Softening of the surgical residency?

First, hours were reduced to 80 hours. Now there’s talk of part-time, or flexible resident hours. The lifestyle takeover of medicine continues.

Update:
Bard-Parker chimes in:

So does this paper offer a solution for a problem that does not exist? Maybe maybe not. With close to eighty percent of chief residents pursuing fellowship training of one form or another maybe extending the training would encourage more residents to stick with general surgery. I doubt it though, while the residency my be part-time one would be hard-pressed to find a part time private practice job right now. Maybe not so hard in the future. The patient population wants knowledgeable, well-rested, and attentive physicians. With the 80-hour workweek limits in training and the habits learned under that system spreading to the “real world”, two out of three isn’t bad.

Comments

Anonymous
Where’s TAPAYNE with his ranting and run-on paragraphs claiming they can only work part-time becuase they were all C students in college and Med school? Oh, he’s probaby tutoring some of those med students right now, turning those A’s into C’s and D’s.
Anonymous
Wait just one freaking minute here.
I dont know who wrote that “study” but they are obviously clueless when it comes to surgical residencies.
Demand for general surgery residencies is at an ALL TIME HIGH. If you go by number of applicants per position, then gen surg is harder to get into than every single specialty out there, including derm, rads, rad onc, etc.
There is absolutely no shortage of med students wanting to go into surgery. Its an absolute joke to claim otherwise.
If they need more surgeons, all they have to do is offer more residency slots. The demand is very strong for gen surg residency right now.
Anonymous
Surgery residents should work a minimum of 120 hours per week. They should not be allowed to marry or have children or pursue any activities that are not directly related to their medical education. They should not receive monetary compensation, but rather, suturing kits and books so they can have something to work on during their time off.
/typical attitude of every surgeon I have ever met
#1 Dinosaur
If by “lifestyle takeover of medicine” you mean treating medical trainees with the respect due them as adults, whose treatment at the hands of “mentors” through the ages has historically been somewhere between inappropriate and obnoxious, then I say “High time.”
It never made sense to me that treating people badly was a good way to mold them into caring individuals. “Toughening them up” doesn’t mean much to me either. Someone has to have the courage to break the cycle of “It was done to me, so by dog I’m going to do it to the next guy.”
Anonymous
Nobody ever figured out one thing: If you reduce surgery residents hours from 120 wk. to 40 per week, you give attending surgeons 100 hrs. week of paperwork between insurance issues, risk management and having to develop “legal plans” and take weeks off from work every time they get fucked up the ass by a lawyer, and who is going to take care of the patients? Medical students? PA’s? Sodomites? And who is going to pay for it?
Anonymous
gen surgery more competitive than derm or rad? Please do site your source because that is the first I have heard of that poppycock.
cdclled
“Demand for general surgery residencies is at an ALL TIME HIGH. If you go by number of applicants per position, then gen surg is harder to get into than every single specialty out there, including derm, rads, rad onc, etc.”
He’s right. I didn’t believe it either so I looked it up on the
AAMC website
The number of applications per derm spot is 1.16 whereas for general surgery it is 1.45
My guess is that this is the result of self selection.
Anonymous
I’m not a general surgeon, but the ones I refer to work horrendous hours doing excellent work. If you can only do a surgical residency if it is 40 hours per week, no one in private practice will hire you. If they are taking call for 36 hour shifts (and operating at midnight) and you sign in at 7A and out at 7P, you won’t be able to find a general surgery job.
Everyone seems to get excited about the work hours of training, but what about the work hours of practice? Therer are far more physicians in practice than in training. Don’t they endanger the lives of the citizens of NYC and beyond?
Part of training is having to make decisions when its not 8AM in the morning after a hearty breakfast and a kiss from mom. You develop the skills to use limited data and poor patient communication to make the best of a bad situation. Spoon feeding our young will not help them learn how to deal in those situations.
I didn’t like the belittling nature of the surgical clerkship experience either, but the general idea was to take your licks and continue to do the job. That is an important thing to learn in life. To succeed you have to develop the “big belly” necessary to digest the good and bad.
Anonymous
Alot of Medical students view surgery as the only “real” medical practice left, where you repair things and save lives. General practitioners are seen as spending their day on the phone fighting insurance companies, ER docs as babysitting drunks, psychiatrists as being Against Tom Hanks.
Anonymous
Exactly. So now that we’ve establsihed for a fact that surgery interest is at an ALL TIME HIGH, then why in the hell would we need to “soften” the residency to attract more candidates?
There is a surplus of candiates for surgery right now. Easing the training makes absolutely no sense.
Expanding the number of residency slots is the right answer. Those who fail to grasp that simple logic baffle me.
Anonymous
with regards to the aamc date, although the numbers of applicants to surgery programs is highest this does not mean that all of these applicants ranked surgery first. This is evident in the fact that when you look at figure 2 on page 7 of the report you will see that although there are a higher number of applicants per position, there is still a higher percentage matched who ranked surgery #1 than 4 other specialties excluding transitional years, i.e. there are four specialties more conpetitive than surgery.
Anonymous
sorry I meant aamc data, not date
Anonymous
you know what. im a surgical resident who didnt make it. and i loved what i was hoping to do. you cant imagine the feelings that you have for the rest of your life from leaving a program.
i am all for it. if someone goes 6-7 years i think they would be a good surgeon. maybe they wont do the most challenging of provedures. but im sure they woudl be competant to do routine operations.
i have already known pathology residents who added a year onto their residency. if anything they can maintain a healthier lifestyle.
when i was a surgical resident i was miserable. i was on call every 3rd night. and when i wasnt on call i was at home on call. its no fun being called into the hospital at 4 in the morning. i did not have a balanced life. i think it would be safe and effective to let them do a flexable program. do it.
WilliamManginoMD
Prior to entering the field of anesthesiology I did several years of surgical training.
The prevailing attitude was that the main problem with being ‘on call’ every other day was that you missed half of the good cases.
When I was an anesthesia attending at Baylor, in Houston, Mike DeBakey used to keep his surgical ICU rotations ‘in house’ for long periods of time.
There is something to be said for following the same [ your ] patients-on whom you’ve operated- until they got out of the unit and past any residual complications.
This continuity of care makes sense.
Sir William Osler said,”The masterword in medicine is work.”
The more cases you do-the better you are-usually. This goes for exposure to “cases” in any specialty.
Maybe it is true that doctors need to be like sequestered ‘monks’ during their training periods.
There are legitimate arguments on both sides of the coin.
The fact is-that if you have library time during the daytime hours in your residency- and lots of conferences and less time running around taking care of sick people’s complications and needs-then you may be in the wrong program.
You can dispute this all you want. Reading should be done at night and on weekends.
The sad fact is that if you are not working your ass off-you are getting shortchanged-in general-on your education.
You may disagree with me-but the fact remains.
Anonymous
When I was a resident..we didnt have no stinkin lifestyle..we lived in the hospital..ate in the hospital..if you wanted to take a crap you damn well better have done it on your own time…I even had to disimpact myself once…these young kids today dont know what rigorous means…i took ATLS when it was only “S”
Anonymous
I respect all of you who put in the time to become the great surgeons that you are, however as a PA student embarking on a 5 week rotation as a grown up with a responsibilities it appears that safety would be an issue if one is expected to put in 15 hour days 7 days a week. I presume making a medical error or perhaps driving my car into the guard rail would be frowned upon. Hence what is so unreasonable in having a medical professional that is well rested and ready to operate as opposed to one that is delirious from a lack of sleep and more prone to error. Just my opinion!

Softening of the surgical residency?

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