Chillest psychiatry residencies in the Northeast?

[psychlover711]

I know this may be controversial but I’m at a point in my life where I no longer want to be overworked. What are some residencies in the Northeast (maybe even South) that have an amazing work life balance?

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[zenmedic]

Hey I'm a PGY-1 resident based around NYC. The most chill place I interviewed in the Northeast was easily Mather Hospital in Port Jefferson. No overnight call, no 24s, every Wednesday off (virtual from home lecture), get wellness days in addition to 4 weeks of vacation. The residents were incredibly happy and said the work life balance was phenomenal. It's through Northwell too so one of the highest salaries in the country, I think they start at 79k. Other chill places I interviewed at were Stony Brook Eastern Long Island, Lehigh Valley, and the Wright Center in Scranton.

 

[TheRightMedication]

Unsolicited advice, you say? Gladly.

Consider the quality of the training, not how chill it is. If it's strenuous but the training is good, it will help you have a chill post-training life, which is, if my math is correct, the rest of your life.

If the program is chill but the training is bad - if you're unprepared clinically, professionally, and from a business perspective, then the rest of your life may not be so chill.

 

[Celexa]

Unsolicited advice, you say? Gladly.

Consider the quality of the training, not how chill it is. If it's strenuous but the training is good, it will help you have a chill post-training life, which is, if my math is correct, the rest of your life.

If the program is chill but the training is bad - if you're unprepared clinically, professionally, and from a business perspective, then the rest of your life may not be so chill.

This is the part so many people don't understand. If your residency doesn't teach you how to efficiently manage patients and let you see a high enough volume to make good judgments quickly then you aren't equipped to take a good job or to operate on your own or to set good boundaries. I see so many people whose day to day workflow makes them so much more miserable than it has to just because they just genuinely don't know how to operate any other way.

 

[psychlover711]

Thank you for your advice, everyone! I certainly don't want to go to a horrible program, I'm just looking for a good balance.

 

[psychlover711]

Hey I'm a PGY-1 resident based around NYC. The most chill place I interviewed in the Northeast was easily Mather Hospital in Port Jefferson. No overnight call, no 24s, every Wednesday off (virtual from home lecture), get wellness days in addition to 4 weeks of vacation. The residents were incredibly happy and said the work life balance was phenomenal. It's through Northwell too so one of the highest salaries in the country, I think they start at 79k. Other chill places I interviewed at were Stony Brook Eastern Long Island, Lehigh Valley, and the Wright Center in Scranton.

Thank you so much for this! I hadn't heard much about the Port Jefferson location so I hadn't added it to my list, but I just did. Sounds awesome.

 

[Stagg737]

Realistically, unless you're at a malignant program, all psych programs are going to be be chill and have a great work-life balance. When I graduated residency, I averaged something like 51 hours per week. If you remove PGY-3 year from that, I probably averaged around 46 hours per week and I was by far the least efficient resident in my class.

Some comments on the Port Jefferson schedule mentioned above: No 24's is a good policy in a residency. I did 24 hour shifts and it honestly did give me some great experience, but I also think it's possible to get that without doing full 24's. Our 24 hour shifts were also more like 10-12 hours of actual work and a lot of sitting around/home call. YMMV with those kinds of shifts. No overnight call is okay. I do think it's important to experience this in residency though. If you take a big kid job after residency that requires overnight call and you've never done it before, you're likely in for a world of hurt. Where I did residency there was no mandatory overnight call after 2nd year and overnight call was always home call. I probably got called in 8-10 times total in my first 2 years. If you want to work inpatient, you're almost guaranteed going to have to take overnight call and one would be very foolish not to get this experience in residency. The 4 day work schedule is maybe a red flag to me. If it's such a great lifestyle residency, why do they need a day in the middle of the week off and how much exposure are they missing out on? I would have loathed that schedule as I like continuity and having to come back and learn new patients every other day I work would have been awful. Unless you're doing outpatient working a 4 day per week schedule (where you work longer hours but less days) or working part-time, this is not how the real world works. At a program like that I'd be more interested in the perspective of their alumni 1-2 years after they graduate to make sure they felt their training was adequate for the real world than the residents who are currently there.

I say this all the time to prospective med students, there are plenty of "lifestyle specialties", but the only fields where that's consistently true in residency are psych and PM&R. Malignant programs in psych can be bad, but 90% or more are not and will still have great lifestyles. Go to a solid program that isn't malignant and your work-life balance will be better than 80% of employed Americans anyway.

