I havent written in a while, just been working hard and living life….  but HAD to post this article which appears to be popping in multiple places, of course at the NYTimes Well colunm (which I difficulty due to its partial or incomplete information) and at the Washington Post.

I am lucky to be in a specialty which follows the guidelines closely. I do not work the CRAZY hours residents do in surgery, internal medicine and ob/gyn for example.  However I currently am working night shift this week and next and find it a challenge to do even a 11-12 hr shift straight through without a break.  Having said this I would MUCH rather work a series of consecutive nights and adjust to the change in sleep pattern than periodically (ie: q3 nights) work night call.  I did that, and it REALLY screwed me up as a medical student.

I cannot EVEN imagine what some of my peers are going through working 24hrs straight and q3 (or sometimes q2 if someone is sick).

a few points I want to comment on:

• The panel also urged greater supervision of doctors in residencies, which last from three to seven years, depending on the specialty. Interns — physicians in their first year of training after medical school — should have supervisors who are in-house and not available just by phone.

I have to agree with this point. The attendings whom I work with while on overnight call in the CPEP (psych ED) who are in the building or within 5 min of the hospital (about how long it takes from them to come from their call room anyway) and jump in when I get backed up with pts or can pass something by if i’m over my head are worth their weight in gold.

• The committee also called for …… assigning chores like wheeling patients to X-rays and drawing blood to other hospital workers so residents have more time for patient care.

This is very variable and an important point. Based on my experience rotating though different hospitals in NYC and my current place I work the level of support for some of these tasks varies. If you dont have a phlebotomy team, or good support on the unit it REALLY eats up your time.

• Research shows that fatigue is also hazardous to the residents themselves, increasing the risk of car accidents and depression. Research shows that fatigue is also hazardous to the residents themselves, increasing the risk of car accidents and depression.

• A study in 1996 found that pediatric residents, who slept on average less than three hours a night when they were on call, were twice as likely to be in car accidents as faculty members, who did not report sleep-deprived nights.

I’ve heard of this.  I drive home after work and notice my own decreased reaction time and difficulty concentrating after overnight call.  Some of the residents self report feeling depressed after doing 2 weeks or more of night call.   After 3 nights of working nights I find myself already having a changed mood…

• The Accreditation Council for Graduate Medical Education, which oversees residency programs, currently sets the maximum workweek at 80 hours, with shifts to last no more than 30 hours. It also requires that residents get at least four days off per month, although there does not have to be one in each week.

When I’m not on night float and working on the floors, its common to have weekend (daytime) call.  I personally find it difficult to recoup in one day after 6 days of work, but I’d rather have that than no days off one weekend a month (which I am to expect in medicine which i start in Jan).

These comments are with the understanding that I have it pretty ‘easy’ comparably to my brethren in other specialties.  I dont know how they do it.