Anyone having FOMO about matching into IM?

[Nocturnist]

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Nocturnist lifestyle is not for everyone. I do 50% fte days (9 hr) and 50% nights (15 hr shift) which I feel is much worse than pure 7 on/ 7 off nights (12 hr). I like my day shifts better and just doing nights for the past 3 years (though it's only 5-6 shifts a month) seems like I'm aging faster. I used to be generally content and healthy but working nights changed it (not sure if that's the only factor I can blame). My present employer said giving up nights is not negotiable (unless I'm above 50 or have health condition which precludes me from working night).
I don't feel it's worth ruining my physical and mental health so I'm moving to pure day time job and I hope I get to feel better again. I'm sure if I do nocturnist work for 3 more years I'll probably kill myself.

At one point you will realize life is more than money and so far I haven't met a single person who is doing pure night work for >5 yrs and remain physically/mentally healthy.

100% agree it's not for everyone.

I will say-wherever you stand on the whole nocturnist=a miserable death trap debate, I can't imagine anything more miserable than a hybrid schedule. I do think it's best to stick to one or the other. The day my employer makes me do a day shift is the day I give my notice.

With that said, one of our nocturnists has been doing it for over 20 years while raising a family, another for 15 years with 3 kids as well, and yet another has been doing it for 11 years. The rest of us are in the 3-7 year range. We're all alive and well, mentally and physically. We've gotten a couple transients over the years specifically doing it as 1-2 year bridge to fellowship, but for the most part we're able to recruit and retain dedicated nocturnists in it for the long haul. All our ER nocturnists have families and have been doing it for over 5 years. We've had a dozen or so locum nocturnists come and go through the years, majority of whom seem to be in their 40s, 10+ year experience, most with kids. A couple of them talk about some side hustles like real estate investing, crypto, and quality improvement work but none of them is actively looking for a way out. One colleague did briefly switch to swing shifts, supposedly for health concerns, but did return to nights a few months later.

Of all my discussions and experience, I'm not aware of any colleague specifically doing it for the money. I certainly wouldn't encourage that.
Most of us do it because we can't imagine doing anything else- the great money is just one part of the 'getting away with something'.

If you were miserable through your night float months in residency, money wont make that a whole lot more tolerable. But if you thrived at night and appreciated the autonomy, straight forwardness, lack of bs, and relative purity of nights- it may be for you!

Edit: also just reread your post and noticed the *15* hour night shift part.
Yeah... that's insane. I've actually never heard of a 15 hour night shift.
Can't say I blame you for feeling that way, not sure anyone could do that for too many years.

 

[blue.jay]

If you were miserable through your night float months in residency, money wont make that a whole lot more tolerable.

Great advice. I hated nights even in residency and I was sure any kind of job with nights will make me miserable. I didn't have choice other than take this job so I can be in the same city as my SO (who was starting residency then).

 

[wamcp]

I am an EM doc that almost never did an overnight shift b/c our place always had nocturnists so the latest my shift ended was 2am so never did a true overnight.

I had a bright idea 10 yrs into attending that I wanted to spend more time with the kids in the summer so signed up for all night for 3 summer months. Rainbows and unicorns, and thought the 11p-6a shift would not be bad. Work 10 dys a month, come home and sleep until noon feeling refreshed and enjoying the whole day with the family until my next shift. Realize that our overnight EM shifts were only 7 hours.

That was the most miserable 3 months and my wife can attest to this. With 3 young kids, there was no sleeping 7 straight hours. Even if they left me alone in my dark media room, the body kept telling me to wake up in 3 hrs. I don't remember even having a straight 7hours sleep for the whole summer. I will say nocturnist really messes you up and with kids its a double whammy.

Anyhow, the two nocturnist did it for probably 10 yrs. One quit medicine and never heard from him again. The other had a psych break down and had to seek mental care.

I would tread very very lightly and have an exit plan for anyone wanting to be a nocturnist.