 

[FlowRate]

As far as Boston programs go, Cambridge Health Alliance provides strong training, especially if you want to have a therapy heavy practice after residency, while probably being one of the more, if not the most, chill psych residency in the city.

I wouldn't rank BWH high on the overall chill program rankings nationally but again, as far as Boston programs go, it got the more favorable workload outcome of the Longwood split.

 

[Merovinge]

Thank you for your advice, everyone! I certainly don't want to go to a horrible program, I'm just looking for a good balance.

Nothing wrong with not going to a super intense psych residency (e.g. Hopkins), but choosing a program that is the "chillest" with workload is just setting yourself up for a lifetime of harder work and/or doing worse at work. If you were applying to surgery and asked this advice, then sure absolutely, but we are already talking about a residency where many places have an average workload around 40 hours/week averaged across 4 years.

Get good training at a non-malignant program and you will have a great balance. I was able to go to concerts/shows, hang out with friends, date, and exercise throughout training and went to a slightly above average workload program.

 

[comp1]

I think searching for a chill residency is actually a really great idea and I fully support it. Psychiatry residency should not be a slog. Now this was 13 years ago, but out on the trail I saw a lot of residencies that used IN HOUSE residents as a sort of night float for psych patients. This is not how attendings practice and it's not how most (if any) non-academic hospitals will function post graduation. This is very financially helpful to the hospital, but I do not believe you learn best at 3 AM. Instead, you should be learning how to take home call and manage issues, particularly nurses, over the phone, which is what you'll be doing for most of your career. I also bizarrely saw psych interns doing 2 months of MICU rotations. This is, again, financially helpful to the hospital, but not educationally valuable. Heck, I even saw residents doing phlebotomy. There is not at all a direct correlation between more work and more education. A chill residency has everyone from LVNs to LCSWs to NPs working at the top of their license so that not everything ends up being done by the residents just because they require the least organization and are cheapest. Ideally, it would show a resident how a hospital or practice should be run so that they know what to be looking for in a first job.

 

[clausewitz2]

I think searching for a chill residency is actually a really great idea and I fully support it. Psychiatry residency should not be a slog. Now this was 13 years ago, but out on the trail I saw a lot of residencies that used IN HOUSE residents as a sort of night float for psych patients. This is not how attendings practice and it's not how most (if any) non-academic hospitals will function post graduation. This is very financially helpful to the hospital, but I do not believe you learn best at 3 AM. Instead, you should be learning how to take home call and manage issues, particularly nurses, over the phone, which is what you'll be doing for most of your career. I also bizarrely saw psych interns doing 2 months of MICU rotations. This is, again, financially helpful to the hospital, but not educationally valuable. Heck, I even saw residents doing phlebotomy. There is not at all a direct correlation between more work and more education. A chill residency has everyone from LVNs to LCSWs to NPs working at the top of their license so that not everything ends up being done by the residents just because they require the least organization and are cheapest. Ideally, it would show a resident how a hospital or practice should be run so that they know what to be looking for in a first job.

Eh, my residency program certainly did this, but for legal reasons in my state, unless a psych hospital is not going to employ any form of restraint or seclusion and not engage with involuntary patients if any kind, it is pretty impossible to function without an MD on site overnight or damn near it. Somebody's gotta do it.

 

[comp1]

Restraint laws are a reason a lot of academic programs give, but they often aren't accurate or they are using not current laws to argue for a heavier resident burden. I'm not saying they aren't requred anywhere, but I am saying that you do not need a physician in person overnight to put a person in restraint or seclusion emergently everywhere. There are actually many hospitals throughout the country, particularly in the rural midwest, that operate with solely teleproviders and many states that give RNs the authority to place a patient in restraint or seclusion emergently with solely a verbal order and no physical presence of the physician or even a telehealth presence. Check the state's laws.

 

[Ironspy]

Where I am I only need to see patients in restraints if they are in restraints continuously >4 hours which never happens bc patients are typically given prns when placed in restraints

 

[comp1]

Where I am I only need to see patients in restraints if they are in restraints continuously >4 hours which never happens bc patients are typically given prns when placed in restraints

Yes, this regulation is common and would in no way justify in house staff every night.

