The craziest thing after starting residency is even if you’re in a “chill” specialty in a non malignant program the work hours and amount of labor exploitation is still insane. “Thou shalt not work 80 hours a week averaged over a month” is a *very* low bar for wellness
It's a pretty low bar. Good news is that there are some specialties that average closer to 50-60 per convos with my colleagues, but not sure on a national level what the averages are
Medical students are getting older and older on average in the US. I'm an MS3 and I started at 29. My class average's age when ee started was 26. That means that we on average will be 30 when we start residency and we won't have the ability to function on little sleep like people did 20 years ago. I need my sleep now and I just want to be a good doctor in residency and I don't want to harm my patients. I'll be 37 when I finish residency.
I don't think this is due to actual aging (26 vs 30 is not that big of a difference). It's probably more due to having more respect and love for yourself in your thirties lol
I worked in surgery and I can confirm that we worked +25 on call no sleep.. this is very common not only in private practice. Physicians and nurses are exhausted but management care only about the numbers .
"Weight lifted off my shoulders, I felt much more free," exactly the words I used to describe my experience after quitting therapy and leaving the mental health industrial complex behind me after ten years. Sometimes you really do need to put yourself first. There are so many narratives and agendas out there but only you can create the one that works for you. Kudos to Ali for having the courage to take the leap.
I’m a doctor , we sacrifice our own health and social lives for our patients, look at what happened in COVID, I would do the same and quit in same situation, because I have value for my family and time, at the end of the day no body cares, so enjoy your life, good for here.
I am a surgery resident. I am on 36 hours shift twice a weak with only 3 Sunday's off. I feel like I am dying. It screwed up my mental health. I can't even speak about it.
just like the truck driver,whose working hours are strictly controlled and restricted by law.Why no one thinks about the harm to patients that sleep deprivation from surgeons can do,even without consideration of physicians'health?It's strange.
Nurse anesthetist take 24-48 hour call, not usually 36, but getting paid $7200 for a weekend I’m not complaining, but resident pay is not enough money for me to do tat😊
Im so proud of u voicing out this inhumane conditions as doctors face. At 36 i have become further from the Creator. I hv no husband/children and i rarely see my brothers' kids and not being part of my family and i loss so many of them. Bt now i dnt knw if im giving the best to my patients and mostly my love ones. I dnt knw hw i can leave without huge financial backlash. Thank u so much for this platform for us😵💫
The car is an excellent example. Professional drivers or truck drivers can not legally drive over specific limitations without sleep due to the known extreme safety issues. With the risk of malpractice suits, and crazy costs of malpractice insurance, it makes no legal sense to me to allow doctors to practice, and especially perform delicate surgeries, with those same levels of lack of sleep.
When I told my doctors about not being able to sleep because of how sick I have been they completely blew it off. They could not care less that I sleep no more than 4 hours a night but usually less than 2. But apparently them not being able to sleep is ok.
I guess that's why they blew it off 😂 "I don't sleep more than 2 hours, who cares if you can't too?" I'm just kidding though and I am genuinely sorry you feel so ill not sleeping is extremely terrible for health and mood 🙏 Just wanted to inject some humor into whatever it is you are going through 🙂
Doctors and medical students are quitting because the field of medicine and academia are so heinously exploitative. I wish it wasn't this way and I truly hope there is change 🙏
Trained for general surgery when there were no hour "restrictions" and during my rotation in CT surgery we would usually put in about 110 to 120 hours a week. On time I did two back to back 24 hours calls... to say the least I was useless and my productivity/thinking skills were terrible. Some took that as a badge of honor... I gave it my best shot, but my body couldn't take it. It can be a bit inhumane. Even know with hour restrictions it is still physically very challenging.
