Counting 80 hours: the life of a pediatric resident

toddler_doctorAt a recent block party, neighbors asked me questions about the life of a resident.  It amazed me how little the general public still knows about the hours a resident works.  Over the years, TV shows have shed some light on what the experience of a resident is like, although none are quite realistic, but it is hard to appreciate from a one hour sitcom what it feels like to do a 12, 24, or 30 hour call.  I found myself repeating, “yes, an 80 hour week,” a few times before the crowd seemed to believe me that this was possible.

I was reminded of when I would call my mom on my post-call bus ride home, before my ritual of eating Frosted Mini Wheat cereal, sleeping with an eye mask to block out the afternoon sun, waking for dinner, and then returning to bed until the next morning.  These calls to my mom occurred at around 1 PM when I was leaving the hospital after a 30-hour call night, during which I likely had no more than a short nap.  In fact, I was always so terrified that I would sleep through an important page that if I did actually get to lay down in a call room I tried to make myself so uncomfortable that I wouldn’t fall into a deep sleep and would clip my pagers and phones around my collar to be closer to my ears.  Anyway, when I would call my mom post-call she would often say something like, “oh you’re out early.”  I would remind her that this wasn’t actually early for me as I arrived at work the day before, but I understood that to the world around me I was heading home long before others were finished with their typical day.

It shouldn’t surprise me though that people outside of medicine are confused by a resident’s schedule because I found nurses in the hospital who also couldn’t understand when we arrived and left.  New nurses on the units would often ask me questions like “how many days a week do you work?”  When I explained that I had four days off per month, they seemed to think I somehow miscalculated.  During a Winter snowstorm one year there was talk about everyone having to sleep at the hospital instead of traveling home in dangerous conditions.  One nurse came up to me and said, “Oh my God, can you imagine having to sleep here?”  I tried to look sympathetic as I thought, yes, I do it every fourth night!

After explaining the lifestyle of a resident to my neighbors they followed with, “well they must pay you well for that.”  Then I had to explain how actually the salaries are fairly standard and are roughly the same as the hourly rate for the hospital cleaning staff.  Suddenly they seemed to look at me with pity and disbelief that anyone would sign up for this position.

The funny thing is that the more I talked about residency, even the long hours and poor pay, the more I started to become nostalgic and miss it.  I missed being there all of the time and feeling like I knew the pulse of the unit where I was working.  I missed admitting patients in the afternoon, spending the evening caring for them, and then presenting them to the team in the morning knowing every single detail.  I missed having hot fudge sundaes by the windows in the atrium with my co-residents at midnight.  I missed the adrenaline rush of the ER trauma pager and the weight of the lead vests on my chest.  I missed holding newborn babies seconds after they were born and presenting them to their mothers.  I missed the thrill of hitting an arterial stick/lumbar puncture/intubation on the first try.  I missed working on a team.  I missed being the one to tell a patient that they were being discharged and seeing them leave healthier than they arrived.

As I work with residents in my clinic now I see them work through their highs and lows.  I feel their struggles and it reminds me of my own.  Residency is messy.  No one does it for the lifestyle and it looks awful on paper, but the experience is certainly unique and a special stage in a physician’s life.  Others might not always understand the details of those 80-hours, but residents know that the lessons learned there cannot be counted.

 

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24 Comments

  1. Kudos to you for having your first child during residency. My husband is an orthopedic surgeon (now in practice for about 8 years) and I know how brutal those years of training can be.

    1. Thank you for your praise. In retrospect, having a child during residency might not have been the best idea, but there are only so many child-bearing years to chose from!

  2. Very interesting, but it’s also troubling! How can you maintain good health, clarity and focus when you are on a schedule like this? To me, this would be a great concern if anyone I loved went into the field. I also wonder why it must be done like this – timing? Perhaps it would take too long to get through the process otherwise?
    Gina B recently posted…Review: e-cloth eBody Spa CollectionMy Profile

    1. Gina, you are hitting on something that is a hot topic right now and an area of much research. Since my residency, there have been restrictions on how long residents can work for. I will say though that even out in practice, physicians are called upon to make important decisions in all types of conditions– sleep deprived, distracted, unhealthy, etc– and residency does prepare us well for the “jump into action” reflex that we need for our careers.

  3. Thank you for sharing your insights into the residency experience. I appreciate the pride you take in your work, but don’t you think this article is contributing to the god complex that many doctors possess? As a manager in the quality department of an urban medical center, I can confidently attribute this complex to many otherwise avoidable deaths and patient safety issues.

    Next time you shed some light into the “real life” of a physician, please maybe add a caveat about all of the resources available–often ones that TV shows don’t show– that make an intern’s, resident’s, and attending’s work life much more pleasant than that of some of their colleagues

    1. Thank you for reading and your comment. I have to disagree though. I wouldn’t say that many doctors have a god complex, nor do I think acknowledging how hard residents work and the low pay they receive is contributing to the issue of patient safety. Resident duty hours are closely monitored so that they comply with ACGME recommendations for safe practices. Furthermore, residents are under much closer supervision that other physicians. As far as the “real life” of a physician, I’m not sure what resources you are referring to, but I assure you that what I described is a real physician’s life, as it was mine.

  4. Thanks so much for this blog! Great explanation of the hours and life of a resident! It definitely was my life during residency (although I was family medicine:) I found that the nurses thought we started when they started their shift, especially the night shift nurses. When they discovered that we had been there since 6am and wouldn’t leave until noon the next day, they were a lot nicer about the pages:) I still find it offensive how much residents get paid compared to new nurses or to a legal secretary! (My intern year I was paid less than my friend who was a legal secretary and only had an associates degree and the new nurse who had only started 2 weeks after I did!) With that all being said,I would totally do it again. Definitely major life lessons were learned:)

    1. Thanks so much for your comment. Residency is still such a mystery to many people, but I am hoping that posts like this can help explain it better. I am happy that it is resonating with so many people. I hope you keep reading.

  5. When I originally commented I clicked the “Notify me when new comments are added” checkbox and now each time a comment is added I get three emails with
    the same comment. Is there any way you can remove people
    from that service? Thanks a lot!
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    1. I’m sorry, but I looked all around and I can’t find a place to unsubscribe you from that. In the email that you receive there should be a place to unsubscribe though.

  6. I wish veterinary residencies were legally limited to only 80 hours a week. I’ve actually had a conversation with our surgery residents where they have said they wish they only had to work 80 hours a week.

    1. I don’t know anything about vet residencies but I would be curious to compare/contrast! I think 80 hours is a reasonable limit for any job though!

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