CALL- Sleep

At Wisconsin, we usually got a few hours of sleep during the week nights. The weekends was a different story. Now granted we were not a "county" hospital, but we did have two death stars (choppers) that brought things in from all over.

night float sucks too

the only 'rule' that you can follow to avoid lots of rough calls, is to go to a program whose main hospital isn't a level I trauma center.

calls at tertiary centers by and large are lighter; that is unless you are at a factory, where you have 25 post-ops a night.

then your life just sucks

You're joking, right? In this day of 24+6 and the 80 hour work week? You'll be able to catch up on your sleep when you're home, tucked in bed by 12 noon post call.

the 80 hour work week is a joke - it just forces the departments to come up with an elaborate way to theoretically put you under 88. No one I know in 10+programs are legitimately under 88. You can hand off a ton of consults or miss out on OR time if you leave at "the exact time" - I think a lot of med students going into surgical fields will be very surprised when they get to residency.

Although I am not going to give out my secrets, I would advise you to look on Frieda. Chances are, if the two is not on in house call (ie. taking home call) you are going to get some sleep at the program. I have found several programs like this. There are some downfalls as home call eliminates the eighty hour work week requirement that you have to be home by one, though. And I agree with the above. I have not heard of a single program that "really" follows the guidelines. You can be for damn sure that the residents say they do though. No one wants to lose their accredidation. So, check frieda my friend.

I have to say that there are definitely programs that adhere to the 80 hour week. In fact I rotated at one, and interviewed at another that have sign-in/sign-out sheets so that residents never go over the 80 hours/week. I'm not going to say that this is the norm, but there are great programs that have been able to figure it out very well.

Adherence to the 80 hour rules depend a lot on the attitude of the faculty. Many programs take the "we always work it out, wink wink" approach. I have spoken to residents from several different programs at various conferences and know that some places , off the record of course, the residents come no where close to fitting under 80 hours but document that they do (like an earlier post said, who wants to get their program discredited before they graduate?). There are however programs, like mine, whose chairman are very anal about the whole thing and dont want to run the chance of getting caught cheating.

Another thing to note is that at programs that have home call, if you go home for any time at all, the 24 hour plus 6 to finish things up rule resets. Apparently there is the possibility of changing the rule to say that if you are there for more than six hours after the "end of the normal work day" (up for interpretation) then the home call person is treated like a in house call person and has to go home at noon (assuming you worked 6am-6am)

Bottom line is that unfortunatly it is tough as a med student interviewing for residency to know a programs true utilization of the rules.

Trivia for you. Who are most work hour violations filed by? Not residents, but teir spouses!

I agree with the above, you have to be careful about how they are doing the whole 80 hour thing. I just went to a program where they have residents on home call and not counting that as working. So in essence you're still working 100 a week it's just when you're on "home call" it doesn't count which is crap.

My intern year in ortho at a level 1 center was pre-80 hr work week, my second year was 80 hour limit so we went to night float. I found that ortho call was hit and miss even at a level 1 in city of over 1 million. I had no hitters and I had no sleepers. I think you'll find this to be true at most places. Interestingly, this year (3rd) is at a Level 2 center. I have found the same to be true, some nights are busy some are not. Realize that people break bones at all hours. I have also found that the addition of spine call or (more importantly) hand call can severely change your night also. something to think about

Sadly, I get the sense that a resident's competence here is gauged by whether you're able to pull the all nighters q3.5 without a blink.

I wouldn't mind staying in the hospital 120 hrs per week so long as I'm allowed to at least see what the call-rooms look like. I envisioned call to be what AceTabulum described- a hit or miss sometimes- probably keeps it interesting that way too. If a few call nights were loaded with trauma, that would be exciting.

maybe even that hospital might benefit from the night float. The worst night float I did was on a rotation that was downright slow. I missed didactics all day, clinic, the OR all day -just sitting around these empty nights wasting my time. DUH??? Don't ask why they hell did they make me do a night float like this??? Night floats should be reserved for where they belong.

BUt for goodness sakes, here, I would be viewed as a 'slacker' because I'd rather wait a 1/2 hour or so to get some so called 'sleep' than do an I&D at 5:32 am on call. If they insist that blinking on call is for wussies, maybe they should try the night float instead.

So your opinions count here.