Typical Week of a Resident

As an emergency medicine attending, I work 36 hours/week, Saturday and Sunday day, and Monday overnight (all 12 hour shifts), and that's my full workweek.

I am waiting for surgery and IM residents to come in and kill the party.

I'm an EM attending now like Apollyon.

I generally work 14-16 12 hour shifts per month. Generally evenly split between days and nights. Again generally speaking every other weekend. Not necessarily EVERY other weekend but usually at least two weekends per month.

I am usually scheduled for 14 shifts per month but there is more work if I want it (and I typically do). The most I have worked in a month is 18.

Not a bad gig really.

Residency in EM holds similar hours. There I worked 18 shifts per month but I would often times work several more moonlighting. The off-service rotations had longer hours.

surgery resident PGY 7 typical work week..

during the week my hours are typically 6am-6pm (and thats M-F, no way around that!)
for interns, its probably more like 5am-6pm since they pre-round.

on RARE occasion, i stay late until around 8 or 9 due to a sick patient or late case.
on those few days that i escape before 4 or 5, i somehow (sick as it may seem) feel like i'm "getting away with something". surgeons can be ridiculously masochistic i guess.

i typically do a day every other weekend of call, so that can add 20-30 hrs. often now, though, we do "Home call" as chiefs so that entails just getting up to round, being at the hospital 3 hrs or so and being "available" for the rest of the day.

usually have at least one weekend and more often 2 per month that you are completely off work and pager from friday night to monday morning.

its really not that bad. i've gotten much more efficient with what i do in my free time. its certainly much better, to me, with the "80 hour" thing.
nonetheless it sucks sometimes, and i have to remind myself that i choose this job everyday (some days, easier than others).

Surgery fellow...

Monday: OR day - so am here from around 0700 to perhaps 1700 or 1800 depending on case load and other work needed to be done.

Tues: am conferences and clinic day - here from 0700 to around 1700

Wed: usually academic day (ie, off) but occasionally we add in an extra case or I spend the day in the Plastics office (so 0900 to around 1600)

Thurs: clinic day again, start 0830 to 1630 or so

Friday: OR again; 0700 to late afternoon, again depending on the schedule.

Weekends are usually off, unless we have patients in house or I have other paperwork to catch up on. No call and despite my asking the nurses to call me when we do have an inpatient, they are used to calling the intern, so I rarely get paged at night.

Surgery residency was a much different story - especially in the days before the 80 hr workweek (my first 3 years).

I'm a psychiatry intern, as a few already mentioned intern year is the worst in any residency. Our hours are different with each rotation and at our program we have a month of inpatient IM at the VA. Needless to say that is our worst rotation of the year but there is a night float system, even so there are days when I was at the hospital from 6:45am to about 8pm "till the work was done".

On to brighter things, most of the year we rotate on the psych inpatient unit. The hours are generally 8am to 3pm. One day of the week one of us stays on the unit "late" till 4:30pm. We take six nights of call a month, one of those is a 24hrs weekend call.

Just wanted to say "thanks!" to all the folks who went into IM so I won't have to!

I am an intern in a "mild" IM program in the west, so it's probably not the horror story most are expectiong...
Inpatient rotations are q5 with "short call" interspersed
Day 1 6am-6pm
Day 2 Long call until noon the next day
Day 3 off at noon sleep all day
Day 4 short call (admit patients until 4 pm)
Day 5 6am - 6pm
We get ~one day off per week ususally the day 1 or day 5. I probably work 70-75 hours per week.
On MICU expect to work ~90 or so. On those months there is no such thing as an "80 hour thing" but we only do one MICU month in our intern year. Overall 6 months inpatient, 1 MICU, 2 CICU, 1 clinic month (vacation), 2 months elective (also vacation unless you are on GI).

you know one thing i did not mention, that in my (humble) experience may be the hardest part of surgery residency (or, i guess, maybe ANY residency, but certainly surgery most often) is that your life often feels it is not "your own".

