I'm angry. Am I evil?

I think I've found this site just in time (at least I hope I have). I'm getting seriously angry about my dh's brutal schedule. His program is non-compliant with the ACGME 80hr work week and it drives me crazy. First I was just angry at the program, now I'm starting to take it out on my dh even though I know it's not his fault.

A little background: I'm actually a very nice and calm person married to a wonderful but rather stressed out first year OB/GYN resident. We have a beautiful 1 yo boy who says "Da da" all the time (Even I'm "Da da"). A happy family by all accounts. We made it through med school no problem. Now I'm really starting to feel the pinch. Lately I refer to myself as a Single Mom.

What have others done when they feel like they want to scream? Are your spouse's programs compliant with the 80 hr rule? If not, what can be done about it? Obviously, I don't want his program closed down, but I feel like the attendings shouldn't be getting away with telling residents to lie about their hours. I welcome all suggestions.

[SuzySunshine]

My husband isn't a resident yet - but Stanford is VERY strict about complying with the hours in the specialties where it is an issue. You're in a tough spot, if your husband's program gets caught they could lose their accredidation (sp?) and be put on probation which I don't suspect would look great when your husband is done and trying to find a job - on the flip side if he speaks up he risks putting himself in a bad position for the next 4+ years because he does have to work with these people.

I wish you luck and I welcome you to the board. We are always hear to bounce ideas off of, vent, etc.

Here is an article which explains what Johns Hopkins is going through with one of their programs which was penalized: http://www.ama-assn.org/sci-pubs/amnews ... sc0915.htm

Good Luck!
Cheri

Welcome to the boards! This is a great place to vent and everyone here can relate on some level.

Now, from what I understand about the 80hr/wk work load...this is coming from a spouse of a peds resident about to start PGY3, if a specialty needs to coverage or the work load isn't being met they can ask for an extension, if you will, on the amount of hours worked by residents. This is done at the program director level I believe, again this may not be the exact way IT works, but it goes like this at the Children's Hospital in KC.
Example- Hem/Onc has three residents on service for the month, that particular service is ALWAYS swamped with very ill children. The residents come in at 6a and leave, if not on call, about 5p. This happens M-F, the weekends they come in at 6a, round and come home about 1p. That is already equal to nearly 70hrs, and that doesn't cover the call nights which are generally Q-3 or 4, depending. So the attendings let the director of the Hem/Onc service now that they can't possibly let the residents out at 80hrs. The director, in a perfect world, fills out the proper documentation and the hopsital is then in compliance. The one major issue here is that the information, RARELY IF EVER gets passed down to the residents....and you know where that leaves the spouse/family of a resident.

Anyway, I may be all wet and not know what I am talking about completely, but this is the way it was explained to me. And we have seen the results by having work weeks that exceed the 80hr limit and no one really seems to care....except the resident family/spouse.

Sorry I can't be more of a motivation and say that you could do X or Y to have it changed, but I haven't figured it out yet either! I can totally relate though, with a 1yr child and intern year. That is what we did, in fact, we liked it SO MUCH that we moved to a different program and did an intern year again with a 2yr old! Keep yourself as calm as you can and enjoy the times when your spouse is home.

Come here often to relieve the pains of the medical journey, we will always listen and most of us will give you more than you bargained for as replies! (See above!)

[houseelf]

Dylans Mom,

Welcome...I'm so sorry that your dh's work is taking over your lives. This is a really hard place to be. I hope that things get resolved for you soon. I hear that ObGyn is a particularly grueling specialty. Best of luck getting things back on track...you will find so many people going through similar circumstances here.

Kelly

thanks for support/ideas

Thanks both for your support and ideas. I checked out the amednews.com articles on the 80hr rules. They were very helpful.

I'm not sure if the program director has requested an extension of hours and is thus in compliance and I just don't know about it. From what he told residents recently, I don't think so. Essentially he said if they didn't turn in timesheets of 80 hours or less he would begrudge them every moment of time they weren't actually with patients-- meaning running down to the cafeteria for a 10 minute lunch couldn't be counted as "working", time driving to clinic shouldn't count, doing dictations, writing histories ect. It's ridiculous.

By the light of day my mood has improved (husband and baby are asleep upstairs) but I still feel like our family in general and my husband in particular is being taken advantage of. It's not a good feeling and sometimes I start to obsess over the letters I want to write/actions I'd like to take. But of course I feel like my hands are tied. I'd still be interested in hearing from anyone else with similar experiiences.

Thanks, Dylansmom

I hear ya, Dylansmom. Downstate has been fined repeatedly for non-compliance with the 80-hour rule - but they would rather pay the fines than expand the residency program. I doubt anything short of disaccreditation at this point would really scare them into complaince! Even the provisions they do make are a mess. For example, my husband - a PGY2 IM resident - just completed a month of "day float." He worked from 1 PM to 12 AM Monday through Thursday, he worked from 8 AM to 12 AM Friday and 8 AM to 9 PM Sunday. He was off Saturdays. So basically, we saw each other only on Saturdays, as he was asleep when I left for work at 7 AM every weekday, and I was asleep when he got home. It was a disastrous month. The program "got away with it" though, because he was technically off every morning PLUS Saturdays. Real generous of them, huh?

Just comiserating...
~Molly~

80 hours would be heaven



I completely relate to you. My husband has been working 100 hr weeks, and all he can do is sleep and eat (sometimes) when he is at home. It is hard watching him be completely exhausted, only to get up at 4:00 to go in for rounds.

We have a two year old. Sometimes I worry that he does not see his daddy enough, and yes, I refer to myself as a single mom sometimes also.

We are in Texas, where are you?

[mommax3]

Hi,

I posted to you earlier, but I guess it was lost....anyway, WELCOME! I am married to an OB/GYN who has been done with residency for a little over two years, so I definitely understand where you are coming from. His residency took place before the 80 hr/week regulations were in place, so he worked between 100 and 125 hours a week on average for the first three years, and a little less the 4th year, maybe between 80 and 100 hours. We had a 2 yr. old when residency started, and a 6 and 3 year old when it ended, so I know all about the single parent thing as well.

Hang in there and vent whenever you want. Feel free to PM me anytime. It really does get better after residency --- whatever relationship you had with your husband is still there, just buried. So keep nurturing the relationship, even when it feels like it is for nothing. I will never say that the four years will go by quickly, because I hated hearing that, but you WILL be on the other side of it and life will be much better. In the meantime, we will be here for you!

Where are you, and are there any spouse support groups where you are? Is your husband in a large or small program? What is the male/female ratio amongst the residents? Are you close to family at all?
Sorry for so many questions!

Sally

misery loves company

Thanks all for you supportive and helpful comments. Even knowing that things will get better after residency, we still have our low points. I'm noticing that even though I feel my husband and I have a solid foundation to our relationship that sometimes the stress of our lives is undermining it. The other day, I got so frustrated with him and his stress (which comes out as negativity) that I insisted that we seek marriage counseling. Sometimes I just don't have the marriage I thought I'd have. It's hard to talk about and difficult to even be honest with myself about it. Of course, counseling costs time and money, two things we have very little of.

My DHs program, to answer someone's question, is in the NY area and has only 4 residents. Like most OB/GYN programs the program is mostly women , 3-1. As far as I know, there is no spouse support group in the area. I'm thinking of starting one, but am not really sure how to do outreach. Any suggestions?

Well, time to vacuum...yipee! Best to all. Dylansmom