Thread: Experiences with clinical rotation duty hours.

I'm curious to hear what others have experienced as far as their most intense hours in rotations. Not like one day was really long and you had a 48 hour call. I'm referring to difficult hours on a regular basis. What is the norm?

Don't get it twisted, I know there is really no real policy that hospital follow for students especially when it comes to offshore students.

However, I will say I would not take back that 120hr/wk. I much rather do 120/wk and learn a lot, then to do 40/wk with my thumb up my butt. You just got to pick your poison. Mine was to work hard and learn.

Originally Posted by rokshana

ahh....but resident duty hours do not have to apply to medical students (seriously....since med students are not employees, they don't pertain).

most programs will not require students to stay longer than the residents, but legally there is no violation

but if you really think that residents don't really stay longer than 80 hours in a week, you are in for a rude awakening....

80 hour weeks. When does that happen? After your call "ends" , you still have to call in the consults, follow up on loose ends, tuck in your patients for the covering team, track down the attending to present your admissions as well as sign out all the covered patients you were following (like 6 teams worth) to their teams. This takes a minimum of 3 hours after your call supposedly ends. That is all per call.

Originally Posted by rokshana

ahh....but resident duty hours do not have to apply to medical students (seriously....since med students are not employees, they don't pertain).

most programs will not require students to stay longer than the residents, but legally there is no violation

but if you really think that residents don't really stay longer than 80 hours in a week, you are in for a rude awakening....

did i say i REALLY think that? i simply pointed out what the law says. you guys get so condescending sometimes lol

Originally Posted by RickRoss

did i say i REALLY think that? i simply pointed out what the law says. you guys get so condescending sometimes lol

and i simply pointed out that your application of that rule (its only a law in NYS-Bell Comission) was incorrectly applied.

Originally Posted by rokshana

and i simply pointed out that your application of that rule (its only a law in NYS-Bell Comission) was incorrectly applied.

so it's not a law, but thanks for arguing semantics i guess

"On July 1, 2003, the ACGME instituted standards for all accredited residency programs, limiting the work week to 80 hours a week averaged over a period of four weeks. These standards have been voluntarily adopted by residency programs."

and before your response of "wow ZOMG you're so naive!!!", yes, i know that most residents work more than 80 hours a week. there, i just saved you a reply.

Originally Posted by RickRoss

so it's not a law, but thanks for arguing semantics i guess

"On July 1, 2003, the ACGME instituted standards for all accredited residency programs, limiting the work week to 80 hours a week averaged over a period of four weeks. These standards have been voluntarily adopted by residency programs."

and before your response of "wow ZOMG you're so naive!!!", yes, i know that most residents work more than 80 hours a week. there, i just saved you a reply.

and residency programs can opt out...there has been talk that surgical programs may separate from the ACGME with the tighter recs for hours (no more than 16 hours for interns and 24 +4 for residents)...

whats probably going to happen is eventually residencies will become longer...at least an additional yr to properly train...

Originally Posted by leo72

80 hour weeks. When does that happen? .

electives and night float

Yep. And even then you might still break 90 hrs

Originally Posted by rokshana

and residency programs can opt out...there has been talk that surgical programs may separate from the ACGME with the tighter recs for hours (no more than 16 hours for interns and 24 +4 for residents)...

whats probably going to happen is eventually residencies will become longer...at least an additional yr to properly train...

i can see certain ones cutting hours and getting longer. but apparently theyre also saying that cutting hours for certain programs wouldnt hurt them (ie IM) since they dont work as many hours after residency. but none of that is supported by research yet, so the system stays as is haha.

Originally Posted by RickRoss

i can see certain ones cutting hours and getting longer. but apparently theyre also saying that cutting hours for certain programs wouldnt hurt them (ie IM) since they dont work as many hours after residency. but none of that is supported by research yet, so the system stays as is haha.

its not able the number of hours you work after residency, but the training you receive that builds the foundation for the rest of your medical career.

i find it interesting that there is so much emphasis and interest in 3rd and 4th yr medical school rotations as if THAT is where physicians really get their training...its not...its residency.

and for clinicians that go into non academic practice, RESIDENCY is where one get their exposure and training to deal with...well whatever may come their way in 30, 40 yrs of practice...you may never as a small town doc or surburban physician ever have to treat a fungemia from cholecystitis, but seeing the zebras sharpens your clinical acumen...

and treating 20 cases of CHF will give you an idea of what to do, but seeing 200 cases of CHF will make it rote...

and sorry, but medicine is by far the most encompassing of the specialties...it would most certainly be lengthened to 4-5 yrs if number of work hours drop to the 40-50 hr/wk concept... what will most likely happen is that medicine will split...there will be inpatient internal medicine programs and outpt primary care programs...or fellowships in hospital medicine after a more outpt based IM residency...fellows don't necessarily come under the 80 hr week.

surgery would definitely lengthen because you just wouldn't get the number of cases you need to become an expert in the field.