Attending Hours

[Dlim]

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When people report hours, does it normally include weekends? I'm considering pediatrics, and possibly specializing in pediatric anesthesiology.

Also, I've been reading posts on here about physician hours and I understand it varies, but is it reasonable to work ~50 hours a week M-F? I also understand I'd make less than other doctors who work 60+, but HOW much less exactly? Will I still be making more than say, the average optometrist/dentist?

 

[disarticulate]

Go to http://www.gaswork.com/ and look around. It will give you a good idea of what jobs require what (i.e. call every 12th day) as well as the pay scale difference between academic and private.

 

[Law2Doc]

When people report hours, does it normally include weekends? I'm considering pediatrics, and possibly specializing in pediatric anesthesiology.

Also, I've been reading posts on here about physician hours and I understand it varies, but is it reasonable to work ~50 hours a week M-F? I also understand I'd make less than other doctors who work 60+, but HOW much less exactly? Will I still be making more than say, the average optometrist/dentist?

The vast majority of physicians will have to take their turn working weekends in most groups or hospital practices in specialties that are not purely elective. People don't just get sick M-F and so there always has to be someone covering on the weekend. In a big enough group this can be spread out a lot, but in a small group or a hospital based you may find yourself doing a couple of weekends or nights a month. Of course if you only do elective procedures or something similarly schedulable, then that might be different.

I don't think gas is necessarily going to be a M-F field. And dentistry is a cash cow, so don't assume you will be earning more than that field with lower hours.

 

[geogil]

If you want banker hours, be a banker. You're going to be working doctor hours if you go into medicine. That means you take call. What that means is you stay up all night and another day to take care of sick people (the exact scheduling of call varies quite a bit), which is what you signed up to do when you became a doctor. As a peds anesthesiologist, you will be doing cases on kids in the middle of the night. You will be doing cases on the weekends. Anesthesiologists work hard, it's reputedly a 'lifestyle' specialty, but anesthesiologists work very hard i.e. 50 hours a week was not considered 'full-time' by a doc I shadowed a while ago. FYI, peds anesthesiology is not a peds subspecialty, but an anesthesiology subspecialty. Sorry to be blunt, but you're going to have to work some wierd hours if you're going to a doctor. Some pre-allo guy will probably blow sunshine at you about boutique medicine and 'lifestyle' specialties, but doctors work hard and they work at night.

 

[nontrdgsbuiucmd]

one of my relatives is an MD working I believe in pediatric neurology or related. She cut back to part time work as the husband is a high-earning executive & they have 3-4 kids.

There are also fields (ED comes to mind, or hospitalist, or army doc) that are not nearly as hours or "on call nights and weekends" intensive as other fields, based on what I've heard from docs in those areas.

So in answer to your question, yes. It is possible. Not typical, but possible.

One lifestyle/career I would not consider was Investment Banking - imagine getting called in on a Friday night and having to work through the weekend and into the next week because a major deal came in. My fam would be a little less OK with that than if I were called in on a Friday night & got home by Saturday morning as a physician.

 

[Law2Doc]

...
There are also fields (ED comes to mind, or hospitalist, or army doc) that are not nearly as hours or "on call nights and weekends" intensive as other fields, based on what I've heard from docs in those areas....

I guess I'm not sure what you are picturing for ED and how you are distinguishing it with "on call nights and weekends". They do shift work. Usually something in the ballpark of 4 twelve hour shifts a week. These shifts are often overnight or on the weekends, particularly so when you are less senior. So you won't be on call, you will be doing your shift. But you will be doing overnights and weekend work, so it's only a semantic distinction.

The other catch is that unlike other fields where you have a certain amount of downtime and may actually catch a few winks while on call, the ED folks generally are working their entire shift. So it's fewer, but harder hours. But probably not any less night/weekend time. Often more. Your sleep cycle may be terminally screwed up.

From what I hear, the folks who go into this field just because of the hours or for reasons other than being excited by the specialty burn out fast and leave in droves.

 

[JacobSilge]

I've known many attendings to work 3 12's per week, but otherwise Law2Doc is spot on that those hours will be jam packed and often inconvenient.

The other catch is that unlike other fields where you have a certain amount of downtime and may actually catch a few winks while on call, the ED folks generally are working their entire shift. So it's fewer, but harder hours. But probably not any less night/weekend time. Often more. Your sleep cycle may be terminally screwed up.

Perhaps I've just spent too much time in crazy academic centers, but it seems like sleep on call is a pretty rare commodity in most fields other than purely consult services.

 

[montessori2md]

Call schedules vary a lot from practice to practice, even w/in specialties. I've been asking around. I've met those who do shift work (7 days on, 7 days off, 12 hour shifts), and those who take call anywhere from q5 to q14, and those who do a full week of call every couple of months (outpt only -I don't believe anyone doing inpatient could survive that). I have yet to have someone tell me they do zero weekends.

W/ peds, I think your schedule would be determined by the size of the practice and how much of your practice was inpatient -theoretically, as hospitalists become a larger part of the pie, call schedule could be reduced, but it's not likely to disappear. Most parents I know would never consider taking their kids to an MD who didn't have a call service for that 2am screaming kid.

Even if you were strictly outpatient family med, you'd still want to be available so that if Mrs. X went to the hospital with an MI, you'd find out and could send over records.

