Religious Observances During Residency

[MrsK]

When someone goes into labor, cardiac arrest, or breaks a hip in the presence of an Orthsox Jew, even it it's at the Wailing Wall on Yom Kippur, Jewish law requires them to act, drive, work, and do whatever is necessary to assist that person.

It's like complaining that you cannot find a parking space because a few stalls are reserved for people who have disabilities and then saying that people who require the accomidation should just stay home. It's ignorant and juvenile.

[Vanquisher]

It's not ignorant and juvenile. If they don't have to go to work and see those patients, They are giving more work to others, getting special treatment, and not performing all the duties required. Sorry, that doesn't work for me. Seems like a loophole.

Sorry, I didn't see Mr. X go into cardiac arrest, and so I can't answer my pager. I can't be at the hospital to see when the ambulance brings in the hip fracture, and I certainly don't want to stick around when there is somebody else to take over for me at 4:00 cause now it's resident Z's problem, so I can get home for the Sabbath.

[MrsK]

As if your DH treated every single person that entered the hospital 24/7/365 for his entire residency all by himself? Seriously? I'm sure he had at least four 24 hour periods off in the space of a month during residency. Seriously, this conversation is just so bigoted that it makes me want to puke.

[Vanquisher]

No, he did not have at least 4 - 24 hour periods off a month. That was what I am saying. He still doesn't have that. Plus, it's not bigoted. I am not advocating for special treatment for anyone, I am arguing for no special treatment for any one group. I am sorry you think that's bigoted. I don't. I've seen dh get dumped on by this, and alison's dh was dumped on for years.

[MrsK]

So, I guess women of child-bearing age should forget about medicine too? My husband's chief took an 8 week maternity leave. She was gone for 56 consecutive days. Boy, that sure inconveinenced lots of people. Women who give birth are impossible to accomidate and should be driven out of medicine because there is nothing they can contribute to the field if they cannot be there 24/7/365.

[diggitydot]

No, he did not have at least 4 - 24 hour periods off a month.

Even here at a ridiculously supportive and friendly residency it's not unheard of for someone to go a month without more than one or two 24-hour periods off during a call block. DH has been on Q3 call for 3 weeks and has had a single 24-hour period off.

[Vanquisher]

I'm not a fan of maternity leave for residents either, no. You should have to give and work as much as everyone else. We've had that discussion before. Lots of male residents get burned by that. Fathers in our program got maybe a day of paternity leave, but many worked with wives in labor. We had residents rounding who were admitted to ICU and with IV poles.

That's too hardcore, but yes, treatment should be equal and fair and more humane for everyone. Medicine happens 24/7/365.

[Vanquisher]

Oh, and If someone can work Saturdays and any other day, I have no problem with their being in any field of medicine.

[MrsK]

There is a lot here that you are missing. When I use the word "ignorant", I do not mean it as an insult. I just mean that there are lots of elements to this that you most likely do not know.

First, this is a heated issue for many cultural, religious, historical and ethnic reasons that I will begin to attempt to explain but could not possibly cover in an on-line forum. On a religious/philosophical level, there is a long and varied history between Jews and medicine. One of the main tenants of Judiasm is "tikkun olam" - a biblical commandment to repair the world. For many people, this translates into healing and medicine. Hence, the prevalence of Jewish mothers bragging about their son, the docta. Also, on an even deeper level, Jews have always placed a special, immutable emphasis on the value of human life and, as I mentioned before, tikkun olam. Practicing medicine permits Jews to fullfil the commandmant of tikkun olam.

On a practical level, medicine was a way for Jews to gain acceptance, prestige and make a living. It’s one of the few professions that remained accessible to Jews when many other doors were closed. Historically, Jews have been barred from owning land. Therefore, observant Jews put a very high emphasis on education which is inalienable. Jews can be persecuted, beaten, evicted from their lands, robbed of their property, and forced into ghettos but their knowledge cannot be taken from them. Also, by becoming doctors, Jews have been able to take care of their own. When Jewish people would not be given care at hospitals and when quotas barred Jews from attending medical schools, Jews built their own hospitals. However, they never stopped at just treating their own and there is a long-standing history of observant Jews creating public medical hospitals (which brings us back to tikkun olam).