 

[Merovinge]

I think searching for a chill residency is actually a really great idea and I fully support it. Psychiatry residency should not be a slog. Now this was 13 years ago, but out on the trail I saw a lot of residencies that used IN HOUSE residents as a sort of night float for psych patients. This is not how attendings practice and it's not how most (if any) non-academic hospitals will function post graduation. This is very financially helpful to the hospital, but I do not believe you learn best at 3 AM. Instead, you should be learning how to take home call and manage issues, particularly nurses, over the phone, which is what you'll be doing for most of your career. I also bizarrely saw psych interns doing 2 months of MICU rotations. This is, again, financially helpful to the hospital, but not educationally valuable. Heck, I even saw residents doing phlebotomy. There is not at all a direct correlation between more work and more education. A chill residency has everyone from LVNs to LCSWs to NPs working at the top of their license so that not everything ends up being done by the residents just because they require the least organization and are cheapest. Ideally, it would show a resident how a hospital or practice should be run so that they know what to be looking for in a first job.

I do agree that most attending's are not going to be in-house in the evenings, but I do not agree that means there is not learning to be done then when in residency. The type of psychopathology that turns up in the ED in the evening, as well as the associated lack of collateral at that time, is just different than doing psych ED work from 8-5. You build autonomy differently when an attending is in house via on the phone. Learning how to physically handle inpatients in the evening and triage basic medical concerns is also a worthwhile experience. I don't think one needs a lot of 24's or nigh float to get the optimal amount of training but I am actually glad I did this work in training. I also have a lot more understanding of what other physicians, EMTs, or jobs that entail 24 hour shifts go through (which is not reason alone to do the training, but is a nice perk).

 

[psych_0]

@psychlover711 what would you personally define as malignant? Chill? Should probably start there if you want a reasonable answer.

 

[clausewitz2]

Restraint laws are a reason a lot of academic programs give, but they often aren't accurate or they are using not current laws to argue for a heavier resident burden. I'm not saying they aren't requred anywhere, but I am saying that you do not need a physician in person overnight to put a person in restraint or seclusion emergently everywhere. There are actually many hospitals throughout the country, particularly in the rural midwest, that operate with solely teleproviders and many states that give RNs the authority to place a patient in restraint or seclusion emergently with solely a verbal order and no physical presence of the physician or even a telehealth presence. Check the state's laws.

In my state use of restraints or seclusion requires evaluation by a physician within 30 minutes of initiation. State law specifically disallows orders sent in by telephone or remotely and orders for these things have to be put in by a physician.

Similarly, the procedure for involuntary commitment requires patients be transported to one of several specially designated facilities for evaluation, and on arrival patients must be seen in person by a physician within two hours. Don't necessarily have to be evaluated that quickly but physician has to lay eyes on them, document something, and attest they are upholding involuntary commitment petition pending further evaluation or something to that effect.

Them's the breaks, unfortunately.

 

[MedMan80]

My residency sucked, but it made me what I am, I learned to grind..a chill residency might be nice to some, but don't expect it to prepare you for much of the real world.

 

[comp1]

In my state use of restraints or seclusion requires evaluation by a physician within 30 minutes of initiation. State law specifically disallows orders sent in by telephone or remotely and orders for these things have to be put in by a physician.

Similarly, the procedure for involuntary commitment requires patients be transported to one of several specially designated facilities for evaluation, and on arrival patients must be seen in person by a physician within two hours. Don't necessarily have to be evaluated that quickly but physician has to lay eyes on them, document something, and attest they are upholding involuntary commitment petition pending further evaluation or something to that effect.

Them's the breaks, unfortunately.

See...that would be a state to avoid when looking for a chill residency, assuming all of that is accurate about state law and not hospital policy.

 

[whopper]

I don't fault anyone for trying to avoid a residency where you're overworked. I do, however, state that you will need to work hard to become a good physician, not seeing tough situations will prevent you from learning and you will not know what to do when seeing these same tough situations as an attending doctor, and that some programs are overboard with being hard. They need to give residents appropriate time to rest, study, and have the support needed for tough situations.

Where I did residency, one of the hospital (and it wasn't mine cause it was spread over 3 hospitals) made the residents get insurance approval which the residents at that location hated. That's a complete example of a program pushing something on residents that doesn't help them become better doctors that's just tedious and hard work. Same hospital only had a voluntary unit. The residents at this hospital didn't learn how to do involuntary commitments, testify in court, so did these same residents dodge a bullet? No. These are things you will need to learn.

