My first year of residency (aka intern year) we were required to log our hours in an online system for purposes of compliance with the US rules you’ve outlined. During my first quarterly evaluation they pointed out that I was routinely violating work hours and that I needed to stop doing that or there would be consequences.

The implication was that I was doing something wrong and trying to work more than 80 hours a week.

In reality I was a completely powerless individual and I routinely had a ton of work dumped on me that took more time than was allotted. By framing it as my problem they made it quite clear: they had no intention of following the rules and I had better falsify my time-keeping records or face consequences.

[–] Ranvier@sopuli.xyz 10 points 8 months ago* (last edited 8 months ago)

Unfortunately a common experience. While they don't tell you to lie, the system is set up to make that the only reasonable option. And even if they were holding to 80 hour max (open secret this limit is broken many places) it would still be too much for any job, let alone something high risk like a doctor in training. If you were on a plane with a pilot in training who'd worked almost 80 hrs and been up for 20 hours straight already, you'd rightfully be very concerned.

Don't forget mandatory resiliency lectures after your 24 hr shift to really rub it in and gaslight you that all of this is somehow your fault.

[–] XTL@sopuli.xyz 1 points 8 months ago (1 children)

Well, in a good organisation this would be an important lesson: you need to signal when you can't get more work done. Whether it's sheer time pressure, contacts, or legal issues, or whatever. Every worker needs to immediately bring up obstacles to their work. It's up to managers/supervisors to find solutions. That's their number one job.

[–] Ranvier@sopuli.xyz 3 points 8 months ago* (last edited 8 months ago)

The problem is there is no recourse like in a normal job. It's not like you can just say, working conditions here are bad I'm going somewhere else. Working conditions are miserable everywhere for residents, 80 hour weeks are a norm not an exception, and switching to other programs is near impossible. There's a specific exception in US anti trust law that helps keep this all going and make it so programs effectively don't need to compete with each other on things like pay and benefits. If a resident were to leave their program, they'd be saddled with 6 figure student loan debt, be unable to use their degree for the most part, and be very unlikely to be picked up by any other program. And if they did, it'd likely be an even worse situation (why else would the position be open?). Though some programs may be better than others, even the best case scenarios are ridiculous and unsafe to any reasonable person looking at them. It's this bizarre case of group insanity where people figure it must be reasonable if so many people put up with it, but anyone outside of medicine would be horrified. The entire residency system is broken, has been from the start, and all the external incentives on the residency system are pushing it to get even worse, not better. Need change forced by law from above, the monopoly ended, or resident unions, all three really.