<p>Apparently, ruthlessPheonix doesn’t think residency is rigorous enough.</p>
<p>Actually, residents can and do moonlight at other jobs during residency. The most common scenario would be working an ER or doc-in-box shift after the intern year.</p>
<p>Virtually all residencies supply pagers, but not cell phones. Land line service is required by some residencies because of greater reliability, though most residencies require only a valid cell or land line number.</p>
<p>A few residencies, for instance, Stanford, provide an allowance for cell phone use. <a href=“http://recon.stanford.edu/Handbook/07-House%20Staff%20Handbook.pdf[/url]”>http://recon.stanford.edu/Handbook/07-House%20Staff%20Handbook.pdf</a></p>
<p>Cell phone use in patient care areas is discouraged by the IT and hospital engineering policy makers, although the evidence shows there is no interference with patient monitors. Despite the prohibition of cell phone use in some hospitals, virtually all doctors use cell phones inside and outside the hospital (though few would pay $230 a month for cell, internet and land line service).</p>
<p>BTW, a google search of “housestaff handbook” can give a snapshot of resident life including hours, food, costs and daily concerns. See the housestaff handbook at USCF’s [Department</a> Of Medicine](<a href=“http://medicine.ucsf.edu/housestaff/policies/handbook.html]Department”>http://medicine.ucsf.edu/housestaff/policies/handbook.html).</p>
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<p>I understand your argument that you don’t need anything. I could find clothes at Wal-mart that were professional “enough” to wear on a daily basis to clinic. Is that where I shop for clothes? Of course not. We could argue all day that I’m wasting money by shopping at Banana Republic and J.Crew for every day stuff, or that a suit from JCPenny at $125 is just as functional as my new Calvin Klein suit I bought this summer for $430. But is that going to change my spending habits? Hell no! I believe that spending that amount is worth it. I think the clothes are better made, more stylish, and represent a greater value.</p>
<p>The same could be said for this issue with the cable/tv/internet/cellphone/landline. Do they need all of those things? Of course not, but obviously they find enough value in them to warrant the cost. I’ve broken down that the costs listed in the article aren’t outlandish, that they seem pretty accurate, so what’s the big deal? Personally, knowing that I will be moving to a location where I likely won’t get frequent broadcasts of my alma mater’s football games, I already anticipate buying ESPN’s GamePlan, and due to the fact that my schedule will be busy, getting a DVR so I can record the games. This is something that is important to me. Do I need it? According to you - no (but I might beg to differ on that). Some people have to have their Desperate Housewives and so that’s an expenditure they’re willing to make.</p>
<p>Further, I’ve heard some places/magazines argue that getting a DVR is more time efficient anyways - you’re not tied to the network’s schedule and you get to fast forward through commercials. </p>
<p>Now does that mean you’re going to make the same decisions on how to spend your money? Of course not, we could run down the list and find all sorts of things that you would be unwilling to cut out of your life. Maybe it’s a gym membership, maybe it’s a bowling league, maybe it’s subscription to a magazine or a website…I dunno. </p>
<p>As for your (hypothetical) complete lack of being able to be reached…I doubt that’s going to win you many friends. Further, residency is a job and I’m willing to guarantee that the contracts have clauses about “at-will employment”…Even if they don’t, making decisions which directly impede your ability to perform that job at a satisfactory level are grounds for dismissal. I think they’ll probably tell you to get a phone, make yourself available, or take a hike…good luck getting into a new residency next year with a firing under your belt.</p>
<p>BRM: I’d probably make some very similar spending decisions re: sports television. I don’t think it’s inappropriate. I just find it odd that CNN is writing articles about how frugal they are.</p>
<p>Yes, they moonlight. </p>
<p>At UIC facilities are antiquated compared to CCOM, but the MD and $$$ make up for the creaky pipes in lab. (My wife is a DO and they get a comparable education, but if the difference is thousands a yr it’d be a no-brainer to go MD.) Anyway, during rotations in Chicago he’d be doing rotations along side UIC 3 and 4th yrs, so CCOM proves no advantage in that respect.</p>
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<p>Uh, no, I don’t think you’re seeing my point. My point is, when you’re in massive debt, you are supposed to be cutting down. Sure, if you’re rich, you can do whatever the heck you want. But if you’re poor, you’re not supposed to be doing that. That’s why you don’t see poverty-stricken students running around buying new cars, wearing Armani, and eating from the best restaurants.</p>