 

[comp1]

Yeah, only ever dealing with voluntary patients is a probably a bit overly narrow. I'm surprised that's allowed by the ACGME, but then there's such a massive push for solely a recovery oriented model, it's probably praised. Insurance boarding is probably not completely without educational merit. But then I like bureaucracy as long as it remains during normal business hours. I'd personally be more concerned about the in house overnight and weekend stuff that I just do not see any attendings doing in my state at all (although certainly some residents do, solely due to hospital or program policies).

 

[Celexa]

See...that would be a state to avoid when looking for a chill residency, assuming all of that is accurate about state law and not hospital policy.

Still possible to have a 'chill' residency.... If the residency doesn't cover one of the places that does involuntary evals or provide night coverage for a facility with involuntary patients. I don't think it's the state laws that end up dictating residency chillness.

 

[whopper]

Yeah, only ever dealing with voluntary patients is a probably a bit overly narrow.

I remember saying the same thing while in the residency, and the residents at that hospital became very defensive. "Are you saying I don't know psychiatry?"
Me: I'm saying you don't know how to do involuntary commitments nor deal with severely mental ill patients cause you've hardly had to do it. That's what I'm saying.

Them: That's not true. Just cause I never do it doesn't mean I don't know how to do it.

Oh boy. One of those arguments I didn't feel like wasting my time on cause the defensiveness and hypersensivity overrides objective reality.

Point is it's not overall "chill" as should be the factor to aim for, but is the had work justified, effective in teaching, and are you supported? Certainly making residents do insurance authorizations that a social worker is supposed to do is a load of crap.

 

[mistafab]

I would say if finding “chill” is a priority, make it known and people should let you know.

For actually becoming skilled, the reverse end of the spectrum should differentiate from “meat moving” I.e. high work low education, vs “work heavy” programs with high work high education. It’s hard to find the right balance, but everything has a general saturation point where the majority of “trainee education” at that PGY level has taken place.

There will be slop in the gears since they need to account for all trainees, but if you choose a high workload program, I would make sure it’s also high education as well so you get value for the blood you put in. That’s a place that if you want to get the most out of your training, you should consider gravitating to.

 

[justalittlestar]

I would agree that no psych residency is going to be overly greuling however I get where you're coming from OP with the search for a chill residency. YMMV but I ranked all the programs without 24 hr shifts higher on my rank list. Current program doesn't have 24s and has a short and long call system and I still feel like I'm getting pretty good exposure.

 

[Celexa]

I would agree that no psych residency is going to be overly greuling however I get where you're coming from OP with the search for a chill residency. YMMV but I ranked all the programs without 24 hr shifts higher on my rank list. Current program doesn't have 24s and has a short and long call system and I still feel like I'm getting pretty good exposure.

I don't find 24 hour shifts to be particularly important in the educational trajectory. After all, it's almost exclusively a phenomenon of residency. It's not something that happens in attending jobs.

Far more important is the question of whether you have appropriately increasing responsibility including being on call in a way that requires you to own your own decisions. You don't want your first attending job to be the first time a decision you make feels consequential. Residency is the time to have the training wheels taken off well there's still someone nearby to help. But if the wheels stay on the entire time, as in some residencies, you aren't prepared for what comes after.

 

[comp1]

I would argue 24 hour in house shifts are worse than unimportant for education, they are actively harmful. They're going to reduce your ability to learn new information for that time period as well as specifically not preparing you for actual attending physician work. Now home call, that's pretty important. I actually think the ACGME harmed at least psychiatric resident education significantly by reducing home call opportunities for resident.

 

[Ironspy]

24 hours calls make people meaner, decrease your ability to learn and increase your risk of mood disorders. Night float sucks also but a bit less. I graduated from a program that did both and was busier than average. One 24h per month is plenty for experience and I don’t recommend more (fwiw I did more). 2-4 weeks of nights/year is plenty and more is not better (again I did more and do not recommend). If you really hate having free time you can moonlight

 

[FlowRate]

24 hours calls make people meaner, decrease your ability to learn and increase your risk of mood disorders. Night float sucks also but a bit less. I graduated from a program that did both and was busier than average. One 24h per month is plenty for experience and I don’t recommend more (fwiw I did more). 2-4 weeks of nights/year is plenty and more is not better (again I did more and do not recommend). If you really hate having free time you can moonlight

Totally agree with this, also from experience. Some amount of nights and weekends is helpful, but there are plenty of programs that give more than is educationally helpful.

