Is medicine designed to take over your entire life?

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I've wondered if this field is designed to consume your entire life. As a medical student, I feel very busy. I'm not the brilliant guy studying a few hours and remembering everything. I have to work hard to have a shot at doing well in courses. I'm fine with that. I knew that signing up. As I approach 2nd year and I begin to think about what field to pursue and what makes a good application, it can be pretty overwhelming. First we need to do well on boards, so some recommend to focus on board prep for that during second year and possibly forego mastering the minutia that separates the top 10% from the top 30%, which is the difference between getting the A. Then I get advice, don't just board prep, you should honor too. Do both.

Next, let's say you've done well on boards and courses, now to be a well rounded applicant, you need to have research. Another thing to tack on to a schedule that doesn't feel like it has that much room in it. After you grab excellent letters of rec, a fair request, I read that you also need to have other crap on your CV to look like your a team player or not just one-sided or boring (good Step 1 + research ONLY). So you should fill your free time with some type of club membership or leadership role. Oh wait, you should be altruistic also, so volunteering or giving back to the community should be on your CV too.

I feel like no matter what I do, there always some extra hurdle to climb until medicine is consuming every moment of my life. It's like the whole application is designed to see who can dedicate the most waking hours to their career while foregoing sleep, exercise, health, hobbies, relationships, etc. to keep our eye on the prize. What prize?

Originally Posted by Cole Trickle

I've wondered if this field is designed to consume your entire life. ...

I feel like no matter what I do, there always some extra hurdle to climb until medicine is consuming every moment of my life. It's like the whole application is designed to see who can dedicate the most waking hours to their career while foregoing sleep, exercise, health, hobbies, relationships, etc. to keep our eye on the prize. What prize?

Having your marriage fall apart three years into being an attending when your spouse finally realizes that you working all the time to the exclusion of everything else wasn't actually just an aspect of residency but has actually become part of your personality?

In all seriousness, the lifestyle in medicine is what you make of it. There will be parts where you have less control than others (residency comes to mind), but you don't have to sacrifice everything to succeed in medical school.

My advice would be quit hanging out with other medical students -- that attitude seems to pervade the whole establishment. Get a hobby which introduces you to other, non-medical people and balance your life. I'd be willing to bet your grades will actually go up (or at least stay the same) and you'll be a lot less unhappy.

When I took step 1, I hadn't seen anyone in my medical school class in 2 months. I was working 8-5 on step 1 prep 6 days a week and then having a relatively normal life outside of that, including lots of time spent with friends I made outside of medicine. It was one of the happier times of my med school life, and I was studying for step 1 at the time. The whole atmosphere of medicine is poisonous when it comes to lifestyle and work/life balance -- get away from it as much as you can and you'll be much better off.

Yep - it's all a game. A few things to consider -

First two years don't matter. Pass, get A's if you can, rock the boards. Period. If you get a 260 and a few C's your first two years, program directors won't bat an eye.

No one studies a couple hours then gets A's - I'm near the top of my class and it's because I read with every spare minute. One of my friends has jokingly dubbed me 'rainman', but I do well because I work hard, not because I'm smart. There are people in the class that are smarter than me that I outperform.

Most residencies don't require top board scores, great research, etc. Also, a lot of what you're saying is if you want to match into the top programs. Not everyone will (or wants to) end up at MGH of Hopkins. Think about it, half of med students are below average and still match......

Research is pretty field specific. Some fields (like radonc) basically require it. Others couldn't care less. Generally, the more competitive, the more important. It's nice if you can swing a research project your in the summer between M1 and M2. Beyond that, a case report or retrospective study in your third or fourth year would be nice. Most of the people who I know that are "doing research" are just doing something minor in someone else's project. Third year is too busy for that.

I don't think anyone cares if you are member of the anesthesia interest group....if you are president, or president of your class, they may care. Even still, it isn't huge.

Extracurricular/volunteering - do something you love. Don't do something to pad your resume. If you love to play a sport, do it - be a little league assistant coach or ref soccer games. If you love to fish, do it, volunteer at the boy scouts and teach kids how to cast. You should just have something that makes you a person. It will be something to talk about during interviews. Don't look at this as something you have to do, it's something you get to do. My school does a bunch of volunteer medical mission trips over seas during breaks or as a fourth year elective. Sure, this is 'altruistic volunteering' - but everyone who has ever gone says it was a blast and they got to visit a new county.

Sorry, that was long. Moral of the story: work hard, do the best you can on your boards, do what you enjoy with the little free time you have. Your third year grades are important.

