Tuesday, October 10, 2006

THE TRUTH ABOUT RESIDENCY

People may think of medical residents and residency as what they see on the television. Pop culture has advanced interest in medicine and health care with shows like "ER", "Scrubs", "House", and "Grey's Anatomy". The increased interest in the medical field is wonderful, but while a couple of these shows provide some comic relief from the horrors of real life medicine, others worsen the publics perception of modern medicine.

Here's the truth about residency...
Residents get paid a salary - usually around $39,000 per year. This is a nice compensation, but most residents work far more hours than the everyday Joe. Up until recently there wasn't a cap on hours a resident could work; however, after a few large medical mistakes and deadly car accidents, a cap has been set at 80 hours per week averaged over 4 weeks. This means a resident, or house officer in some locations, could work more than 80 hours a week for a week or two as long as the other two weeks are less than 80 a piece. Using $39,000 as an average yearly salary, this means medical residents get paid about $9.38 / hour - IF they adhere to the 80 hour work week. Not a very good salary for 8 years of post-high school training.

Here's the really good part, many of these residents actually like to enjoy life outside of work and a lot even have a spouse and kids. Now, if you were getting paid by salary and it didn't matter how many hours you were at work, would you want to stay at work longer to learn more...of course not. So, here's the skinny about residents...

1. More work does NOT equal more money, so why would you want to work more. From the emergency department persepctive, medical residents who are called to come consult or admit a patient in the ER can be some of the most lazy and work-adverse people in the hospital. They will think of any reason possible to sweep that patient to another service, which leads us to the next point...

2. It is always better to consult than admit, which is why many services will try to avoid the admission. This means less calls in the middle of the night (b/c you are not that patient's primary admitting doctor) and no discharge summary. Less work, less effort.

3. They hate their pagers. Pagers mean more work.

4. They absolutely hate ER consults or admits. These take lots of time out of a day and usually happen when you least want them (like 3 AM). Another reason to try and sweep the patient to a different admitting service.

5. They hate having lots of patients in the hospital (more patients = more time = more work).

6. They really hate difficult and/or needy patients and patient's families . Who wouldn't? These patients take up more time than they need and make work much harder to tolerate.

7. Unlike shows such as "Grey's Anatomy" in which all the residents are getting laid most of the time, medical residents are more often lacking in the sexual realm and sex-deprived; hence, why many medical marriages don't work and why many residents and doctors end up marrying attractive nurses. Now, what do you think it would be like with a two doctor marriage?

8. Medical residents are supposed to be studying a lot and reading every medical tidbit they can get their hands on. Truth, why would you want to read if you worked 80 hours that week and never really got to see your spouse or kids...and your sex-deprived?

9. It is true, residents can usually fall asleep anywhere. This includes floors, elevators, meetings, lectures, and while driving in cars.

10. For you patients out there who demand the "A team" and ride into the hospital on your high horse, shut up and take what you get. Do NOT by any means ask if the doctor speaking to you is a resident or staff. They all know what you mean by this quesion, it infers that you are more worried about their care and that you think the resident does not know what he or she is doing. The truth, aside from the operating room setting, that resident has probably performed the same amount or more of the basic hospital procedures than the staff doctor in the last year. I don't know how many times I've watched a staff physician who is a bit out of practice, b/c they spend more time educating than performing, absolutely screw up a small and relatively easy procedure. My advice, unless the resident is obviously nervous, shaky and sweating, have them perform the procedure, you'll never know the difference. Plus, you will have contributed to that physician's future.

Last note, upon leaving residency, all of these traits will change. They will make much more money, will get paid extra for consults and admissions from the ER, and will have more time to spend with family and doing things they love, like sex.

8 Comments:

Anonymous Anonymous said...

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6:59 PM  
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7:03 PM  
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7:27 PM  
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7:44 PM  
Blogger Charity Doc said...

Dude, you've been hit by the spambots. Gotta put up the comment moderation wall.

When I was a resident...hehehehe....I made $24,000/yr as an intern and maxed out at $27k by the end of my 4th yr. of residency. I lived on hospital food and drug reps' lunches. Drove a beat up Datsun B310. Worked 27 shifts/month in the ED. One week vacation/yr. We literally were residents as we practically lived at the hospital.

11:07 PM  
Blogger Irishdoc said...

Ahhh... this is my life right now. Struggling to get by in Los Angeles with a husband and a baby and making 36,000 a year. Why did I ever sign up for this.

3:03 PM  
Anonymous Jason said...

Everything said above is so true about the medical world. Any resident who denies it is lying to themselves.

One of my favorite quotes from Samuel Shem's book, The House of God is "Remember, the patient is the one with the disease." As a resident, that is the hardest thing to do at 3AM when you haven't had a meal for 20 hours, your dehydrated, haven't slept for 30 hours and a nurse pages you to say the family of Mrs. Smith is angry because you never ordered the eye drops she takes at home.

The first thought that goes through your mind is: $#&! the eye drops, the lady is septic and we are saving her life. The second thought is just as wrong and is directed at the family. The third thought comes only if you think hard back to that essay you wrote to get into medical school about why you wanted to be a doctor then, maybe, you realize the eye drops are important to Mrs. Smith, and if that thought is not interrupted by a code blue or your pager you might just go ahead and order the damn eye drops.

1:09 PM  
Anonymous Anonymous said...

But right now I'd like to smash my pager. And why is it that attendings talk and talk and talk and tell you stuff they think you've never ever heard? My lord, I feel like they treat me like I'm eight years old. Daddy can I hold the camera? I'm so incredibly sick of residency.

9:18 PM  

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