as medical people many of us are type A, "eat the right baby food" and "type the right thank you letters adn things will work out" kind of control freaks, and when you're an intern of any type (or a surg resident of any year)...your life is not your own.

that being said you can almost NEVER commit to anything and be dependable. that's the hardest part. you think "tuesday will be a light day, only 3 lap choles, sure i can be at your party, meet you for dinner, make my flight to the vegas bachelorette party, etc etc" and low and behold one of the chronic inpatients crumps and the lap choles bleeds and the whole thing is shot.

and youre stuck watching the clock in the OR/ICU, getting more bitter internally with every tick, wishing you could at least CALL your 'mom, sig other, kids, dog walker, etc etc' and explain. but you're scrubbed/sterile and it just can't happen.

for that reason i admire any person willing to be partnered for life with a surgeon.

that happens to me i would guess at least twice a month. i suspect it happens "less" in ED medicine (and i envy you, believe me!)
and it can get old. you can never accurately predict your hours, and i can't tell you how many times i've missed birthday/bachelor parties/dates/ trips/concerts things i had planned for months and months.

but all things considered, i guess these are small sacrifices for the great job we have.

duplicate

Hospital doc...3-4 12 hour shifts a week. Usually 14-16 shifts per month. No call from home.
Internship/Residency before work hour regs? 100-120 hours per week. One day off every 2 weeks. Shifts as long as 52 hours without sleep.

collegefreak12 said:

Wow....do most EM doctors work less or around 40 hours?

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Anywhere from 32-40, with some nuts doing 48 or 60 hours per week. The deal is that, though, for the hours an EM doc is at work, they're working. The places where the docs are working 24 hours shifts are often mind-numbingly boring. For 8's and 12's, whomever is paying you is getting their money's worth out of you.

Prelim IM intern:

Ward months 8 months out of 12 (wards include open icu so usually have 25% of your patient load in one of the ICU's)

typical schedule is 6am-5pm (or until you get your physical and paperwork done); I'm usually done with my 'busy' work by 2 and then just chilling and waiting for radiology or labs I've ordered so that I can follow the patient and respond (this I can mostly do by phone) and call is q4-6 just depending on number of interns on your team. It totals out to close to 80 hour average for 4 weeks. I do like to follow the labs and stuff that is pending for the day so I will call the nurses from 5pm-9pm a lot so the next day is easier too since I know all the results of what we're doing for the patients.

elective for four months varies depending on elective and your work ethic I guess.

Next year I'm in EM!! so i'll still be an intern, but I think the hours will be a little better and no overnight call will be the biggest difference I think. I never mind staying long periods during the day, but the overnight call is what kills me. In my intern year I always am here til 1pm no matter how efficient I am, the earliest I've left is 12:20 one time.

Psych attending, early career, large multi-specialty group.
M-F I hit the hospital about 0830, review my inpatient charts and start rounding on my 8 beds at 9. Usually have a noon conference of some sort, then travel to one of my 2 clinics. See 5-8 patients in the afternoon. Leave by 6, though sometimes do notes from home later in the evening via secure remote log-in to EMR system. Call 3-4 times a year is phone coverage through the week, then weekend admissions and consults.

General Surgery

M-F: Days start 5-6 am and end 6 to 8pm (12-15 hr days)
Weekends: Only come in if you are on call.
Call is Q3-Q4, come in at usual time during weekedays, 7-8am on weekends. Leave around 1-2pm post call.
This usually averages out to 90 hours/week, maybe slightly more.
No home call. Your time is YOUR time when you leave the hospital.

Attending surgeons have a HUGE amount of variablity. 60 hours/week is average (meaning for every attending working 80+ hours/week, there's one working in the 40s).

