4 ms·

In medical school, 120 hour weeks really only exist for 4th year med students who are on sub-internships in surgical specialties like neurosurgery, orthopedic s

by jac241 8y ago

In medical school, 120 hour weeks really only exist for 4th year med students who are on sub-internships in surgical specialties like neurosurgery, orthopedic surgery, general surgery, etc. Students in those fields do 3 or so month long sub-i's at hospitals they want to do residency at. They basically function as month long interviews for those programs, and are also used to get letters of recommendation from prominent faculty in the field. People who are interested in those fields know about the hour requirements on sub-i's and in residency, and self-select in a way. The reason resident physicians work so much is because residents make $60k working 80+ hour weeks, and the PAs or NPs who would be willing to cover the floors at night would make $150k+ working 40hrs/wk. Residents also have no collective bargaining power because of the residency match system. You can't easily leave one program and go to another because you don't like the working conditions, for example. If you want to leave, you're more or less blackballed unless you're switching fields. And you don't want to speak up about the conditions because you've got $300k in debt and a degree that's useless until you finish residency.

gerbilly 8y ago
So they are being taken advantage of then. Sounds like they should just legislate away the "Residency match system."
- jac241 8y ago
  Ironically, congress passed a law in 2004 to give the NRMP, the organization that runs the match, immunity from antitrust legislation. https://en.wikipedia.org/wiki/National_Resident_Matching_Program#Lawsuit https://en.wikipedia.org/wiki/National_Resident_Matching_Pro...
sxg 8y ago
I'm currently in my 4th year of medical school, and I have to clarify your comment on the hours worked. We're held to the same hours limits as residents, which is 80 hrs/week averaged over 4 weeks and an average of 1 day off per 7 days. We most often come near these hours on surgical specialty rotations (like the ones you noted). However, these are completely voluntary rotations. I'm not interested in surgery, and I have no surgery rotations scheduled at all during this year. Most of this year is actually spent on residency interviews. I've been traveling to different cities in the US about twice per week since October, and will continue through the end of January with breaks for the holidays. I have no hospital duties from September–January. The 3rd year of medical school is much tougher since we spend about 10 months of that year on rotations in the hospital. While some rotations are much lighter, others like surgery again get close to the hours limits. This is complicated by the shelf exams we take every 8–12 weeks. These require an additional ~2–3 hours/day of studying and most of a weekend day as well. Obviously, this study time is not counted towards the hours limits, but it definitely factors into fatigue and burn out.
- jchanimal 8y ago
  Where do we go to change that 80 to 32? This thread is making me feel unsafe.
  - sxg 8y ago
    So the other side of this problem is resident education. The ACGME in conjunction with medical specialty boards govern the requirements for graduating from residency. There are hard requirements on how many and which kinds of procedures you need to do and patients you need to treat over the course of your residency. Residents meet those requirements with the current average 80 hrs/week and ~3–5 years of training. Moving from 80 to 32 hrs/week would likely require an expansion of training time to ~6–10 years, which residents would be absolutely against (I know I would be). I've been in school forgoing a "real job" with a salary for nearly a decade, and I'll be in my mid-30s before I become an independently practicing physician under the current system. Although the work hours are abhorrent, I don't want to add more years to my training in exchange for better hours.

by jac241 8y ago

gerbilly 8y ago

So they are being taken advantage of then. Sounds like they should just legislate away the "Residency match system."

jac241 8y ago
Ironically, congress passed a law in 2004 to give the NRMP, the organization that runs the match, immunity from antitrust legislation. https://en.wikipedia.org/wiki/National_Resident_Matching_Program#Lawsuit https://en.wikipedia.org/wiki/National_Resident_Matching_Pro...

sxg 8y ago

I'm currently in my 4th year of medical school, and I have to clarify your comment on the hours worked. We're held to the same hours limits as residents, which is 80 hrs/week averaged over 4 weeks and an average of 1 day off per 7 days. We most often come near these hours on surgical specialty rotations (like the ones you noted). However, these are completely voluntary rotations. I'm not interested in surgery, and I have no surgery rotations scheduled at all during this year. Most of this year is actually spent on residency interviews. I've been traveling to different cities in the US about twice per week since October, and will continue through the end of January with breaks for the holidays. I have no hospital duties from September–January. The 3rd year of medical school is much tougher since we spend about 10 months of that year on rotations in the hospital. While some rotations are much lighter, others like surgery again get close to the hours limits. This is complicated by the shelf exams we take every 8–12 weeks. These require an additional ~2–3 hours/day of studying and most of a weekend day as well. Obviously, this study time is not counted towards the hours limits, but it definitely factors into fatigue and burn out.

jchanimal 8y ago
Where do we go to change that 80 to 32? This thread is making me feel unsafe.
- sxg 8y ago
  So the other side of this problem is resident education. The ACGME in conjunction with medical specialty boards govern the requirements for graduating from residency. There are hard requirements on how many and which kinds of procedures you need to do and patients you need to treat over the course of your residency. Residents meet those requirements with the current average 80 hrs/week and ~3–5 years of training. Moving from 80 to 32 hrs/week would likely require an expansion of training time to ~6–10 years, which residents would be absolutely against (I know I would be). I've been in school forgoing a "real job" with a salary for nearly a decade, and I'll be in my mid-30s before I become an independently practicing physician under the current system. Although the work hours are abhorrent, I don't want to add more years to my training in exchange for better hours.