My advice would be quit hanging out with other medical students -- that attitude seems to pervade the whole establishment. Get a hobby which introduces you to other, non-medical people and balance your life. I'd be willing to bet your grades will actually go up (or at least stay the same) and you'll be a lot less unhappy.

When I took step 1, I hadn't seen anyone in my medical school class in 2 months. I was working 8-5 on step 1 prep 6 days a week and then having a relatively normal life outside of that, including lots of time spent with friends I made outside of medicine. It was one of the happier times of my med school life, and I was studying for step 1 at the time. The whole atmosphere of medicine is poisonous when it comes to lifestyle and work/life balance -- get away from it as much as you can and you'll be much better off.

Good advice. I lived with friends that were not med students the first two years of med school. When I studied too long, they would grab me to toss the frisbee or watch some football. It keeps you sane. Its bad to sit next to another guy who is going balls to the wall studying (becuase he thinks youre doing the same) - vicious cycle.

Also, I left town and went home to study for step 1. You know what you need to learn. When someone else says some esoteric fact that will never show up on boards, it shoots your confidence and you don't need that when trying to tame the beast.

Originally Posted by FSU2013

Yep - it's all a game. A few things to consider -

First two years don't matter. Pass, get A's if you can, rock the boards. Period. If you get a 260 and a few C's your first two years, program directors won't bat an eye.

No one studies a couple hours then gets A's - I'm near the top of my class and it's because I read with every spare minute. One of my friends has jokingly dubbed me 'rainman', but I do well because I work hard, not because I'm smart. There are people in the class that are smarter than me that I outperform.

Most residencies don't require top board scores, great research, etc. Also, a lot of what you're saying is if you want to match into the top programs. Not everyone will (or wants to) end up at MGH of Hopkins. Think about it, half of med students are below average and still match......

Research is pretty field specific. Some fields (like radonc) basically require it. Others couldn't care less. Generally, the more competitive, the more important. It's nice if you can swing a research project your in the summer between M1 and M2. Beyond that, a case report or retrospective study in your third or fourth year would be nice. Most of the people who I know that are "doing research" are just doing something minor in someone else's project. Third year is too busy for that.

I don't think anyone cares if you are member of the anesthesia interest group....if you are president, or president of your class, they may care. Even still, it isn't huge.

Extracurricular/volunteering - do something you love. Don't do something to pad your resume. If you love to play a sport, do it - be a little league assistant coach or ref soccer games. If you love to fish, do it, volunteer at the boy scouts and teach kids how to cast. You should just have something that makes you a person. It will be something to talk about during interviews. Don't look at this as something you have to do, it's something you get to do. My school does a bunch of volunteer medical mission trips over seas during breaks or as a fourth year elective. Sure, this is 'altruistic volunteering' - but everyone who has ever gone says it was a blast and they got to visit a new county.

Sorry, that was long. Moral of the story: work hard, do the best you can on your boards, do what you enjoy with the little free time you have. Your third year grades are important.

Second everything FSU said with two additions: Try to get all A's the first two years because even though the general wisdom is that they don't matter, older attendings consistently seem to care about them. Maybe they used to be important?

Also, a few C's can disqualify you from AOA at some schools so keep that in mind. Some specialties care about that more than others.

Just my experience thus far...

Originally Posted by Sheldor

Second everything FSU saidwith two additions: Try to get all A's the first two years because even though the general wisdom is that they don't matter, older attendings consistently seem to care about them. Maybe they used to be important?

Also, a few C's can disqualify from AOA at some schools so keep that in mind. Some specialties care about that more than others.

Just my experience this far...

Ok, so just outperform 85% of my class in every course? Sounds simple enough.

Thanks for other replies.

Originally Posted by Cole Trickle

Ok, so just outperform 85% of my class in every course? Sounds simple enough.

Thanks for other replies.

Easier than it sounds

Seriously though, I said "try" for a reason. You may not pull it off, but my opinion is that it's best to get the best grades you can to leave all doors open. I know people who focused on step 1, got meh grades, then had a bad test day and got in the low 200's on step 1. FSU's advice is great, but not everyone can get a 260 on step 1. If you have a bad test day and score lower than you want to, a strong GPA can help (a little), but it's definitely better than pairing a sub par performance on step 1 with a low GPA.

Nope, not by a longshot.

Every moment you spend away from learning medicine, you are doing wrong by your future patients.