Nocturnist is not for everyone (the majority) of people.
It’s great for me because:

1) it really does let me have much more time with my toddler

2) I can trade on the stock market which closes at 4pm est, without any job duties interfering

3) I am still only 30 yo and can tolerate it.
There is no way I can imagine doing nights full time past age 40-50. The stock market is allowing me to gtfo medicine before I get much older. Have achieved past 2 million in net worth now, so I could just go to part time now anyway which is far more tolerable long term.

 

[Nocturnist]

No but my bright idea came with working 10 shift rather than my typical 14 shifts a month due to the increase pay. Still quite miserable. No way I could do 12 hr 7 on/off.

I remember when we were working on the nocturnist bonuses and I would have voted for whatever they wanted. Night people may think they handle it well but they don't realize what they don't know. Have you guys ever looked at before & after pics of our presidents? Those 4-8 yrs really take their toll on them. Same with Nocturnists.

Oh, did I mention that when the kids woke up in the am my poor wife had to keep a 2,4&6 yr old quiet so dad could try to get a decent sleep?

I actually took you up on it for ****s and giggles!

Here's What These Presidents Looked Like Before and After Serving in Office

Needless to say, running the country isn't easy.

www.goodhousekeeping.com

Some of them look like they haven't aged a day. Some I honestly couldn't tell which was the before or after. Obama went gray, not quite a zebra for men in their mid-late 40s? Anyway, there's ample research about the statistically significant deviation of political candidates' heights and even hair lines from average as a reflection of power and dominance...so theyre probably as a whole a (cess)pool of much better genetics than my mortal nocturnist behind.

Ironically our ER nocturnists are all some of the most ridiculously in shape docs in the hospital. Alot of the daytime ER docs look like they're really falling apart to me.

I think everyone owes it to their health and wellbeing to find a job where they can eat well, exercise, and get good sleep.
It sounds like your situation unfortunately wasn't affording you the latter. That could be a very different situation 5 years from now when your kids are in school/not crying through the day. At least that's what my colleagues with school aged children who are never going back to days tell me.

But appreciate you advocating for our bonuses and the comparison to the most powerful men in the world- promise we'll never lie to you or raise your taxes!

 

[wamcp]

But did you make $700 per hour out of residency clearing 750k/year only working 10 nights per month as has been presented in this thread? Because if not you didnt have the SDN median job

No one has given such outlandish figures. It’s actually 250k/year at 10 nights a month for my base and I’ve hit >500K with averaging 10 moonlighting shifts per month.

 

[chessknt]

No one has given such outlandish figures. It’s actually 250k/year at 10 nights a month for my base and I’ve hit >500K with averaging 10 moonlighting shifts per month.

Maximum compensation pathway offered during first three years as attending?

If you wanna look at 90th percentile nocturnist and compare that to 90th percentile cards/gi you’re looking at close to seven figures without a doubt more if they work like a dog like some of the jobs posters here. There truly is no comparison. Every hospital has to file a 990 form, which...

forums.studentdoctor.net

 

[wamcp]

Maximum compensation pathway offered during first three years as attending?

If you wanna look at 90th percentile nocturnist and compare that to 90th percentile cards/gi you’re looking at close to seven figures without a doubt more if they work like a dog like some of the jobs posters here. There truly is no comparison. Every hospital has to file a 990 form, which...

forums.studentdoctor.net

And? Where did anyone in that thread say they are making 700k with 10 shifts a month?

700K is still possible regardless..just have to really work for it. And in postcovid land with a tighter job market, very unlikely to get the extra shifts needed.

precovid I had times that I pulled in 60-70K in a single month due to working 28 shifts in the 30 day period and they were paying $225-250/hr for 12 hour night shifts needing urgent coverage.

Obviously, if you wanted to make 700K a year in a more sustainable manner then you need to do GI or cards. But if you want to gtfo medicine asap without 3 additional years of fellowship then nocturnist is one of the few ways to do it.

