Average OR day at my school starts with team rounds at 6 AM. Surgeries begin by 8. Nurses are pretty good, so there’s not much floor work during the day, but things like EVDs and family discussions are squeezed between cases. Residents usually do 3-4 cases and finish by 6ish.  Clinic is two half days a week. Call is Q4 with the juniors handling consults on the floor, seniors operating, and chief on backup/home call if needed.

I haven’t done any aways, so I don’t really know how other programs are run (e.g. those with night float systems). Residents usually average 80 hour per week here, but I’m wondering what is the biggest time suck at the 100+ hr/week programs that are super malignant

Not going home post call

first, more hours doesn’t automatically mean a program is more malignant…

second, in my experience the busier programs typically have more of everything you have listed (more floor work, more consults, more procedures, etc), which makes it harder to get out at a reasonable time at night and/or post call.

Nervous System - 12 November 2009 02:53 PM

second, in my experience the busier programs typically have more of everything you have listed (more floor work, more consults, more procedures, etc), which makes it harder to get out at a reasonable time at night and/or post call.

This.  Particularly more consults.  What I did not appreciate as a medical student was that each time you get called for a consult you can pretty much plan on forty five minutes to an hour of time being taken away from other things you were planning on doing.  It isn’t necessarily that the actual work of the consult takes that long, but waiting to get labs back or imaging in addition to returning calls easily takes that long.

Also, having attendings that round really late can suck away time.  And having two conferences a week scheduled from 5-6 really kills time.  There are plenty of days where a group of residents finishes all of their work at 3 or 4 and could go home if they didn’t have to stick around for conference from 5-6.

p.s.  And the reason that you won’t sleep at night isn’t because there is a ridiculous amount of work to do, it’s that stat coags take two hours and fifteen minutes to result on patients who need a ventriculostomy.