<p>That’s what fiscal responsibility is all about: you’re not supposed to buy things you can’t afford. Instead, you’re supposed to save your money and learn the discipline to delay your gratification until such time that you can afford it. Isn’t that something all our parents taught us? People who don’t have a lot of money are not supposed to spending a lot of money. Is that really such a controversial point? </p>
<p>So, to your point, sure, I buy plenty of things that aren’t truly necessary. But the big difference is that I can afford them. Specifically, I don’t have a giant negative net worth hanging around my neck like an albatross. If I did, I would surely cut back massively. But apparently, not this couple. </p>
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<p>And here’s a way that’s even more efficient. Just borrow the DVD box set from your public library for free. That’s what I do. </p>
<p>Remember, these are resident doctors here who are working Ibanking hours. It’s not like they have a lot of time to be camping out in front of the tube anyway. They need to know what’s going on with Gray’s Anatomy, not Grey’s Anatomy.</p>
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<p>Let me put it to you this way. I know plenty of people who have successfully demanded that their employers pay for their cellphone bills. And they don’t occupy positions as important as resident doctors. Heck, they don’t even get paid as much as do resident doctors (who aren’t getting paid very much anyway). Heck, these people don’t even hold bachelor’s degrees (and I think a few of them didn’t even graduate from high school). Yet somehow they were able to negotiate their cellphone bill away. I have to imagine that this couple could do the same.</p>
<p>Besides, think of it this way. I would hardly call such a request particularly controversial. If something is necessary for the performance of the job, then I think it’s fair that the employer should pay for it. Why not? After all, what’s next? Should hospitals demand that residents now have to pay for all of the medical gear they use on their jobs? Maybe they should even have to personally pay for all of the medications they prescribe to their patients too? These are all costs that are necessary to perform the job too. So if hospitals can force residents to pay for their own ability to be reached, why not also force them to pay for everything they do on their jobs?</p>
<p>Sakky, these two future doctors are making a bet that they will be able to afford the debt they are taking on when they become doctors. They are borrowing now and they are expecting their future earnings to take care of that debt.</p>
<p>Is that a bad bet?</p>
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<p>Nice one lol</p>
<p>Sakky, I don’t think this is getting us anywhere. I have no doubt that we each fully understand and appreciate the other’s points on the cable issue, but we’re arguing from very different end points - where I don’t believe there is any middle ground. I keep saying that we aren’t in a position to question the decisions they’ve made and you are saying they need to make better decisions. I don’t see where this can go any farther.</p>
<p>As for the negotiation of cell phones (and please remember that I don’t know of any hospitals that have actually done this, only heard rumors)…here’s my take - certainly attending physicians, nurses, staff, etc that are employed by or have privileges with the hospital have the leverage to make such negotiations. And I fully agree that it’s only fair in such a situation for the hospital to make some sort of subsidizing payments.</p>
<p>In the case of residents though, all the leverage rests with the residency program. As much as the hospital needs the cheap labor provided by residents, completing a residency successfully is much more important for the resident than labor issues are for the hospital. While residency is a job, it’s also an educational component, one that if not completed leaves one’s career hopes sharply diminished. Because of the match and the timing of it, there’s almost zero freedom for residents to move once they’ve committed to a program. I believe (don’t quote me on this) that submittal of a rank-order list confirms understanding that the resident is in agreement to work where they are matched and only in extreme circumstances can changes be made. Because of this set up, residents are lacking one key component that the people you made reference to have - the ability to walk. Regular employees (of any business) don’t have to worry about the detriment to their future careers that leaving a residency program might have on a young physician’s. All the power in such a situation lies with the residency program. What options does a resident have?
