[mv]

My current schedule is 12 days on 13 hour shifts followed by two days off. Resident physicians get screwed and only recently were 'limited' to 80 hour work weeks. I would love even a five day work week.

I have noticed my moral has dropped immensely on this schedule. It is definitely hard to balance work with social life, exercise, and sleep.

[cloverich]

Yeah but in all fairness that's only a couple years and is where most of your learning will occur.

Moreover, if the ama didn't limit the supply of physicians to boost salary, you could get better hours (post resident) at the cost of lower salary (still over 100k). Is that a trade you think most physicians want?

[PhasmaFelis]

> Yeah but in all fairness that's only a couple years and is where most of your learning will occur.

Oh, well that makes sense then. People learn best when they're depressed and sleep-deprived, right?

[kamaal]

No but in general you tend to get serious and learn a lot in difficult and pressing situations than other wise. It ends up being stressful, but good things come out of it. This is not a long term strategy, but works for a few weeks/months.

When I started my career, I went into a very famous IT firm here in India. Being from a non-CS background they put us through a grueling training schedule. Which together with the course work, assignments, project work, tests, interviews and exams put us on a 20 hour schedule for around 3-4 months- Failure means getting fired, and in this country where getting jobs is quite difficult for a fresher that was not even an option. We stayed in the campus hostel, pretty much training and occasional recreation is what we did.

Guess what even after 7-8 years later, the biggest edge I hold over my peers is that training. Basically because we went through every thing there is about out there. At the end, we might have gained what one would gain after 2-3 years of working in a few months. Needless to say that set a new bench mark for us, knowing we had absorbed the difficult and come out strong- You change into a different person.

[fizx]

You don't learn facts well. But you learn how to cope with extreme stress. Apparently the medical field values that. Some life-or-death surgeries are many hours long, so it makes some sense that this would be the case.

[droopyEyelids]

What percent of doctors do you think have do deal with hour long life-or-death surgeries? .5%? 5%?

[fizx]

The general-practice doctors I know all have stories about them. They're not uncommon. Also, doctors have on-call rotations. People get shot, stabbed, in car accidents, etc at all hours. So odds are that even if you avoid the planned long surgeries, you'll still have a low-sleep surgery at some point.

[collyw]

Most at some point in their training.

[sjy]

Why are working hours in the medical industry so crazy? It doesn't seem to be in anyone's interest.

[dsr_]

Tradition, hazing, survivorship bias, and the fact that the people who are in charge of the system are only starting to think of quality-control statistics as something that could apply to the practice of general medicine.

[shellum]

My brother in law just finished a residency and we asked him the same question. Apparently more mistakes are made in hand offs between doctors than from tired doctors.

[barry-cotter]

I am too lazy to check since I'm on my phone but I believe in the UK between less fatigue and fewer handoff errors it's a wash except for surgeons where there's a clear loss, as in under the new system more patients die.

[tghw]

There have been hospitals that have cut resident hours to more reasonable schedules. They measured the number of errors, hoping to see a drop. Unfortunately, the number of errors stayed the same.

The problem is that shorter hours increases the number of patient handoffs between doctors. Most residents cap at 12 patients. So, as you're trying to get out the door to go home, eat some food and sleep, you have to brief the incoming doctor on 10-12 hours of care for 12 patients. Either you have to go fast and skip some stuff, or you'll be there forever.

[dkersten]

So, what's really needed is a better tracking, monitoring and handoff system? I don't know anything about hospitals, so have no idea how they currently do things and if there even is a way to make a better system work (and if they would even budget for such a system), but just going by the comments here, it sounds to me that there is a big need for improvement.

[tghw]

I think it's probably more about protocol. One example is that some departments would hand off in alphabetical order by patient name. Seems logical, but if Ms. Abraham is doing just fine, but Mr. Zimmerman is in critical condition, well, you can see the flaw. They found that doing handoffs in order of severity helped decrease error rates.

The other issue is interruptions. Hospitals are busy places, and sometimes someone needs to get in and get some information from one of the doctors doing the handoff, causing a legitimate interruption. As we know, even a few seconds can derail your whole train of thought. It's definitely still an open problem.

[seanflyon]

The AMA artificially limits the number of doctors. Supply and demand.

[boobsbr]

I think it's almost criminal what doctors and residents are subjected to.