How exhausting is your typical call night in your group?


  • Total voters
    21

Bingo84

2+ Year Member
Jul 23, 2016
11
1
hello everyone,
I am a fourth year and deciding between anesthesia and IM. I'm a mom and don't know a single real world attending to ask my questions and I'm not sure the info from my mentors in academics is entirely correct.

Like >99% of moms in medicine, I am concerned about possibly going into a specialty with little flexibility in terms of hours. From what I understand, finding jobs with little call/weekends is harder to come by these days--and if you do find these jobs you may be losing your skills. So I'm gearing up for the possibility of working ~55-60 hrs/week as an attending. Correct me if I'm wrong but it is my understanding that it would be somewhat more difficult to join a group and earn decent money (>$200k) without taking a moderate amount of call.

What worries me about the lifestyle of anesthesia is having little option to not take call in the case that it is unsustainable for my family and I. (I'm the type of person who regularly needs >6 hrs sleep). To me, if call was a light duty job then I feel like I could handle it. If call is typically more the pace of working a shift in the ED then I think anesthesia is not the specialty for me.

I know jobs vary in the non-academic world, but I'm trying to get a glimpse of the typical call in anesthesia. So tell me how it is! Are you exhausted after a night of call?

Also, any comments on the typical amount calls per month would be helpful.
 
  • Like
Reactions: sancus3

SaltyDog

Perpetual Try-Hard Snarky B*tch
10+ Year Member
Aug 10, 2007
3,910
6,937
Closer to Mexico
Status
Attending Physician
That's a fairly unanswerable question because it's so extremely variable. There are all sorts of jobs out there from high stress busy call jobs to no-call no-weekend mommy-track jobs and everything in between. Even in my practice I have some brutal calls and others where I sleep all night. If you are flexible (geographically) you can find an anesthesia job that suits your situation. Do what you like.
 

Ezekiel2517

Anesthesiologist
10+ Year Member
Jan 21, 2005
634
580
CA
Status
Attending Physician
There is a lot of flexibility in PP, but it depends on the group and what type of facilities they cover. There are people in my group who do nothing but surgicenter and GI and never take call or work on weekends and make >300k.
 
  • Like
Reactions: nimbus
OP
B

Bingo84

2+ Year Member
Jul 23, 2016
11
1
I assumed that those types of jobs were kind of disappearing but that could just be according to these types of forums so now I don't know what to believe. I guess the other thing I'm worried about is working in that type of setting for a few years and losing my skills and have a tough job getting hired in other types of settings. Correct me if This isn't an issue.

For those who work in pp and rarely do your own cases, do you feel like you are just as competent as when you graduated from residency? Someone once told me the best anesthesiologist is the one on their last day of residency. This also makes me nervous about going into anesthesia.
 

Random Anesthesiologist

Random Anesthesiologist
10+ Year Member
Mar 16, 2008
1,543
304
There are no to little call jobs out there. But you will be taking a lot of call during residency. If you want to know more about motherhood and anesthesiology, PM me.
 

GravelRider

SDN Lifetime Donor
Lifetime Donor
5+ Year Member
Sep 30, 2014
1,910
2,644
Status
Attending Physician
Internal Medicine gives you WAY more options going forward in terms of career flexibility. If that is your main concern, I would choose IM. Only do anesthesia if you love anesthesia. I did both residencies and while I prefer practicing anesthesia, IM gives you many more options.
 

rakotomazoto

ASA Member
10+ Year Member
Aug 25, 2009
318
291
Southern California
Status
Attending Physician
I agree with figuring out which one is more interesting and satisfying to you because I would rather be on call overnight doing anesthesia (like I am doing right now) than IM from 9-5. But my perspective is extremely limited, I am only a CA-2. The excitement and intellectual curiosity wanes, I can already see an evolution in how I view call from when I was a med student until now. Even the most exciting things become routine with repetition and in my opinion, you are wise to consider the potential schedule that you will be stuck with once it all becomes just another day at the office.

The other factor is that you are trying to predict the future job market based on what is happening today, so in the end you are making a big decision with limited and imperfect data, as you often have to do in clinical situations. I agree that IM is a safer gamble in the sense that mid-level creep is not as huge a factor and you can branch out into so many areas from your IM residency, which is only 3 years instead of 4 for anesthesiology.

I chose anesthesiology because I truly felt it was the best fit for my personality and skills and decided I would accept the consequences of that decision, even if the specialty crashes and burns as people on this message board and elsewhere have been predicting for decades now.

