6 ms·

Do you really work 90 hours? That's 13 hours a day 7 days a week. How does that even work logistically when you need to eat, sleep, commute, do laundry, shop fo

by erentz 10y ago

Do you really work 90 hours? That's 13 hours a day 7 days a week. How does that even work logistically when you need to eat, sleep, commute, do laundry, shop for food, and hopefully also see family or friends on occasion.

xanderstrike 10y ago
I'm assuming it's 90 billable hours. He said he waited two hours to do a ten minute procedure, sounds like most of his day is spent waiting rather than working.
- vacri 10y ago
  That's two hours that he can't be off with his family, reading a book, having a drink, learning to juggle rings, so on and so forth. It's definitely 'work', even if it is standing there twiddling your thumbs because you're waiting on colleagues.
northern_lights 10y ago
I am nearing the end of medical school now, and I can assure you there are many surgeons who consistently work 80-90 hours/wk. I see it most often in surgeons who have subspecialized and do extremely technical work. Family, social, laundry, food, etc, all become things that you take care of whenever you get a free second. It's very, very difficult to describe the path a person takes to get to that point, but the profession can absolutely be all-consuming. It's one of the reasons surgery is less competitive as a specialty than it used to be - people see the brutal hours and make the choice to pursue options with a more attractive work-life balance.
- sp332 10y ago
  Isn't that a little backwards though? The more surgeons there are, the more the work could be spread out, and the hours would be saner.
  - northern_lights 10y ago
    1.) It's a very time-consuming and hands-on process to train a surgeon. There aren't many other fields that I'm aware of with the same level of intense apprenticeship as surgery (and medicine in general). My first thought after entering medicine was to marvel at how much effort goes into training a single physician. There is a lot of training at between a 1:1 - 1:3 student-preceptor ratio in an effort to produce very high-quality physicians. So, the solution is not exactly as easy as, "well just make more surgeons." 2.) The federal government controls the number of residency slots each year, through Medicare funding for residency programs. I don't pretend to know the details of how it works, but my impression is that to get more residents per year, you need to convince Congress that it's necessary. 3.) Classic chicken-and-egg problem. Any medical student can go into surgery if they want to, unless their performance up till that point is seriously below par. However, there are many other specialties that offer more attractive lifestyles. So to increase the number of students who choose to do surgery, you'd need to find a way of signaling to students that the life of a surgeon isn't all back-to-back divorces, microwave dinners, and 80-90hr work weeks.
    - JBlue42 10y ago
      Q's re: #2 - If Congress were convinced of that, would that help lower medical costs for patients or possibly increase it? That's assuming without some sort of tax increase to pay for it. #3 - I guess this why I've heard that dermatology is one of the most competitive fields to get into - good hours, not as much stress, and good pay.
FreedomToCreate 10y ago
And get time to read articles on HN
- wernercd 10y ago
  What do you think he does in the 110 minute he was waiting to do the 10 minute procedure?
cloverich 10y ago
I still remember the first day of my surgery rotation, when the head surgeon came in to give us a lecture: "Sorry if I'm a bit off, I just finished a 30 hour shift and haven't slept yet." lol. It varies greatly by specialty and program but I can assure there are physicians who literally test the limits of how much you can work in a week.
- adamweld 10y ago
  That sounds incredibly dangerous. I don't doubt that it happens, but I'd much prefer the person cutting me open to not be fatigued and exhausted.
  - cloverich 10y ago
    It is. In surgical specialties, until very recently it not only happened but was absolutely normal and expected. I had one attending outright tell us that we (students) were not allowed to sleep on our 30 hour on-call shifts. To give some context, it is only recently that rules were passed to limit those hours -- to 80 (!!!) per week. However, this is a vestige of the old culture and is slowly but surely being replaced both by new rules and, generally speaking, a better culture. http://www.acgme.org/What-We-Do/Accreditation/Duty-Hours http://www.acgme.org/What-We-Do/Accreditation/Duty-Hours
lloyd-christmas 10y ago
My father is an oncologist. He's out the door before 5am and gets home at 7:30.
Spooky23 10y ago
When I had my back surgery, my doc was there at 630a when I arrived for a 730a surgery, which took about 6 hours. He met me at 800p in PT to check on me. I asked and he told me that was a fairly typical surgery day.
lightbendover 10y ago
My wife is a neurosurgeon in residency and she absolutely works 90-~110 hours just about every week. She barely sleeps and eats one or two big meals a day (almost always ordered from Seamless), we have to live within a couple blocks of the hospital, and I just don't see how she would survive on her own if I wasn't around as far as food/laundry/etc.. is concerned -- I think that answers all of your questions.

