r/Residency 1d ago

DISCUSSION Working conditions for Residents US vs UK

People often talk about the hours in the US being higher (although part of this is balanced out with the fact that the intensity of the hours is less in the US compared to the UK), but I’ve seen no threads which discuss the day-to-day differences.

I’m a PGY3 in the UK. We often have to deal with crappy PCs that are really slow, spend time trying to get the printer to work, fighting to find a space to just sit and use a computer on the ward (a lot of wards don’t have a “doctors office” anymore, and even the ones that do usually cram more doctors than there are seats/PC’s). Moreover a lot of our time is taken up with basic procedures like venepuncture, cannulation, urinary catherisation etc. A lot of the time it feels like you’re not “doctoring”.

Was just wondering how the average US resident experience compared?

0 Upvotes

31 comments sorted by

31

u/SOFDoctor Attending 1d ago

Please elaborate how the hours in the US are less intense compared to your venipunctures, waiting for slow computers, getting printers to work, and not even “doctoring.”

4

u/dabeezmane 1d ago

Trying to fix a printer is actually very stressful

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u/idkwtda115 1d ago

Trying to find a functioning printer to print off G&S labels for a patient with an UGIB… good times.

0

u/Powerful-Forever9996 14h ago

The doctoring doesn’t stop needing to be done. You have to do that whilst also doing all of the shit that prevents you from doing the job you actually have to do to make the patients not die. It’s like being a doctor with your hands tied behind your back.

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u/idkwtda115 1d ago

I said a lot of the time, not all the time… and patient caps aren’t a thing in the UK*. We still round, execute plans and manage sick patients on the wards but we have to deal with all of the stuff I listed in the original post.

*we have “minimum staffing” levels on paper, but in reality this is rarely adhered to. I’ve done rotations where I was regularly expected to round on 12-15 patients, while also having to do blood draws and wrestle with crappy IT/clinical systems, all in a 8-9 hour shift. An intern being capped at 7 patients is not a thing here.

25

u/SOFDoctor Attending 1d ago

I think you’re grossly unaware of how healthcare and residency works in the US.

1

u/idkwtda115 22h ago

Educate me, then. It’s literally what I asked for in the original post…

4

u/LR-over-NS PGY4 20h ago

Internal medicine teams usually capped at 10 per intern, days are 10-14 hours long. Surgery teams have no cap, I’ve had friends who carried lists of 40, days are routinely 14hrs or longer.

I think you’re catching flak because what you’re describing sounds chill as fuck. If you’re looking for a printer to tend to your GI bleeder they must not be unstable or you’re not the one fixing them. If you’re working 8-9 hrs for inpatient medicine that’s basically same hours as an office job.

1

u/idkwtda115 11h ago

How is what I’m describing chill? More patients to look after and more ancillary tasks to do in less hours per day, lol wut. There’s even a commenter on this thread who worked in both systems that agrees with the individual hours in the US are less intense.

8-9 hours is a normal day for a internal medicine job. On calls are 12.5 hours. We have a lot of on calls. I’m not comparing it to the ghoulish rostering residents work through in the US, just making a point that we don’t work office hours.

1

u/LR-over-NS PGY4 10h ago

8-9 hrs is office hours though, full stop. Idc how intense it is, being at the hospital longer just sucks.

As an intern my 12 hrs were almost nonstop clinical work. I think it varies by hospital and amount of duties on the intern but I seriously doubt most people are doing little/chill work during their time at work during inpatient medicine in the US unless your at the VA.

9

u/talashrrg Fellow 1d ago

We deal with the same obnoxious tech/environmental issues in the US. Nurses can draw blood and place easy foleys in most places though.

7

u/SnakeEyez88 Attending 1d ago

8-9 shift? Is this an outpatient rotation?

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u/idkwtda115 22h ago

Inpatient hospital medicine

12

u/DilaudidWithIVbenny Fellow 1d ago

All the things you describe are considered ancillary or nursing tasks in the US (venipuncture by phlebotomy, IV cannulation by the nurse, urinary catheters by the nurse). Resident level procedures in IM include things like paracentesis, thoracentesis, bedside (informal) ultrasound, lumbar puncture, arterial puncture/ lines, central lines. Programs where residents are required to do nursing tasks are uncommon (many NYC programs are know culprits), and competitive residents tend to avoid those places.

