Work Hours

Resident work hours is a hot topic in medical education lately, and is also a hot topic at our house. It isn't a secret that residents work a lot of hours, but living it is completely different than hearing about it. What surprises most people is that not too long ago the hours were even longer. The limits were only put into place around 2003 and in 2011 they are revamping them again. Our staff roll their eyes at us when we yawn or our heads bob during noon conference, and they will tell us stories about working for 120 hours per week when they were residents. With a smile they say, "The term 'resident' actually means something, you know."

Essentially, the current "recommended" work limits are:

• A total shift should not exceed 30 hours, but we cannot assume care of new patients after 24 hours. Practically speaking, we come in at 6am, admit patients all night, round with our staff the next morning, and then hopefully leave around noon.
• The work week should be limited to 80 hours/week averaged over 4 weeks.
• At least one 24-hour period per week should be free of duties averaged over 4 weeks (i.e. four days off per month, including weekends and holidays).
• Call cannot be more frequent than every third night. That mostly applies to surgery residents who are notorious for breaking work hours. In medicine, our most frequent call schedule is "q4" (every fourth night), and that only happens when we're working in the ICU.
• Any of these rules can be broken for the sake of patient care (i.e. one of your patients gets really sick and you want to stay to help take care of them).

It sounds like a lot of work. It is a lot of work. However, time actually goes pretty quickly. There is a lot to do and a lot to learn. Our patients tend to expect to see the same doctor every morning and in the middle of the night when they have questions. And, honestly, sometimes it is tough to hand off patients who you've been working hard to diagnose and treat to another resident who doesn't know nearly as much about them as you do. (Or maybe that is just me and the anal/controlling part of my personality).

Regardless of how difficult it is to trust another person with my patients, it is still always a relief to walk out of the hospital doors and into my living room where a little smiling face and a kiss from a handsome man are waiting.