stupid question

i think that who ever told you it varies by program was leading you in the right direction. you will busy no matter where you go, but thats kinda the point isn't? How else are you gonna get the experience you need before you are on your own? That said, there is a point where you stop learning and start just putting in service (i.e. you have done 3 million tibial nails, is one more really helping or just keeping you up on call). This is what probaly varies a lot also b/t programs b/c of the differing nature of the institutions type of volume, etc. Sometimes smaller places will keep you just as busy on call as a big urban trauma center b/c they are the only center in a particular area so they get everything. I have several buddies in Gen surg internships right now, and i can tell you that they all work like dogs, and most of them arent really seeing how they will possibly fall under the new 80 hour rule. as a third year you should be concentrating on honoring as many rotations as you can to help you get good letters/deans letter, etc. Make yourself as competitive as you can so that if you do decide to make resident lifestyle a large part of your ranking of programs you can have a better shot at the place you want!

Good advice Bonedoc,
One thing I may add: My experience in talking to residents on the interview trail has lead me to the conclusion that some of the posted information on FREIDA (particularly hours for ortho) should be taken with a grain of salt. Plus, with the new 80hr work week coming this information may quickly become even less reliable.
As far as choosing residency based upon the lifestyle, be careful. I think many people on this site would agree that if you truly enjoy orthopaedics, you don't really find yourself counting the hours passing. Just a thought.
Good luck tearing up 3rd year.

thanks for the good advice guys, it really helps - but i still don't know, is ortho as bad as gen surg in terms of hours...anyone have a guess as to what the avg is per week (do any programs fall well under the 80hr rule). i know i'll have to put in the time anywhere i go, and hopefully i'll enjoy it enough that i won't notice the hours passing me by, but still we all need time for other stuff, and i am just trying to estimate how free time i'll have compared to other surgical subspecialities. thanks

perhaps I misread you post, but if you are looking for a program that falls "well under" the 80 hour rule you may want to rethink going into a surgical field. With the new rules going into effect this July(some programs are already implementing them) you will work 80-88 hours a week (8 hours are allowed for 'educational time' over the 80.) Many programs are pulling their hair out trying to figure out how to schedule it all. At almost all programs you are going to be putting in your 80, and probably more unofficially (i.e. I suspect some programs will make lectures, etc. something that is optional on your own time.)

The number of patients/resident and amount of work is not going to change when the new rules come into effect.

So for most programs you will work your tail off at least during your junior years. But you should be so scared about how much you need to learn that you are happy to be there working.

This is something that you really need to investigate because if you aren't ready to put in those hours you're going to have a rough time.

Good luck with whatever you do.

I agree, if you are really concerned about getting well under 80 hours, orthopaedics might not be the field. And that is not a criticism, just a reality. For me, it was never a question of how many hours will I put in. I knew right off the bat that I would rather work 110+ a week doing something that I loved rather than 60 doing something that I didn't. And maybe that makes me masochistic, I don't know. There are plenty of fields where you can have more time to do as you choose and if you find one you like, go for it, I think that is completely reasonable. The important thing is that you realize what is going to be the best life for you personally.
I for one, think that the 80 hour thing might prove to be impossible, not only from a logistical standpoint but also for our education. There is a lot of ortho to learn in 5 years as it is. We shall see.
Good luck, and if you decide that 100hrs with saws and drills is better than 50 with a stethescope, then more power to you.

Some clarifications need to be made regarding these new ACGME rules. The 88 hour total mentioned by one of the responses above is not entirely true. Programs may individually apply for a 10% increase, but it certainly is not built-in to the rules. The ACGME makes it sound as if this 10% extension will be granted only rarely, and only with very sound academic rationale.

As far as compliance, programs will all have difficulty pulling it off, but you should be keen on those programs that have a plan ready to meet the guidelines for two reasons:

1) you WILL be tired at some point in residency, if not all points, even at "only" 80 hours; you do not want then to have to lie to pretend that your program meets the guidelines. This could make you bitter.

2) Unlike the old deal in NY state, these guidelines are enforced by accreditation. You do not want to find yourself as a 4th year in a program that suddenly loses accreditation because it has not met the guidelines.

Every program will struggle with the rules, but you should find a program where the faculty and residents are at least already thinking about how to make it work, if not trying new systems ahead of time.

These ACGME rules add a totally new aspect to the strengths and weaknesses of various programs that you should pay very close attention to as you interview. Look carefully and skeptically at programs that have a high ratio of number of hospitals/ERs to number of residents. Many small programs and many medium to large programs that cover multiple hospitals and their ERs will have great difficulty dealing with the restrictions on call. The result is that as a junior resident in these programs you will spend a MAJORITY of your week covering night call, which is of very little educational value. Programs that have enough residents to easily cover on a less-frequent call schedule will have improved education in this new system because a smaller portion of those work hours will be spent in a call room.

op1

Op1
Just had to correct one area of the previous post. The part about night call being of "VERY LITTLE" educational value is ABSOLUTELY WRONG!!!
Trauma/fractures make up the basis of modern day ortho. Every orthopod must know basic fracture care, especially early in their career. Night call gives you the autonomy, experience and confidence you'll inevitably require upon graduation.
The fact is that a majority of trauma occurs outside the 9-5, M-F work hours of most.
True, call can be VERY PAINFUL but virtually every orthopod, for that matter every physician, has stories about some of the interesting/crazy/dangerous/"first time" things they did while on call.
If you're not at a busy trauma center then your call can probably be taken from home...Do you really need to be there for low grade temps, constipation or htn.
My opinion: SOME call is necessary...just not the insane amount some programs try to get away with.
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