Are emergency medicine and sleep medicine the only overnight jobs for a doctor?

[Gauss44]

Are emergency medicine and sleep medicine the only overnight jobs for a doctor? I know I'm a rarity, but overnight is my favorite shift. Ideally, I want to make an attempt at getting some experience in every overnight job for doctors. I think I need to add, ICU. What other kinds of doctors work overnight?

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[AspiringERMD]

I think hospitalists do. And radiologists must, I would think, because the ED isn't going to wait until morning for imaging tests to be read (someone please correct me if I'm wrong; I totally could be). OB-GYN does irregularly, of course. That's all I can think of off the top of my head.

 

[Deranged Medic]

Level 1 and 2 trauma centers have surgeons in house 24/7. The are also required to have many other specialties readily available, and unless they live near the hospital, many of these are in house as well. http://www.amtrauma.org/?page=TraumaLevels

The ED I used to work in frequently called down ortho during the night to do reductions. It was usually the resident, but I imagine there was an attending somewhere in the hospital.

 

[Tappinfool66]

I think hospitalists do. And radiologists must, I would think, because the ED isn't going to wait until morning for imaging tests to be read (someone please correct me if I'm wrong; I totally could be). OB-GYN does irregularly, of course. That's all I can think of off the top of my head.

Our hospital has radiologists in house until 10pm, and if we need images read after that we send the images to doctors in India or Australia through something called NightHawk to have them read.

 

[TheLeadSeed]

I work in the ER as a scribe and most of the time when we need to consult a specialist for a specific diagnosis, there is a whiteboard that lists a doctor on call for each specialty. For radiology, we use an online program from 7pm-7am that sends the images to be read. I was surprised to see that we do send a lot of calls throught out the night to patients' primary care doctors as well.

 

[NickNaylor]

Almost every specialty will have people in-house overnight in a hospital setting. Or, if you're not in house, then you'll be on call and will be fielding management questions, admitting new patients, etc.

 

[Catalystik]

Are emergency medicine and sleep medicine the only overnight jobs for a doctor? I know I'm a rarity, but overnight is my favorite shift. Ideally, I want to make an attempt at getting some experience in every overnight job for doctors. I think I need to add, ICU. What other kinds of doctors work overnight?

Neonatologist.

 

[AspiringERMD]

Our hospital has radiologists in house until 10pm, and if we need images read after that we send the images to doctors in India or Australia through something called NightHawk to have them read.

Very interesting! Thank you.

 

[bc65]

Are you sure that you will enjoy working the night shift forever? Have you actually worked a night shift for any significant period of time? Switching back and forth between day and night is brutal and probably not good for your health, so if you try to be up during the day on weekends, for example, you may be defeating the value of working nights.

All specialties have people on call at night, but those night shifts are in addition to regular daytime hours, as few specialties are busy enough at night to have a physician work overnight full-time.

Agree with post above: sleep medicine is a day job. Technicians run the sleep lab at night. ER is the only one with regular night-time work. I would ask some ER docs if it's possible to work exclusive night shifts. Hospitalist is another specialty with people who actually work full time overnight. Again, I would check with several hospitalist to find out if it's possible to work the night shift permanently at their hospitals. Perhaps anesthesia in some very busy trauma hospitals, but few would have enough work for that to bring in a good salary. Ask some anesthesiologists about that. I don't believe that most ICUs have physicians in house full time at night, but you might look into that field as well. I think that usually hospitalists cross cover the ICU at night, in my experience. Some ICUs might have 24 hour shifts, which won't be what you're looking for.

But unless you have actually done the night shift long term and liked it, and unless you keep your entire life on the night shift, I think you won't enjoy the experience.

 

[medic86]

Very interesting! Thank you.

Or USROC.

Those guys are... ugh.

I think hospitalists do. And radiologists must, I would think, because the ED isn't going to wait until morning for imaging tests to be read (someone please correct me if I'm wrong; I totally could be). OB-GYN does irregularly, of course.
That's all I can think of off the top of my head.

