Surgeon Hospitalized for 6 Weeks After Working 180-Hour Shifts, Gets Called an ‘Emotional Female’

Most attendings manage to work 60% the hours of residents (scribes, PAs, NPs, etc etc etc), and make generally make fine money doing so with fine volume in their practices. It's exploitation. Stop trying to make it something it's not. Most time in places like ICUs or wards is spent in front of computers writing notes that no one reads and taking consults that can absolutely wait until morning. Get real man.

Do you plan to take colace pages at 2 am as an attending? How about happily indulging nurses that piss and moan about electrolyte orders being ordered correctly? Plan on taking 2 hours to discharge a patient because the wound vac needs to get set up and he's homeless/psychotic/no family/whatever? Other than reading or answers to obvious consults (90% of them, most of which could wait till morning), this is most of what constitutes the "learning" outside the OR.

Honestly, the very fact that 95% of residents come out competent just by showing up during residency (and that there's a huge variation in hours worked across the same residency specialty depending on the program) is all the evidence you'll ever need that medicine, for the most part, ain't all that difficult. Truly, you can be a lazy moron and if you're a warm body you'll match surgery easily somewhere. That shitty program is probably accredited, and it's probably fine. For the most part in medicine, we just keep doing shit over and over until you don't fuck it up. The best learning is generally from 8am-12pm when you're not exhausted, and diminishing returns is absolutely real.

People talk about "volume" in residency like it's some badge of honor. No one ever talks about "talent" or "teachability" as being much more important to people's learning than "time spent." To surgeons, everyone is like the football players in Rudy, and it's all about how hard you work that determines how good you'll be. Wishful thinking from a crowd that probably never did sports growing up.

Even freaking attendings all admit "I learned more in the first year of practice than any time!" This is borderline admission that training models generally suck in medicine and that it's more a contest of, "figure it out, and try not to be a damn moron about generally simple decisions you make or piss off your patients."

And yet, with fewer hours spent in house by residents and them presumably being less than adequate doctors (by your logic, not mine), medicine keeps getting better, surgical complication rates go down, and people live longer and longer. Funny how that works, huh?

/r/medicine Thread Parent Link - nextshark.com