W/ anesthesia, I should think you'd have to pay some serious dues to get to a point where you did zero weekends. Maybe if you were able to get in w/ a private outpatient surgical center that only did procedures M-F.

I think weekend call is awesome if the trade-off is that you get a weekday off -you get a day to run errands, shop w/o the crowds, maybe go volunteer at your kids' school or a free clinic. But I do like my sleep.

 

[deuist]

There are also fields (ED comes to mind, or hospitalist, or army doc) that are not nearly as hours or "on call nights and weekends" intensive as other fields, based on what I've heard from docs in those areas.

Law2Doc already got you on the emergency physicians, so I'll comment on the other two. Hospitalists also work shifts, including weekends and swapping to nights occasionally. While some groups will let you work M-F on days only, you're going to pay a big pay hit.

Military physicians work the same hours are civilians, despite what you've heard from recruiters.

 

[Dlim]

Thanks for all the responses so far. I'm not looking for an easy way out. I'm still planning on shadowing different specialties, and have no doubt that rotations during 4th year will change my opinion on which field I want to pursue.

Also, thank you for clarifying that peds anesthesiology is 3 years anesthesiology residency + 1-2 more years for peds.

I was just wondering b/c from hearing the insane hours doctors work, I wonder how much time they have for their family (for those who do have families). I have no doubt that I'll love my job, and I'm not asking about the hours because I wouldnt want to work, but more because I wanna see realistically how much time I would have for my family in the future.

So for those who have families, regardless of what specialty you are, are you satisfied with the amount of time you get to spend with your spouse and children?

 

[Dlim]

While some groups will let you work M-F on days only, you're going to pay a big pay hit.

I understand that, but exactly how much of a pay hit, on average, or hypothetically?

 

[geogil]

Ok, I was insufficiently clear. Anesthesiology is:
PGY1: intern
PGY 2-4: Anesthesiology (these are the Clinical Anesthesia or CA years 1-3)
Peds is a 1 year fellowship after that. You're looking at 5 years then.
Again, I reiterate: if you want good hours, then don't do medicine.

 

[geogil]

I understand that, but exactly how much of a pay hit, on average, or hypothetically?

Physicians aren't paid hourly like many jobs, so the reduced workload does not correspond 1:1 to a decreased pay. As others have noted, in order to get a cush schedule, you have to put in your time and pay your dues. You will have to be very high up in your group's hierarchy, be it an anesthesia group or otherwise before you can start working easy hours. By putting in your time, I mean that you will be senior to everyone there before you can start working easy hours, so we're talking about 20 years of time.

I have a secret : nobody really loves working nights and weekends. We all want to see our families and have hobbies. The trouble is, those darn patients get sick at 3 am on a saturday. Check out the anesthesia sub-forum, the attendings and residents that post there are none to fond of 'lifestylers' who choose gas so they don't have to work hard. You'll bust your butt to earn that cush attending salary.

If you're set on working controllable hours, I think that EM is a good bet (i'm not implying that EM docs are slackers). You work a fixed number of shifts a month, and, though the hours will sometimes be crappy, when you're done, you're done.

Best of luck, and think long and hard before you choose medicine if you want a cushy job with normal business hours.

 

[nontrdgsbuiucmd]

Law2Doc already got you on the emergency physicians, so I'll comment on the other two. Hospitalists also work shifts, including weekends and swapping to nights occasionally. While some groups will let you work M-F on days only, you're going to pay a big pay hit.

Military physicians work the same hours are civilians, despite what you've heard from recruiters.

my bad, I'd not specified that I was referring to the total number of hours worked per week being reasonably short in emergency med, hospitalist, and some army doc areas, not that I think becoming an ED physician or hospitalist means you only work M-F days.

No thanks, no recruiters for me, that whole conformity thing is just not a real good fit. I'm not aware of any medical path where you could work M-F, 9-5.

I'd intended to convey that if a person wants reasonably short hours, he or she does not automatically have to exclude medicine as a career choice.

 

[deuist]

I'm not aware of any medical path where you could work M-F, 9-5.

There are a few: derm, occupational medicine, travel medicine, urgent care clinic.

 

[Re3iRtH]

Law2Doc already got you on the emergency physicians, so I'll comment on the other two. Hospitalists also work shifts, including weekends and swapping to nights occasionally. While some groups will let you work M-F on days only, you're going to pay a big pay hit.

Military physicians work the same hours are civilians, despite what you've heard from recruiters.

Are you a USUHS student by chance? Be careful making that statement. I personally
have talked to 10-15 military docs in certain subspecialities, and they
have worked in both civilian and military. I can tell you this for a fact,
for most sub-specialities, read: ie. allergy / child neuro / nuclear medicine etc.
military physicians work significantly less. Thats how it just works
out with the demand and patient populations.
General surgeons the MAJORITY of the time (in the states) work less, compared to
civilian, this is not a question. These physicians that
I spoke with all are past their commitment, and one reason (not the only)
they decided to stay in the military was the controllable hours.
You will notice those 3 subspecialities I listed above are generally
referral specialities, thats why they can work the standard military
7:30 to 4. Recruiters don't know jack about medicine. Talk to docs
that have been there and done that.