I think as you mentioned the business model of hospital medicine is changing rapidly. The hospitals and particularly ER’s are seen now as primary care settings for the overwhelming migrant situation, drug users, rampant mentally ill populations and uninsured. This is unsustainable with no politician willing to address the mess which they created. Doctors like her are just victims of a system clearly not designed for this level of numbers. It’s the hospitalist part that is the key here. If she was in private practice but just scheduled patients for procedures then her experience would be different. Another aspect to consider is a generational difference. My parents generation had so much hardships and I never heard mental health from their mouths. They knew and accepted life is difficult. I don’t think this generation is able to put up with high levels of stress. My niece just got out of dental school and after two years of working is already tired and burnt out and all I hear is the word mental health. I’ve been working for 30 plus years and just did it. This is not to say any approach is right or wrong and i do applaud anyone willing to improve their lives and doing what is right for them even if that means quitting their jobs.
As a Gen Z, I absolutely agree with you. I understand that situations really do make one sad but everyone is just having too many mental health issues. The previous generation had no problems even with more hardships than us.
Many of your points are true and I think many in the other generations relied heavily on God and on prayer to cope with difficult, conditions. However, in the case of the doctor in this video, I don't think she fits a category of crying mental health when not necessary. She recognized that there were work conditions that were being imposed on her that were not safe for patients' health and her holistic health(mental health and including body, soul, and spirit), all in the name of corporate changes most likely for the love of money. These were circumstances of life that she could change. I think God gave her wisdom to see that she was being set up for a destructive end and she gracefully changed paths. I'm not saying that you were implying her decision was from a lack of coping strategies related to mental health. I just felt the need to highlight the soundness of mind and wisdom in her decision making.
Reducing it down to not being able to deal with stress is uninformed. Baby boomers have all sorts of untreated mental health issues because of the “they knew how to deal with stress” lies. Not only did they not deal with stress well (hording, high degrees of stress-related illness, abuse toward their children leading to estrangement), all their mental health issues are being manifested in subsequent generations. What you are seeing is that people are actually managing their mental health issues now instead of suppressing them or passing them on to the next generation. It’s popular to come down on these younger generations but it’s misdirected.
I think you are wrong. I think people in the other generation probably had a lot of mental health and physical health illnesses but they had no doctors and there was poor health illiteracy and no therapy out there. Ask in clinical medicine we learn that if you ignore and suppress mental health it manifest as pain and disease in the body. Yes so their coping mechanism was “God”. And they did develop diseases and die prematurely. So I think it is a generational and intellectual/knowledge based issue. People need to open their eyes and smell the roses.
The schedule was the main reason that I chose a PhD route over an MD. I could still be involved in medicine/health but I didn't have to sacrifice my own health. I would love for this to change for MD's. I want my doctor well rested and not overwhelmed when they see me.
In Turkey resident doctors have around ten 24 hour shifts in a month and they didn't use to have the 24 hours off the day after, they just kept on working their normal shift, which can often extend to 9pm. This changed recently (2-3 years ago) when a doctor fell asleep, drove into a truck and died after such a shift. (which is eerily similar to what Dr Jubbal described here!) THAT is what it took to change this insane system, to make it into the still very much inhumane system. I'm surprised to hear similar problems from such a developed nation, although the compensation is making it at least somewhat explainable there. I'm just curious, is the residents' schedule similar to this also? worse/better?
That shouldn’t even HAVE to happen for these changes to occur…an ounce of prevention. But unfortunately, we (our systems) push people until these tragedies occur and say “I’m sorry” when it’s too late.
Seeing videos like this makes me grade I chose not to do MD. I was pressured by my family to go to medical school and I knew if I did, it would be the beginning of my unhappiness. Even studying for the MCAT made me feel dreadful each day. It felt like the nail of a coffin being hammered down.
I was in a pediatrics residency program and we were used to the bone. Even when they had now that could cover shifts they would make us do 24 hour shifts so that the management could save money. I feel like I was cheated and mentally and physically tortured in the name of “training.”