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[li]They can stick it out and refuse to get a phone, only increasing the ire of all those they work with, yet some how manage to avoid getting fired.</p>[/li]
<p>[li]They can cave and get a phone and survive with little to no repurcussions</p>[/li]
<p>[li]They can stick it out, refuse to get a phone and get fired, thus leaving them mid July/early August with no where to go, and a dismissal on their hands that they have to explain when they go through match for the following year. (And Residency Directors most definitely talk to each other).</p>[/li]
<p>[li]They can quit on principle, still have no place to go, have no job, massive debt and have to go through the match again. </p>[/li]
<p>[/ul]</p>
<p>Now if you’re in a city like Chicago, and a common specialty like Peds, there are probably some other options, and you can explore what nearby programs have open spots…but it’s not like there’s a whole lot of hope. </p>
<p>But if you’re an Ortho resident in Denver at the University of Colorado…at the only Ortho residency in the state, you have zero other immediate options nearby, and since ortho is so competitive, it’s not like there are open spots just laying vacant all over the country. </p>
<p>Of course all this assumes that you’re some sort of weirdo anyways who has managed to live through 2007 without a cell phone (I know of one person under the age of 40 who doesn’t have a cell phone - hell, my grandmother has had three phones this decade). So who knows what sort of crazy decision such a person might make.</p>
<p>But the point is, yes, there is a chance at negotiation, and yes, the fair thing would be for the hospital to subsidize, but those things aside, the situation is more complicated than that.</p>
<p>Sooo…by the time i reach residency, im going to be one poor ■■■■■■■, living a crummy life, and my ill work my ass off all day, go home at night to my wife and she’ll bich at me more about how much life sux here, then i’ll sleep for 4 hours, wake up, and the process repeats? I won’t even have time to use the internet or watch cable… ***…</p>
<p>Well it’s not so bad. You’ll be used to living the life of a student anyways, so it’ll be easier.</p>
<p>The lesson here, kids: Marry for money!</p>
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<p>If you think it’s that awful, don’t go into medicine. I don’t think patients need miserable doctors inflicted upon them. There are lots of other ways to make a living.</p>
<p>If medicine really is the career for you, I think you’ll find a way to make it work. Residents work long hours, for sure, but I don’t know any who have lives as terrible as the example you gave. Really, it’s doable. :)</p>
<p>Residency is tiring and not well-paid and you lose a lot of the time you would want to invest in other things. And physicians are notorious for having marital troubles.</p>
<p>But ideally, it’ll also be a lot of fun. It’ll be hard to keep track of that, in the midst of all the chaos, but hopefully, deep down, you still remember that, too.</p>
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<p>Well, let me put it to you this way. What would you think if you saw one of your kids spending beyond their means? </p>
<p>That’s what it ultimately comes down to. If you don’t have money, you’re not supposed to be spending money. Responsible parents don’t teach their kids to assume a boatload of debt and then still expect to live the same lifestyle than they would otherwise. Debt is supposed to be constricting. If you don’t want your lifestyle to be constricted, then you shouldn’t go into debt. </p>
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<p>I’m simply saying that one should adjust your expenditures to match your current financial situation. When you don’t have money, you should try not to spend money. </p>
<p>I’ll put it to you this way. I know rich MBA students who were former financial analysts and who knew that they would almost certainly be heading into another highly lucrative finance job after graduation, yet adjusted their expenditure levels when they went back to school; for example, they got dirt-cheap apartments, ditched their cars and relied on mass transit, and became mavens at finding all of the free food on campus. And yes, many of them decided not to sign up for cable-TV either. </p>
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<p>Well, if that’s the case, then you have to ask why don’t hospitals just press the advantage to the fullest? For example, why even bother paying the residents at all? Why not just tell residents that they don’t really have a “job”, but are simply in an extended training and educational program, and hence, they don’t have to be paid a salary? Heck, why not just make the residents pay the hospital to work there? You said it yourself: the doc’s wouldn’t be able to do anything because they have no options. </p>
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<p>There is a big difference between having a cellphone, and actually telling your employer that you have a cellphone, as well as providing your phone number to your employer. I believe you are perfectly within your rights in simply choosing not to provide this information simply because of it’s personal nature. {After all, it’s my own personal number. What’s next - do I have to tell them what my personal email address and the URL of my personal blog is too?}</p>
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Gee whiz, Sakky. You’ve got a good point and you’ve made it. But jiminy. We’re getting out there a bit, aren’t we? I’ve lost sight of the mainland. </p>
<p>One good thing about free will, most times we can choose which cross we want to die on. </p>
<p>I wouldn’t pick this one. But that’s just me.</p>