What’s maximum number of hours that clinical clerk can work per week?

[birdy21]

13 hours ago, Egg_McMuffin said:

That's a lot of calls for a clerk. At my school we get 1 call per week for IM. I agree that they are very busy though. Sleeping 2-3 hours is an exception. 

If you do calls don't you get the next day off though? I'm curious how it adds up to 90 hours.

Just went and looked back at my calendar, this particular week was: 26 hour call sat, regular day mon (8-10 hrs), on call tues/post call weds, regular Thurs, on call Friday. I was also on call the next Sunday so I think it ended up working out to like over 120 hours in an 8 day span. Totally ludicrous. We do 1 in 4 call on IM to "simulate residency" but it's not always evenly spaced out. I think my final week I only had 1 call shift so that week would have only been 50-60 hours.

Also, I should note for anyone that's discouraged by this, IM is notoriously the busiest rotation with the most amount of call for us. I've had rotations in outpatient clinics that finish early in the afternoon so you might work for less than 30 hours that week. I probably average somewhere in the 50-60 hour range 

[bellejolie]

1 hour ago, birdy21 said:

Just went and looked back at my calendar, this particular week was: 26 hour call sat, regular day mon (8-10 hrs), on call tues/post call weds, regular Thurs, on call Friday. I was also on call the next Sunday so I think it ended up working out to like over 120 hours in an 8 day span. Totally ludicrous. We do 1 in 4 call on IM to "simulate residency" but it's not always evenly spaced out. I think my final week I only had 1 call shift so that week would have only been 50-60 hours.

Also, I should note for anyone that's discouraged by this, IM is notoriously the busiest rotation with the most amount of call for us. I've had rotations in outpatient clinics that finish early in the afternoon so you might work for less than 30 hours that week. I probably average somewhere in the 50-60 hour range 

honestly i look back at some of these rotations and i'm like how did i get through this LOL. like it really takes a strong amount of will and a lot of coffee. plus the pressure of paying off the debt def keeps you getting up each morning haha!

[rmorelan]

41 minutes ago, bellejolie said:

honestly i look back at some of these rotations and i'm like how did i get through this LOL. like it really takes a strong amount of will and a lot of coffee. plus the pressure of paying off the debt def keeps you getting up each morning haha!

ha plus you know it is finite, and all of your class is right there doing it do. That is a big part of it. Compared to my friends outside of medicine what we did was insane, but of us on the inside it was just perfectly normal. 

[zxcccxz]

8 minutes ago, rmorelan said:

ha plus you know it is finite, and all of your class is right there doing it do. That is a big part of it. Compared to my friends outside of medicine what we did was insane, but of us on the inside it was just perfectly normal. 

It actually funny you bring that up... I was speaking to some of my engineering friends yesterday, and one of them turned down a high-paying job at Facebook because "A 60-hour work week would kill me", and I'm here actually paying tuition to work 80 hours/week. I feel that we just have a warped sense of what "insane hours" mean, because to us that's the level that a neurosurgeon would work, but to anyone normal, even a family doctor works pretty long hours.

[bread]

Yeah, I think what I found hardest about being a clerk was working those hours and then having to come home and study.  I got very burnt out on my IM rotation especially - with my call schedule the way it was, I felt like I never actually had a day off (and I never had more than 1 day off in a row, with how things worked out).  And sometimes you don't have time for a proper lunch/dinner or even bathroom breaks (especially on surgery when you're rounding and then scrubbed for very long cases, or OB when there's a lot of deliveries + triage patients + sections + postpartum patients which seems to be more often than not).  There were definitely times as a clerk where you felt like all you did was work --> study --> sleep --> repeat.  But honestly, I think for me there were enough lighter times that it made things manageable and allowed them to keep being enjoyable.  I see how hard residents work and sometimes wonder how it's possible, but when you're in it, you just do it and get through it, and of course it helps so much when you're enjoying what you do. 

[Sunshine!]

Any other first year med students panicking reading this thread? I don't know how to function on less than 8hrs of sleep hahaha!

[ellorie]

43 minutes ago, bread said:

Yeah, I think what I found hardest about being a clerk was working those hours and then having to come home and study.  I got very burnt out on my IM rotation especially - with my call schedule the way it was, I felt like I never actually had a day off (and I never had more than 1 day off in a row, with how things worked out).  And sometimes you don't have time for a proper lunch/dinner or even bathroom breaks (especially on surgery when you're rounding and then scrubbed for very long cases, or OB when there's a lot of deliveries + triage patients + sections + postpartum patients which seems to be more often than not).  There were definitely times as a clerk where you felt like all you did was work --> study --> sleep --> repeat.  But honestly, I think for me there were enough lighter times that it made things manageable and allowed them to keep being enjoyable.  I see how hard residents work and sometimes wonder how it's possible, but when you're in it, you just do it and get through it, and of course it helps so much when you're enjoying what you do. 

