Shortening work hours, lengthening residency

Rumor has it that resident work hours will be shortened to 56-hours per week. How to make up the experience? Add a year to residency of course.

I wonder how many medical students would support that, considering the burden of $140,000 they have in school loans waiting to be repaid.

Robert Centor with further thoughts.

Comments

Alyssa
As an upcoming third year, I haven’t had the good fortune of having 30 hour shifts just yet. But I’m also an older student and a woman who wants a family, and I have to say, 80 hour weeks still seems pretty daunting to me and my fiance when we think about starting a family. Kids take time and I want to have the time to be home at least semi-normal hours. Maybe this isn’t an issue for a lot of future residents, but from my point of view, I’d rather take an extra year and have a more humane schedule. Sure it’s extra interest on my loans, but it’s a compromise I’d be willing to live with.
Doc99
A recent article by Barden et al. from New York Presbyterian Hospital-Weill Medical College of Cornell University serves as an objective example of commentary about resident work hours from those who have experienced the Bell Regulations. 2 These authors examined their own program. Though they looked at resident attitudes towards work hours, other parameters were also examined: faculty attitudes, ABSITE scores, and chief resident case numbers. Additionally, they delineated when and how their program altered its resident work hours. They concluded that the reduction in work hours has had subjective and objective benefits on quality of life and resident education but has had a negative impact on resident and attending perception of patient care.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1514464
Anonymous
As the above poster shows, the old guard is dead.
Once a upon a time (the 1990s) the concept was that you put your life on hold during residency. The theory was that this time was dedicated to learning your craft well.
Of course, back then it was normal to expect that any doc who knew her (his?) craft well would make a decent living.
Techinically, the economics came home to roost: Medicaid paid fees that vary from joking to insulting and medicare pays poorly.
Private insurance is following suit.
The system punished those who put their lives on hold. Now we have a new generation who is much less naive than we were.
I only hope they enough not to hurt me when I am sick. They will not gain the clinical knowlege they need in residency – perhaps in fellowship or in the 1st few years of practice?
Anonymous
Try this for an option alyssa. Don’t get pregnant for 6 months(not hard as a resident/med student/intern), then get diagnosed with infertility. Then ask your residency director for conjugal visits requiring “time off” when spouse is ready and available. Throw in something about medical necessity and he cannot refuse. Then you can get time off also during pregnancy /after delivery as part of FMLA. Finish same time as everyone else, take boards and work part time as your family grows.
Its the American way.
integrativepsychiatry
Unfortunately from many, this figure is more like upwards of 250K. I would like to know who gets such a steep discount!
Advice for 3rd & 4th years: look into fields which have slightly lighter training schedules or are more supportive of women having families: peds, psych, neuro, etc…
While you rotate, ask residents their opinion about how their program responds to pregnancies. You may notice differences exist. I particularly witnessed foriegn born FMG’s getting intense pressure from programs to take minimal amounts of time off, far below that of the FMLA.
Anonymous
Having worked some 140 hour weeks in the “old days”, and finding it not conducive to learning beyond a certain point, I supported the restriction to 80 hour weeks. They fit pretty well with what I thought was optimal for training when I was doing more.
Beyond a certain point of sleep deprivation, the exhausted brain is very inefficient at learning.
I would not support a further drastic reduction.
It is not just the significant restriction of clinical exposure, but also will develope a very different mindset in doctors towards comprehensive clinical responsibility for the patient.

Shortening work hours, lengthening residency

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