 

[Nocturnist]

No one has given such outlandish figures. It’s actually 250k/year at 10 nights a month for my base and I’ve hit >500K with averaging 10 moonlighting shifts per month.

Dude doesn't let such petty nuisances like facts and reality interfere with the nightly trolling duties.

Keep crushing it.

 

[chessknt]

And? Where did anyone in that thread say they are making 700k with 10 shifts a month?

700K is still possible regardless..just have to really work for it. And in postcovid land with a tighter job market, very unlikely to get the extra shifts needed.

precovid I had times that I pulled in 60-70K in a single month due to working 28 shifts in the 30 day period and they were paying $225-250/hr for 12 hour night shifts needing urgent coverage.

Obviously, if you wanted to make 700K a year in a more sustainable manner then you need to do GI or cards. But if you want to gtfo medicine asap without 3 additional years of fellowship then nocturnist is one of the few ways to do it.

I believe that poster cites 0.5 FTE as 5 shifts per month and there claims to make 600-700 which is almost 500/hr. You might not think that is outlandish but I assure you it is unless I messed up the math.

 

[Splenda88]

I believe that poster cites 0.5 FTE as 5 shifts per month and there claims to make 600-700 which is almost 500/hr. You might not think that is outlandish but I assure you it is unless I messed up the math.

No one has said that. There are few hospitalists who make >500k/yr but these people work their butt off. What people were saying in that thread was that it is not difficult to make 400k/yr as a hospitalist.

As @wamcp said, if your goal is to get out of medicine early (10-12 yrs), a 3-yr residency (IM/FM/EM) is one of the most effective ways to do that.

 

[HemeOncHopeful19]

I don’t think there are any Cardiologists out there wishing they did Anesthesia.

OP also you can never predict what will happen years down the road. When I graduated I did have some FOMO after slacking off a bit in medical school and missing out on a more competitive speciality that had higher pay, better hours and was related to my interests. That field was Rad Onc.

 

[CCM-MD]

I don’t think there are any Cardiologists out there wishing they did Anesthesia.

OP also you can never predict what will happen years down the road. When I graduated I did have some FOMO after slacking off a bit in medical school and missing out on a more competitive speciality that had higher pay, better hours and was related to my interests. That field was Rad Onc.

I actually know 2 cardiologists from training who wished they did anesthesia. One has a son who is doing anesthesia now.

I bet you are glad you didn’t do rad onc now, given their ongoing struggles.

 

[emergentmd]

I remember surgeons, cardiologists, OB, hospitalists coming to the ER 10 yrs ago wishing they went into ER. I made as much or more than most of them working 14dys/mo. I would leave sometimes at 1pm after my 7 hr shifts and they were still in clinic and facing night call with a full clinic schedule the next day.

Grass not always greener and in truth prob worse..

 

[HemeOncHopeful19]

I actually know 2 cardiologists from training who wished they did anesthesia. One has a son who is doing anesthesia now.

I bet you are glad you didn’t do rad onc now, given their ongoing struggles.

Yeah that was my point, and goes with the post above. Rad Onc clearly turned out to be a sinking ship (but who knows in 10 years it may be king again). I am glad I didn't do it for other reasons as I don't think I would have liked it as much as Med Onc but then again if you gave me a terrible job market for Med Onc I might feel otherwise. Things ebb and flow throughout the years although I think on the whole all fields will be slowly but surely going downhill in the future. You might as well pick something you like as long as it meets your minimum salary/lifestyle expectations.

 

[ecogfive]

Appreciate this advice and insight! I'm not gonna lie -- when I posted this I must have been feeling all kinds of emotions. Everyone was so giddy about their specialty choice -- magnified by social media posts -- I likely felt uncertain that because I was not excited myself that perhaps my heart was not tuned to IM, but a month later since this post I realize that was a temporary feeling. I feel great about my specialty choice, and not even because of all the doors that are open -- I just like the whole diagnostic workup that entails all of Internal Medicine. I'm pretty excited, frankly, for residency to start!

Glad your head is in a better place. You're going to do great!