Also, if anyone is in a residency cohort with multiple people who might prefer 12's over 24's, it's totally worth asking if you can split shifts with other people. I way preferred that arrangement because 24's are really unfun, especially if you're on a busy service with little to no downtime.

ETA: Our night float shifts were 14 hours so sometimes we'd split as 10 hour day / 14 hour night. That way you at least get out for a normalish dinner time / time for evening plans on the day shift.

 

[Celexa]

Totally agree with this, also from experience. Some amount of nights and weekends is helpful, but there are plenty of programs that give more than is educationally helpful.

Also, if anyone is in a residency cohort with multiple people who might prefer 12's over 24's, it's totally worth asking if you can split shifts with other people. I way preferred that arrangement because 24's are really unfun, especially if you're on a busy service with little to no downtime.

Yes it's worth noting that the bias against 24s isn't universal. I split mine. I had coresidents who preferred to just do 24s and be done.

 

[mistafab]

I disagree with saying that 24s are not useful.

Where else can we be punched repeatedly in the stomach by life?

A lesson worth learning… i’m told.

 

[clausewitz2]

I disagree with saying that 24s are not useful.

Where else can we be punched repeatedly in the stomach by life?

A lesson worth learning… i’m told.

. . . by the people putting on boxing gloves.

 

[justalittlestar]

I would argue 24 hour in house shifts are worse than unimportant for education, they are actively harmful. They're going to reduce your ability to learn new information for that time period as well as specifically not preparing you for actual attending physician work. Now home call, that's pretty important. I actually think the ACGME harmed at least psychiatric resident education significantly by reducing home call opportunities for resident.

Interestingly enough I heard home call also kinda sucks 😆

 

[whopper]

24 hours calls make people meaner, decrease your ability to learn and increase your risk of mood disorders. Night float sucks also but a bit less. I graduated from a program that did both and was busier than average. One 24h per month is plenty for experience and I don’t recommend more (fwiw I did more). 2-4 weeks of nights/year is plenty and more is not better (again I did more and do not recommend). If you really hate having free time you can moonlight

IMHO overnight calls are a good learning experience-up to maybe 15 of them. After that you've learned what it's going to give you. I encourage doing it, but only up to the learned benefit point. (And yes I realize a program is going to make you do it well over that point if they make you do overnight call). Why 15? More or less for most people, cause after doing it that many times you know your own physical and mental limits of what you can handle. Such a thing is useful in long-term emergency situations. Such things do happen, but not often. E.g. there's an ER episode where (and I think it was cause a bus or train crashed) all of the local hospitals knew they were going to be screwed with too much work for the next few days. I remember it was when Clooney was on the show. He knew the ambulances were going to show up in about 3-4 hours. He told the nurse "wake me up in 3 hours, I'm taking a sleeping pill" or something like that cause he knew he was likely not going to sleep for 72 hours.

Interestingly enough I heard home call also kinda sucks 😆

Rules might've changed, but if I remember correctly if you do home-call they can still make you come back into work next day for a full day of work. That's fine unless it's the type of home call where you aren't going to get any sleep at all in which case you'd probably be better doing the call in the hospital.

 

[Stagg737]

Interestingly enough I heard home call also kinda sucks 😆

This can vary massively. My home call was pretty laid back 95% of the time. You call the unit you're covering at 10pm and ask them if they need anything for the night and make sure everyone's got PRNs ordered. In all of residency I had one night where I did not get more than 2 hours of straight sleep, and probably got called in to the ER overnight about 20% of the time during 2nd year which was the only year we covered it overnight, so maybe 4-5x total. Only time I had to go into the unit overnight was when a patient's eye pain was getting worse and nursing sent me a pic that looked like orbital cellulitis. I went in, consulted ophtho (who actually showed up at 11pm) and patient was transferred to medical floor. Home call only sucked when there were 3+ overnight admissions where we'd have to wake up to put in orders, which was not common. We also had a system where if you had a rough night overnight, you could leave work the next day after 11 or noon if you had your notes done.

Rules might've changed, but if I remember correctly if you do home-call they can still make you come back into work next day for a full day of work. That's fine unless it's the type of home call where you aren't going to get any sleep at all in which case you'd probably be better doing the call in the hospital.

As far as I know they have not, and I'm still at an academic institution. Part of why call obligations can vary so much in terms of suckage during residency.

