Friday, May 23, 2008

Hoping Beyond Hope

There are several items that I hope don't happen - even though I know there's a very good chance that they'll occur anyway. Like gas stopping its ridiculous and out of control move towards $4 and $5 a gallon.

What I really hope is just merely a rumor mill is this, a cut of work hours from 80 to 56 per week. I found this link from Medschool Hell - who, naturally, is in support of the move.

I've already blogged about this topic in the past, so I will allow you to read over that post and refresh yourselves. Clearly I do not believe cutting the work-hours anymore will lead to significant changes for the better.

What it will do is just lengthen an already long process with residencies adding additional years, create further punch-clock mindsets in residents entering the work-force, and leave a large topic of discussion still on the table: debt repayment.

Hell, as it is the government has been trying to get underpaid residents to pay back on loans by reducing the years that they can defer or forbear or simply removing the option of "economic hardship" from the list of reasons. So adding more years will do what? Create more financial burdens, reduce the chance to moonlight, make residency akin to a 40 hour a week job where-in doctors will become even more hesistant to do anything past 5pm? Is that what we really want?

Think about it before you'd say that working a few less hours isn't that bad.

17 comments:

Bostonian in NY said...

For what it's worth, some of the SDNers have their heads up their asses.

They're really goign to try to financially leverage programs into adhering to hours? Don't they realize that is going to further pressure residents into lying about their hours? Imagine the hell that would rain down on a resident if he reported an hours violation and then cost his program a couple grand on top of picking up half the patient load that they normally adhere to...that's not exactly going to foster a healthy learning environment, especially when the attendings (who pretty much monitor everything that the residents do) have to start picking up the patients that are getting dropped through the cracks.

If you want the PM&R lifestyle, you can deal with the PM&R paycheck and all the preconceived notions (right or wrong) that come along with it.

OMDG said...

I am totally ok with a 60 or so hour work week. That's still plenty as far as I'm concerned. I'd even be ok if they lengthened training a year. I'll already be ancient when I get done. What's one more year! At least with 60 hours/week I'd get to see my kids AS they grew up and not just after.

Interestingly, anesthesia residents do work a 60 hour week at my hospital, and get pain $100/hr for overtime. Doesn't sound so bad, does it? And they still finish in the allotted time.

Anonymous said...

Pardon my ignorance, but you guys pay tuition for your post graduate training programs, yes?

The Caffeine Lady said...

Aris: No. Med school is completely free in America... Everyone's just joking about "debt repayment"...

Anonymous said...

OMDG,

I've heard of some anesthesia programs that will pay "overtime" if residents work past a certain time or more than a certain amount of hours. Part of that comes from the ASA instituting hours rules long before the 80 hour mandate based on several malpractice cases involving tired residents and staff.

Even though there are a few that can get by (since anesthesia has less floor care they typically do mostly training-oriented items while at work, unlike some others) I feel many specialties require at least 80 hours. Surgery is definitely one. After all, much of the work is done after rounds - which would be harder to do if you shortened the work day. And I, for one, am not in favor of an additional year. I just don't love my debt that much.

Aris,
Yes, we pay out the ass for tuition. My debt is a mortgage and will only increase as I defer through residency.

Anonymous said...

Thank you, M. If you'd read my enquiry, rather than rushing in with a smart comment, you'll notice I was actually referring to postgraduate tuition, not medical school tuition. I wasn't clear as to whether the fees stop after graduation, or if you have to pony up for the training you get in residency, too.

OMDG said...

Aris,

To answer your question: No, you don't pay tuition for residency training. But if you take out loans to pay for med school, you will accrue interest on them during that time.

Anonymous said...

Ta, OMDG. That's what I suspected - just wanted to be sure. As somebody who graduated med school with an interest free, relatively small debt to the Government, it's interesting to hear from the other side. Our post graduate training comparatively takes a lot longer before we reach consultancy - partly due to the fact we don't work the horrendous hours you guys do over there.

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