In medical school, 120 hour weeks really only exist for 4th year med students who are on sub-internships in surgical specialties like neurosurgery, orthopedic surgery, general surgery, etc. Students in those fields do 3 or so month long sub-i's at hospitals they want to do residency at. They basically function as month long interviews for those programs, and are also used to get letters of recommendation from prominent faculty in the field. People who are interested in those fields know about the hour requirements on sub-i's and in residency, and self-select in a way.

The reason resident physicians work so much is because residents make $60k working 80+ hour weeks, and the PAs or NPs who would be willing to cover the floors at night would make $150k+ working 40hrs/wk. Residents also have no collective bargaining power because of the residency match system. You can't easily leave one program and go to another because you don't like the working conditions, for example. If you want to leave, you're more or less blackballed unless you're switching fields. And you don't want to speak up about the conditions because you've got $300k in debt and a degree that's useless until you finish residency.

I'm currently in my 4th year of medical school, and I have to clarify your comment on the hours worked. We're held to the same hours limits as residents, which is 80 hrs/week averaged over 4 weeks and an average of 1 day off per 7 days. We most often come near these hours on surgical specialty rotations (like the ones you noted). However, these are completely voluntary rotations. I'm not interested in surgery, and I have no surgery rotations scheduled at all during this year. Most of this year is actually spent on residency interviews. I've been traveling to different cities in the US about twice per week since October, and will continue through the end of January with breaks for the holidays. I have no hospital duties from September–January.

The 3rd year of medical school is much tougher since we spend about 10 months of that year on rotations in the hospital. While some rotations are much lighter, others like surgery again get close to the hours limits. This is complicated by the shelf exams we take every 8–12 weeks. These require an additional ~2–3 hours/day of studying and most of a weekend day as well. Obviously, this study time is not counted towards the hours limits, but it definitely factors into fatigue and burn out.

Where do we go to change that 80 to 32? This thread is making me feel unsafe.

So the other side of this problem is resident education. The ACGME in conjunction with medical specialty boards govern the requirements for graduating from residency. There are hard requirements on how many and which kinds of procedures you need to do and patients you need to treat over the course of your residency. Residents meet those requirements with the current average 80 hrs/week and ~3–5 years of training. Moving from 80 to 32 hrs/week would likely require an expansion of training time to ~6–10 years, which residents would be absolutely against (I know I would be). I've been in school forgoing a "real job" with a salary for nearly a decade, and I'll be in my mid-30s before I become an independently practicing physician under the current system. Although the work hours are abhorrent, I don't want to add more years to my training in exchange for better hours.

So they are being taken advantage of then.

Sounds like they should just legislate away the "Residency match system."

Ironically, congress passed a law in 2004 to give the NRMP, the organization that runs the match, immunity from antitrust legislation. https://en.wikipedia.org/wiki/National_Resident_Matching_Pro...

Saying that "pre-med training" (whatever that means) consists of 120 hour work weeks is not accurate but it's probably just because we're using the wrong words.

Pre-med = college, and aside from the highly scientific work load is no different than any other college experience.

Medical school (no longer called "pre-med" by anyone) is typically 2 years of classes and 2 years of clinical rotations. The rotations are not going to be 120 hours a week but may be 60-80. But unless you go to a teaching hospital and consent to student contact (which may or may not be a requirement of treatment) no med school student is touching you.

Residency is after med school (they're full doctors now) where you train your specialty, and at least in the 4 year program I'm familiar with, their title is intern, resident, resident, senior resident for each of the four years. They have increasingly high levels of responsibility as they progress and by the 4th year they are basically oversight/management of the other residents who assist on complex cases and bring in at attending physician(s) for big stuff. Hours are typically 80+ and I'm sure you could approach 100 for very demanding or emergent specialties but it's certainly not "pre-med training" and 120 is pushing it for sure.

After you graduate residency you move to an attending, fellowship, or research position and the hours drop back down to the 60-70 range and decrease as you gain seniority.

And on top of those 60-80 hours per week you need to add all the time prepping for exams and boards, correct? That study time is work too, and that pushing up to 120 hours per week.