Residents in the US have 80 hours with maximum of 28 hour shifts, not a ton better. Though average salary is better at 58,000. Still, considering the hours worked and 8 years of schooling up to that point, ugh.

Residency is just a terrible idea through and through, absolutely insane. Where else could you start a job and be told "right so you're new here, this is life and death decision making, we'd like you to stay up working for 28 hrs straight doing this. Alright, get to work!"

If a resident gets two days off, it's called a "golden weekend." What most people refer to as, a weekend. It's just exploitation. Even more so when you consider Medicare pays for residents (and they even pay the hospitals more than the resident's actual salary! So the hospital pockets that difference and benefits from all the direct value the residents generate too). There's even an exception in US anti trust law to make the system legal. Glad more residents are unionizing here as well. Residency is horrible and needs to go.

https://www.acgme.org/globalassets/pfassets/programrequirements/cprresidency_2023.pdf

There's even this lovely line:

The program, in partnership with its Sponsoring Institution, must ensure adequate sleep facilities and safe transportation options for residents who may be too fatigued to safely return home

So, so tired not even safe to return home (which I mean they're right, it is not safe to be driving after staying up 24 hours straight) but continue doing patient care while you're that impaired, it's fine.

In a prospective study, new medical interns went from 3.9% meeting criteria for major depressive disorder to 25% after starting. And depression was linked with increased medical errors to boot. Of course mean work hours was a major association of depression too.

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/210823

Totally asinine, a whole enormous meat grinding machine that needs to go, but is stuck in place by historical inertia and current profits for large hospitals.

[–] explodicle@local106.com 2 points 8 months ago (2 children)

Is it rude to start asking them how long they've been up? I don't even want medical advice from someone who's been up 28 hours.

[–] Ranvier@sopuli.xyz 3 points 8 months ago (1 children)

I understand the sentiment but it's not really helpful. They're still the ones on call, they need to talk to you, and will be writing your orders and things anyways. Not really like they can just say, oh yeah I am tired I'll just go home and sleep and abandon all these patients here, why didn't I think of that?

Helpful things would be writing congressmen and senators about reform to the residency system, supporting unionization efforts. Change will only come if forced from above or if residents get more of a say. Ideal situation in my mind would be a more typical work schedule capped at closer to 50 hours a week, maybe with increased residency training time overall and increased pay during that time to compensate (need to keep up with cripplingly high student loan debt for those who didn't have wealthy parents who payed for medical school).

Even attending physicians will really need to start unionizing if they don't want to get totally lost in the shuffle, since they're mostly employed directly now instead of running their own practices or specialty group, they get very little say in how things are done.

[–] explodicle@local106.com 2 points 8 months ago

I'm imagining that I might just leave and try either a different place, or treat it myself. One can't blame a doctor for "choosing" to be up so long that they'll make an understandable but deadly mistake.

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