat of penalties, are not. If this is something that's important to you, you need to talk to the residents at the programs you're interviewing at and get the real story, because there's plenty of places out there where you can get a great education without working >80 hrs/week!

Since you're harping on it, can you give us some names? Every program I've interviewed at the residents and faculty assure us that they are in compliance. How do we find out the truth?

 

[edmadison]

Yeah and what is it with all this medical technology. Back in my day we didn't have vaccines. It just made the kids tougher.

Come on. Wake up. The 80 hour work week is a good thing. If you don't believe that, take a poll of how many doctors would wan't to be operated on by surgeons who haven't slept in 35 hours. If a program is dedicated to removing the stupid tasks that waste time with no educational value the cost will be small -- at least in specialties that don't require manual skills such a surgery. Reach in the wallet and hire a few PAs to take care of the scut.

As for the hours one works as an attending, I wish I could smack every attending who tells me, "there's no 80 work rule for us." You guys pick the hours you work and you get paid well for what you do. It's not like you're going to starve to death if you work part time.

Ed

 

[iatrosB]

I will say only one thng to you guys

1. the "80 hour rule" is very new , and a lot of us that trained without it , regard you training with it as somehow below par.
As an intern ,when I thought I had it rough, I was doing a month as in the after hours outpatient clinic, working with a different private medical staff each night.
One night I worked with a real old timer who did his residency in the 50's
He told me that they didn't even get paid as a resident. They got a stipend for room and board. He took call every other night, and on his "night off" ( you newbies will call this post-call ) he worked as an insurance adjuster to make ends meet

as an attending , I often go over 80 hrs in some weeks. there is no chicken-**** ACGME group complaining on my behalf. I just do my time and function. that's life ( I trained like that so I am used to it. It's become second nature )

many of you might work some rough hours once OUT of residency. You will certainly run across a grey-haired attending that will pull all weekend in-house on service, while he goes through 2 fellows and 4 residents
Frankly, I am pretty embarrassed at the sudden onset of ***** wimp attitude with you folks training in my profession. I hope you can hack it once you are done if God forbid you must put in an 81 hr week and have no agency to fight on your behalf.

I think the whole 80 hr garbage ought to be scrapped. It's a joke to the rest of american physicians that trained in the old system and regard the new bunch of whiners as people that don't deserve yo be admitted into the club

Just one time I would like to not see new residents whining about some work hour restrictions! Get some cajones !

The tone of this post is not in line with the tone of the peds forum. Someone so bitter and cold obviously has not spent significant time in the peds forum and I would dare say is not a practicing pediatrician. If he/she is, I wouldn't take my kid to such a player hater.

 

[care bear]

I will say only one thng to you guys

1. the "80 hour rule" is very new , and a lot of us that trained without it , regard you training with it as somehow below par.
As an intern ,when I thought I had it rough, I was doing a month as in the after hours outpatient clinic, working with a different private medical staff each night.
One night I worked with a real old timer who did his residency in the 50's
He told me that they didn't even get paid as a resident. They got a stipend for room and board. He took call every other night, and on his "night off" ( you newbies will call this post-call ) he worked as an insurance adjuster to make ends meet

as an attending , I often go over 80 hrs in some weeks. there is no chicken-**** ACGME group complaining on my behalf. I just do my time and function. that's life ( I trained like that so I am used to it. It's become second nature )

many of you might work some rough hours once OUT of residency. You will certainly run across a grey-haired attending that will pull all weekend in-house on service, while he goes through 2 fellows and 4 residents
Frankly, I am pretty embarrassed at the sudden onset of ***** wimp attitude with you folks training in my profession. I hope you can hack it once you are done if God forbid you must put in an 81 hr week and have no agency to fight on your behalf.

I think the whole 80 hr garbage ought to be scrapped. It's a joke to the rest of american physicians that trained in the old system and regard the new bunch of whiners as people that don't deserve yo be admitted into the club

Just one time I would like to not see new residents whining about some work hour restrictions! Get some cajones !

it's not a 'club', it's a career. i want to have children of my own, preferably in my prime childbearing years. there's no reason i should have to forgo that, or that my kids should have to suffer so that I can help other sick kids. that is why i started this thread and if it makes me a '*****', well. . .what can i say. i am a woman. that's all the term '*****' means anyway. a deragatory way of referring to a man, saying that he is like a woman because he is not being tough in a certain situation.
i reject that whole paradigm. i have NO need to prove my toughness. of course if there's a good reason not to leave the hospital, i understand that. but i am not looking for a lifestyle of wearing myself into the ground unneccesarily. and it doesn't have to be the physician lifestyle. but i suppose all physicians in europe and australia. . heck, just about everywhere else in the world. . . are '*******', too. oh well. at least their kids get to know them!

i apologize for the frustrated tone of this post, but i think it's inevitable whenever there is such a clash of paradigms. i probably wouldn't say this out loud to an attending in person, but then again, you probably wouldn't say what you said out loud to medical students and residents either.