EMTs, Paramedics, Anesthesia all work 24 hour shifts very often. I would say simply don’t do it (emergency medicine) if you are not prepared for the 24 hour shifts. I don’t like working 8, 10 or 12 hour shifts. I prefer 16 or 24 hours. It’s really not for everybody Less handover = less mistakes during handover, but, that is only if the physician is well rested, which is not so common with surgical specialties such as OB. I would say not getting enough sleep is the problem but shorter shifts would also solve the problem, maybe there is more than one solution
I flew for 28 years as a commercial pilot. With two pilots you couldn’t be on duty for more than 14 hours without a 10 hour rest period. Even then it was exhausting work at times. Truck drivers are limited (12 hours?) per shift. Yet doctors have no such limitations. That’s why medical malpractice constitute the third leading cause of preventable death in this country. 60000 are killed by gun violence every year. That pales in comparison to the 250000-400000 killed by doctors. Shame on you as a profession!
Medicine is dying at this point. Doctors aren't taking caring of their own patients like in my father's days. Most of them are taken over by business guys and insurances who doesn't have a clue of medicine and taking care of patients correctly. Glad I changed careers before it was too late, as I care about people and their well being. Companies and groups don't care. They care about hrs and profits. Plus it ruins family and personal life.
Do you agree with my take? Let me know in the comments.
The craziest thing after starting residency is even if you’re in a “chill” specialty in a non malignant program the work hours and amount of labor exploitation is still insane.
“Thou shalt not work 80 hours a week averaged over a month” is a *very* low bar for wellness
It's a pretty low bar. Good news is that there are some specialties that average closer to 50-60 per convos with my colleagues, but not sure on a national level what the averages are
Which specialties have lower hours, please?
Why do you have to work so many hours in residency? Like what are you doing that whole time
Wing bullied and harassed by everyone and their mother
@@erinnorwood6124psychiatry, internal medicine once you’re an attending, outpatient jobs like anesthesia/dermatology
Medical students are getting older and older on average in the US. I'm an MS3 and I started at 29. My class average's age when ee started was 26. That means that we on average will be 30 when we start residency and we won't have the ability to function on little sleep like people did 20 years ago. I need my sleep now and I just want to be a good doctor in residency and I don't want to harm my patients. I'll be 37 when I finish residency.
Yep, I'm a 33 y/o PGY-1. Would have recommended starting younger if I could
P
I hope things change when I start after a few years working as a nurse
I don't think this is due to actual aging (26 vs 30 is not that big of a difference). It's probably more due to having more respect and love for yourself in your thirties lol
Yeahhh I’m starting undergrad at 29 and pursing medicine 😅If all goes well, I’ll be in my 40s
I worked in surgery and I can confirm that we worked +25 on call no sleep.. this is very common not only in private practice. Physicians and nurses are exhausted but management care only about the numbers .
"Weight lifted off my shoulders, I felt much more free," exactly the words I used to describe my experience after quitting therapy and leaving the mental health industrial complex behind me after ten years. Sometimes you really do need to put yourself first. There are so many narratives and agendas out there but only you can create the one that works for you. Kudos to Ali for having the courage to take the leap.
I’m a doctor , we sacrifice our own health and social lives for our patients, look at what happened in COVID, I would do the same and quit in same situation, because I have value for my family and time, at the end of the day no body cares, so enjoy your life, good for here.
I am a surgery resident. I am on 36 hours shift twice a weak with only 3 Sunday's off. I feel like I am dying. It screwed up my mental health. I can't even speak about it.
just like the truck driver,whose working hours are strictly controlled and restricted by law.Why no one thinks about the harm to patients that sleep deprivation from surgeons can do,even without consideration of physicians'health?It's strange.
Nurse anesthetist take 24-48 hour call, not usually 36, but getting paid $7200 for a weekend
I’m not complaining, but resident pay is not enough money for me to do tat😊
Im so proud of u voicing out this inhumane conditions as doctors face. At 36 i have become further from the Creator. I hv no husband/children and i rarely see my brothers' kids and not being part of my family and i loss so many of them. Bt now i dnt knw if im giving the best to my patients and mostly my love ones. I dnt knw hw i can leave without huge financial backlash. Thank u so much for this platform for us😵💫
🙏Praying for your guidance, refreshing, and reconciliation by the grace of the Almighty💖
The car is an excellent example. Professional drivers or truck drivers can not legally drive over specific limitations without sleep due to the known extreme safety issues. With the risk of malpractice suits, and crazy costs of malpractice insurance, it makes no legal sense to me to allow doctors to practice, and especially perform delicate surgeries, with those same levels of lack of sleep.
