Thread: Does the 80hr work week rule apply to students?

Just wondering if the 80hr work week limit applies to med students rotating through 3rd and 4th year? Can we pull 110-120+hrs/wk when we rotate through the surgical and ob/gyn services if we wanted to?

There's an interesting article out recently about even further restricting the 80hr work week: Panel Calls for Changes in Doctor Training

There are good arguments for and against this from both sides. Personally, I'd rather suck it up and do the hours than end up having to an extra year of residency. Especially if my life is gonna be put on hold during those years of training.

I don't think the 80 hour work week applies to students. and the residents i spoke with laughed when I brought up the topic, meaning the 80 hour work week was not enforced at their residency program and they easily worked well over 80hours a week. I would say an average day for surgery was 14 hour days, get in at 5am leave at about 7pm, if you add a 24 hour call on friday or saturday which isn't unusual that would put you over 80 hours in that week.

when you guys are "on call" what do you actually get to do? it sounds really cool (i'm in first term...............................)

i avg 90-100hrs/week on obgyn with calls Q4

and trust me, call isnt cool, it only sounds cool

Good to know. Thanks Jay and RussianJoo. I've always known that some programs imply to their residents to put down 80hrs despite having worked in excess of that. I'm surprised they still keep doing this since if they're caught in violation of ACGME's recommendation, they can have their residency accreditation status pulled. I guess they're still doing this because they think residents won't whistleblow out of fear of being blacklisted. Many programs probably won't say it explicitly, but they'll imply that it's ok to lie and not follow the law. Talk about medical ethics and professionalism, huh? I'm surprised they keep on emphasizing that in med school when in reality it seems like such a farce. Did you hear about the Plaxico Burress coverup recently by New York-Cornell ED docs?

actually the 80hr work week is AVG. so you can work 90 one week and 70 the next and as long as the 1 month weekly avg is 80/wk it is good

Point noted. By the way Jay, are you averaging 90-100hrs at Jamaica? How are their rotations so far? Do they give you an alphanumeric beeper for call? Are phones allowed on site?

depends on the hospital you are at and how they view duty hours...the NJ hospitals for the most part view duty hours to pertain to students as well as residents...the NY ones not so much...

as for programs enforcing the 80 hours...i can only speak for mine, but they are very adamant about staying within the houirs...sure there are some times where you will go over (unit months are probably the biggest culprits) but then you will have those elective months where you will barely hit 40 hours...hopefully it will all balance out in the end

Originally Posted by rokshana

depends on the hospital you are at and how they view duty hours...the NJ hospitals for the most part view duty hours to pertain to students as well as residents...the NY ones not so much...

as for programs enforcing the 80 hours...i can only speak for mine, but they are very adamant about staying within the houirs...sure there are some times where you will go over (unit months are probably the biggest culprits) but then you will have those elective months where you will barely hit 40 hours...hopefully it will all balance out in the end

Rokshana, as an intern you still have electives? What kind of program are you in? IM? Also, since you're in the mix, I wanna know what your opinion is of the 80hr rule? Do you feel like it's affecting your training because you have to spend a large amount of that time doing paperwork, lab draws, etc.? Stuff you're stuck doing because of poor ancillary staffing. Is it hard to care for your patients because they're being handed off in shifts and thus makes it hard for you to follow them through their disease course, indirectly making you care less about them? Many doctors of the past are saying that the new regulations have produced a generation of less experienced physicians. I'm just trying to get a feel if that's true for someone going through it rather than someone looking back in hindsight.

Originally Posted by Cassius1999

Rokshana, as an intern you still have electives? What kind of program are you in? IM? Also, since you're in the mix, I wanna know what your opinion is of the 80hr rule? Do you feel like it's affecting your training because you have to spend a large amount of that time doing paperwork, lab draws, etc.? Stuff you're stuck doing because of poor ancillary staffing. Is it hard to care for your patients because they're being handed off in shifts and thus makes it hard for you to follow them through their disease course, indirectly making you care less about them? Many doctors of the past are saying that the new regulations have produced a generation of less experienced physicians. I'm just trying to get a feel if that's true for someone going through it rather than someone looking back in hindsight.

well sometimes its limiting, especially the 30 hour at a stretch and esp the 10 hours between shifts...i'm not one to leave work for others to do, so its a bit hard for me to delegate somethings to my fellow interns or residents...i'm at a university program, we still have written charts (except at the VA which is all computerized), so yeah sometimes all the note writing is very time consuming...there is sooo much repetition to some notes and to write it over and over,day after day is a pain.

ancillary staff at my hospital is pretty decent so i don't really worry about having to do blood draws or chase down labs or so forth (though some floors are better than others...).

we do have a night float, which doesn't start till 7pm, but the ward teams generally can leave starting at 4pm and if they leave then, they sign out to the on call team, who in turn signs out to night float at 7pm...there can be something easily llost with two hand offs, plus NF will do admissions and then hand off to the teams in the AM...you really do have a better grasp of your pts if you do the admission yourself...i think the model of a night team and a day team would give better continuity, but to do this you either have to be at a fairly large program or one that has residents spend a great deal of time on the wards.

and yes, you do have electives...and IMHO its important to have electives in the 1st year...if you are interested in fellowship, its important to get started early...one to see what you are interested in if undecided and two to get your foot in the door if you already know what you want to do...you apply for fellowships in your 2nd year (in IM) if you aren't taking a break, and if you have a fellowship program at your hospital, they should know who you are, that you are interested in the field, and can get you started with research early...my program gives us 10 weeks of elective time...my 1st 2 weeks were in GI and while GI is not something I'm all that interested in, i found it fun, and more importantlyI got to know the fellows...and a GI consult is one you often call for on the floor during your ward months, the next 4 weeks i spent doing endocrine...my field of choice..reinforced that endo is what i want to do and gave me a chance to meet most of the faculty and the fellows. I have 4 more weeks and hope i can do radiology...because it really is important to be able to interepret XR, esp CXRs without having to talk to the radiologist...if you do rads as a 4th year elective, at least learn how to read a CXR!!

the learning curve is STEEP!! so you learn...at the beginning of the year in july i felt i wasn't much different than my 4th yr sub i...now ....the difference is exponential...but the gap between me and my residents is still pretty decent, so the curve is still steep!

hope this helps!