Friday, June 22, 2007

Life's Not Fair

I just met our new crop of interns. Technically, we aren't supposed to call them interns anymore. We're supposed to call them PGY-1s (as in Post Graduate Year 1; I'm a PGY-4). Whatever. Tomato / tomato. Ok, that doesn't really come through in print...

They seem nervous, but ready to be moving on to the next chapter in their lives.

I got a few emails from them, as I sent out the schedule. Things like, "I have wards block 1, can you make sure I don't have call for the following 4 dates?" or "I have a wedding in Canada to go to, so can I have 2 days off in a row in the ICU?" Both of these emails have caused me to shake my head in wonder. What's happening to the doctors of the future?

First of all, when on the wards, you're q4. That means every 4th night you're on call. That means asking for multiple days to NOT be on call is not going to work. The ICU is worse, because you're q3. That's a darn rough schedule. There's no way to get 2 days off in a row, because you're on, post, off...on-post-off...etc etc. Don't ask me for 2 days in a row off, when it's not mathematically possible.

When I was a 3rd year med student, we didn't have the rules we do now -- can't work more than 80 hours in a week, can't be on call more frequently than q3, can't work more than 30 hours in a row... My first rotation was surgery. I did vascular surgery for 3 weeks. I got 1 day off. Total. I got in to the hospital at 4am daily. I didn't leave until 7 or 8pm when I wasn't on call. When I was on call (q3), I'd get in a 4a, stay over and work, then leave at 6 or 7 the next night. It sucked. When I was on OB, we were q2 for the few days before Thanksgiving. My roommate R. and I did 4 days of q2. I got done the Wed before Thanksgiving and went to bed at 8p. I didn't wake up until 4p on Thanksgiving. I almost missed the big lunch at my friend's in Baltimore.

Do I think we should go back to that? No. I was miserable, my classmates were miserable, and I'm sure patient care suffered. However, it did teach me that residency is work. It's more than a job, it's your LIFE. For 3 years. In my email to the new interns, I wrote: "Here's your schedule for block 1. I have done my best to accommodate requests. Unfortunately, you will miss a lot of things this year. You will miss birthdays and anniversaries and holidays and religious holidays and graduations. You will work on your birthday and your child's birthday and most major holidays. Residency requires a lot of sacrifice."

I heard through the grapevine that one of the R2s was upset because of her schedule. She said it wasn't fair that she has 2 more weeks of call than a lot of her friends. I said to her, "You know what? Life's not fair." To my shock, that answer didn't satisfy her. Perhaps if she did a few q2s or worked 18 days without a day off, perhaps then she'd see things differently.

I can only hope that these new residents remember my words of warning. Perhaps I should put a sign up in my office...

Friday, June 8, 2007


Today was Day 2 of my tenure as Chief Resident. Lots of drama in the past 2 days. Suffice it to say, this may be a very busy year.

I published the schedules for all 125 interns and residents today. I'm waiting for the flood of complaints, arguments, weeping and gnashing of teeth. I was extremely nervous as I went to put the schedule online. I kept thinking, "Should I check it again? Should I make sure I've everything?" I don't know how many more times I could have checked it. I'm just crossing my fingers that any mistakes that are there aren't going to be major.

Wednesday, June 6, 2007

Working 6 to 8...

Not as catchy as the old Dolly Parton ditty. Oh, well. It's actually 6p to 8a, so it's terribly depressing. It's horrible going home in the morning, only to know you've got to come back -- the same day! It's like time never moves. I hate it. Just one more night, then I'm done!

And by "done," I mean done with my responsibilities as a resident. Yep, tomorrow starts my tenure as Chief Resident. I'll be glad to shed one job and just focus on the other.

Starting this position is extremely overwhelming. I've been getting 3-4 emails a day for the last week, where the old chief is telling all her contacts that they should be contacting me. I don't even know who these people are or why I need them! I suppose I'll figure that out, slowly and painfully.

Let the games begin...