Eighty hour work week

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Eighty hour work week

Postby Helen » 23 Oct 2003, 22:09

I am a PGY 2 Pediatric Resident in a Univ Program in FL. Recently, I ended up with a Q2 call b'coz the chief wanted to go out of town on some emergency. Is this fair, I mean, rules are created to be followed and the very person who should be enforcing it is pushing it on me. All you chiefs out there...dont be like this guy!
Helen
 

80- HR RULE

Postby AbdulH » 01 Nov 2003, 22:31

Not fair at all. ACGME procedure says that you have to take this up with the Residency program director. If you are not satisfied with his reply, write to your institution's education committee...and then to ACGME. But looking at it practically, no residency director wants to be bothered about this or anything else....don't you guys agree...I mean, when was the last time the program director actually did anything good for us on his own...without anyone forcing him to....my suggession, BYPASS ALL THIS AND WRITE DIRECTLY TO ACGME COMPLAINTS OFFICER. YOU CAN BE ANONYMOUS IF YOU WANT TO. The address is:

Marsha Miller
ACGME Complaint Officer
Suite 2000
515 North State Street
Chicago, IL 60610-4322
mmiller@acgme.org
312-755-5041
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ACGME and work hours

Postby IntMed Resident » 18 Feb 2004, 00:07

Yea, teach them a lesson - put their programs on probation. ACGME is very serious now. Just send an anonymous e-mail or fax
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NRMP Lawsuit

Postby GoodIMG » 21 Mar 2004, 14:23

Especially with the law suit against NRMP, ACGME & AMA/Frieda, ACGME is very serious about violations of its rules. Go to http://www.savethematch.org to get full info on the law suit and its current status.
GoodIMG
 

Re:

Postby Star76 » 02 Jun 2004, 06:58

Can somebody please tell me exactly what this law says? Does it say how many patients can we have under supervision, how many patients can we admit per day or when can we go home after a night call etc? Is there a web site where I can find these info? Thank you.
Star76
 

Re:

Postby XOX » 02 Jun 2004, 07:13

The rule says that: "duty periods cannot last for more than 24 hours". How do we calculate these 24 hours when we are on call? Thanks.
XOX
 

ACGME Residency Work Hour Regulations

Postby spartfam » 24 Jul 2004, 17:24

I would recommend looking at http://www.acgme.org/DutyHours/dutyHrs_Index.asp

You should find everything you need there.
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Re:

Postby LVDoc » 07 Oct 2004, 14:35

Star76 wrote:Can somebody please tell me exactly what this law says? Does it say how many patients can we have under supervision, how many patients can we admit per day or when can we go home after a night call etc? Is there a web site where I can find these info? Thank you.

For interns, the cap is 12 patients under their care. Apparently if they need to cross-cover their colleagues (i.e. days off) then the overflows are defaulted to the senior (as usual). A resident has a cap of 20 under their care so that includes personal patients AND those seen by the interns. At least, that's what I've been told. Who knows? :)
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Using search feature

Postby Search » 30 May 2005, 07:58

Using search feature:

To search articles or messages in this forum, click on the search button at the top of this page (any page- 5 th line from the top). Then enter your search subject (one or more words).

This will save you time. It will search through the over 4000 messages in this forum and get you the relevant messages/posts.

GL in your search.
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TALK with Residency Program Director

Postby ladef68 » 31 May 2005, 18:29

Contact your Graduate Medical Education Office. Once I clocked my hours where I was back in the hospital with only 8 hours away and my residency director was in big trouble from the GME Office.
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Postby WoodDoc » 16 Jun 2005, 18:20

We Americans sure whine a lot. We have it easier today than our predecessors ever could have imagined. Don't forget: there was a time when they were called "residents" because they lived in the hospital. So you had to take Q2 call once--big deal. Did you survive it? The 80 hour work rule is a good idea only to people who want to avoid work--people who would no doubt love to see a 40 hour work week or even a 20 hour work week. The 80 hour rule has caused residency programs to dismantle the standard Q4 overnight call and replace it with a night float system. If people are honest, you have to admit that the best learning in medicine is found in admitting patients. You don't learn as much when an overnight doc admits and then hands them to you the next day with a full plan in place. You learn by seeing a patient present with a set of symptoms, postulating on what might be the cause, reading about those possibilities in textbooks and journal articles and EBM websites like Cochrane and UpToDate.

And yet today, we have people moaning the blues because they had to work Q2 once. I start my PGY-2 in Neurology on July 1 and will be on call my first night and then 2 days later. Is it going to be painful? Yes. Will I survive it? Yes. Do I have a legitimate reason to complain about it? No. There was a nice medical ethics paper published a few years ago entitled "The Virtuous Physician." The virtuous physician puts his own desires/interests secondary to the well-being of his patients. For decades, physicians have been taking Q2 and Q3 call and living with it. And now our lazy generation (self included) whine about the rare occasion in which we might have to work a Q2. Interestingly enough, I'd wager that mistakes in patient care have not been decreased one iota by limiting the work week to 80 hours. If there has been any decrease in morbidity/mortality in academic institutions, it's more likely due to improvements in system-wide practices such as marking the correct limb for amputation prior to surgery or having verbal orders repeated back to the physician for verification.