Obviously, there are the physical requirements of food and sleep. I have found that I can optimize my time by sleeping 5 hours per night while receiving IV nutrition, so while I am awake I can focus all of my time on studying.

Someone gave a talk at my school and said "Medicine will take everything from you that you are willing to give it." Exactly how much is a personal decision, but depends heavily on your own goals and what you feel is important to you. If you're killing yourself to check all the appropriate boxes, that may be ok if it serves your ultimate goal, but there are countless avenues where it doesn't matter.

Personally I've tried to balance my time by doing CV-building things that I truly enjoy and are things that I would do even if it didn't matter. I do a little "fluff" just so mine isn't terribly shorter than everyone elses, but I feel mine is also peppered with things that speak to who I am and fit in the grander story of my life.

Something I've found interesting on the CV front: ask friends of yours if you can read theirs and let them read yours. I find it fascinating how some people come across exactly as who they are while others seem a little generic and harder to id from just the paper. I find some of the most compelling parts are where they thought up and started something new, be it an interest group or a charity or something entirely different. I know one person in particular who has done this repeatedly and I swear I could pick them out of the line up even if we'd never met.

Originally Posted by D elegans

Obviously, there is the physical requirements of food and sleep. I have found that I can optimize my time by sleeping 5 hours per night while receiving IV nutrition, so while I am awake I can focus all of my time on studying.

http://www.huffingtonpost.com/2012/0...n_1498240.html

Originally Posted by Cole Trickle

I've wondered if this field is designed to consume your entire life. As a medical student, I feel very busy. I'm not the brilliant guy studying a few hours and remembering everything. I have to work hard to have a shot at doing well in courses. I'm fine with that. I knew that signing up. As I approach 2nd year and I begin to think about what field to pursue and what makes a good application, it can be pretty overwhelming. First we need to do well on boards, so some recommend to focus on board prep for that during second year and possibly forego mastering the minutia that separates the top 10% from the top 30%, which is the difference between getting the A. Then I get advice, don't just board prep, you should honor too. Do both.

Next, let's say you've done well on boards and courses, now to be a well rounded applicant, you need to have research. Another thing to tack on to a schedule that doesn't feel like it has that much room in it. After you grab excellent letters of rec, a fair request, I read that you also need to have other crap on your CV to look like your a team player or not just one-sided or boring (good Step 1 + research ONLY). So you should fill your free time with some type of club membership or leadership role. Oh wait, you should be altruistic also, so volunteering or giving back to the community should be on your CV too.

I feel like no matter what I do, there always some extra hurdle to climb until medicine is consuming every moment of my life. It's like the whole application is designed to see who can dedicate the most waking hours to their career while foregoing sleep, exercise, health, hobbies, relationships, etc. to keep our eye on the prize. What prize?

If medicine at this stage is consuming so much of your life, I guarantee you that there are aspects of your studying that are inefficient. Not about being smart, it's about being efficient and using efficient resources.

No you don't have to honor your courses, you dont have to do research and you don't have to pad your CV. These are misconceptions. Keep your eye on the most important stuff like Step I, II, LOR and clinical grade in the field you want and then forget the rest. It will not be important period if the first 3-4 things I mentioned aren't solid.

Medical school did not consume my life, it was great. I worked hard, but I was efficient, prioritized life as well and had spouse/family members helped tremendously emotionally along the way. Am at a fantastic place now without doing much of what you described.

What's also evident is that you may be having feelings of anxiety of everything this upcoming which is magnifying everything.You may be feeling the need to do well in everything and many students do in OCD type trait many of us have..hopefully this can be a time of learning of when to let go of certain things in order to have a sane life. I hope you can see to focus on the big picture of becoming a great doctor, focus on the game only in terms of Steps, LORs and clinical grades in your field and try to let go of the rest. You can't do everything but the beauty is you don't need to. You will be absolutely fine for almost everything without it.

Originally Posted by Shnurek

http://www.huffingtonpost.com/2012/0...n_1498240.html

The US doesn't stand a chance

As a med student, I oftentimes feel entrapped in medicine because I feel a great need to study non-stop in order to yield high grades and future board scores. My entire life is centered around studying. It is my sole priority. Then comes health (food, exercise, sleep), then social relationships. I do not enjoy this, but it is necessary. The only thing motivating me to continue enduring these long hours is the hopes that I will enter a specialty that will afford me some lifestyle, or quality of life, where I don't feel a constant pressure to work and or study. So the way I justify all my studying is that it's a temporary investment. In residency, I will be having more social interactions with patients and colleagues. By the time I'm an attending, I will have time for a family. Until then, I sit in this library until I get to where I need to get. It's a sad concept to me because I feel as though my freedom is limited, but at the same time, all this studying is an investment for future freedom as an attending.