Specifically, regarding Orthodox Jewish practices in modern medical training, within Jewish Orthodoxy, there are rules prohibiting observant Jews from continuing training if doing so will require the desecration of Sabbath. Orthdox Jews are required by rulings of Orthodox Rabbinic authorities to seek out residency programs that will allow them to observe Sabbath. A ruling published by the Association of Orthodox Jewish Scientists states that a physician must seek association with the most reputable and prestigious hospital possible to ensure excellent training and continuing education but if superior training is to be acquired at the price of Sabbath desecration, the student-physician must forego the educational advances of the prestigious hospital. The ruling also requires initiation of open discussion with the training hospital administration before accepting residency. There is a clear requirement to investigate any Sabbath conflicts before the match and to discuss issues of Sabbath observance with the program director before ranking any program.

In the circumstances discussed here, the resident and the program should have addressed and agreed upon the manner in which Sabbath observance would be handled prior to the match. The program has made a decision that the residency candidate is sufficiently qualified and desirable enough to accomidate. Many programs are set up to be "shomar Sabbath friendly" and some even advertize as such. And Sabbath-observant residents who enter these programs agree that while they cannot do the same call as the other residents, they will do an equivalent amount of call as their co-workers. Equivalent call responsibilities are usually arranged by having the Sabbath-observant resident do additional call on Sundays and national holidays to make up for Friday nights and Saturdays. There are a myriad of factors that go into determining whether a program is shomar Sabbath friendly and whether any given candidate is suitable for residency at that hospital. Which is why I'm saying that it is inappropriate to make blanket assumptions about the relative fairness of such arrangements when you are seeing only a tiny sliver of those factors.

[Vanquisher]

I never said that I cared about programs and their agreements. I could give a shit about programs. It's the other residents and medical students that have to pick up slack.

I also never said that there was not history or tradition behind medicine, Judaism, and Sabbath restrictions. Merely, I said that medicine is 24/7/365, which it is.

I am not responsible for the historical persecution of Jewish people nor current anti-semetism. I do think that if you can't work on a Saturday or Christmas or Arbor Day, you shouldn't do modern medical training. It's just my personal opinion. I've had to miss many a "sacred" day to medicine. Anniversaries, Birthdays, Thanksgiving, Christmas (we celebrate) and I was once a practicing Christian.

No special treatment.

[MrsK]

I did not call YOU ignorant, juvenile or a bigot. But, as I stated, I do think that many of the opinions expressed in this thread are ignorant, juvenile, and biggoted -- and they are the sort of statments that have historically lead to persecution of persons of various ethnicities, religions and persuasions.

[diggitydot]

I used the term "butt-hurt", so I think I get to claim the juvenile labeling this thread.

[Thirteen]

Regarding Special Days and Time Off:
When I was in labor, DH was working, and couldn't see me.
He didn't miss the birth of his son, but he wasn't there for a lot of the labor.
I didn't get mad, because that's just how it is. I didn't think we would get special treatment, even at his hospital.

The program gave him 5 days off (which he had to make up, post-graduation, on a surgery Q3 rotation).

Another resident used her 4 week research rotation to stay home with her new son. She still pulled a presentation and paper out of it, and presented when the baby was 4 weeks.
That was the only way she could get true maternity leave without having to make it up.

Residency sucks.


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[Vishenka69]

I'm not sure how this works in the rest of the country but in NE, there are a number of programs that offer some spots (usually 1-2) each year to Orthodox Jews. For the most part these are Jewish hospitals (such as Maimonides). Applicants are aware of this when they apply, that there will be someone who won't take any Friday night or Saturday call. Some of these hospitals even have fellowships and attending positions with similar rules. If a non-Jewish med students interviews at such a hospital and ranks them and then matches in the program, then they shouldn't be complaining later on. If they don't agree with the special treatment that a few residents get, they shouldn't have ranked that program to begin with. Again, I don't know if outside of NE such special treatments aren't disclosed ahead of time.

I understand that you friend feels she's been treated unfairly, but is it also possible that whoever made the schedule didn't realize that getting a whole day off for Easter can be a big deal? The one thing residency taught us is that holidays, whether religious or personal are expandable and can be celebrated whenever.