MGH - Resident Rule Violations

[madeintaiwan]

DH is in agreement with Jenn, Flynn, and Abigail. He says that the rate of resident mishaps have not decreased since the enforcement of the 80 hour rule. Logging hours is a waste of time. Of course they're going to fudge their hours. If the GME shuts their program down due to "violations" it only hurts the resident and their future career. DH feels that if he, as a resident, has an issue with the hours he should go directly to his PD or chair and discuss the matter rather than ratting them out to the GME. Apparently the GME dinged his program this year for having too many cases. Whatever. I would rather the "practicing" be done in residency with an attending assisting rather than the attending practicing on me because he/she didn't get enough experience and teaching during their residency. DH's chair was discussing how fellowships have become entirely necessary, a 6th year rather than strictly a specialization year, in ortho now due to not getting enough experience during residency. And I'm sorry, no one wants to add more years to their residency, especially to any type of surgical residency. It's bad enough that fellowships are becoming an extra year of residency.

And there is no 80 hour rule in attendinghood. Could you imagine? I'm sorry sir, we couldn't finish your spine surgery because I've reached this week's hourly allowance. Oh, don't push I have to change shifts. Unfortunately, medicine is not for the weak or lazy. And as much as I hate residency and medicine, I know the kind of doctor I would like to have, for myself and my 3 children, and I expect my husband to be no less than that. If you sign up for a job, do it all the way. Medicine is definitely not a job that you should be half assing and trying to find ways to cut corners.

[SuzySunshine]

DH's hospital, at least in his department I can't speak to the others, follows the 80 hour rule religiously. The chairman is constantly on their case if they report over, wants to know why and how they can fix it. Fibbing about your hours is not an option here, the residents police each other because they really want it to work.

Now DH agrees with Flynn's husband that it shortchanges those residents, like himself, that want to get the work in and learn. He feels eventually it will lengthen the nsg residency because residents won't be learning everything they need to, or will increase the number of fellowships.

Good for those residents that had the guts to speak up both about the violations and about the desire to work/learn more.

[ides]

I haven't read the whole thread yet but I do want to reply.

Dh's program follows the 80hr rule, sometimes. And I stress sometimes. They let it be known (under the radar) that it is to be reported that all hours conform, even if they don't. Dh doesn't agree that you are less trained if you follow the 80hr rule. He thinks he could be trained in less time if they took away so much of the scut work that takes up 60% or more of their time. He feels they should hire PA's to do a lot of it or make the nursing staff actually work, but it hasn't yet happened and it's much cheaper for the hospital to have the residents over worked then the other options.

[Rapunzel]

It's not just surgery with MGH. When dh was at Brigham it was kind of a stereotype that MGH's programs were mostly all like military boot-camp. I know that there was a definite difference in how the radiology programs treated their residents. Just a perspective on MGH in particular....

[ides]

the problem with the system is that it relies on residents to report compliance. Whether or not you like the rule, that's a flawed reporting system.

If they don't report it, they could be forced to work too many hours. If they do report it, they face possible repercussions including their program being uncertified. If their program loses certification, then their residency at that institution is no longer accredited to teach them. Seems like a circular reference to me.

yes