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Wednesday, November 4, 2009

Hours

My anesthesia intern husband just texted me that he got a call from the program director because he accidentally went over his 80 hours last week. He usually tries very hard to monitor his hours because his program can get in trouble if residents are working more than allowed.

This got me thinking... if your husband or significant other is an intern:

What are his current hours?

If he HAS gone over 80 hours what did he do about it? (It's happened to my husband a couple of times and he just "fibbed" on his timecard)

How are you adjusting to the schedule?

As an anesthesia intern, my husband has to do three months in Medicine rotations. After this month he will be finished with those three month requirements, which means his schedule was very front-loaded with the harder months and from now on we should be on a much easier schedule.

How does he (and you) like the program so far in terms of the people and support they are given?

I can't wait to hear your thoughts :)

Labels: residency

12 Comments:

Mrs T said...: Oh goodness, Beth, my MSIII husband is desperate to do ortho...and reading your post makes me so upset :( I had always relied on the 80 hour rule to get me through it! It sounds like it is all a fraud! I am curious to hear whether other specialties are in a similar situation?

Although I have little hope...he is on OBGYN right now and worked 14 hours yesterday and they did not let him eat lunch!!!; November 4, 2009 at 2:19 PM
Audrey said...: My DH is a PGY1 in Internal Medicine. He averages 80 hours a week, sometimes more/less. The most he's worked was 100. The least has been around 65. Nobody has ever said anything to him about logging more than 80 - that I'm aware of.

I remember during medical school, there was a comment made about reporting programs that require more than 80 hours, and how it puts the residents in a tough situation. If you report your program, it may get shut down. Then, you'd be a resident without a program, which would stink.

I get through it one month at a time. Really. If someone asks me about next month, I have no answers, because I'm focused on THIS month. We get the schedule a week before the month begins. I put it on a calendar along with our other activieis and it goes on our fridge. This way, I know when DH will join us and when we do things on our own. It help sets expectations so nobody is disappointed or angry. I do have to admit that DH is very good about leaving as soon as he can (even if he's late) and not dawdling when coming home.

About missing lunch. That happens. DH lost 20 pounds when we started this July. (He had gained some during MSIV) If he makes noon conference and lunch is provided, he'll eat. Otherwise, he grabs a snack in the lounge if he makes it there. He gets fast food on the way home if he's late. I always make sure to have snack food available for him so he can binge if needed. (Not ideal for good health, but he does need the calories.)

Sorry to ramble. It's hard. Good luck.; November 4, 2009 at 2:59 PM
Mrs. D said...: My husband is an Internal medicine intern. Am not sure exactly how many hours he works a week - but I'd say right around 80.

Adjusting to the schedule is tough because it changes so frequently. We just try to take it one rotation at a time.

Like Audrey said, the missing meals just happens. Like missing sleep. Husband sometimes gets nothing more than some graham crackers on tough call days. And he often tells me he had maybe one drink of water all day. He has definitely lost weight since starting residency!

As for support... It totally depends on the rotation and the attendings/senior residents. Some of them are great, others not so much.

No advice here - but I do agree wholeheartedly with Beth about having low expectations! Then you get pleasant surprises instead of disappointments.; November 4, 2009 at 3:34 PM
Julie @ Bunsen Burner Bakery said...: My husband routinely worked over 100 hours/week (generally 3 out of 4 weeks per month) during his intern year in medicine. The hospital didn't care -- apparently, it has to do with the percentage of physicians working under 80 hours/week, so if he slipped through the cracks and worked significantly more hours, they didn't care. Never asked him to change the hours on his timesheet -- he just kept logging them as over 100.

Now that he is in radiology, he doesn't have to worry about pushing the 80 hour/week limit.