OB definitely has someone on in-house overnight call whether they have laboring patients or not.

 

[JPA178]

I don't mind working overnight either, but for me I can imagine that will change once a family and kids are in the picture.

 

[bc65]

OB definitely has someone on in-house overnight call whether they have laboring patients or not.

Yes they do, but in all the hospitals that I have worked in, that's in addition to their regular daytime practices. I doubt that there are many jobs for an OB to work ONLY nights, and never see patients in the office. It's probably worth asking an ob/gyn doc about that.

 

[deuist]

OB definitely has someone on in-house overnight call whether they have laboring patients or not.

You gotta love SDN. A not-doctor asks a relevant question, and a lot of not-doctors give wrong answers. The only specialty that is absolutely in the hospital overnight is emergency medicine. Most hospitals will employ hospitalists overnight, but some of the smaller rural areas might use physician assistants, or may even call the primary care physician at home to come in and admit. Every other specialty – whether it works overnight or not – is dependent upon the needs of the hospital. Many tertiary care centers will have radiologists in-house overnight. However, I work at one facility where the radiologist goes home in the early evening and I have to call him during the middle of the night if I want a read on something. Obstetricians stay in-house only if a patient is close to delivery, or is hired as a laborist for a busy labor and delivery unit. At many of the smaller facilities, the doctor goes home – even if the patient is in labor – and does not come back until right before delivery. If any of you are parents and went to a smaller hospital, then you'll remember that the labor and delivery nurse did the hourly checkup and you didn't see the obstetrician and tell it was time to deliver. Some specialties which also might require overnight stays include trauma surgeons (a requirement at all level I facilities) and intensivists. Sleep specialists do not work overnight shifts. The labs are run by technicians who will collect the data, which is then interpreted the next day by the physician. The best answer that I can give you is that you should expect to be in the hospital a lot while you are resident or fellow. After that, the size and scope of the hospital where you work will largely determine if you get to sleep at night.

 

[deuist]

I doubt that there are many jobs for an OB to work ONLY nights, and never see patients in the office.

Obstetricians can get a job as a laborist, which involves staying in the hospital solely for the purpose of delivering babies. There are no clinic responsibilities as a laborist. It's a newer employment model that runs similar to emergency medicine and hospitalist. Granted, the facility needs to be large enough to support this kind of model – but it does exist.

 

[mimelim]

OB definitely has someone on in-house overnight call whether they have laboring patients or not.

When you use words like "definitely" you should know something about what you are talking about. This is categorically false.

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Most specialties can have some sort of overnight call, but will not have dedicated overnight "shifts". There are exceptions to this of course, extremely busy ICUs may allow for an intensivist to take all the overnight coverage, laborists as @deuist describes above, etc, but they are not the norm and certainly not something to count on.

In order to work almost exclusively at night, you have to be in a "shift" oriented specialty like EM or diagnostic rads.

 

[medic86]

You gotta love SDN. A not-doctor asks a relevant question, and a lot of not-doctors give wrong answers. The only specialty that is absolutely in the hospital overnight is emergency medicine. Most hospitals will employ hospitalists overnight, but some of the smaller rural areas might use physician assistants, or may even call the primary care physician at home to come in and admit. Every other specialty – whether it works overnight or not – is dependent upon the needs of the hospital. Many tertiary care centers will have radiologists in-house overnight. However, I work at one facility where the radiologist goes home in the early evening and I have to call him during the middle of the night if I want a read on something. Obstetricians stay in-house only if a patient is close to delivery, or is hired as a laborist for a busy labor and delivery unit. At many of the smaller facilities, the doctor goes home – even if the patient is in labor – and does not come back until right before delivery. If any of you are parents and went to a smaller hospital, then you'll remember that the labor and delivery nurse did the hourly checkup and you didn't see the obstetrician and tell it was time to deliver. Some specialties which also might require overnight stays include trauma surgeons (a requirement at all level I facilities) and intensivists. Sleep specialists do not work overnight shifts. The labs are run by technicians who will collect the data, which is then interpreted the next day by the physician. The best answer that I can give you is that you should expect to be in the hospital a lot while you are resident or fellow. After that, the size and scope of the hospital where you work will largely determine if you get to sleep at night.

