What is the point of it? is it to cut down on healthcare overhead by having a virtual doctor work for $7 an hour. is it a hazing ritual. Is it just the way its always been done so people still do it. do they need the experience or what? I dont see the point in working someone 120 hours a week sometimes as it will just put patients lives at risk, why bother?
I don’t believe that Maryland residents are more overworked than the residents of any of our other states or commonwealths. What makes you think that they are?
i meant MD as in medical doctor. I thought some people would not know what a resident was unless i put MD with it.
Sure confused the hell out of me, too. Especially as I’m a “MD resident” in the sense of being a person who lives in Maryland.
You answered your own question when you called it a “hazing ritual”. From what I understand, medical residents, like military recruits, are overworked to prepare them for working under extraordinary conditions. Of course, reduced costs probably has a lot to do with it too, now that MBAs are making medical decisions for HMO members.
Because the cost of living is too high. They should move to VA.
With physicians (see, there’s a less confusing term, Herr General), it’s a lot of “we did this so now you have to do it too”. I’m sure there’s a lot of rationalization within the medical community of why it’s a rite of passage.
Actually, it’s a hell of a lot better than it used to be. They’ve passed a lot of regulations on the hours you can work as a medical resident in the last several years. Now, in most specialties, you’re only allowed to work 80 hours a week. Sugery and anesthesiology are still allowed the crazy-ass hours they’ve always had, I think, but it’s a lot a lot better for most residents.
Frankly, I can’t imagine how utterly hideous it must have been to be married to a resident 20 years ago, when 100- to 120-hour weeks were the norm. Dealing with the constant exhaustion and depression and lack of quality couple time that the current system produces is quite bad enough. Dealing with the old system must have been pure, unadulterated hell on earth.
If you want a look at how medical education used to be, I suggest reading The Intern Blues by Robert Marion, as well as his Learning to Play God. The House of God is a pretty good novel about residency. Dr.J says it’s all just like real life, except for all the sex.
I thought Dr.J was an active resident so he wouldn’t be affected by the old way of life. I know Qagdop the Mercotan (whatever his name is) was a resident when working 40 hrs straight was normal.
Are you married to a resident CrazyCatLady? all the documentaries i’ve seen seem to imply that marriages almost never last a residency. Must be hard.
ShibbOleth, thats actually pretty funny. should’ve said ‘physician residents’. damn.
SMOOCH
According to my doctor sister, it’s a juvenile rite of passage that amount to little more than hazing.
And, yes, it does endanger the public for the amusement of the older doctors.
Like fraternity hazing, some says ‘boys will be boys’ and doctoring is a man’s world, but perhaps the increase in women residents will change that attitude.
Nope, all residents in all programs are now limited to 80 hours a week, 30 hours at a stretch (with no new patients or call responsibilities after 24), and no less than 10 hours between shifts.
Why do we do it/have we done it? There’s a saying among the hard-core docs that the only problem with being on call every other night is that you miss half the cases. Working you to death was supposed to teach you to be a strong, effective physician who can handle anything thrown at you.
Fortunately, good sense has prevailed, and while 80-hour weeks and 30-hour shifts are tough by any measure, and the job is still emotionally draining, it’s not quite so ridiculous as it used to be.
As we’re constantly reminded, it was the public (and the threat of Congressional action) that led us to enact rules like these. The medical profession has fought it tooth and nail, and I heard so much bitching about it that I flatly forbade anyone to diss the work hours rules in my presence. I’m a believer, because I know how useless I am on a post-call afternoon, and I know how tough residency has been on my marriage, so I refuse to feel bad about “only” working 80 hours a week.
(Oh, and yes, CCL is married to a resident–me. Our being married always comes as a surprise, it seems.)
Dr. J
Yeah, Wes, I’m married to Dr.J. He’s currently a second-year, so he’s reaped the benefits of the reforms they’ve made to the system. Those changes are pretty damned recent in the scheme of things, though; they’ve all been made within the last fifteen to twenty years. Go read The Intern Blues. It’s a non-fiction account of a group of peds interns in the early-to-mid eighties, before they started putting in hours caps.
Like I said, it’s hard enough to hold a relationship together the way things are now. The divorce rate for residents tends to be fairly high even in good programs, and it tends to be astronomical in the really tough ones. It just boggles my mind that anybody managed to hold it together under the old system.
As for why the system is the way it is, there are a lot of contributing factors. Part of it is that that’s how it’s always been done, and what was good enough for the Old Guard is good enough for the newbies. Part of it is a weed-out thing, seperating those who can handle the stress and exhaustion, and those who can’t. Part of it is economics, and how much staff a hospital can afford to hire. Part of it is that it’s hard to come up with a better way to do things that’s still affordable, so changes come really, really slowly.
I just don’t see how the fact that patient care would be compromised wouldn’t make medical professionals rethink the residency hours. This is kind of off topic but there is an idea floating around putting a cap on nursing hours too, 60 hours a week max, 12 hours at a time max for the same reason, because overworking nurses puts patients lives at unnecessary risk.
http://story.news.yahoo.com/news?tmpl=story&u=/nm/20031104/hl_nm/health_nurses_dc_1
IMHO
Not a doc here, but I’ve heard interviews with MDs who support the traditional workload and suggest that they think that the traditional residencies, in addition to being a sort of boot camp to toughen you up…also expose the residents to the totality of a patient’s conditions. You don’t just see the patient after breakfast at 9am, but at all hours of the day. This (according to them) is a good training to understand progression of diseases etc…