Edit: and let me quality what I mean by freedom. To me, freedom is the ability to choose what you want to do that day, whether that be watch TV, workout, have dinner with friends etc. Right now, I don't have that freedom b/c I must spend every waking second that I'm not taking care of my physical health studying

Originally Posted by CassieBagley

As a med student, I oftentimes feel entrapped in medicine because I feel a great need to study non-stop in order to yield high grades and future board scores. My entire life is centered around studying. It is my sole priority. Then comes health (food, exercise, sleep), then social relationships. I do not enjoy this, but it is necessary. The only thing motivating me to continue enduring these long hours is the hopes that I will enter a specialty that will afford me some lifestyle, or quality of life, where I don't feel a constant pressure to work and or study. So the way I justify all my studying is that it's a temporary investment. In residency, I will be having more social interactions with patients and colleagues. By the time I'm an attending, I will have time for a family. Until then, I sit in this library until I get to where I need to get. It's a sad concept to me because I feel as though my freedom is limited, but at the same time, all this studying is an investment for future freedom as an attending.

Edit: and let me quality what I mean by freedom. To me, freedom is the ability to choose what you want to do that day, whether that be watch TV, workout, have dinner with friends etc. Right now, I don't have that freedom b/c I must spend every waking second that I'm not taking care of my physical health studying

But that's my point. Everyone says it gets worse, not easier. So right now you have the most freedom, most free time, least stress, least responsibility. The demands only increase.

So to play this "I'm going through purgatory" card seems like an awful gamble.

Originally Posted by Cole Trickle

But that's my point. Everyone says it gets worse, not easier. So right now you have the most freedom, most free time, least stress, least responsibility. The demands only increase.

So to play this "I'm going through purgatory" card seems like an awful gamble.

The purgatory card is mainly focused on the act of studying. Though I genuinely enjoy learning about medicine, I don't enjoy forcing myself to sit for hours on end until I can recite my notes from memory. I think this changes a bit in residency and beyond because you are actually working, as opposed to studying. The very act of working is something that will bring "life" to medicine for me through patient and colleague interactions. The other aspect is the number of hours of free time. I think the difference is that in med school you can always be studying for a future exam. In residency, depending on which one you do, once you finish your day you can get at least a few hours of freedom.

Residents/attending- please chime in....

IMHO, all professional jobs (not just medicine, but certainly medicine) are huge time draws and actually bad career choices for folks who aren't ready to spend a significant part of their life immersed in their job. It's the trade off for the high salary and important work. Don't shoot the messenger, but trying to not have this be the case is often met with futility.

Originally Posted by CassieBagley

...In residency, depending on which one you do, once you finish your day you can get at least a few hours of freedom.

Residents/attending- please chime in....

you have much bigger and more important exams looming in residency, the boards. You absolutely will need to keep reading in residency. Possibly more than now. Pretty much every evaluation you receive throughout residency will include the recommendation "read more".

You know your a medical student when you consider sleeping and eating a waste of time (because you want to be studying)

Originally Posted by Law2Doc

you have much bigger and more important exams looming in residency, the boards. You absolutely will need to keep reading in residency. Possibly more than now. Pretty much every evaluation you receive throughout residency will include the recommendation "read more".

Let's say you do a residency like ortho or anesthesia where you do not plan to do a fellowship, do the boards or evaluations matter for applying to jobs? For example, in med school we aim for the highest step score possible b/c it has a large bearing on our residencies, but do the residency boards have a large bearing on anything other than fellowships (or is it more like the bar exam- P/NP?)

Originally Posted by Law2Doc

IMHO, all professional jobs (not just medicine, but certainly medicine) are huge time draws and actually bad career choices for folks who aren't ready to spend a significant part of their life immersed in their job. It's the trade off for the high salary and important work. Don't shoot the messenger, but trying to not have this be the case is often met with futility.

I do agree with you here. This is a total commitment type of career.

But what this proposes is not an answer but the build-up of a tense dramatic chord that must resolve somewhere.

I'm not talking about getting the band back together during intern year. But the necessary steps to keep oneself together, composed, and psychologically healthy. So that one can put the most into your work when your there. To me this means exercise, a good dose of quiet time to yourself. Taking walks or whatever. And doing at least some things you enjoy.