Weird facilities, then.

The L&D ward I worked in for over a year required an OB in-house on-call, regardless of whether they had laboring patients.

Who cuts on the prolapsed cord patient that comes through the door when you don't have an OB in-house?

 

[medic86]

When you use words like "definitely" you should know something about what you are talking about. This is categorically false.

------------------------------------------------------

Most specialties can have some sort of overnight call, but will not have dedicated overnight "shifts". There are exceptions to this of course, extremely busy ICUs may allow for an intensivist to take all the overnight coverage, laborists as @deuist describes above, etc, but they are not the norm and certainly not something to count on.

In order to work almost exclusively at night, you have to be in a "shift" oriented specialty like EM or diagnostic rads.

Well, I apologize for basing my judgment on what I knew to be true, based on my experience.

It actually makes sense to me, given how commonplace it is for a patient to come through the door and need to have a caesarean performed immediately.

 

[TREDWISE]

Are you sure that you will enjoy working the night shift forever? Have you actually worked a night shift for any significant period of time? Switching back and forth between day and night is brutal and probably not good for your health, so if you try to be up during the day on weekends, for example, you may be defeating the value of working nights.

All specialties have people on call at night, but those night shifts are in addition to regular daytime hours, as few specialties are busy enough at night to have a physician work overnight full-time.

Agree with post above: sleep medicine is a day job. Technicians run the sleep lab at night. ER is the only one with regular night-time work. I would ask some ER docs if it's possible to work exclusive night shifts. Hospitalist is another specialty with people who actually work full time overnight. Again, I would check with several hospitalist to find out if it's possible to work the night shift permanently at their hospitals. Perhaps anesthesia in some very busy trauma hospitals, but few would have enough work for that to bring in a good salary. Ask some anesthesiologists about that. I don't believe that most ICUs have physicians in house full time at night, but you might look into that field as well. I think that usually hospitalists cross cover the ICU at night, in my experience. Some ICUs might have 24 hour shifts, which won't be what you're looking for.

But unless you have actually done the night shift long term and liked it, and unless you keep your entire life on the night shift, I think you won't enjoy the experience.

Beat me to it. As bc65 said, generally sleep doctors don't stay overnight (techs do).

 

[Ismet]

Well, I apologize for basing my judgment on what I knew to be true, based on my experience.

It actually makes sense to me, given how commonplace it is for a patient to come through the door and need to have a caesarean performed immediately.

SouthernSurgeon beat me to it, but this is not a generalized thing.

The Women's hospital in my med school's system sees >11,000 births a year, so yeah there's someone there overnight. But when I was at a small community hospital, we saw maybe 3 births a day, and thus there is "definitely" not always an attending in house overnight.

 

[bc65]

The L&D ward I worked in for over a year required an OB in-house on-call, regardless of whether they had laboring patients.

Yes, they are in-house, working overnight, but that's usually in addition to working their regular day job. So an obsterician will work regular daytime hours, anywhere from 40-50 or 60 hours during weekdays, and in addition, will work overnight once every week or two, or maybe more often. Or, as deuist described, they will be home on call those nights, waiting to be called in when the delivery is immenent. Again, that's in addition to working a regular day schedule. Almost all specialties have someone available, or in-house , overnight. But OP was asking about a specialty where you work ONLY night shifts, and never work during the day. Except for ER, and some hospitalists, and the rare laborist he described, such jobs are very rare. And even ER jobs may require that the night shifts be shared equally by everyone, so that OP might not be able to do the night shift exclusively.

 

[medic86]

I apologize, guys.