A lot of rambling above--sorry. The point is, we have it better than physicians ever have during residency--and it gets easier and easier every year. The unfortunate part is that we become less self-reliant and more reliant upon consultants and our peripheral brains (i.e. all those pocket medicine books we carry) to do the thinking for us. How are we as a group to become good physicians as such? So work the occasional Q2 and take it like a man. Don't whine and tattle on your program. Afterall, the first poster said him/her-self that the upper level had an "emergency." If your program doesn't have a culture of wanting to help each other out, it's not a very good program. My two cents.
WoodDoc
 

some cheese with that whine?

Postby klebsiellapneumonia » 07 Aug 2005, 21:25

to wood doc:
i can't agree with you more. maybe i'm just a fool, but i sort of expected to be working hard during my residency. who are these people that thought they would have a similar life to other people during these 3-? years? we have time to do things, but it's not going to be the same. and the reason is the fact that we are committing ourselves to the profession we have decided to embrace. it is unfathomable to me that people will go online and bitch about these things. every week i have to enter my workhours online and i always have to subtract hours since the 4-week total is always over 80. what does it matter to me? i'm not in this to think about when my next break is. i'm doing this b/c this is what i love. like you stated before, can you imagine these characters in their residencies 10 years ago? any of these people who feel this way should have chosen a profession in medical records. from what i hear, their hours are pretty regular and they aren't really required to overwork, b/c that is just an outrageous prospect.
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Re: Eighty hour work week

Postby Code Blue » 10 Nov 2005, 22:02

Helen wrote:I am a PGY 2 Pediatric Resident in a Univ Program in FL. Recently, I ended up with a Q2 call b'coz the chief wanted to go out of town on some emergency. Is this fair, I mean, rules are created to be followed and the very person who should be enforcing it is pushing it on me. All you chiefs out there...dont be like this guy!


So you had Q2 call once or was it for the entire month? And if your chief really had an emergency, what's wrong with that? If his mom died in a car wreck and had to leave town, you're going to hold that against him? And the fact that your program doesn't have a back up resident would be completely amazing. Now if you really only had to do Q2 call once or twice, then please shut up and stop your whining.

I'm amazed by all the talk of "REPORT THEIR ASSES TO THE ACGME!" You know, unless you have an absolutely malignant program with poor communication between residents and the administration, there is no reason why things cannot be handled internally. My program made huge changes to how rotations were designed because of concerns of working over the 80 and 30 hours without someone blowing the whistle to the ACGME.

And as for the "80 hours" -- there has not been one study that showed that tired residents caused increased patient morbidity and mortality directly, and like Wood doc said, I don't think that the 80 hours restrictions will be shown to improve patient morbidity and mortality. Sure we may wreck our cars more often or not catch every intricacy of an EKG after 30 hours of work, but we have not been shown to make more mistakes that have affected patient morbidity and mortality.
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my thought

Postby stickler » 10 Nov 2005, 22:30

I think rules are rules! If the law says a truck driver can't drive more than 6 hours straight or a pilot can't fly more than so many hours a day, that's the way it is. May do you macho fucks think that this is some right of passage? Do you think you're better b/c you worked without sleeping while trying to take care of a persons life. People have worked for years to try and make the training of physicians more civil but some of you seem to defend the ways of the past. WHY DON'T YOU GO TRAIN IN CHINA if you're so tuff? There you get to live in the hospital for a year without seeing your family ! I really see alot of people eager to be treated by commie docs in this country! NO! What people want in a physician is a real, caring, awake and smart person with a personality better than a smoldering turd.
stickler
 

Re: my thought

Postby Code Blue » 17 Nov 2005, 17:59

stickler wrote:I think rules are rules! If the law says a truck driver can't drive more than 6 hours straight or a pilot can't fly more than so many hours a day, that's the way it is. May do you macho fucks think that this is some right of passage? Do you think you're better b/c you worked without sleeping while trying to take care of a persons life. People have worked for years to try and make the training of physicians more civil but some of you seem to defend the ways of the past. WHY DON'T YOU GO TRAIN IN CHINA if you're so tuff? There you get to live in the hospital for a year without seeing your family ! I really see alot of people eager to be treated by commie docs in this country! NO! What people want in a physician is a real, caring, awake and smart person with a personality better than a smoldering turd.


Ok -- I think you lost your credibility when you used the word commie and typed tuff instead of tough.

I'm guessing that you're the type of person who would raise a stink if you worked 1 minute over 30 hours. You would probably also be the first person to run to the ACGME and cry about it, or rip your program apart during the RRC site visits. My program may not be perfect, and we still have the occasional person who works more than 30 hours or 80 hours. But at least the administration and residents are mature enough to be responsive to this issues and make changes to the structure of the program to fix the problem --- all this done without running to the ACGME.

And as for commie doctors - those "commie doctors" have a patient base larger than both north and south america combined -- so yes, there are a lot of people eager to see these "commie doctors." And for the love of god, please learn to spell before you use "tuff" in a person's chart.
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