1

u/idkwtda115 1d ago

Sounds like a dream. Are residents in the US expected to scribe for attendings when they round?

5

u/DilaudidWithIVbenny Fellow 1d ago

No. Residents write the progress note for the day and the attending co-signs it. Scribing is considered something not even a med student should be doing because your job is learning to practice medicine. Some high volume attendings in certain specialties (EM or surgical ones) will often hire a dedicated scribe, but these are typically pre-med students working a low paying job in exchange for experience and exposure.

10

u/CorrelateClinically3 1d ago edited 1d ago

You guys have 48 hour work limits. Sit this one out bud. We are capped at 80. Some of us cross that.

“bUt ThE pRiNtEr DoEsNt wOrK iN tHe uK”

1

u/idkwtda115 22h ago

What are you getting so bent out of shape for, relax lmfao

6

u/Petitoiseau13 MS4 1d ago

I have spent many hours on the phone with IT trying to get our computers/printers to work in the US, lol. We even have to clean our own work rooms (like sweeping and mopping, not just keeping surfaces clean). I don’t think this experience is universal all over the US but a LOT of what we do doesn’t feel like “doctoring”.

3

u/FloridlyQuixotic PGY2 1d ago

lol wut. For like 3 months only one of our printers in clinic worked because they couldn’t find any paper for the other printers and then once that one ran out of paper were for just printing stuff to the deck on the other side of the hospital. It took one of our residents to figure out that there was printer paper somewhere in the hospital because the supply person just didn’t bother to check.

Our computers are slow as hell and our EMR freezes regularly. We also don’t have enough computers for everyone in many parts of the hospital. I am frequently doing the med rec because it’s not done by the clinic staff or ward clerks. When I want to book surgeries, I am doing essentially all the tasks of a surgery scheduler because we don’t have one. We also don’t have a cap on patients.

We very frequently have to do non-physician tasks on top of all the physician tasks we have to do.

2

u/bagelizumab 1d ago

Tbf, US also spends a lot of time and effort doing med reconciliation and chart digging because there are often times different hospital systems and their communication can be pretty ass, unlike having a single unified system for NHS.

I would also imagine patients tend to have higher BMI in US vs UK just based on national average, and as you are imagine they are not healthy. These patients with a BMI of 60+ rolling in and out of hospital with massive charts due to multiple co-morbidities takes a lot of effort to care for and chart appropriately.

Like I can ensure you, just because there is a cap doesn’t mean US residents are just out there drinking milkshakes and playing Pokémon Go.

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u/idkwtda115 22h ago

Yeah I never said you guys are, but the truth is, pretty much every post out there made by a UK doctor who moved to the US reports the hours were less intense. Most of the people commenting on this thread having probably only worked in the US system, so how would they know how it compares to the intensity in the NHS?

Clarification: I’m talking about the intensity of each individual hour worked, rather than the intensity of 48 vs 70-80 hours.

2

u/Powerful-Forever9996 14h ago

I have worked in both systems. Being a doctor in the USA is immensely easier than being a doctor in the UK. The hours are longer but other than that every aspect of your professional life is better and easier than in the UK.

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u/idkwtda115 11h ago

Hush hush, the US residents don’t like hearing this - so I’ve learned from this thread.

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u/chicagosurgeon1 1d ago

Why don’t you buy your own laptop?

0

u/idkwtda115 22h ago

How does that solve anything

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u/chicagosurgeon1 19h ago

You complained about finding a PC and slow PCs. I just solved 2 of your problems.

1

u/idkwtda115 11h ago

No you didn’t. How are you getting the clinical systems on there? I don’t need a laptop to send emails bro.

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u/chicagosurgeon1 9h ago

Huh? In america, not your terrible country, we have Epic on our laptops. Im sorry your country sucks