I actually found residency far better than clerkship even though I worked harder.  The absence of constant studying (except for PGY5) helps so much because you can actually use a lot of your "at home" time as actual down time (or at least I was able to - if you have kids I'm sure it's different but that's true of everything).  The evaluation is also less intense because even though you're thinking about getting a job, the scrutiny is less for a lot of it, and you stay in one place for long enough that you don't have to impress every single second.  You also have more of a sense of being useful and belonging in your program rather than always feeling vaguely out of place.

[capoo]

4 minutes ago, Sunshine! said:

Any other first year med students panicking reading this thread? I don't know how to function on less than 8hrs of sleep hahaha!

I’m already functioning on 6-7 hours of sleep (worse during exam time) as a 1st year med student ahahaha

[ellorie]

6 minutes ago, Sunshine! said:

Any other first year med students panicking reading this thread? I don't know how to function on less than 8hrs of sleep hahaha!

Neither did I before clerkship - never pulled an all nighter in my life prior to that point or really even went to bed all that late.  It's surprising what you can adapt to.  I was incredibly anxious about it before I did it, but it turned out to be totally doable.  Unpleasant at times, but doable.  You learn what strategies help you manage.  Best advice I ever got from a resident was to bring a pair of clean underwear and socks to call.  Turns out a change of undergarments half way through the night is surprisingly refreshing! It really does work...

[MaudeB]

16 minutes ago, Sunshine! said:

Any other first year med students panicking reading this thread? I don't know how to function on less than 8hrs of sleep hahaha!

I deferred my admission and I'm supposed to start next fall but yes, I am freaking out reading this...

[bread]

42 minutes ago, Sunshine! said:

Any other first year med students panicking reading this thread? I don't know how to function on less than 8hrs of sleep hahaha!

So sorry - I did not mean to startle you!  It's honestly very manageable (and faculty is very accommodating with taking short leaves if needed).  Also felt that we had a lot of support through the process, both from the faculty and from upper years.  Really happy to chat at any time if you have any questions

 

Edited to add that as for the sleep, I was the same way.  Didn't think I could function on less than 8 hours before med school.  But like @ellorie said, you'd be surprised at what you can get used to.  I was really worried about waking up so early on some rotations, making it pretty much impossible to get "enough" sleep, but when you're busy during the day, it's much different than sitting through a lecture.  And I chose to not study on post-call days and let myself sleep in lots on the weekend, which really helped.  I also second the suggestion of bringing a change of socks for call shifts.  I also brought mouth wash, gum, and deodorant, which were lifesavers!

[bread]

39 minutes ago, ellorie said:

I actually found residency far better than clerkship even though I worked harder.  The absence of constant studying (except for PGY5) helps so much because you can actually use a lot of your "at home" time as actual down time (or at least I was able to - if you have kids I'm sure it's different but that's true of everything).  The evaluation is also less intense because even though you're thinking about getting a job, the scrutiny is less for a lot of it, and you stay in one place for long enough that you don't have to impress every single second.  You also have more of a sense of being useful and belonging in your program rather than always feeling vaguely out of place.

This is really great to hear!  I've already been finding that a bit with being in the post-CaRMS period now in fourth year.  Weekends off are truly weekends off (for now until LMCC studying and interviews start, haha), and it's nice not being evaluated as often or to the same degree as third year.

[bread]

(Deleted) - Made a double post in error  

 

[birdy21]

7 hours ago, neurologist19 said:

Sorry I didn't mean to come across as know it all and I don't want to discount your experience... take it as a personal opinion but I am a mature student (I have master's and work experience) and at this point my BS detector is quite sharp. Before starting grad school people told me grad student needs to to work in the lab all dat until 9-10 pm and it took me only going to grad school to find out how much far from truth those statement were. With medical school, It might be 80 hours of clocking in/out but I still doubt anyone could do 80 hours of work. Is it considered work if you idling at your desk in the hospital browsing social media? Do you consider the whole time you are ready to pick a call during your night shifts work? 

I've never said (let alone even thought) this before, but if you really think it's BS about med students working these hours, then I hope you don't end up in med school. Working in a step-down ICU unit during a global pandemic did not consist of me sitting around, browsing social media. Infact, any down time I had was spent either sleeping or studying, because you really might only get a couple hours of free time on any given evening. Of course this is not the same for every rotation but please stop trying to discount experiences of something you have not gone through and (clearly) know nothing about.