I'm a radiation oncology resident. My hours vary by rotation, but here are the typical hours for a clinical rotation (A minimum of 3 out of 4 years in our residency are spent in clinical rotations - this is after the one year internship which is another matter all together):

M-F working in the clinic, with occasional inpatients (there is no inpatient service; if we admit a patient, we care for them on top of our clinic duties). I usually come in between 7 and 8am and stay until 6-9pm depending on how busy I am. Technically, we get weekends off, but I usually have to come in 2-4 weekend days per month to catch up on paperwork/dictations/etc. This works out to be a 60-70 hour work week on average.

We take home call approximately every 7th week for one week at a time. This adds a variable amount of work (I've had weeks without a single call and weeks with multiple emergency treatments).

The above does not include time spent studying, which can stretch to many hours per week, especially in the first year or two of residency before you have the essential studies memorized for all of the sites we treat.

Apollyon said:

As an emergency medicine attending, I work 36 hours/week, Saturday and Sunday day, and Monday overnight (all 12 hour shifts), and that's my full workweek.

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Is this type of schedule easily possible as an EM doctor or do you get priority to choose your own schedule based on your own seniority, talent, etc?

Also, as an EM doctor, is it possible to work a heavy schedule for a few months and then take a month off?

JadedSurgeon said:

Is this type of schedule easily possible as an EM doctor or do you get priority to choose your own schedule based on your own seniority, talent, etc?

Also, as an EM doctor, is it possible to work a heavy schedule for a few months and then take a month off?

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Scheduling is pretty fluid, so a schedule like mine isn't really desired (which is why I get it). Many groups will tell you that scheduling is equitable (such as the old guys doing as many nights as the younger ones).

As for crushing one month to get the next one off, it's possible, but it's also a function of how lenient your group is (as the time you take up in the first month might leave someone else short, and then you're missing for the next one, creating another gap). What is possible is to do the first 12 days of the month, take the next 18 days off, then the first 18 days of the next month, and then work the last 12 days. Since that would be two stretches of 12 days of 12 hour days, though, I don't know if it would be worth it.

Apollyon said:

Scheduling is pretty fluid, so a schedule like mine isn't really desired (which is why I get it). Many groups will tell you that scheduling is equitable (such as the old guys doing as many nights as the younger ones).

As for crushing one month to get the next one off, it's possible, but it's also a function of how lenient your group is (as the time you take up in the first month might leave someone else short, and then you're missing for the next one, creating another gap). What is possible is to do the first 12 days of the month, take the next 18 days off, then the first 18 days of the next month, and then work the last 12 days. Since that would be two stretches of 12 days of 12 hour days, though, I don't know if it would be worth it.

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Do you mind if I ask you about how much one can expect to make working 36 hours a week, as you do, in EM?

Just Joshin said:

Do you mind if I ask you about how much one can expect to make working 36 hours a week, as you do, in EM?

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I am trolling here, but I thought I would include some input to this question. I am currently a nursing student (BSN program -- but will be taking my pre-req's and will be applying to med school in a few years). Anyways, I have a nursing instructor who is married to an EM doc. I was having a conversation with her a few months back about her husband, his previous education, how he likes his work, etc... She was telling me that he is in his mid 50's and works 3 12's a week (his shifts are a little different -- he works 3 p.m. to 3 a.m. 3 days a week). I didn't ask the question, "how much does he make", however, she did voluntarily offer the information. She stated her husband makes around $145 an hour.

I have no clue what the "hourly" rate of an EM doc is; however, I do know from looking at statistics and reports and EM docs average well over $200K a year. Her husband makes around $250K a year (145 * 36 hrs * 52 wks). That is of course pre-tax income.

I live in a city where EM docs are scarce because of the relatively abundance of new hospitals around the city. Furthermore, until last year, our city had no EM residency. My professor had told me that her husband knows of a few open positions around the city that are paying their EM docs well over the $145 mark.

sistermike said:

I am trolling here, but I thought I would include some input to this question. I am currently a nursing student (BSN program -- but will be taking my pre-req's and will be applying to med school in a few years). Anyways, I have a nursing instructor who is married to an EM doc. I was having a conversation with her a few months back about her husband, his previous education, how he likes his work, etc... She was telling me that he is in his mid 50's and works 3 12's a week (his shifts are a little different -- he works 3 p.m. to 3 a.m. 3 days a week). I didn't ask the question, "how much does he make", however, she did voluntarily offer the information. She stated her husband makes around $145 an hour.