So that you don't bring your zombified, cranky, insufferable self to the displeasure of everybody around you, as is often the case. I've worked for these doctors. And my instinct is they never knew how to shut off the perpetual rat race. That puts they guy with mile long resume and strung out on heroin daughter on a pedestal and totally ignores the unassuming workaday physician who has a healthy disposition and homelife but doesn't have an award to his name.

This is the pathos of medical culture we all have to answer to. Which the OP refers. And to that which is not answered by.....Suck it up! (signed...management)

Originally Posted by CassieBagley

Let's say you do a residency like ortho or anesthesia where you do not plan to do a fellowship, do the boards or evaluations matter for applying to jobs? For example, in med school we aim for the highest step score possible b/c it has a large bearing on our residencies, but do the residency boards have a large bearing on anything other than fellowships (or is it more like the bar exam- P/NP?)

Passing your specialty boards is very important for getting and keeping a job as well as hospital privileges. Your actual score doesn't matter for jobs so long as you passed, but I suppose there could be an oddball specialty out there where it does.

Originally Posted by CassieBagley

Let's say you do a residency like ortho or anesthesia where you do not plan to do a fellowship, do the boards or evaluations matter for applying to jobs? For example, in med school we aim for the highest step score possible b/c it has a large bearing on our residencies, but do the residency boards have a large bearing on anything other than fellowships (or is it more like the bar exam- P/NP?)

Agree with Smurfette that if you don't pass your boards, you are pretty much hosed in getting a job. It's generally P/NP, but the amount of knowledge in your specialty you need to just pass is pretty significant -- you will want to be reading all through residency -- it's not an everyone automatically passes kind of thing. And FWIW, you really can't expect to pick a field like ortho and not expect to work crazy hard throughout residency -- this is not a lifestyle path.

Originally Posted by Smurfette

Passing your specialty boards is very important for getting and keeping a job as well as hospital privileges. Your actual score doesn't matter for jobs so long as you passed, but I suppose there could be an oddball specialty out there where it does.

Has anyone ever had sex in the bathroom during the middle of their boards like they did in Grey's Anatomy?

(Hey, I don't watch it, my girlfriend does--I'm just a passive observer).

Originally Posted by FSU2013

No one studies a couple hours then gets A's - I'm near the top of my class and it's because I read with every spare minute. One of my friends has jokingly dubbed me 'rainman', but I do well because I work hard, not because I'm smart. There are people in the class that are smarter than me that I outperform.

This guy is speaking the truth. I don't care who you talk to in you class, but the top performers are studying a lot (despite whatever they may tell you). There was a girl in my class who would get to the library at 5am and stay until 11pm religiously for 2 years.

The best advice I would give is to make a schedule and stick to it.

If you say 7am-7pm are your working hours only, and midnight is your bedtime, you will have a good amount of time to have a life. 12 hours of work is a ton, but once you start breaking the schedule you will feel perpetually behind and guilty, thereby cut out on your personal time, and wind up in a dive.

As for research/extracurriculars, I would suggest you pick 1 thing in each and make your availability known beforehand. Tell your research advisor you can do 5 hours a week for 2 years, and get a leadership role in a club that doesn't involve much time (ie treasurer, event manager). Hobbies like running, kayaking, etc can also all be listed on your CV and will help to make you look more well rounded.

Originally Posted by CaptainSSO

Has anyone ever had sex in the bathroom during the middle of their boards like they did in Grey's Anatomy?

(Hey, I don't watch it, my girlfriend does--I'm just a passive observer).

In residency you have sex in every bathroom, call room, utility closet and stairwell you see. That's the whole reason residents put up with the long hours and low pay. Duh.

Originally Posted by sanityonleave

The whole atmosphere of medicine is poisonous.

Originally Posted by CassieBagley

, all this studying is an investment for future freedom as an attending.

Edit: and let me quality what I mean by freedom. To me, freedom is the ability to choose what you want to do that day, whether that be watch TV, workout, have dinner with friends etc. Right now, I don't have that freedom b/c I must spend every waking second that I'm not taking care of my physical health studying

not gonna happen. hate to burst your bubble but you will have less freedon as an attending. Sorry!! pm me for details as to what your future holds

Originally Posted by Valadi

This guy is speaking the truth. I don't care who you talk to in you class, but the top performers are studying a lot (despite whatever they may tell you). There was a girl in my class who would get to the library at 5am and stay until 11pm religiously for 2 years.

The best advice I would give is to make a schedule and stick to it.