Good luck making your decision! As painful as it would be, you can always switch from one to the other if you head down one path and realize at some point that it's not your cup of tea. Even if you did both, you would be no further behind than someone who wanted to do neurosurgery as far as years spent in training.
 

Planktonmd

Moderator Emeritus
Lifetime Donor
10+ Year Member
Nov 2, 2006
7,027
2,207
The South
Status
Attending Physician
I appreciate your honesty in describing your situation and your expectations.
While anesthesiology is notoriously known as a "life style" specialty, most practicing anesthesiologists would disagree with that categorization.
This is a high stress, high liability, low recognition specialty. You can certainly find a job at a surgicenter with good hours, no call, and reasonable compensation, but that job is nothing but an over qualified CRNA job.
And after a few years of doing such job your skills would have eroded to the point that you can't really hold a real anesthesiologist job, you basically become a super CRNA.
If being a super nurse does not bother you then anesthesia is what you should do!
 
  • Like
Reactions: nimbus and FFP

Ezekiel2517

Anesthesiologist
10+ Year Member
Jan 21, 2005
634
580
CA
Status
Attending Physician
I assumed that those types of jobs were kind of disappearing but that could just be according to these types of forums so now I don't know what to believe. I guess the other thing I'm worried about is working in that type of setting for a few years and losing my skills and have a tough job getting hired in other types of settings. Correct me if This isn't an issue.

For those who work in pp and rarely do your own cases, do you feel like you are just as competent as when you graduated from residency? Someone once told me the best anesthesiologist is the one on their last day of residency. This also makes me nervous about going into anesthesia.
Those jobs will always exist as long as those facilities continue to exist and they need us. Unless you do GI everyday, I wouldn't be too worried about losing skills. You still have to use your skills in a surgicenter setting and you have to be very efficient. Obviously you may become a little rusty with lines or epidurals but it doesn't take long to get sharp with those again. As far as saying that the best anesthesiologist is the one on the last day of residency, that is laughable. You are nowhere close to being as good as you can be when you graduate. I went from training to doing all my own cases and the learning curve in the first 3-6 months is as steep as any period during residency.
 
OP
B

Bingo84

2+ Year Member
Jul 23, 2016
11
1
Thanks for the replies! It seems the consensus is that Mon-Friday jobs are feasible but there are downsides (losing a bit of skills and obviously pay). This is somewhat encouraging as I had the impression that the vast majority of these jobs had been swallowed up by CRNAs.
Working in this type of setting would by no means be a dream job for me, but it's nice to know that the option would exist if I need to step back a little for awhile for my family.
 

FFP

Just another jerk
Gold Donor
10+ Year Member
Oct 17, 2007
7,602
7,835
Status
Attending Physician
If you are not 100% convinced about and committed to anesthesia, do yourself a favor and get into a good academic IM program. Having a strong patient-doctor relationship is priceless; otherwise you're just a mercenary, the cheaper the better.
 

Nivens

Cog in the Machine
5+ Year Member
Dec 5, 2012
425
436
Leafcull
Status
Fellow [Any Field]
I've enjoyed my first few weeks of CA-1, but I miss my doctor-patient relationships. This completely took me by surprise, as I went in to anesthesia because I thought I wanted to something akin to a physician-engineer (a more objective data-driven daily practice), and discovered during my internal medicine intern year that the best part of being a doctor is interacting with the patients. I do post-op checks now and the patients, despite being thrilled with their anesthesia, don't remember me at all. Really think about this stuff before you choose!
 

bashwell

5+ Year Member
Mar 20, 2013
1,934
1,948
Status
Resident [Any Field]
I've enjoyed my first few weeks of CA-1, but I miss my doctor-patient relationships. This completely took me by surprise, as I went in to anesthesia because I thought I wanted to something akin to a physician-engineer (a more objective data-driven daily practice), and discovered during my internal medicine intern year that the best part of being a doctor is interacting with the patients. I do post-op checks now and the patients, despite being thrilled with their anesthesia, don't remember me at all. Really think about this stuff before you choose!
In general I really like interacting with patients too (e.g., the conversations, the expressed gratitude), but sometimes it can get exhausting for me, and then I long for some peace and quiet. But maybe it's my introverted nature. I suppose for extroverts this wouldn't be a problem.
 