 

[kas23]

The tone of this post is not in line with the tone of the peds forum. Someone so bitter and cold obviously has not spent significant time in the peds forum and I would dare say is not a practicing pediatrician. If he/she is, I wouldn't take my kid to such a player hater.

Yes, I agree. What the heck. This is a forum for the lowly baby doctor. C'mon, we aren't real doctors (like surgeons are), so lay off the heavy words. We like being lazy and the 80-hr work week is our savior. Bring your harsh words to the derm forum.

 

[augmel]

Sorry but I have to agree with the above poster that not all programs are in compliance. I spent 3 months last summer at a top 10 school in which they had a system to try and get below 80 hours but I never saw any attempt at enforcing the 30 hour limit. People were there post call till 5 all the time. I don't know if the interns were under 80 or not. The residents probably were.

 

[aphistis]

I will say only one thng to you guys

1. the "80 hour rule" is very new , and a lot of us that trained without it , regard you training with it as somehow below par.
As an intern ,when I thought I had it rough, I was doing a month as in the after hours outpatient clinic, working with a different private medical staff each night.
One night I worked with a real old timer who did his residency in the 50's
He told me that they didn't even get paid as a resident. They got a stipend for room and board. He took call every other night, and on his "night off" ( you newbies will call this post-call ) he worked as an insurance adjuster to make ends meet

as an attending , I often go over 80 hrs in some weeks. there is no chicken-**** ACGME group complaining on my behalf. I just do my time and function. that's life ( I trained like that so I am used to it. It's become second nature )

many of you might work some rough hours once OUT of residency. You will certainly run across a grey-haired attending that will pull all weekend in-house on service, while he goes through 2 fellows and 4 residents
Frankly, I am pretty embarrassed at the sudden onset of ***** wimp attitude with you folks training in my profession. I hope you can hack it once you are done if God forbid you must put in an 81 hr week and have no agency to fight on your behalf.

I think the whole 80 hr garbage ought to be scrapped. It's a joke to the rest of american physicians that trained in the old system and regard the new bunch of whiners as people that don't deserve yo be admitted into the club

Just one time I would like to not see new residents whining about some work hour restrictions! Get some cajones !

Come on, folks. A new user, with fewer than 10 posts, comes from nowhere to make a condescending post about how much better he supposedly is than everyone here, and then disappears? I can't believe y'all didn't see "TROLL" blinking in neon letters before your eyes.

 

[jdog]

I am half way through a pediatrics program. I am usually in compliance with 80 hr but not sometimes. To put things in perspective, Pediatrics residency is a JOKE complared to surgery residency. Not even in the same planet. I am sorry if this insults anyone, but after just having hung out for a few days with my old roomate from meds school who is a surg resident, he is out the door by 4 am EVERY SINGLE DAY and he has to do this for 5 years. Often he gets home after 9 pm and takes q3 call.

Pediatrics aint that bad in the grand scheme.

Now, compared to some other specialties Peds is gruelling. Keep in mind that you can learn a lot of peds on the job.

Other specialties that may appear to be really easy such as Rads and Path, they have to read very extensively outside of work.

I would say that Peds on average is easier than IM and all surgical subspecialites.

 

[KidDr]

Since you're harping on it, can you give us some names? Every program I've interviewed at the residents and faculty assure us that they are in compliance. How do we find out the truth?

That's great that all the programs you've interviewed at are in compliance, and it seems like most programs are. In regards to the programs I know of that are not in compliance, I'm not going to name them, but they are both "top" programs. Look, I don't need to name them--you'll figure it out on the interview trail. As long as you probe a little bit, people will tell you what's going on.

I realize that for some people, this issue isn't a big deal, and I respect that. I just think that med students have a right to know what they're getting into with residency. In most other jobs we wouldn't have to do detective work to figure it out, but that's sometimes the way it is with applying for residency.