Palatino's recent activity
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentOh I responded to @Suuncle about this also but I am curoius: How do your 24 hour shifts work? We often do Q3, which is every three days it's a 28 and the day in between is either off (Sat, Sun,...Oh I responded to @Suuncle about this also but I am curoius:
How do your 24 hour shifts work? We often do Q3, which is every three days it's a 28 and the day in between is either off (Sat, Sun, Mon) or 12-hr (Tues, Weds, Thurs, Fri).
When we have day/night teams it's usually a 14 hour day shift team and a 12 hour night shift team with alternating 24s on weekends. My least favorite schedule was 6pm-6am 6 days a week.
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentThe culture is getting better. Cardiac is bad, I have effectively ruled that specialty out. Once the training is over if you find a good position maybe you can eke out a reasonable quality of life...The culture is getting better. Cardiac is bad, I have effectively ruled that specialty out. Once the training is over if you find a good position maybe you can eke out a reasonable quality of life if you have good partners and mostly elective cases and someone else managing ECMO. The training is atrocious. 100+ hour weeks for years. And at home you are doing research, studying, living, and breathing cardiac surgery. I know one female cardiac surgeon but I don't know much about her at all. I see the cardiac ORs running all night long. They are operating when I leave the hospital at night, and operating when I get there in the morning.
Some specialties are better. Breast surgery has no emergencies and is a primarily scheduled breast cancer surgeries. It also tends to attract more women and patients in my experience appreciate female physicians.
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentHow do your 24 hour shifts work? We often do Q3, which is every three days it's a 28 and the day in between is either off (Sat, Sun, Mon) or 12-hr (Tues, Weds, Thurs, Fri). When we have day/night...How do your 24 hour shifts work? We often do Q3, which is every three days it's a 28 and the day in between is either off (Sat, Sun, Mon) or 12-hr (Tues, Weds, Thurs, Fri).
When we have day/night teams it's usually a 14 hour day shift team and a 12 hour night shift team with alternating 24s on weekends. My least favorite schedule was 6pm-6am 6 days a week.
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentYes I have patients who also have to change hospitals due to employment changes. I find this to be super frustrating from a physician standpoint. They have their own surgeon who has done multiple...Yes I have patients who also have to change hospitals due to employment changes. I find this to be super frustrating from a physician standpoint. They have their own surgeon who has done multiple surgeries on this patient and known them very well. Then they get transferred to us and we have to start from the bottom figuring out what surgeries have been done, what medical treatment has been attempted, what needs to be done.
My advice for anyone here is to keep meticulous records of their medical care and especially operative reports (which you often have to ask your surgeon for) because on our end it's very piecemeal.
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentNo hallucinations yet.... I do feel a bit slower. When talking to patients in the morning sometimes I have to take extra time to think about what I am going to say next. I think my reaction time...No hallucinations yet.... I do feel a bit slower. When talking to patients in the morning sometimes I have to take extra time to think about what I am going to say next. I think my reaction time is a bit blunted but I rarely have to do anything technical after 22+ hours, usually the fresh team comes on by then. Usually.
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentMost of my colleagues use energy drinks. I find it gives me a bad stomach ache and I get jittery and can't focus when I need to. I drink a coffee in the morning and do my best to stay hydrated. I...Most of my colleagues use energy drinks. I find it gives me a bad stomach ache and I get jittery and can't focus when I need to. I drink a coffee in the morning and do my best to stay hydrated. I usually have some snacks like nuts, trail mix, beef jerky during the day and nights. I try to sleep when I can. On a good night I can get 4 hours of sleep. On a bad night it's zero.
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentI am in a blue state. I have heard from my ob-gyn colleagues that they are getting patients from red states who are asking for abortions and are at higher risk due to delays in care. Like most of...I am in a blue state. I have heard from my ob-gyn colleagues that they are getting patients from red states who are asking for abortions and are at higher risk due to delays in care.
Like most of this community I am left-leaning. I think healthcare is a right, not a privilege and everyone should have access to high quality healthcare. I think that poor primary care is making Americans sicker and this is costlier in the long run. I have amputated too many legs due to poorly controlled diabetes for my comfort. I hate that patients are being punished for having medical conditions and lack the support they need.
I also have worked in a lot of government run hospitals. The bureaucracy and inefficiency at the VA is second to none. The poor quality of care at county hospitals makes my stomach turn. I am worried that with the ballooning costs of healthcare globally the government simply wouldn't be able to keep up with the needs of our country. I don't have a solution and am worried about what the next twenty years will look like for the aging population as well.
I found surgeons tend to be right-leaning even in my blue state. Usually, this is because they are strongly independent people who dislike government interference in their daily practice. They feel like they are able to provide better care when there is less regulation. To an extent, I believe them.
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentHaha I have heard stories. I am married though and try to keep my personal life away from the hospital as much as I can.Haha I have heard stories. I am married though and try to keep my personal life away from the hospital as much as I can.
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Comment on General surgery resident in the US on a 28 hour shift. AMA! in ~health
Palatino Link ParentGeneral surgery historically was the basis of surgical training and afterwards surgeons would pursue additional training to sub-specialize. Today surgeons tend to specialize earlier and pick a...General surgery historically was the basis of surgical training and afterwards surgeons would pursue additional training to sub-specialize. Today surgeons tend to specialize earlier and pick a path at the end of medical school. Specialties such as orthopedic surgery, neurosurgery, ENT and head and neck surgery are separate training pathways. Other specialties that were originally from general surgery are also now separating (plastic and reconstructive surgery, vascular surgery, cardiac surgery, thoracic surgery). This leaves general surgery with surgery involving the alimentary tract (esophagus to anus), hernia surgery, skin and soft tissue surgery, biliary tract surgery (gallbladder removal), some endocrine surgery (thyroids, parathyroids, adrenals), cancer surgery involving the GI tract, solid organ transplant surgery, breast surgery, and trauma surgery. General surgeons are also qualified to run surgical ICUs and we spend lots of time training in various ICU settings.
The pressure is constant but I am adapting to it. I found first year to be more stressful even though second year is higher stakes and more responsibilities. I find stress increases in unfamiliar situations which fortunately are less and less as my training goes on. Stress also increases when the number of things I need to do is higher than the amount of time I have in a day, and as I have gotten more efficient this is also less often. I wouldn't say this field is for the faint of heart.
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General surgery resident in the US on a 28 hour shift. AMA!
Hi everyone! I am new to Tildes and wanted to say hi to the ~Health community. I am on a 28 hour emergency general surgery call today and have a bit of downtime. I also noticed that the post on...
Hi everyone! I am new to Tildes and wanted to say hi to the ~Health community. I am on a 28 hour emergency general surgery call today and have a bit of downtime. I also noticed that the post on the moral crisis of America's doctors had some interest so I thought I would answer any questions about that or training to be a surgeon in the United States. I am finishing my 2nd year of a 7-year training program. Ask me (almost) anything!
44 votes
For residents the max we are allowed to work are 28 hours straight. We also cannot work more than 80 hour weeks averaged over 4 weeks. (OK to work 110 hours one week and 50 hours the next week).
As an attending surgeon there are zero regulations. I have seen attending surgeons pass out from exhaustion.