by erentz 10y ago

xanderstrike 10y ago

I'm assuming it's 90 billable hours. He said he waited two hours to do a ten minute procedure, sounds like most of his day is spent waiting rather than working.

vacri 10y ago
That's two hours that he can't be off with his family, reading a book, having a drink, learning to juggle rings, so on and so forth. It's definitely 'work', even if it is standing there twiddling your thumbs because you're waiting on colleagues.

northern_lights 10y ago

I am nearing the end of medical school now, and I can assure you there are many surgeons who consistently work 80-90 hours/wk. I see it most often in surgeons who have subspecialized and do extremely technical work. Family, social, laundry, food, etc, all become things that you take care of whenever you get a free second. It's very, very difficult to describe the path a person takes to get to that point, but the profession can absolutely be all-consuming. It's one of the reasons surgery is less competitive as a specialty than it used to be - people see the brutal hours and make the choice to pursue options with a more attractive work-life balance.

sp332 10y ago
Isn't that a little backwards though? The more surgeons there are, the more the work could be spread out, and the hours would be saner.
- northern_lights 10y ago
  1.) It's a very time-consuming and hands-on process to train a surgeon. There aren't many other fields that I'm aware of with the same level of intense apprenticeship as surgery (and medicine in general). My first thought after entering medicine was to marvel at how much effort goes into training a single physician. There is a lot of training at between a 1:1 - 1:3 student-preceptor ratio in an effort to produce very high-quality physicians. So, the solution is not exactly as easy as, "well just make more surgeons." 2.) The federal government controls the number of residency slots each year, through Medicare funding for residency programs. I don't pretend to know the details of how it works, but my impression is that to get more residents per year, you need to convince Congress that it's necessary. 3.) Classic chicken-and-egg problem. Any medical student can go into surgery if they want to, unless their performance up till that point is seriously below par. However, there are many other specialties that offer more attractive lifestyles. So to increase the number of students who choose to do surgery, you'd need to find a way of signaling to students that the life of a surgeon isn't all back-to-back divorces, microwave dinners, and 80-90hr work weeks.
  - JBlue42 10y ago
    Q's re: #2 - If Congress were convinced of that, would that help lower medical costs for patients or possibly increase it? That's assuming without some sort of tax increase to pay for it. #3 - I guess this why I've heard that dermatology is one of the most competitive fields to get into - good hours, not as much stress, and good pay.

FreedomToCreate 10y ago

And get time to read articles on HN

wernercd 10y ago
What do you think he does in the 110 minute he was waiting to do the 10 minute procedure?

cloverich 10y ago

I still remember the first day of my surgery rotation, when the head surgeon came in to give us a lecture: "Sorry if I'm a bit off, I just finished a 30 hour shift and haven't slept yet." lol. It varies greatly by specialty and program but I can assure there are physicians who literally test the limits of how much you can work in a week.

adamweld 10y ago
That sounds incredibly dangerous. I don't doubt that it happens, but I'd much prefer the person cutting me open to not be fatigued and exhausted.
- cloverich 10y ago
  It is. In surgical specialties, until very recently it not only happened but was absolutely normal and expected. I had one attending outright tell us that we (students) were not allowed to sleep on our 30 hour on-call shifts. To give some context, it is only recently that rules were passed to limit those hours -- to 80 (!!!) per week. However, this is a vestige of the old culture and is slowly but surely being replaced both by new rules and, generally speaking, a better culture. http://www.acgme.org/What-We-Do/Accreditation/Duty-Hours http://www.acgme.org/What-We-Do/Accreditation/Duty-Hours

lloyd-christmas 10y ago

My father is an oncologist. He's out the door before 5am and gets home at 7:30.

Spooky23 10y ago

When I had my back surgery, my doc was there at 630a when I arrived for a 730a surgery, which took about 6 hours. He met me at 800p in PT to check on me. I asked and he told me that was a fairly typical surgery day.

lightbendover 10y ago

My wife is a neurosurgeon in residency and she absolutely works 90-~110 hours just about every week. She barely sleeps and eats one or two big meals a day (almost always ordered from Seamless), we have to live within a couple blocks of the hospital, and I just don't see how she would survive on her own if I wasn't around as far as food/laundry/etc.. is concerned -- I think that answers all of your questions.