I felt upset about her hours all through medical school only to discover residency is worse. There are no fellows in her program either so the residents handle it all. I feel I've just accepted her terrible schedule at this point. I'm most saddened that we won't be able to have children for another five years until she's completed her fellowship, especially because I'm in my mid-30s.
Writing this comment makes me realize how painful it feels at times that her medical training runs our lives.
My wife is getting ready to start an OB/GYN residency next year (lasts 4 years for those who don't know). She just wrapped up interview season and each program had just about the same scheduling for their residents: 5 12-hour shifts at a minimum if you're lucky with one 24-hour shift per week on top of that. Often times I heard "one weekend off every six weeks". Then there's call.
I write this as I read more through your comment... the statement on the kids, medical training running your life... all true.
The other part, that I'm sure you can personally relate to, is "The Match". The "sorting hat" algorithm that all 4th-year med school students have to go through. For those unaware, the match dictates the program that a doctor candidate (MD or DO) must attend for residency. Given where my wife attended medical school, we already know that we're going to have to pack up and leave the home that we've established over 4 years since there are no residencies in our region. But since everything is done through "The Match", it's really a toss-up where in the country we end up (she applied to every program in the country since competition mandates that everybody do absolutely everything)... we'll be finding out in about 6 weeks where we will live come summertime. "Runs our lives"... so accurate.
I do what I can to support my wife through this endless process, but boy is it exhausting for everyone involved. I have no clue how she does it.
It truly is an enormous sacrifice of - really - some of the best (at least youthful) years of your life. Want to become a doctor? Say bye-bye to your 20s.
Edit: drawing context from another person who also commented on your post, we've also heard kids during second-half of residency can be a good route to go. We're thinking 3rd year ourselves.
The Match was especially brutal on us because there were only a handful of programs within 2000 miles of our home (West Coast) so we said goodbye to our lifelong friends and family and moved out East.
It's a bit late for you, but I created a website (https://medmap.io) to help with The Match process. I have plans to improve it and make it more community driven, but it at least helps visualize your options.
- I don't see a way to differentiate between DO and MD programs. Along the same lines, several of the programs she applied to (like Grandview in Dayton: http://www.ketteringhealth.org/grandviewmeded/residencies.cf...) don't appear on this map (though some do, but again no indication of DO). What is the datasource for the map? Is there any way it could be enrichened?
How does this work out in the long term?
In the places I've seen that (not medical). It stops after a while because either the rhythm got back to normal or people burned out.
As for burnout, alcoholism is relatively high among many medical specialties: https://www.sciencedaily.com/releases/2016/03/160314111353.h...
Of course, it's a different story if she will be in a more sane line of work, such as hospitalist, ER doc, etc.
Because under normal circumstances, a competently run hospital should be able to function with normal 8-hour shifts. If that's not possible, then management fucked up. Accepting these kind of hours as standard is completely unreasonable and dangerous, especially in hospital, where lives depend people being awake enough to do their job safely. People responsible for that should not merely be fired, but locked up.
>Medicare already funds a bulk of the residency training in this country -- to the tune of about $9.5 billion a year. But its support was capped by Congress in the Budget Control Act of 1997.
Most doctors don't work for the hospital. That's one of the many reasons behind the strong opposition to Obamacare the creation and consolidation of regional medical systems is making more doctors salaries employees and reduces their bargaining power.
In my case, I suffered from this issue after a back surgery when some dumbass hospitalist read my chart wrong and told the nurse to cut off pain medication 10 hours after a spinal fusion. I asked the nurse for meds after she woke me up at 3 AM (to take my blood pressure and ask if my birthday had changed) and she refused and essentially accused me of shopping for narcotics.
When my surgeon checked in on me at the start of his day (5AM), he was shocked and got things fixed.
But couldn't this also be explained by said person lacking enough sleep?
Er, why? This reeks of a pretty serious administrative fuck-up.
When my wife was having our baby, the nurses had to log into three different systems -- an OBstetrics system, the hospitals charting/EMR and the pharmaceutical system. That meant going through the ritual 3 times.
A doctor can't necessarily predict how much time a patient will need. If a doc is on an 8-hour shift (hypothetical; I doubt any docs are so lucky!), and gets a new patient at the 6 hour mark, it might not be known if the patient will only be in the hospital for an hour, which would be fine, or 4 hours, which would push the doc to 10 hours.
As the argument goes, that patient is safer staying with the doc into his/her 10th hour on the job, versus being transferred to a different, fresher doctor midway through. I think there's enough truth there for it to be persuasive, but 1) there are limits to how effective a doctor is going to be after a certain amount of time, and the benefits of patient continuity must start dropping as the doctor has been working longer, and 2) there seems to be little attention paid to improving the process of handing a patient off between two doctors, which could further reduce problems related to lack of continuity to the point where a doctor who has been working 10 hours will cause more bad outcomes than shifting patients to fresher doctors would.
But that's a big part of the problem already. It shouldn't be luck to have an 8 hour shift, it should be standard. And of course there may be times when circumstances demand you deviate from that standard, but if you start with 12 hour shifts, you already start wrong, and it can only get worse.
Residency, by not granting you those things that people normally take for granted, helps you appreciate them!
All women deal with it differently, but most are able to function within their normal bounds until at least the six or seventh month.
> Writing this comment makes me realize how painful it feels at times that her medical training runs our lives.
s/runs/ruins/?
smh. "freezing eggs" is not a trivial solution.
https://www.theguardian.com/commentisfree/2015/oct/21/women-...
If you don't have the time to have sex and give birth, you sure as hell don't have time to go through IVF retrieval cycles!
We need to start addressing the leading cause of medical accidents - physicians/nurses sleep deprivation.
Nursing in many states is challenged by unsafely high patient:staff ratios, excessive documentation requirements (on extremely slow user interfaces), and the need to vigorously double-check physician's orders (dangerous drug interactions, over-dosages, etc).
medical residents will routinely do back to back 24 hour shifts with no sleep and even the ICU attendings will do a week of every other day 24 hour shifts.
The 16 hour rule only applies to interns. Once you reach second year the rule is 80 hours a week averaged over four weeks. This means that 100 hour weeks still do happen.
I'm laughing...
Is weed a kind of tea, or is that an energy bar?
Next you're going to be blaming the patients.
Also, I work 7 days in a row and then have 7 days off, which I absolutely love. I have the option of working 5-days every week and having weekends off, but I prefer my current schedule.
I think I'm pretty well-paid, but are there better/easier ways to make money? Yes, of course. My college roommate probably makes more than me and my understanding is that he just sits in meetings and adjusts Excel spreadsheets all day managing someone else's money. But hey, whatever. I could work at night instead of the day, it would be easier (no discharges), and I would make over 430k. But I don't want to do that. Instead, I work with a residency program and get to teach, which is very rewarding.
I think overall it's just a matter of perspective and expectations.
They explicitly said 17 hours was rare.
But yes, to agree with the sibling comment, I'd prefer to never have any doctor in any hospital seeing a patient after they have been working for 17 or more straight hours.
I hear about doctors like you, but I have never experienced someone like it in real life.
Maybe one day.
My hunch is that when a plane crashes, everyone freaks because planes aren't supposed to crash. When someone dies at a hospital nobody notices because people die at hospitals all the time.
Is this problem US specific, or global? And, isn't the real problem a scarcity of qualified doctors? Which, if people follow your advice, becomes worse?