When I told my doctors about not being able to sleep because of how sick I have been they completely blew it off. They could not care less that I sleep no more than 4 hours a night but usually less than 2.
But apparently them not being able to sleep is ok.
I guess that's why they blew it off 😂 "I don't sleep more than 2 hours, who cares if you can't too?" I'm just kidding though and I am genuinely sorry you feel so ill not sleeping is extremely terrible for health and mood 🙏 Just wanted to inject some humor into whatever it is you are going through 🙂
Doctors and medical students are quitting because the field of medicine and academia are so heinously exploitative. I wish it wasn't this way and I truly hope there is change 🙏
Trained for general surgery when there were no hour "restrictions" and during my rotation in CT surgery we would usually put in about 110 to 120 hours a week. On time I did two back to back 24 hours calls... to say the least I was useless and my productivity/thinking skills were terrible. Some took that as a badge of honor... I gave it my best shot, but my body couldn't take it. It can be a bit inhumane. Even know with hour restrictions it is still physically very challenging.
I think as you mentioned the business model of hospital medicine is changing rapidly. The hospitals and particularly ER’s are seen now as primary care settings for the overwhelming migrant situation, drug users, rampant mentally ill populations and uninsured. This is unsustainable with no politician willing to address the mess which they created. Doctors like her are just victims of a system clearly not designed for this level of numbers. It’s the hospitalist part that is the key here. If she was in private practice but just scheduled patients for procedures then her experience would be different. Another aspect to consider is a generational difference. My parents generation had so much hardships and I never heard mental health from their mouths. They knew and accepted life is difficult. I don’t think this generation is able to put up with high levels of stress. My niece just got out of dental school and after two years of working is already tired and burnt out and all I hear is the word mental health. I’ve been working for 30 plus years and just did it. This is not to say any approach is right or wrong and i do applaud anyone willing to improve their lives and doing what is right for them even if that means quitting their jobs.
As a Gen Z, I absolutely agree with you.
I understand that situations really do make one sad but everyone is just having too many mental health issues. The previous generation had no problems even with more hardships than us.
Many of your points are true and I think many in the other generations relied heavily on God and on prayer to cope with difficult, conditions. However, in the case of the doctor in this video, I don't think she fits a category of crying mental health when not necessary. She recognized that there were work conditions that were being imposed on her that were not safe for patients' health and her holistic health(mental health and including body, soul, and spirit), all in the name of corporate changes most likely for the love of money. These were circumstances of life that she could change. I think God gave her wisdom to see that she was being set up for a destructive end and she gracefully changed paths. I'm not saying that you were implying her decision was from a lack of coping strategies related to mental health. I just felt the need to highlight the soundness of mind and wisdom in her decision making.
Reducing it down to not being able to deal with stress is uninformed. Baby boomers have all sorts of untreated mental health issues because of the “they knew how to deal with stress” lies. Not only did they not deal with stress well (hording, high degrees of stress-related illness, abuse toward their children leading to estrangement), all their mental health issues are being manifested in subsequent generations. What you are seeing is that people are actually managing their mental
health issues now instead of suppressing them or passing them on to the next generation. It’s popular to come down on these younger generations but it’s misdirected.
I think you are wrong. I think people in the other generation probably had a lot of mental health and physical health illnesses but they had no doctors and there was poor health illiteracy and no therapy out there. Ask in clinical medicine we learn that if you ignore and suppress mental health it manifest as pain and disease in the body. Yes so their coping mechanism was “God”. And they did develop diseases and die prematurely. So I think it is a generational and intellectual/knowledge based issue. People need to open their eyes and smell the roses.
