I have some bad news

Personal vlog / day schedule (brief context)

The video starts as a “day in the life” vlog and transitions into a commentary/rant about recent and proposed changes to residency training work-hour and program requirements overseen by the ACGME, framed by the creator’s own hospital rotation experience.

• The narrator (a resident) begins the week rounding on inpatient chronic pain patients, with plans to move to an outpatient clinic later.
• They mention a “new pay scale” from a recent union negotiation (PGY-3 salary stated as $101,000).
• They preview moving to the ICU next week and describe the schedule as “brutal.”

Main news commentary: history and shifting rules on resident work hours

The creator walks through a timeline of how resident work-hour rules evolved:

• The rules were created after the Libby Zion case (1984).
• They were later nationalized (2003).
• They were tightened further (2011/16-hour awake limit).
• They were loosened (2017), which allowed 24-hour shifts again.

They argue that the 2017 loosening was based on evidence suggesting flexible schedules weren’t worse for patients, but they emphasize that resident well-being may have worsened. In particular, they highlight frustration with rest/time off, claiming that resident-impact concerns aren’t emphasized enough.

Current ACGME proposal: cutting/rescoping program requirements

A central “headline” of the video is that the ACGME proposed changes (published September 8) that would reduce residency program rule coverage by about 43%.

The narrator clarifies that some of the reduction is administrative/technical consolidation. However, they argue the proposal also contains specific substantive changes that could worsen working conditions and safety for residents.

Specific proposed changes the creator criticizes

• Reduced rest time after 24-hour shifts

  • The proposal would cut mandatory time off from 14 hours to 12 hours.
  • The narrator argues this could harm resident safety and patient safety—noting that real recovery time after a shift often includes sign-out, leaving the hospital, and driving home.

• Potential removal of an 8-hours-between-shifts guideline

  • The creator says deleting this guidance could allow schedules with effectively less-than-8-hour gaps.

• Removing the written constraint on in-house call frequency

  • The proposal removes guidance such as “no more frequent than every third night.”
  • The narrator warns this could enable “terrible” scheduling.

Overall, their theme is that deleting or weakening scheduling constraints can allow programs to create worse schedules if explicit guardrails are removed.

Proposed changes the creator views more positively

The narrator also points to parts of the proposal they see as improvements:

• Pregnancy protections

  • Adds requirements for written policies for pregnant residents, including scheduling changes and follow-ups.
  • Includes protected time for pumping.
  • States that residents who miss duties due to pregnancy do not have to make up those hours.

• 80-hour rule handling

  • The creator says the proposal retains the 80-hour rule, but changes how averaging works.
  • The 80-hour limit would apply within the same rotation rather than averaging across more disparate rotations, which they view as an improvement.

Process and call for action

• The proposal is not final and is open for public comment until October 22.
• The narrator encourages residents to submit specific anecdotes and feedback rather than only general statements like “residency is hard.”
• They also credit and recommend another video by a friend, Rachel Southern, for additional coverage.

Presenters / Contributors

• Shawn Anderson — main narrator/presenter
• Rachel Southern — mentioned as a contributor whose prior video is recommended