- Joined
- Jul 7, 2016
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Currently an intern at a general surgery program. The faculty are great, the chiefs are more than fair, and my co-residents are for the most part awesome. Couple of odd eggs, but that's at any program.
Unfortunately, logging duty hours is a complete farce, and everyone is complicit in turning a blind eye. Let me tell you about my ACTUAL DAY:
1) Wake up at 4:30/5 ---> shower --> hospital at 5:30, pre-round --> work --> home 7:30 on a good day. There will be atleast 1-2 days where I am there until 9 or later. So on average, that's 14 hours x 5 = 70 (MINIMUM).
2) We have to come in on the weekend and round atleast 1 day a week. I could either a) wake up around 3:30 to come in around 4 and prewrite my notes --> round 6 - 7 --> orders, notes, signout --> out by 10AM = 6 hours.
So right there, that is 76 hours MINIMUM.
3) We also have to take call 1-2x a week. Friday call, tack on another 15 hours to the "minimum" 70 hours = 85 (12 hours additional + you are rounding on your patients the next day). Saturday call, tack on 28 hours = 98 hours.
4) Duty hours is based on the average of 14 days ---> so AT MINUMUM, you are working average 79 hours a week IF YOU TAKE FRIDAY call. Calls are split 50/50 friday/saturday.
Imagine that...if you work absolutely minimum and only take friday call, you still log 79 hours a week. How often do you think we work the minimum required hours? In the past 4 months I've been here, not even once.
So how do people end up logging their hours? M-F 6-6PM + call days. Literally everyone logs it this way, even though it is completely a lie. What happens if you log accurately? I got an email from the program coordinator informing me that violating duty hours is a serious offense and that I should look over my log to make sure I am logging accurately. Lets say I stay headstrong..what happens next?
1) Chiefs get notified.
2) PD gets notified
3) PD probably has a word with the Chief
4) Chief and everyone else gets pissed off (especially if they end up having to cover for you) ---> you look like the trouble maker here.
Lastly, I am a prelim going into an advanced program. If logging duty hours puts me on bad terms with the PD and residents, I am already on extremely thin ice. If I get fired, there goes my advanced position and career.
So in summary, I have 0 leverage and absolutely everything to lose if I log accurately. Lastly, I realize I may be bitching, but the PGY2's and 3s in surg absolutely work past the 80 hours on a weekly basis given that they have to take consults AND operate. They've just given up on logging hours accurately and acknowledge that it is part of residency.
If the ACGME really wants to enforce duty hours, they should have residents clock in and out digitally. None of this manual logging bull****. Otherwise, the program has 0 incentive to ensure adequate staffing and ensure duty hours are protected. Sorry for the rant, just a little jaded at the moment.
Unfortunately, logging duty hours is a complete farce, and everyone is complicit in turning a blind eye. Let me tell you about my ACTUAL DAY:
1) Wake up at 4:30/5 ---> shower --> hospital at 5:30, pre-round --> work --> home 7:30 on a good day. There will be atleast 1-2 days where I am there until 9 or later. So on average, that's 14 hours x 5 = 70 (MINIMUM).
2) We have to come in on the weekend and round atleast 1 day a week. I could either a) wake up around 3:30 to come in around 4 and prewrite my notes --> round 6 - 7 --> orders, notes, signout --> out by 10AM = 6 hours.
So right there, that is 76 hours MINIMUM.
3) We also have to take call 1-2x a week. Friday call, tack on another 15 hours to the "minimum" 70 hours = 85 (12 hours additional + you are rounding on your patients the next day). Saturday call, tack on 28 hours = 98 hours.
4) Duty hours is based on the average of 14 days ---> so AT MINUMUM, you are working average 79 hours a week IF YOU TAKE FRIDAY call. Calls are split 50/50 friday/saturday.
Imagine that...if you work absolutely minimum and only take friday call, you still log 79 hours a week. How often do you think we work the minimum required hours? In the past 4 months I've been here, not even once.
So how do people end up logging their hours? M-F 6-6PM + call days. Literally everyone logs it this way, even though it is completely a lie. What happens if you log accurately? I got an email from the program coordinator informing me that violating duty hours is a serious offense and that I should look over my log to make sure I am logging accurately. Lets say I stay headstrong..what happens next?
1) Chiefs get notified.
2) PD gets notified
3) PD probably has a word with the Chief
4) Chief and everyone else gets pissed off (especially if they end up having to cover for you) ---> you look like the trouble maker here.
Lastly, I am a prelim going into an advanced program. If logging duty hours puts me on bad terms with the PD and residents, I am already on extremely thin ice. If I get fired, there goes my advanced position and career.
So in summary, I have 0 leverage and absolutely everything to lose if I log accurately. Lastly, I realize I may be bitching, but the PGY2's and 3s in surg absolutely work past the 80 hours on a weekly basis given that they have to take consults AND operate. They've just given up on logging hours accurately and acknowledge that it is part of residency.
If the ACGME really wants to enforce duty hours, they should have residents clock in and out digitally. None of this manual logging bull****. Otherwise, the program has 0 incentive to ensure adequate staffing and ensure duty hours are protected. Sorry for the rant, just a little jaded at the moment.