Nivens

Cog in the Machine
5+ Year Member
Dec 5, 2012
425
436
Leafcull
Status
Fellow [Any Field]
In general I really like interacting with patients too (e.g., the conversations, the expressed gratitude), but sometimes it can get exhausting for me, and then I long for some peace and quiet. But maybe it's my introverted nature. I suppose for extroverts this wouldn't be a problem.
I'm a very extroverted guy with midwestern parents (both salespeople) who strikes up conversation with random people in checkout lines in grocery stores. I should have seen this coming...
 
OP
B

Bingo84

2+ Year Member
Jul 23, 2016
11
1
Question: this may be kind of dumb, but they just don't teach us this lingo.
When someone says they work 60 hrs/week with home call Q7....if they only come in for only 3 hours during the night do they include only those 3 hours in the 60 hours/week or the entirety of their call (aka 24 hrs)?
 

nolagas

Member
15+ Year Member
Aug 13, 2004
1,305
647
Status
Thanks for the replies! It seems the consensus is that Mon-Friday jobs are feasible but there are downsides (losing a bit of skills and obviously pay). This is somewhat encouraging as I had the impression that the vast majority of these jobs had been swallowed up by CRNAs.
Working in this type of setting would by no means be a dream job for me, but it's nice to know that the option would exist if I need to step back a little for awhile for my family.
There are M-F jobs where you won't lose your skills too. I had a 7-5 job with cardiac, peds, ob, regional, neuro, etc. and it paid pretty well. I don't know how common a job like that is but I bet lots of groups would let you do the biggest cases all day and take little call if the price is right.
 

Arch Guillotti

Senior Member
Staff member
Administrator
Lifetime Donor
15+ Year Member
Aug 8, 2001
7,741
1,546
Status
Attending Physician
Question: this may be kind of dumb, but they just don't teach us this lingo.
When someone says they work 60 hrs/week with home call Q7....if they only come in for only 3 hours during the night do they include only those 3 hours in the 60 hours/week or the entirety of their call (aka 24 hrs)?
I would include the whole 24 in the 60 hour a week estimate.
 

pjl

ASA Member
10+ Year Member
Oct 29, 2006
920
509
Status
Attending Physician
I would include the whole 24 in the 60 hour a week estimate.
In that case, I "worked" 114 hours last week. In hospital ~58. But that was my 3 on call shifts and one of my 3 backup call shifts for the month.
Counting hours is weird.


Sent from my iPad using SDN mobile app
 

FFP

Just another jerk
Gold Donor
10+ Year Member
Oct 17, 2007
7,602
7,835
Status
Attending Physician
@bashwell , no offense, either put on your Student status,I r stop giving advice.
I'm a very extroverted guy with midwestern parents (both salespeople) who strikes up conversation with random people in checkout lines in grocery stores. I should have seen this coming...
You will be highly popular with surgeons and OR people. Keep talking.
 
OP
B

Bingo84

2+ Year Member
Jul 23, 2016
11
1
In that case, I "worked" 114 hours last week. In hospital ~58. But that was my 3 on call shifts and one of my 3 backup call shifts for the month.
Counting hours is weird.


Sent from my iPad using SDN mobile app
How many of your 58 hours were after midnight? Also, is this a typical average weekly hours for full time anesthesiologists in your experience?

I'm just trying to get a better idea of what I'm getting myself into before I jump in. I believe salaries for new grads are say $325,000 (I know I know...probably going down). Is this for a ~60 hour work week?
 

FFP

Just another jerk
Gold Donor
10+ Year Member
Oct 17, 2007
7,602
7,835
Status
Attending Physician
@FFP I'm not giving advice to anyone here! I'm just stating how I personally feel about interacting with patients (as an introvert). Please re-read what I wrote above.
Shoot, sorry. I didn't want to post that. Grrrrrr! :oops:

Anyway, since the cat is out of the bag, what I meant is that people could misjudge you for an attending, because you tend to speak as if from your experience as an anesthesiologist.
 