The only big problem he has had was they originally promised to do his weekend call duties back to back -- instead of working one day per weekend twice as many weekends, he would get to go in both Saturday and Sunday and have the extra weekend free to come visit me since we live apart. They have fallen through on that promise, so he's pretty disappointed that it cuts the weekends we can see each other in half.; November 4, 2009 at 3:51 PM
Anonymous said...: Beth, my husband is also a 2nd year ortho resident. He averages 100 hours/week. Low expectations are a must (however, that's easier said than done). I wish his program offered support for the wives but it doesn't. I actually haven't even met most of them which is sad. I hear it gets better by 4th year so I am holding out for that :-); November 4, 2009 at 7:18 PM
Gwen said...: My experience with the 80hr week was that it was something to aim for, but it was understood that sometimes they just might not hit it. Then again, my hubby did his internship the year before the 80hr rule started, so when he was PGY2&3, they were still working the kinks out.

As for skipping meals, my husband just started his first attending position, and it hasn't improved. He often tells me that he ate "lunch" at 4 or 5, if at all.

Dealing with the schedule has gotten a little easier, if that's any consolation. We have tried to set up a kind of schedule for which nights he's planning to stay late and which ones he's coming home. Of course, things sometimes come up, but he tries to stick to it as much as possible, and I try to be understanding when he can't. It seems to be working out pretty well for us. I will say that I always had this notion that family dinners would become the norm one day, but I've pretty much let go of that. Even on his "early" nights, he's too late to eat with us, so family dinner is pretty much a weekends-only event at our house.; November 4, 2009 at 8:54 PM
C said...: The 80 hour week is an average. The rule is that over 4 weeks they can't average more then 80 hours. My DH is nsg and rarely breaks the average rule though one week could be more and one less. In his program they're never told to go home when they hit 80 but the chair does watch their hours and if they're over he wants to know why - its not acceptable to him. DH has learned its all about patient management and expectations.

As for support - meet the other wives! Seriously! If there is a department secretary or a resident program secretary ask for the home addresses/phones of the residents and set up a night out or a play date. We have a play group of all the wives in the program and we have a girls night out and whoever can make it each time does. Granted we only have about 10 wives but they're all going through the same thing, some with and some without kids.; November 4, 2009 at 9:53 PM
Alexandra said...: That would be nice to have 10 wives....I'm the only one besides a really older wife of a 4th year. All my hubby's other residents are women, so I would have to have like a boy's night out and hang out with all the other guys.....not to mention only one other resident even has a kid, so we are all kinda alone in that aspect.

I think that is so weird about the hours. They make sure they schedule 80 or even less, just to make sure and Tom has never gone over.....I'm so sorry other programs are so insane with their hours, and to make their residents lie about their hours is just terrible. Sorry.; November 4, 2009 at 11:32 PM
SeekerofGrace said...: So this would be a good area to try to find out about when ranking programs, it sounds like. I'm sorry to all whose husbands are being overworked... wow.; November 4, 2009 at 11:50 PM
Timani said...: A tip for all those wives of overworked husbands...send them with granola bars. They can stick a couple in a pocket and can eat one while walking down a hall. That was a tip for us when my husband started 3rd year rotation during med school.

To those who interview time hasn't arrived yet, I'd tell you man to pay CLOSE attention to what the residents say at the programs they are interviewing!!!

My husband's General Surgery program only schedules them 72 hrs week/max. They are not to fudge on reporting hours, he has never heard anyone reamed for going over. The most he worked is 85 one week, but had about 70 the next.

My husband decided before residency that he was going to accurately report his hours even if it meant getting in trouble...if programs haven't made that change on their own and keep getting away with it, they won't change. They need some pressure from the top to "make" them change.

For the med school wives, unfortunately students aren't mandated to 80 hr week averages.; November 5, 2009 at 2:17 PM
Aarone said...: This comment has been removed by a blog administrator.; November 6, 2009 at 6:15 AM
Tif Sweeney said...: My hubby is a PGY1 in Anesthesia too!! Some months the hours can be terribly brutal. Others are not so bad! If he goes over his hours, he will get in trouble, so his programs monitors them pretty closely. And, it is an average as mentioned earlier. In a month, you cannot average over 80 hours. Some stipulations are going into place (not exactly sure where) in which the programs will be fined and it can affect their accreditation if these rules are broke. There is hope for those who come after us!!! It is getting better, especially when you compare it to before this 80 hour requirement was put into place!!; November 17, 2009 at 1:24 PM

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Wednesday, November 4, 2009

Hours

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