Monday, May 22, 2017

4 days

During my Medicine rotations during med school and also during my Medicine intern year, we had four days off per month.  I believe that's the minimum that residencies are forced to provide.

Maybe this makes me a delicate little snowflake, but I think 4 days off per month is nowhere near enough.  Especially when the other 26-27 days of the month, you are waking up super early, leaving super late, and sometimes spending the night in the hospital.  I remember one resident said she got a simple cold and it lasted for two months because she was so overworked that she couldn't shake it.

Is it any wonder residents are so burned out?

There was one month during internship when I was feeling really depressed and burned out, and I was going into a stretch of working nearly two weeks nonstop with two overnights wedged in there.  I asked my lovely (not) senior resident if there was any way I could have even a half day off in there.  In retrospect, I'm embarrassed I asked because the answer was so obviously no.  She let me have it: "If you get a day off, that means someone else has to cover for you!"  

The solution, in my mind, is that we need to train more physicians so the ones we have aren't so overworked and miserable.  Yet I doubt that the four days off per month policy will ever change.


  1. As an outsider I always thought residencies were unnecessarily grueling. What is the point other than getting cheap labor?

    1. Cheap labor isnt the only point, but it's pretty major. The rest is the younger generation sucking up to the older generation who walked uphill to work both ways in the snow every day. 😐

  2. I think the culture that says that this is okay needs to change, and I say this as someone who is not a doctor and just reads your blog because I like reading things.

    It does not make you a delicate little snowflake to be a human being with a human body that needs downtime. As a physician, you know more than most people about how bad it is for the body and the brain to keep up that pace. I've never understood why med schools and residency programs operate the way they do. It's like you're practicing modern-day medicine with the public, yet practicing blood-letting and attributing physical ailments to demons amongst yourselves. It makes no sense.

  3. I was at the National Patient Safety Foundation conference last week. There was a brief discussion on this when the science in clear that judgment becomes impaired, and simple tasks become daunting. They was a survey of residents who reported an increase in traffic accidents after working 24 hours as opposed to getting "regular shifts". FAA mandates pilots only can fly so many hours yet, residents and even attendings can be up 24. The madness needs to stop for safety sake, and the government needs to fund more slots to pay for it.

  4. This needs to stop not only for the residents' sake, but for the PATIENTS!

  5. In my experience, it wasn't even "four days off." Those "days off" - particularly at the beginning of intern year - were days to catch up on work (writing discharge summaries, usually), sleep, and life (laundry, grocery shopping, cooking for the week). It's a miserable way to live.

    I can think of some possible ways to justify the experience, but I don't really think we're better served by this sort of thing.

  6. I found my days off during internship were spent sleeping. I have no idea how people without partners showed up to work with cleaned and ironed uniforms. I still remember the first day I travelled both to and from work all in daylight, ten months after I started, and I live in the tropics!
    All hail my long suffering husband, who sees me on average six days a month. Despite the fact I am no longer an intern and even have minions of my own now (I try and treat them well)