I have no clue what the "hourly" rate of an EM doc is; however, I do know from looking at statistics and reports and EM docs average well over $200K a year. Her husband makes around $250K a year (145 * 36 hrs * 52 wks). That is of course pre-tax income.

I live in a city where EM docs are scarce because of the relatively abundance of new hospitals around the city. Furthermore, until last year, our city had no EM residency. My professor had told me that her husband knows of a few open positions around the city that are paying their EM docs well over the $145 mark.

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las vegas? or no wait they're just starting a residency this year...

LanceArmstrong said:

las vegas? or no wait they're just starting a residency this year...

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Yeah, Las Vegas... is it just starting this year? I know UMC was granted approval in June(ish) of 2006, and I had figured they had accepted residents already.

Just Joshin said:

Do you mind if I ask you about how much one can expect to make working 36 hours a week, as you do, in EM?

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I won't give you solid numbers (sorry, that's a confidential thing, truly speaking, due to my contract), but I will tell you that I am very comfortable, in the top 3-4% of all income in the US, and have, bar none, the best benefits package of anyone anywhere, that I would put head to head with anyone. I tell you this as I am eating a $20 steak (and not a restauarant steak - it's a 2lb porterhouse from Publix - you'd pay $40 or more for this steak in a restaurant). I mention that because there is light at the end of the tunnel - from anesthesiology to urology, from occupational medicine to neurosurgery, it's really good to have a few bucks in your pocket.

General Surgery intern here.

5-6AM to 4-6PM M-F depending on service and patient load, Conference every Friday from 12 till 5PM.. In the OR most every day starting at 8AM. Call works out to about Q4 with us getting 2 weekends off per month.

Not bad and I have great case numbers.

OB/Gyn Intern...

Arrive at hospital 5:45a-6a... pre-round then round with R3 at 7a... on the labor deck from 7:30a - 6:30-7pm (depending how long board sign-out is)... we have a night-float system so call is usually q. 7, 24 hours...

Night float... 6pm-8am Sun-Thurs

Sorry to seem ignorant...but what does Q1,Q2, Q3 mean? I am thinking quater years...?

sonyvaio2700 said:

Sorry to seem ignorant...but what does Q1,Q2, Q3 mean? I am thinking quater years...?

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"Q" stands for either 'every' or 'each'. So when someone says they are on-call Q4, it means that they are on call every fourth day. Q is often used with prescriptions also.. so like q4h means 'every 4 hours'.

Does that help?

EM resident.. most attendings work 1500-1700 hours a yr so 32-36 hours a week. lots of different shifts. salary is good and highly dependent on geography.

EctopicFetus said:

EM resident.. most attendings work 1500-1700 hours a yr so 32-36 hours a week. lots of different shifts. salary is good and highly dependent on geography.

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wow. that's awesome! is this at your particular hospital or pretty representative across the board?

Apollyon said:

I won't give you solid numbers (sorry, that's a confidential thing, truly speaking, due to my contract), but I will tell you that I am very comfortable, in the top 3-4% of all income in the US, and have, bar none, the best benefits package of anyone anywhere, that I would put head to head with anyone. I tell you this as I am eating a $20 steak (and not a restauarant steak - it's a 2lb porterhouse from Publix - you'd pay $40 or more for this steak in a restaurant). I mention that because there is light at the end of the tunnel - from anesthesiology to urology, from occupational medicine to neurosurgery, it's really good to have a few bucks in your pocket.

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Apollyon said:

As an emergency medicine attending, I work 36 hours/week, Saturday and Sunday day, and Monday overnight (all 12 hour shifts), and that's my full workweek.

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*single tear slides down face*

Joy