If you say 7am-7pm are your working hours only, and midnight is your bedtime, you will have a good amount of time to have a life. 12 hours of work is a ton, but once you start breaking the schedule you will feel perpetually behind and guilty, thereby cut out on your personal time, and wind up in a dive.

I'm going to have to disagree with you a little bit. Yes, anyone near the top of their class is working very hard, but they aren't necessarily putting in 12/14/16 hours days every day or whatever. Perhaps if you want to be top 5 / junior AOA, that's what would be required -- but I'm in the top 10-15% of our class (granted, state school, not as crazy competitive as some) and I don't put in very many 12 hours days. I think the key is to treat it like a full time (or sometimes slightly super-full time) job -- put in your 50-55 hours a week and make sure you're using your time efficiently. I'm definitely average when it comes to intelligence in med school, so it should be doable for anyone. I think the key is to work smarter, not harder.

Originally Posted by darby11

What I really meant was medical school has a poisonous atmosphere -- saying medicine is casting a much wider net than I intended. Though medicine doesn't nurture work/life balance well as a rule, ha.

Originally Posted by Cole Trickle

But that's my point. Everyone says it gets worse, not easier. So right now you have the most freedom, most free time, least stress, least responsibility. The demands only increase.

So to play this "I'm going through purgatory" card seems like an awful gamble.

It gets better after it gets worse. Most people think it bottoms out at Intern year, though there have been a few posters who thought that MS3 or even MS2 was as bad as it gets. I've never met anyone who thought life didn't get drastically better when they became any attending, except for a few surgeons who went through a couple of years of psuedo residnecy to make partner in a medical group.

Originally Posted by Law2Doc

In residency you have sex in every bathroom, call room, utility closet and stairwell you see. That's the whole reason residents put up with the long hours and low pay. Duh.

oh and don't forget empty patient beds

Originally Posted by CaptainSSO

Has anyone ever had sex in the bathroom during the middle of their boards like they did in Grey's Anatomy?

Yes.

Originally Posted by KnuxNole

oh and don't forget empty patient beds

Why empty?

Originally Posted by Law2Doc

Why empty?

just make sure to read their chart first...

Originally Posted by bassvp

just make sure to read their chart first...

Meh, just use universal precautions and double glove.

Originally Posted by Law2Doc

IMHO, all professional jobs (not just medicine, but certainly medicine) are huge time draws and actually bad career choices for folks who aren't ready to spend a significant part of their life immersed in their job. It's the trade off for the high salary and important work. Don't shoot the messenger, but trying to not have this be the case is often met with futility.

Yeah, seriously. This is the nature of the beast. Medical education & training is incredibly unhealthy and there's basically zero quality of life for long stretches of time.

When I read stuff like the original post, I just think to myself, what the hell did you think you were signing up for?

Did you miss all the masochism and self-flagellation in speeches from fossilized alumni during orientation? At this point after a hundred iterations, I think I could give that speech myself now. I think the theme was sacrifice.

Funnily enough if you get those old guys alone all they want to talk about is their money. Anyways.

There's going to be times in residency that you're going to put in more time in one shift than the majority of Americans do for that week. Then you're going to go home for a little bit, come back and do it again.

Originally Posted by hrandani

...
There's going to be times in residency that you're going to put in more time in one shift than the majority of Americans do for that week. Then you're going to go home for a little bit, come back and do it again.

yeah, residency is one of the few professional experiences where you are going to put in a hard busy 24 hour shift and afterwards still lose sleep worrying about whether you hosed your colleagues by leaving too many loose ends for them to tidy up, and worrying whether you left the patients in a not too precarious situation. It's simply not the normal, take off your work hat at the quitting bell and feel good about a solid days work, system I imagine you could get in some jobs.

Originally Posted by hrandani

Yeah, seriously. This is the nature of the beast. Medical education & training is incredibly unhealthy and there's basically zero quality of life for long stretches of time.

When I read stuff like the original post, I just think to myself, what the hell did you think you were signing up for?

Did you miss all the masochism and self-flagellation in speeches from fossilized alumni during orientation? At this point after a hundred iterations, I think I could give that speech myself now. I think the theme was sacrifice.

Funnily enough if you get those old guys alone all they want to talk about is their money. Anyways.

There's going to be times in residency that you're going to put in more time in one shift than the majority of Americans do for that week. Then you're going to go home for a little bit, come back and do it again.

I guess I was thinking I could spend less than 70 hrs a week on work.

