Surgical Residency Study

[ides]

I believe so. I truly believe any doctor - resident or attending - who is working on inadequate sleep is putting patients in danger.

I think they should eliminate undergrad requirements, let people go straight into medical school (which may need to be extended one or two semesters or offer summer classes), and extend residency for those who wouldn't get enough experience under safe work hour restrictions. The total number of years in school wouldn't change much, but they would have more experience doing their specialty.

This is what they do in Ireland. Your major, what ever it is is chosen when you are accepted to university. I.e you apply to a college & a field of study from high school. The results of testing & entrance are then published in the newspaper. If in medicine you have more years but its less than eight - I think maybe six.

[Chrisada]

The best preperation DH ever for being a physician was teaching HS for two years prior to medical school. He went to college intending to get a Ph.D in Engineering without medicine ever being on his radar.

[ladymoreta]

Yes, but I also think that attendings should have work hour restrictions, so residents wouldn't need to get used to working with no restrictions. Doctors are biologically just humans, regardless of how much they'd like it to be otherwise. They can fall into the same problems with sleep deprivation as pilots and truck drivers. Being smart unfortunately doesn't change your body's need for sleep.

And guys, I'm not one of those "I need 8 hours a night, so everyone else must, too" kind of people. I function very well on just a little sleep. But, I know what it is like being chronically sleep deprived. Either I've gotten the wrong impression, or your spouses are living the way I did my junior year of high school. I got about 3-4 hours of sleep per night, and "caught up" on weekends when we didn't have tests. (My school had 2 Saturdays per month when we had tests, and some of the other weekends were spent taking ACT and SAT tests and practice tests whenever they were offered. I went to church on Sunday mornings.) I know what it feels like to live for months on that little sleep, and I just don't want someone living like that making decisions about my or my family's health. I was confident about my performance then, too...

[niener]

DH has always been a 5-6 hour max sleeper, even in high school. On the days he "sleeps in" he might sleep 8, tops. I, on the other hand, need 9 to feel fully rested. Reason #45982 why I'm not a doctor.

I think it would be nice to have the option to do an abbreviated undergrad with a direct tract into med school so it would take maybe 6 years to reach residency instead of 8 for those who know what they want to do earlier on.

[PrincessFiona]

Work restrictions need to stay in place and residency needs to be extended in all fields.

[PrincessFiona]

I dont know any attendings who take q2 or q3 call. Even in surgery its more like q6 or more

[HouseofWool]

I dont know any attendings who take q2 or q3 call. Even in surgery its more like q6 or more

unless you are a sole practioner, then all bets are off. I know that the doc I work for takes 7 days a month at his main hospital plus locums work at another facility. That doesn't count the days when one of his patients are admitted for a complication and request him. I

[SuzySunshine]

DH's attending call is basically q-5 though they do take the weekends in 3 day chunks, his first one is this weekend, we'll see how it goes.

What I found with DH was that when he was a resident and used to 5-6 hours of sleep a night he was fine, but now that he's not (and even in his fellowship) he got used to 6-8 hours of sleep and now has a harder time functioning on less.

I think a 6 year program that included med school is something that could be looked into but I agree straight into med school out of high school would just cause more drop outs.

[lovelight]

They do have some 7 year undergrad/ med school combos...I guess it only cuts it by a year but still an option

[Pollyanna]

I dont know any attendings who take q2 or q3 call. Even in surgery its more like q6 or more

Around here q3 is standard for OB, Q4 would be considered an easy schedule. And really, even when not on call a lot of OB's go in for certain patients on their "days off" (I use that term loosely, lol).

[PrincessFiona]

Our OBs would never tolerate q3. Lol. The practice of medicine will likely have to change too. It maybe that will less doctors will go into small practices and large group practices will become the norm. At any rate things do you need to change for the safety of doctors and patients and alsi family. If it is still possible to train competent doctors adding a year or 2 on to training but limiting work hours a little would it to be worth it?

Our new doctors boiled or do they just value their health and family?

[PrincessFiona]

Spoiled. Damned voice to txt!

[PrincessFiona]

I also have to ask how much is it worth it to become a doctor? Let's be honest here we all talk about the fact that our spouses are not available to us and our children. many older doctors that I have met greatly regret ther choice. If they could do it again they would spend more time with their wives and children. What type of family to be want to give to our children? What relationship do our husbands and wives deserve to have to their hildren? And what about the kids? Is there really no other way to train a competent doctor?

[PrincessFiona]

Do we. Gaah

[DCJenn]

I completely agree w/ Kris that training restrictions need to stay and residencies need to lengthen.

As for attending call, here for child neurology they do it in 2 week shifts- basically that person is responsible for any PICU, Ward, ER, etc. calls and the management of those patients during the evenings/overnights/weekends. On a normal call shift, he'll go into the hospital on both Saturday and Sunday of both weeks (it's a Wednesday-Wednesday shift. When they're fully staffed, they're on-call every 6 weeks. He has gone in overnight on a couple of calls over the past few years but it's rare.

I think medicine is one of those careers that will always require a significant sacrifice from everyone in the family. I don't think you can train a competent doctor without the in-depth training they go through. I also think that having some real life experience before medicine is a key component- even if that 'real life' experience is just undergrad. (although at least in my experience, undergrad is nothing more than extended high school with a legal drinking age)

J.