[neurologist19]

45 minutes ago, birdy21 said:

I've never said (let alone even thought) this before, but if you really think it's BS about med students working these hours, then I hope you don't end up in med school. Working in a step-down ICU unit during a global pandemic did not consist of me sitting around, browsing social media. Infact, any down time I had was spent either sleeping or studying, because you really might only get a couple hours of free time on any given evening. Of course this is not the same for every rotation but please stop trying to discount experiences of something you have not gone through and (clearly) know nothing about.

As a physician you might need to develop an open mind. "This is what I think so please just accept it" is not going to work with people who are not your patients (even with patients, you come across like this and they will run for the door." I thought they would teach critical thinking in medical school so you should consider than not everyone would "take your word for it" without their own independent thinking.

[birdy21]

32 minutes ago, neurologist19 said:

As a physician you might need to develop an open mind. "This is what I think so please just accept it" is not going to work with people who are not your patients (even with patients, you come across like this and they will run for the door." I thought they would teach critical thinking in medical school so you should consider than not everyone would "take your word for it" without their own independent thinking.

Thank you for the unsolicited insights on patient care from a premed student, lmao.

[JohnGrisham]

3 hours ago, ellorie said:

I actually found residency far better than clerkship even though I worked harder.  The absence of constant studying (except for PGY5) helps so much because you can actually use a lot of your "at home" time as actual down time (or at least I was able to - if you have kids I'm sure it's different but that's true of everything).  The evaluation is also less intense because even though you're thinking about getting a job, the scrutiny is less for a lot of it, and you stay in one place for long enough that you don't have to impress every single second.  You also have more of a sense of being useful and belonging in your program rather than always feeling vaguely out of place.

I agree. I found residency much better - stopped caring about evaluations and just focused on learning what i needed to know, and focused on patient satisfaction/outcomes. Preceptors were much more about just helping me get what i needed, and I was happy to put up with scut work on off-service, if they at least guided me and "cut to the chase" for consults/admits etc.  

I had many times where i would be asked if I wanted to scrub in, and politely said "I'm good, you go ahead, I will catch up with you later". Felt glorious on the surgical rotations.

[neurologist19]

11 minutes ago, birdy21 said:

Thank you for the unsolicited insights on patient care from a premed student, lmao.

You sound young so I'll give it to you. Good luck

[JohnGrisham]

 

43 minutes ago, neurologist19 said:

As a physician you might need to develop an open mind. "This is what I think so please just accept it" is not going to work with people who are not your patients (even with patients, you come across like this and they will run for the door." I thought they would teach critical thinking in medical school so you should consider than not everyone would "take your word for it" without their own independent thinking.

As an outside observer to this conversation, you should really re-read the tone and way they presented their view to you. They were being very polite and trying to point out some potential blindspots, and encouraging you to not diminish the expressed experiences of others  - no matter how you may not be able to "believe them".

Your initial tone and inferences that the students simply were clocked in and on social media was a bit off-putting. While the content may be realistic and plausible, its the delivery. I agree, some students are definitely doing that and over-exageratting. But I don't think its fair to just assume everyone is. 

I definitely had true 80 hours weeks  as a medical student and they were infrequent, and i was definitely spending at least 80% of the time working - and I had worked 80 hours weeks sporadically before Medicine.   And I did notice some of my colleagues would be up all night on some rotations - mostly because they were relatively slower at doing Internal Medicine consults/admits at 3am compared to me; because who in their right mind can function and write up elaborate DDx and treatment plans at 3am? What would normally take maybe 1 hour during the day, can take up to 3hrs at night for many, especially when you factor in lead time to review your cases with the residents or attendings.    

That was just me own experience as a medical student, that carried forward into residency. We can only share our experiences, and those of our close peers who have also gone through the path. It is generally reflective in "you don't know how it is, until you go through it". 

[JohnGrisham]

3 hours ago, ellorie said:

Neither did I before clerkship - never pulled an all nighter in my life prior to that point or really even went to bed all that late.  It's surprising what you can adapt to.  I was incredibly anxious about it before I did it, but it turned out to be totally doable.  Unpleasant at times, but doable.  You learn what strategies help you manage.  Best advice I ever got from a resident was to bring a pair of clean underwear and socks to call.  Turns out a change of undergarments half way through the night is surprisingly refreshing! It really does work...

I chuckled, I started that during a particularly grueling residency rotation, and flossing. Feel fresh and clean on that quick 15minute break between consults.

[Butterfly_]

9 hours ago, neurologist19 said:

Sorry I didn't mean to come across as know it all and I don't want to discount your experience... take it as a personal opinion but I am a mature student (I have master's and work experience) and at this point my BS detector is quite sharp. Before starting grad school people told me grad student needs to to work in the lab all dat until 9-10 pm and it took me only going to grad school to find out how much far from truth those statement were. With medical school, It might be 80 hours of clocking in/out but I still doubt anyone could do 80 hours of work. Is it considered work if you idling at your desk in the hospital browsing social media? Do you consider the whole time you are ready to pick a call during your night shifts work? 