The schedule was the main reason that I chose a PhD route over an MD. I could still be involved in medicine/health but I didn't have to sacrifice my own health. I would love for this to change for MD's. I want my doctor well rested and not overwhelmed when they see me.
mature decision. many of us (including myself) when younger don't think about lifestyle enough and how priorities change over time
Agreed so much. When everyone else is getting married or in a relationship and unavailable, it’s hard to live a lonely
Can you let me know the amount of hours you work as a phd because I am considering that and want to know what your job is like.
Many PHD work 80 hrs a week, so it’s not a vacation to be an academic. Keep that in mind.
Sure but you’re still NOT a doctor.
In Turkey resident doctors have around ten 24 hour shifts in a month and they didn't use to have the 24 hours off the day after, they just kept on working their normal shift, which can often extend to 9pm. This changed recently (2-3 years ago) when a doctor fell asleep, drove into a truck and died after such a shift. (which is eerily similar to what Dr Jubbal described here!) THAT is what it took to change this insane system, to make it into the still very much inhumane system.
I'm surprised to hear similar problems from such a developed nation, although the compensation is making it at least somewhat explainable there. I'm just curious, is the residents' schedule similar to this also? worse/better?
Yes resident is same and worse, and no the compensation does not make it worth it.
That shouldn’t even HAVE to happen for these changes to occur…an ounce of prevention. But unfortunately, we (our systems) push people until these tragedies occur and say “I’m sorry” when it’s too late.
Seeing videos like this makes me grade I chose not to do MD. I was pressured by my family to go to medical school and I knew if I did, it would be the beginning of my unhappiness. Even studying for the MCAT made me feel dreadful each day. It felt like the nail of a coffin being hammered down.
I was in a pediatrics residency program and we were used to the bone. Even when they had now that could cover shifts they would make us do 24 hour shifts so that the management could save money. I feel like I was cheated and mentally and physically tortured in the name of “training.”
Could you talk about how noncompete can limit physicians’ ability to leave toxic work?
Why would a healthcare environment require you to work a 24 hour shift? That is completely asinine.
EMTs, Paramedics, Anesthesia all work 24 hour shifts very often. I would say simply don’t do it (emergency medicine) if you are not prepared for the 24 hour shifts. I don’t like working 8, 10 or 12 hour shifts. I prefer 16 or 24 hours. It’s really not for everybody
Less handover = less mistakes during handover, but, that is only if the physician is well rested, which is not so common with surgical specialties such as OB. I would say not getting enough sleep is the problem but shorter shifts would also solve the problem, maybe there is more than one solution
M not in US, but I had 36 hour shift every 4 to 5 days. I hated it.
@@reddbenddisn’t 8-12 hours a shorter shift 24 hours though
We do 36 hours calls, no sleep, sometimes no food for 24+hrs, 2-3 times a week, only have 1 sunday off.
Greetings, Dr. Jubbal.
I have a request. Could you please make a video about USCE for International Applicants?
Please bring in FM opening his own PP guest please!
Excellent video
That's interesting because I thought all ob/gyn attendings had to do 24 hr calls? That's one of the main reasons I knew I would never go into it
I flew for 28 years as a commercial pilot. With two pilots you couldn’t be on duty for more than 14 hours without a 10 hour rest period. Even then it was exhausting work at times. Truck drivers are limited (12 hours?) per shift. Yet doctors have no such limitations. That’s why medical malpractice constitute the third leading cause of preventable death in this country. 60000 are killed by gun violence every year. That pales in comparison to the 250000-400000 killed by doctors. Shame on you as a profession!
I really like Dr Ali.
Let's be honest. If these MDs didn't have that social media $ they never could have afforded to quit.
Just commenting for the algorithm 💙
Hmmm
Medicine is dying at this point. Doctors aren't taking caring of their own patients like in my father's days. Most of them are taken over by business guys and insurances who doesn't have a clue of medicine and taking care of patients correctly. Glad I changed careers before it was too late, as I care about people and their well being. Companies and groups don't care. They care about hrs and profits. Plus it ruins family and personal life.