Tuesday, May 28, 2013

Residency Should Be Limited to 40 hours Per Week

Residency should be set to a maximum of 40 hours per week.  The idea that a person can be productive, efficient, and offer their "best" selves for 80-100 hours per week is false.  By allowing a normal schedule for doctors in training, this will allow for balance in their lives and ultimately better care for patients. 

Residents will be happier and nicer to patients. The majority of residents who are apathetic, short with staff and patients, and visibly burnt out are in specialities where they work more hours per week.  One of the greatest gifts an MD can give to patients is truly listening and understanding their patients.  When you've only slept for 3 hours last night, this is impossible. 

"But we did it, so you have to do it too." I understand that before residency work hours were set to 80 per week, prior MDs' routinely worked 100-120 hours.  But times have changed.  We are busier than they were 20-30 years ago.  Before they probably got more sleep and had less patients in the hospital.  The number of patients seen in ED and hospitals has increased each year.  More hospitals are shutting down and the hospitals that are open continue to see more patients. 

"We won't get enough training."  During residency, I noted there was a lot of downtime and a lot of "non-clinical" activity.  For example, waiting for attendings in clinic to present, hunting down an old CT report that was done at an outside hospital, or faxing paperwork.  Residents spend time doing miscellaneous activities, not relevant to their clinical skills. Residency should be like an espresso of information. The rest should be delegated or deleted.

Less depression, anxiety, and alcohol/drug abuse.  Every year, 300-400 doctors commit suicide. That's almost an entire medical school.  I believe that one of the contributors to this is being overworked and burnout.  Since residency and medical school sets the foundation for our clinical careers, we need to get the right habits from the start. 

Doctors are human and need balance.  The way we treat and respect our residents will be the way they treat and respect their patients.  And sooner or later, we will all be patients.


Skeptical Scalpel said...

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White Coat Investor said...

I also disagree.

I agree for career longevity that 80 hours a week is insane. But for residency.....I think the pendulum has swung too far. I was the first year with the 80 hour a week limit. I did 120 hour weeks as a med student. That's not smart. But I think 80 hours a week is fine outside the ED and 60 on shift in an ED. The idea that someone can't learn and can't give fine care more than 40 hours a week is dumb. That's not residency. You're not living in the hospital at all. Ask residents if they'd rather do a 6 year residency, at $45K a year for 40 hours a week or a 3 year residency at 80 hours a week. There's your answer. Too much to learn in 3-5 years to just do 40 hours a week.

There's a poll on Sermo, so far 92% of doctors disagree with you.

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