Call Nights

I am curious as to what your opinions all are on this subject:



As medical wives/husbands we all have learned to deal with the dreaded "c" word. I have learned a lot on the history of call and medicine's modern evolution in training in general. I have found out that residents were called such because they actually had to reside at the hospital. Medical students and residents had to have the dean's approval to marry. The modern version of surgery heirarchy we have today originated in the military.



Now, I would say things have notably improved for doctors' personal lives in the last few decades (isn't it nice that residents are now "officially" employees even if it doesn't mean anything). I am wondering about call, though. My husband has had to be on call at Parkland a great deal. He has had rotations at other cities and their hospitals (as well as the military). He has been repeatedly told that in fields such as Surgery and Radiology there is the Parkland way and then there is the way everyone else does things. The Parkland way is "What doesn't kill you makes you stronger." In other words, they foster an atmosphere of contention, have very strict levels of inane heirarchy (socially - like sitting arrangements in the lounge), and have HORRIBLE call. Now, I am wondering why this is still so. I know that certain hospitals (primarily in the Air Force) have rotation switches: ie one week you work the grave yard shift and the next week a day shift. Doesn't this sound so much saner? I know on these schedules my husband actually functions rather than stumbling through life like a zombie! Isn't it a little absurd that the military of all places has the jump on the situation?



The only reasoning I can come up with for the archaic ideas of call nights (as opposed to SCHEDULING) are the pathetic whines of "I did it and suffered, so you all should have to, also!" How BITTER! This seems to me to impede progress (who can be innovative when they haven't slept in 36 hours? Is there a more logical explanation for this?



Jennifer

You are so right about the "Parkland Way". That was Richard's first interview for residency. He knew instantly that it was not a good match for our family. I was 7 months pregnant with our 3rd child at that time and all I could see was the tall buildings and he was saying it isn't family friendly. Well, we didn't even rank them. I really can't say the call there is worse than other places that we went to and actually liked. I know where your coming from when you say "serve your time". I too think that this is pretty unfair. If surgery or radiology is the field of medicine chosen your best bet would be to research each program and find the one that fits your family. They ARE out there, you just have to find them ~ Devera

You know what is interesting about the subject of "call"....realizing that it doesn't have to be this way but being forced to accept that the study of medicine in this country is simply not very...."human"....maybe Steve will want to jump in here because he has had some experience with the European systems as well...



But my experience abroad with my husband showed me that other medical systems (competent ones, mind you) were capable of training very talented physicians without breaking their mind, body, and spirit!



My husband is German born and raised...he studied in Germany in a 6 year medical program (this is like undergrad/medschool combine)that was very much didactic-based...they did clerkships without call and then an additional year after the 6 in which they did 3 mo of Internal Med, 3 mo of Surgery and 3 mo of an elective. My husband had call 3 times during the Surgery rotation...that is it....it simply was not expected of medical students. Their job was to learn the pathophysiology of illness as well as differential diagnosis and physical exam skills....kind of a one-step at a time approach.



The residency training in Germany did consist of call...but he always came home the next morning....didn't stay all day too exhausted to work....but forced to anyway....you know the drill!



The bottom line? My husband scored in the top 8% of USMLE 1 and 2 test-takers when he took our exams to enter the country....he is aghast at some of the things that our medical students do not know about the biochemistry of certain illnesses, etc....He feels that in a large part this is due to the fact that they are forced to swallow the info in two years and then move on to a clerkship situation in which they do scutwork and dont' really have the opportunity very often to LEARN.....our med schools graduate students who have force-fed themselves the info and been beaten to a pulp during clerkships...then residency starts and they are expected to be "doctors"...that's a tough pill to swallow. I think that it is unfair to the medical students, residents and their families....but I have seen a system where it works differently that I have as a comparison.





my .02,





Kristen