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Thu May 7 03:07:26 BST 2009

I just got home from my TYPICAL day of seeing patients in the office, operating, rounding, teaching, administrative responsibilities, seeing consults, teaching, responding to the emergent needs of my colleagues caring for their patients, rounding, operating and finally...more paperwork. I just sat down to open my e-mails at 2145...my day started at 0600. Typical day for me and I enjoyed most all of it. Do the residents training today (most of whom will be joining the ranks of private practice like myself) honestly think their work week will only be 80 hours!!!?? In these days of ever worsening reimbursement and ever increasing business costs...you have to work LONG and HARD to make a living and to be available to your patients and the physicians who need your help and expertise as a WELL TRAINED SURGEON. My program director beat that into us and I am a FIRM believer that the patient comes first and last and really does not care if you are tired when they are the ones in need of your help!!

Gregory T. Squires, MD FACS
Clinical Assistant Professor of Surgery
Medical University of South Carolina
Director of Trauma
Trident Regional Medical Center
Charleston, SC

In a message dated 05/06/09 16:56:04 Eastern Daylight Time, jduchesn at tulane.edu writes:
How can we set a time schedule for the PRIVILEDGE of being trained as a SURGEON? 
The field of Surgery needs full time commitment not part time effort. 
Duchesne 
CharityOne- New Orleans 
Sent via BlackBerry by AT&T 

-----Original Message----- 
From: Andre Carneiro <a.carneiro at enflurane.com> 

Date: Wed, 6 May 2009 21:38:13 
To: Trauma and Critical Care mailing list<trauma-list at trauma.org> 
Subject: Re: to Doc Holiday-DELAYED response 

Whilst I completely agree that we trainees are not being exposed to enough 
workload (48 hours! Are they mad??), I would also like to remind you that no 
athlete trains 80 hours a week (no matter how serious they are about their 
performance) and high performing athletes are well aware of the risk of 
overtraining. 
Meaning that surely there must be a happy medium that doesn't mean we live 
in a complete state of tiredness which, I believe, has been proven time and 
again to lead to incidents of varying degrees of severity. 

Best wishes from across the pond 

Andre de Castro Carneiro 
Specialist Registrar 
Anaesthetics and Critical Care 
The Leeds Teaching Hospitals NHS Trust 

2009/5/6 Jose Luis Danguilan <jdanguilan at gmail.com> 

> I fully agree with Dr. Gross. We seem to baby the new generation of 
> surgical 
> residents. Hard work has never killed anyone. Fire makes steel strong in 
> the 
> same way challenges toughen a person or did I get my metaphors mixed up? 
> 
> A fellow triceratops, 
> 
> Jose Luis J. Danguilan, MD 
> Manila, Philippines 
> 
> On Wed, May 6, 2009 at 7:26 PM, Gross, Ronald < 
> Ronald.Gross at baystatehealth.org> wrote: 
> 
> > And when you finally finish your truncated 5 year surgical residency, 
> with 
> > protected educational time, sleep time and no more that 80 hours per 
> week, 
> > and you have to go out into the REAL world, will your patients understand 
> > that you need to go home now 'cause you're sleepy, and someone they have 
> > never seen will be caring for them? 
> > 
> > Athletes learn endurance by working harder and longer in their workouts 
> > then they have to do in the "real deal".  Our stakes are FAR higher than 
> any 
> > athletes' stakes, and yet we are failing to teach our residents the 
> expanse 
> > of knowledge they will need, and we are failing to prepare them for the 
> real 
> > world, where there isn't protected education time, and guaranteed sleep 
> > time. 
> > 
> > I know, my wife has told me on several occasions that I am a dinosaur. 
>  She 
> > is probably right.....but this dinosaur has been true to his calling, and 
> > will never stop being fully responsible for the care of his patients - 
> all 
> > the time! 
> > 
> > (OOPS, need to take a nap now.  Worked too long.........) 
> > 
> > Best to you all, 
> > Ron 
> > 
> > 
> > 
> > -----Original Message----- 
> > From: trauma-list-bounces at trauma.org [mailto: 
> > trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova 
> > Sent: Tuesday, May 05, 2009 4:50 PM 
> > To: trauma-list at trauma.org 
> > Subject: to Doc Holiday-DELAYED response 
> > 
> > Dr Holiday, sorry for retarded response-just read your note on resident 
> > hours (March). Thanks and yes, you are right, there is evidence that long 
> > hours result in reduced effciency and eventual harm to the patient. I 
> dont 
> > think I will ever agree witht eh 48hr/wk schedule for SURGERY 
> residents-it 
> > has to be MORE than that. Am not saying 120hrs, but should be reasonable 
> > enough to get suffucuent experience and not to feel 'dead' at the end of 
> the 
> > day. Maybe someone needs to design a study to determine the cutoff... 
> > And you are right, there are perhaps other ways of increasing the quality 
> > of residency without making the hours too long as well. The problem is, 
> > given how conservative the health care system is, it will take decades to 
> > change it. 
> > Cheers. KH 
> > 
> > 
> > 
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