Foot's in my mouth.

 

[Law2Doc]

At my facility we have ED, hospitalists, radiologists, trauma surgeons, and L&D doctors there all night every night. These are shifts, not call -- the same people may be there a couple of weeks at a time. Most of the other specialties have people there on call, many in house, a few not. There's a lot of push in many fields for 24/7 attending coverage. So its not just ED anymore -- the overall model is changing. Im not a fan of this in terms of resident training, but its happening. So yeah lots of opportunity for attending night work. Lots of expectations for folks to do some night work as well, whether they want to or not. Big hospitals are busy places at night these days. Unless you go into derm or rheum or allergy or occupational medicine, expect some nights. In a lot of fields, expect weeks of nights.

 

[AspiringERMD]

You gotta love SDN. A not-doctor asks a relevant question, and a lot of not-doctors give wrong answers. The only specialty that is absolutely in the hospital overnight is emergency medicine. Most hospitals will employ hospitalists overnight, but some of the smaller rural areas might use physician assistants, or may even call the primary care physician at home to come in and admit. Every other specialty – whether it works overnight or not – is dependent upon the needs of the hospital. Many tertiary care centers will have radiologists in-house overnight. However, I work at one facility where the radiologist goes home in the early evening and I have to call him during the middle of the night if I want a read on something. Obstetricians stay in-house only if a patient is close to delivery, or is hired as a laborist for a busy labor and delivery unit. At many of the smaller facilities, the doctor goes home – even if the patient is in labor – and does not come back until right before delivery. If any of you are parents and went to a smaller hospital, then you'll remember that the labor and delivery nurse did the hourly checkup and you didn't see the obstetrician and tell it was time to deliver. Some specialties which also might require overnight stays include trauma surgeons (a requirement at all level I facilities) and intensivists. Sleep specialists do not work overnight shifts. The labs are run by technicians who will collect the data, which is then interpreted the next day by the physician. The best answer that I can give you is that you should expect to be in the hospital a lot while you are resident or fellow. After that, the size and scope of the hospital where you work will largely determine if you get to sleep at night.

Lol. I've never been so happy to have put the disclaimer "please correct me if I'm wrong; I totally could be" in my first response. Thank you very much for setting us straight.

 

[deuist]

It's actually not a requirement for a trauma surgeon to be in house to be a level 1 trauma center. You need a PGY4 or greater in house, with attending supervision available for "immediate response" (i.e. they need to live close to the hospital).

True, I knew of one hospital where the surgery department rented a house down the street for the on-call attending to sleep in. In general, the level I trauma centers are going to have a surgeon in-house, however loosely that gets defined.

 

[WingedOx]

If you REALLY wanted to work only overnight, you could probably find someone to pay you to do it in just about any specialty. The question of where and how is where it gets complicated and it may require some creativity and flexibility on your part.

 

[deuist]

You can definitely work only nights as an emergency physician. Doing so can lead to a set schedule and at some places, a slightly higher pay.

 

[DrBowtie]

Our hospital has radiologists in house until 10pm, and if we need images read after that we send the images to doctors in India or Australia through something called NightHawk to have them read.

The vast majority of night radiology is done by domestic US radiologists.

 

[Tappinfool66]

The vast majority of night radiology is done by domestic US radiologists.

I'm not saying that's not true. I'm just saying that I was told that the films from our hospital specifically were read by radiologists in Australia and India from 10pm to about 7am.

 

[DrBowtie]

I'm not saying that's not true. I'm just saying that I was told that the films from our hospital specifically were read by radiologists in Australia and India from 10pm to about 7am.

Prelims only I suspect. Final reads in AM by in house rads I presume for billing purposes.

 

[Hospitalized]

You can definitely work only nights as an emergency physician. Doing so can lead to a set schedule and at some places, a slightly higher pay.

I believe there are a few hospitalists who do this as well. They tend to work 12 hour shifts, and ER works 8, but I think that once again will vary by hospital.