Last edited:
  • Like
Reactions: bashwell

bashwell

5+ Year Member
Mar 20, 2013
1,934
1,948
Status
Resident [Any Field]
Shoot, sorry. I didn't want to post that. Grrrrrr! :oops:

Anyway, since the cat is out of the bag, what I meant is that, in many threads, people could misjudge you for an attending, because you tend to speak as if from experience as an anesthesiologist.
Thanks @FFP :)

Honestly I don't mean to speak as if I'm an experienced anesthesiologist, definitely not my intention! Maybe I'm too sloppy with my words or tone, maybe I'm treating my time on SDN too casually, maybe I say stuff that I believe is jokey but obviously doesn't come across that way to people, maybe I have a socially awkward sense of humour (I am a former computer science major after all!), etc., but again I definitely don't mean to give people the wrong impression about myself. I have to admit I have been lazy about changing my status, but I changed it, so hopefully it's clearer now. I'll be an intern very soon however so I'll have to change it again in a few months, but knowing me I'll probably be lazy again and not doing anything about it for a while. :)
 
  • Like
Reactions: FFP

pjl

ASA Member
10+ Year Member
Oct 29, 2006
920
509
Status
Attending Physician
How many of your 58 hours were after midnight? Also, is this a typical average weekly hours for full time anesthesiologists in your experience?

I'm just trying to get a better idea of what I'm getting myself into before I jump in. I believe salaries for new grads are say $325,000 (I know I know...probably going down). Is this for a ~60 hour work week?
It depends on the week. 55-60 hours is my average overall, but again it depends how you count call.
When I tracked it a while ago, on call I averaged 6 hours out of my house between 1900 and 0700. But this is highly dependent on the job.

Just remember, a CRNA working 40 hours a week makes ~185 with 6 weeks off. Low stress, zero preops, no followup, someone to back them up if there is any instability or "confusing stuff" going on. So if they get 1.5x for overtime, at 60 hours a week it is ~310. MDs should be higher than that, and if you are not, you need to evaluate the job offer and negotiate more. I dont expect that MD salaries will drop below CRNA pay, but MDs need to understand what they are worth.

I would rather sit in a room than run my butt off supervising for the same pay.


Sent from my iPad using SDN mobile app
 
Last edited:

FFP

Just another jerk
Gold Donor
10+ Year Member
Oct 17, 2007
7,602
7,835
Status
Attending Physician
@pjl, MDs understand. It's just that, in certain markets, MDs have two choices: the employer's way or the highway. Especially generalists, or people who don't bring any special needed expertise to the table.

And, supposedly, we are not in a recession, meaning it's as good as it gets.
 

pjl

ASA Member
10+ Year Member
Oct 29, 2006
920
509
Status
Attending Physician
@pjl, MDs understand. It's just that, in certain markets, MDs have two choices: the employer's way or the highway. Especially generalists, or people who don't bring any special needed expertise to the table.

And, supposedly, we are not in a recession, meaning it's as good as it gets.
Moving is an option that some choose not to take.

I would agree that salaries and overall job prospects are down in general, despite increased average per MGMA. I just want to make sure new grads do the math for themselves, and dont read all the doom and gloom on here to mean they have to accept really crap jobs.


Sent from my iPad using SDN mobile app
 

GravelRider

SDN Lifetime Donor
Lifetime Donor
5+ Year Member
Sep 30, 2014
1,910
2,644
Status
Attending Physician
Moving is an option that some choose not to take.
Moving is not an option for a lot of people. Is our whole identity our job? Do family and friends not matter anymore? There are other ways to fight this [email protected] system beyond moving to some backwoods locale where you don't know anyone.
 
  • Like
Reactions: FFP

pjl

ASA Member
10+ Year Member
Oct 29, 2006
920
509
Status
Attending Physician
Moving is not an option for a lot of people. Is our whole identity our job? Do family and friends not matter anymore? There are other ways to fight this [email protected] system beyond moving to some backwoods locale where you don't know anyone.
Discuss these thoughts with those in other industries. Your upward trajectory is limited at the point where you stop being willing to move. That is the decision that must be made by each person. For some, nearby family is worth more, for others, the "right" job.
Moving is ALWAYS an option, just not one that you may choose.


Sent from my iPad using SDN mobile app
 

BobBarker

Member
10+ Year Member
Dec 13, 2005
3,046
1,063
Status
Attending Physician
Always remember that you can do pain, have your own clinic, and never work overnight/weekends/holidays.
 

GravelRider

SDN Lifetime Donor
Lifetime Donor
5+ Year Member
Sep 30, 2014
1,910
2,644
Status
Attending Physician
Discuss these thoughts with those in other industries. Your upward trajectory is limited at the point where you stop being willing to move. That is the decision that must be made by each person. For some, nearby family is worth more, for others, the "right" job.
Moving is ALWAYS an option, just not one that you may choose.


Sent from my iPad using SDN mobile app
Becoming less and less the case in this connected world. Aside from certain blue collar industries and super specialized industries where the earning power is much higher than medicine, this is not necessarily the case anymore.