I used to work over 100 hours per week in investment banking. It’s definitely doable, just pure torture and essentially no health/wellbeing or life outside of work. 
 

The fact the one has to be away from home and in their work location IS considered work. You can’t relax; you have to be on your game. Also, keep in mind, you PAY for your Masters Degree whereas residents GET PAID. Expectations are different. 

[frenchpress]

3 hours ago, neurologist19 said:

"This is what I think so please just accept it" is not going to work with people who are not your patients (even with patients, you come across like this and they will run for the door." I thought they would teach critical thinking in medical school so you should consider than not everyone would "take your word for it"

Most of the posters are sharing their own experiences, and have been quite polite in response to your initial disbelief - they’ve elaborated, given examples and context, etc. In response, you’re talking down to people and trying to claim that that lived experience isn’t valid evidence or can’t possibly be true. 

I am not feeling as diplomatic as @JohnGrisham today. It’s painfully ironic that you’re suggesting others need to have an open mind, when you’re being completely closed minded to the possibility that your expectations might not be in line with the reality of what many of us have gone through in medical school and residency. If this is how you react to people who are trying to express their lived experience to you, especially in an area in which you don’t know that much about, how will you deal with patients? Will you also be prone to second guess everything your patients tell you, because you have masters degree and you know better? Or will you just rudely give them a pass because they “sound young”? For someone who claims to be a mature student, you’re coming off as pretty immature and arrogant.   

[neurologist19]

2 hours ago, frenchpress said:

Most of the posters are sharing their own experiences, and have been quite polite in response to your initial disbelief - they’ve elaborated, given examples and context, etc. In response, you’re talking down to people and trying to claim that that lived experience isn’t valid evidence or can’t possibly be true. 

I am not feeling as diplomatic as @JohnGrisham today. It’s painfully ironic that you’re suggesting others need to have an open mind, when you’re being completely closed minded to the possibility that your expectations might not be in line with the reality of what many of us have gone through in medical school and residency. If this is how you react to people who are trying to express their lived experience to you, especially in an area in which you don’t know that much about, how will you deal with patients? Will you also be prone to second guess everything your patients tell you, because you have masters degree and you know better? Or will you just rudely give them a pass because they “sound young”? For someone who claims to be a mature student, you’re coming off as pretty immature and arrogant.   

I guess this whole thread turned into a circle jerk sort of thing, if you excuse my bluntness. If you feel the need to go around complaining about working 80 or 100 hours, I wonder if it wasn't better to leave the medicine to those people who don't count hours and just focus on their work because they love medicine as a way of life not as work. As a patient, I prefer a doctor with lower undergrad GPA and MCAT score who is passionate about helping me rather than a top shot who resents me for overworking him/her. Anyways, this is my last post here and I will not reply back to any reply anymore. just a suggestion and something I heard from a good friend a long time ago and it was along this line : do what you love and you will never work a day in your life.

 

[rmorelan]

10 hours ago, ellorie said:

Neither did I before clerkship - never pulled an all nighter in my life prior to that point or really even went to bed all that late.  It's surprising what you can adapt to.  I was incredibly anxious about it before I did it, but it turned out to be totally doable.  Unpleasant at times, but doable.  You learn what strategies help you manage.  Best advice I ever got from a resident was to bring a pair of clean underwear and socks to call.  Turns out a change of undergarments half way through the night is surprisingly refreshing! It really does work...

yup - people just well learn how to do it. 

[Butterfly_]

2 hours ago, neurologist19 said:

I guess this whole thread turned into a circle jerk sort of thing, if you excuse my bluntness. If you feel the need to go around complaining about working 80 or 100 hours, I wonder if it wasn't better to leave the medicine to those people who don't count hours and just focus on their work because they love medicine as a way of life not as work. As a patient, I prefer a doctor with lower undergrad GPA and MCAT score who is passionate about helping me rather than a top shot who resents me for overworking him/her. Anyways, this is my last post here and I will not reply back to any reply anymore. just a suggestion and something I heard from a good friend a long time ago and it was along this line : do what you love and you will never work a day in your life.

 

It’s really naive to think that as long as you love what you do, working 80-100 hours all the time is okay. This is not about counting hours, it’s about worklife balance. If physicians cannot properly care for themselves, how can they care for their patients? Thankfully hours get a lot better as a staff, so there is a light at the end of the tunnel. However, burnout is real and there are other priorities in life that matter just as much as one’s career, like family, hobbies, and personal health.

I don’t think any of the posters here said that they resented their patients for working long hours and why do you assume that high GPA students aren’t passionate about medicine?