A few Questions..

[Nsent]

1) Regarding residency lifestyle...

With Q3 call, an 80 hr work week only has 20 hours left (assuming 30 hour shifts). That doesnt seem too bad to me. So are all programs out there not following the rule?? Dont you think it will eventually be followed or that its trending in that direction? ...then the life of the NS resident wont be so bad??

For instance, my thinking is if youre on call monday and thursday... you work twelve hours wednesday and 8 hours saturday. Plus, if following the rules youre out by noon on tuesday and friday.

2) PGYears 3 and 4 (or whichever are not OR based)....

How are the years of neurorads/neuropath/neuro and research, with regard to call, hours etc??

3) As an attending...

Can a NS leave the hospital setting, have a private office? In what way? (spine...)

Thank you for your time!

-MSIII

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[mpp]

Most neurosurgery programs are given 88 hours as the limit. Patients and procedures don't follow a time clock. You leave when the work is done (which is never) or when someone is able to relieve you without sacrificing patient care. Don't go into any specialty (especially not neurosurgery) with the mindset of "I'll work x number of hours on Wednesday and Friday..." It just doesn't work that way in the real world.

Different programs do different things with the non-clinical time during residency. In our program we have one year where your clinical responsibilities/call are solely to cover for people on vacation or at conferences and another full year protected from any clinical duty.

I do not understand your 3rd question. Most every neurosurgeon (private or academic) works in the hospital and has an office/clinic. Most neurosurgical procedures (spine or otherwise) are elective, not emergent.

 

[Nsent]

thank you for your time, mpp.

I guess my third question was not clear but you did answer it. I meant that as an attending, how much opportunity is there to base a practice on elective procedures, ie no call

I know the questions im asking are making me sound like Im trying to plan a cushy life of neurosurg.... It's not the case, its just that these are the questions I didnt ask when I was on my surgery rotation, for fear of sounding like I dont wanna work.

I understand a 4hr procedure frequently turns into a 10hr procedure. But what I dont understand is if these hours are logged, then are there programs out there that will attempt to shorten other shifts for the resident invovled in that case....in order to abide by the 88 hr rule.

 

[mpp]

Yes, they will try to work it out in the ed by giving days off and such. The 88-hour rule is easy to deal with since it's an average over 4 weeks. The tougher one is the 30 hours in a row since that is not an average but if there are enough residents to cover then this should not be an issue. Some programs have switched to a night float type system to prevent anyone from even coming close to the 30-hour mark (or the 88-hour since it's the 2-3 call nights in a week that put you over the top).

It is likely that the current soft 10-hour rule (states that residents SHOULD have 10 hours off between shifts) will likely be changed to MUST (since it was probably an oversight in the first place) in the near future. This will be a real problem. Coming in at 4:30 in the morning is not uncommon. If the 10-hour rule were in place than you must have left by 6:30 pm. the evening before which can be difficult to impossible at times.

 

[Nsent]

thank you very much for the info mpp... I had no idea.

What makes you think that 10hr rule will be enstated??