I don't think this is impossible, I hear EM physicians talking about working <40 hours a week. I'm sure others know more examples of physicians who don't work every waking hour.

I would estimate most (>50%) physicians don't work over 60 hrs.

Wait so you guys are actually planning to practice medicine after med school? Are we expected to do this?

Originally Posted by Wheatley

Wait so you guys are actually planning to practice medicine after med school? Are we expected to do this?

I was doing medical school for my own edification.

I'm going to be a vodka smuggler in the Alaskan Bush.

Originally Posted by Cole Trickle

I would estimate most (>50%) physicians don't work over 60 hrs.

More like 70% do work over 60.

Originally Posted by Cole Trickle

I guess I was thinking I could spend less than 70 hrs a week on work.

I don't think this is impossible, I hear EM physicians talking about working <40 hours a week. I'm sure others know more examples of physicians who don't work every waking hour.

I would estimate most (>50%) physicians don't work over 60 hrs.

Precisely, a balanced life is possible for a dedicated professional. But the chances of it shrink the more you assume the crucifix position at every opportunity.

Taking the example of an intern on call does not serve your the original question because it is an extreme and it is a phase of training that has to be done but that no one need repeat.

This desire for the sanctity of your own crucifixion is the piety of fools and dullards who lack the imagination to do something else with themselves besides work.

I mean to live well while working 50 hours a week to pay down my debt. But it takes technique and balance. Not something we're taught or encouraged to learn.

Originally Posted by The Imprisoned

More like 70% do work over 60.

Where do these numbers come from, this seems unlikely. Especially given the average age of our physician work force.

Originally Posted by Abider

Where do these numbers come from, this seems unlikely. Especially given the average age of our physician work force.

Honestly I could be wrong. I'm basing it on neighbors and family friends. They are in anesthesia and surgery.

Originally Posted by The Imprisoned

Honestly I could be wrong. I'm basing it on neighbors and family friends. They are in anesthesia and surgery.

Surgeons work brutal hours, no doubt. But once they become attendings it is possible for them to choose a 30-50 hour/week work schedule. Maybe once a workaholic always a workaholic.

My specialty of interest from my readings of their forum on sdn are an aged bunch who eek out a 35 hour week on average.

My desire to pay down debt should put me in the workinest set among them. And I know how to chill like a big dog.

Last point is that we seem as a group to lack a basic ability to be interested and turned on by all the amazing things in life. Which is sad. We get grounded and pounded by the carrot and stick game so long all we can come up is...."uh....Medicine hurts because it just does...so shut your face noob!".

Originally Posted by Abider

Last point is that we seem as a group to lack a basic ability to be interested and turned on by all the amazing things in life. Which is sad. We get grounded and pounded by the carrot and stick game so long all we can come up is...."uh....Medicine hurts because it just does...so shut your face noob!".

Where's the evidence for this?

:P

Originally Posted by Abider

Surgeons work brutal hours, no doubt. But once they become attendings it is possible for them to choose a 30-50 hour/week work schedule. Maybe once a workaholic always a workaholic...

most surgeons emerge from residency/fellowship and see their hours shoot upwards, not down.

But even outside of surgery, I think you have to separate out the 65 year old doctor who is easing down to the 30-40 hour, semi-retired phase of his career, (and who seriously skews any average number of hours worked you might see), and folks during the decade or so immediately following residency. Most older doctors got into medicine in a very different time, when patient volumes were lower and per patient dollars were higher. These days of declining reimbursements, you have to work more and more each year just to keep the same level of income. You will work 65-80 hours a week during many residencies, only to emerge and end up working 85-90 hours per week for a lot of years as a clinician because you are the low man on the totem pole at whatever practice you join, and you are the reason the 65 year old can do his 40 hours a week schedule, and additionally you initially are going to need to double ad triple check things when it's your own name on the lawsuit, not a residency.

I suspect most on here aren't focused on what hours they will work at the end of their career, and are looking at what will happen right out of residency. In most cases hours are gonna be rough at that stage of your career, and for many years beyond that. Anyone telling you that residency is a short tunnel of bad hours but that you will be working a cushy 40 hours per week after that is lying to you (unless perhaps you go into EM, and even in that case the 40 hours will be the less desirable night and holiday shifts at the beginning of your career.)

Originally Posted by Law2Doc

most surgeons emerge from residency/fellowship and see their hours shoot upwards, not down.