 

[Celexa]

IMHO overnight calls are a good learning experience-up to maybe 15 of them. After that you've learned what it's going to give you. I encourage doing it, but only up to the learned benefit point. (And yes I realize a program is going to make you do it well over that point if they make you do overnight call). Why 15? More or less for most people, cause after doing it that many times you know your own physical and mental limits of what you can handle. Such a thing is useful in long-term emergency situations. Such things do happen, but not often. E.g. there's an ER episode where (and I think it was cause a bus or train crashed) all of the local hospitals knew they were going to be screwed with too much work for the next few days. I remember it was when Clooney was on the show. He knew the ambulances were going to show up in about 3-4 hours. He told the nurse "wake me up in 3 hours, I'm taking a sleeping pill" or something like that cause he knew he was likely not going to sleep for 72 hours.



Rules might've changed, but if I remember correctly if you do home-call they can still make you come back into work next day for a full day of work. That's fine unless it's the type of home call where you aren't going to get any sleep at all in which case you'd probably be better doing the call in the hospital.

Overnight and 24 hr call aren't synonymous though. A lot of programs use a night float system now. I agree some degree of mostly independent overnights are important.

As for how many, I'd say wherever the line is between being worried the pager is going to go off and just hating the world when it does.....

 

[Osminog]

I would argue 24 hour in house shifts are worse than unimportant for education, they are actively harmful. They're going to reduce your ability to learn new information for that time period as well as specifically not preparing you for actual attending physician work. Now home call, that's pretty important. I actually think the ACGME harmed at least psychiatric resident education significantly by reducing home call opportunities for resident.

My residency program has frequent 24-hour in-house call shifts, and I couldn't agree more.

Residency applicants, take heed.

 

[psychemdoc]

My residency program has frequent 24-hour in-house call shifts, and I couldn't agree more.

Residency applicants, take heed.

Name and shame if you can.

 

[Mad Jack]

Eh, my residency program certainly did this, but for legal reasons in my state, unless a psych hospital is not going to employ any form of restraint or seclusion and not engage with involuntary patients if any kind, it is pretty impossible to function without an MD on site overnight or damn near it. Somebody's gotta do it.

For restraints and seclusions we have coverage from the hospitalist services at basically every hospital I cover for the in-person aspects of it. You still get a phone call, but no need to be in-house. Stand-alone psychiatric hospitals though, they all have overnight psychiatrists on-site, and the ones with residents utilize residents for this

 

[Merovinge]

My residency program has frequent 24-hour in-house call shifts, and I couldn't agree more.

Residency applicants, take heed.

Yeash, I did like a dozen across all of my adult training and that seemed reasonable. After each one you felt like you were demonstrably closer to never doing them again. That said, I have since ran into multiple people who choose to work 24 hour shifts in a psych ED, to each their own...

 

[Celexa]

Yeash, I did like a dozen across all of my adult training and that seemed reasonable. After each one you felt like you were demonstrably closer to never doing them again. That said, I have since ran into multiple people who choose to work 24 hour shifts in a psych ED, to each their own...

Yeah I have a residency colleague who chose as their first job out of residency essentially to do two back-to-back 24s in a psych Ed twice a month. Count as a full-time job given the hours. Sounds like absolute hell on Earth to me and there is no amount of money you could give me to do that, but some people think it's great.

 

[Merovinge]

Yeah I have a residency colleague who chose as their first job out of residency essentially to do two back-to-back 24s in a psych Ed twice a month. Count as a full-time job given the hours. Sounds like absolute hell on Earth to me and there is no amount of money you could give me to do that, but some people think it's great.

Yeah I know a mid career doc that would drive around 90 min do 24 on, 24 off at hotel, 24 on, travel back home and do that twice per month. It was odd because he was a full time practicing psychiatrist but not in the city he lived in and spent the bulk of his time at home/doing hobbies.

 

[psychemdoc]

Yeah I know a mid career doc that would drive around 90 min do 24 on, 24 off at hotel, 24 on, travel back home and do that twice per month. It was odd because he was a full time practicing psychiatrist but not in the city he lived in and spent the bulk of his time at home/doing hobbies.

I don’t understand how anyone can do 24 of psych ER. I’m assuming most places that have psych ER have constant demand. You can’t shut your eyes for 2 hours straight any given day. That’s tough to see how anyone at any age would opt for that. Rural ERs for EM docs? Sure I can see that and have. Very doable but not psych ones. Clearly some of these ERs must be very different.