But even outside of surgery, I think you have to separate out the 65 year old doctor who is easing down to the 30-40 hour, semi-retired phase of his career, (and who seriously skews any average number of hours worked you might see), and folks during the decade or so immediately following residency. Most older doctors got into medicine in a very different time, when patient volumes were lower and per patient dollars were higher. These days of declining reimbursements, you have to work more and more each year just to keep the same level of income. You will work 65-80 hours a week during many residencies, only to emerge and end up working 85-90 hours per week for a lot of years as a clinician because you are the low man on the totem pole at whatever practice you join, and you are the reason the 65 year old can do his 40 hours a week schedule, and additionally you initially are going to need to double ad triple check things when it's your own name on the lawsuit, not a residency.

Well. You have a closer perspective than I do. But this is just not what I've heard or seen. The ED doc's I worked with were all partners and extremely variable. Some 10 shifts a month some 20. The pediatric docs I worked for all worked 35-55 hours a week. The 35-hour docs were mommies and semi-retired. And the 50 hour plus crew were picking up weekend shifts in the urgent care clinic on top of managing there panels. Sometimes they covered the inpatient call so I'll say 65 on the high top end.

The IM docs I've seen were largely hospitalists--7 on/7 off. Don't know the hours. But much over 60 would surprise me. The family docs in the outpatient clinics worked a 45-50 hours with steady regularity.

My neurosurgeon is the only guy I've seen that really rocked what your talking about. He was a monster. Other than that. I've never seen anything close to what your referring to in terms of Attendings.

The 65-80 hours a week for residents is what I expected. Why that would go up by 20 hours a week as a junior physician makes little sense to me. I have no data on it. Maybe we just have worked in vastly different environments.

My experience is West Coast. I have heard the East Coast likes to grind it out harder. ?

Originally Posted by Abider

Well. You have a closer perspective than I do. But this is just not what I've heard or seen. The ED doc's I worked with were all partners and extremely variable. Some 10 shifts a month some 20. The pediatric docs I worked for all worked 35-55 hours a week. The 35-hour docs were mommies and semi-retired. And the 50 hour plus crew were picking up weekend shifts in the urgent care clinic on top of managing there panels. Sometimes they covered the inpatient call so I'll say 65 on the high top end.

The IM docs I've seen were largely hospitalists--7 on/7 off. Don't know the hours. But much over 60 would surprise me. The family docs in the outpatient clinics worked a 45-50 hours with steady regularity.

My neurosurgeon is the only guy I've seen that really rocked what your talking about. He was a monster. Other than that. I've never seen anything close to what your referring to in terms of Attendings.

The 65-80 hours a week for residents is what I expected. Why that would go up by 20 hours a week as a junior physician makes little sense to me. I have no data on it. Maybe we just have worked in vastly different environments.

My experience is West Coast. I have heard the East Coast likes to grind it out harder. ?

Part time peds workers, per diem urgent care folks and hospitalists are not really good groups to base your analysis. These tend to be transient positions, not careers. And bear in mind that the window of time you as a premed work with folks is often not the whole picture. most FM docs have a few hours before and after work when they are returning calls, seeing patients in various hospitals who have been admitted, etc. Pediatrics in particular can leave work at 5 and be returning calls to parents until the wee hours of the night each night.

And yes your hours typically go up after residency. You are the low man on the totem pole. You suddenly have personal liability you didn't before. You realize the buck stops here and you aren't as knowledgable or as confident as you'd like. All this translates to a number of very long houred years.

Originally Posted by Law2Doc

Part time peds workers, per diem urgent care folks and hospitalists are not really good groups to base your analysis. These tend to be transient positions, not careers. And bear in mind that the window of time you as a premed work with folks is often not the whole picture. most FM docs have a few hours before and after work when they are returning calls, seeing patients in various hospitals who have been admitted, etc. Pediatrics in particular can leave work at 5 and be returning calls to parents until the wee hours of the night each night.

And yes your hours typically go up after residency. You are the low man on the totem pole. You suddenly have personal liability you didn't before. You realize the buck stops here and you aren't as knowledgable or as confident as you'd like. All this translates to a number of very long houred years.

No, I'm not an idiot. I know exactly what it means for doc's to stay late and finish up their charting and things. I accounted for that.

I think we must be talking about different models of practice. HMO vs junior doc in group physician practice bucking for partnership. But I'd really have to see corroborating evidence that docs typically crank up their hours compared to residency. That's not the Central Dogma I'm familiar with.

You have a certain bent of mind that I don't trust in these assessments. I suspect you would project the necessary and righteously glum toil of anything. But as I have nothing to back up mine, I certainly cannot say you're wrong.