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Is it possible to work mostly/primarily days after completing residency? Or will you pretty much need to have some sort of rotating schedule (ie. cycle through days, swing shift, nights...etc)?
Days only/primarily
- Thread starter NRAI2001
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If you find a group that already has nocturnists or you do locums and state you will only work days (will severely limit you): yes.
If you do not find a group that already has nocturnists: no.
If you do not find a group that already has nocturnists: no.
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If you have enough nocturnists as said above it can happen. my group has fallen into the pattern of we all have our shift or two we work so rarely does a day person work a night and even more rare a night person works a day. Although from what I gather from people who work elsewhere it's more common for a rotating schedule.
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Yeah I had two groups that were days only I passed just for a 30 minute shorter commute
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I really get annoyed by this millennial type question. It's like asking "If I wait tables at this restaurant (open 7 days a week), do I have to work weekends?" "If I get this corporate gig, do I have to come in at 8am? (I like sleeping late...)" "Can I get two hour lunch breaks?", etc..
Look, the ER is open 24/7 and someone has to staff it. If you somehow got tricked into entering this specialty not knowing or comprehending the general work schedule then you've only got only yourself to blame. Sure, anything is possible and count your lucky stars if you have one or two nocturnists that can soak up the nights but for the rest....just suck it up and take your night lumps. What...you make several thousand dollars a year and can't work a few nights? I don't care what kind of sleeping disorder or family situation you have personally, trust me....you WILL survive.
Look, the ER is open 24/7 and someone has to staff it. If you somehow got tricked into entering this specialty not knowing or comprehending the general work schedule then you've only got only yourself to blame. Sure, anything is possible and count your lucky stars if you have one or two nocturnists that can soak up the nights but for the rest....just suck it up and take your night lumps. What...you make several thousand dollars a year and can't work a few nights? I don't care what kind of sleeping disorder or family situation you have personally, trust me....you WILL survive.
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You'll find as many EM jobs like this, as you'll find jobs for surgeons that don't require operating on people.
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Depending where you are in your career you won’t be as good if you don’t work at night in my opinion. The pathology and being more on your own is invaluable early on.
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I agree and disagree. I agree that you should only go into EM if you are OK with working an odd schedule (evenings, nights, weekends, and holidays). However, I disagree with "you WILL survive." Yes, you will survive, but the question is: will you thrive? More specifically, it behooves medical students to carefully consider whether or not they want to work this odd schedule when they are much older... You can go into any number of medical specialties and have a more or less regular schedule.
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Yes EDs are open 24/7..
I was just wondering what the job markets are like out there. Obviously you will take a pay cut and limit where you can work if this is a strict limit for yourself. I m just wondering... for me personally I wouldn't mind doing a few nights a month (which seems like what most EM docs end up doing in private practice).
The ED at the hospital I work at now there are a few docs that only do nights so it lightens the load for the docs that prefer days. I believe the day docs end up doing about 3-4 night shifts a month.. which really isn't that bad imho. Or if you do something like you do an entire week of nights every month or two... and everyone takes their turns doing nights.
It seems like at some of the smaller EDs its more possible to strictly do days bc the staffing numbers they need are much lower.
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"Hello darkness my old friend..."
I would die if I had to wake up in the morning and go to work. To each their own. I'm perfectly happy working all nights.
I would die if I had to wake up in the morning and go to work. To each their own. I'm perfectly happy working all nights.
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Well, you're going to die earlier working only nights, anyhow (no judgment - I worked 100 nights in 2011 in Hawai'i, and I had the world by the ass).
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On the contrary, at a smaller ED (i.e. single coverage, lower volume), if they do 12 hour shifts, 50% of the shifts are nights.
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U could just work per diem. U pick ur schedule. Find a wife that has benefits. Get paid more. I’m doing that now while in fellowship works out nicely.
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Long hours and hard work shouldn't be a shock to someone who went into medicine, no? I mean, what specialties have a 9-5 schedule other than primary care specialties? (I know some GP's that work a hell of a lot more hours/week than I do for less than half the pay.) Rads? Derm? Heme/Onc? It's sure not going to be any of the surgical specialties. It won't be anesthesia or even neurology. I would go so far as to say that the medical specialties that are predictably 9-5 and low stress are in the minority. If someone wanted low stress and predictable hours, they should have gone into dentistry. I just find all the belly aching (in general, not you personally...) humorous when you start comparing hours and call schedule to other specialties (especially surgery). Our surgical colleagues work exceedingly more hours and more nights than we work. I mean, think about it... 12-14 shifts/mo on average for FT status where most of us work. 130-140 hours per month. That's 33-35 hours per week. I can tell you that in my career before medicine, I consistently worked much more than that and routinely had to work late and on the weekends. We've got it pretty damn good in medicine and especially in EM. I count my lucky stars that I'm able to work as little as I do (though I currently work a lot) and still make bank...enjoying what I do, no less.
But hey, if someone really really hates nights. There are plenty of solutions. Cough up enough differential among the day docs to pay for a full time nocturnist. Someone will do it for the right price. The usual problem? (Including my current group.) Everyone is always very excited and supportive to hire a nocturnist....until they are asked to contribute towards a differential. "Wait, it's gonna cost me how much again? Hmm, you know guys...maybe 3-4 nights/mo isn't so bad. Let's revisit this next year..." 😀
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Millennial type question? The newbies in my group work the nights and the senior partners only work days. Each group is different. Most don't like nights. I'm averaging 6-10 nights/month right now and look forward to the day at which I don't have to do as many as I am currently.
Yes being a true nocturnist or nights preference person will DEFINITELY make you more marketable. It can help you break into a group that is otherwise "full" or not looking to hire. It can definitely help you get a job in a tight market. In the two groups I work for the true nocturnists definitely get some schedule privileges. Generally speaking as long as it's nights they can pick their shifts. In one group, one partner (who is a strict nocturnist) ALWAYS works Monday through Wednesday night, every weekend is a 4 day weekend! Another partner in a different group gets to pick his vacation blocks before everyone else. There are probably some "fringe" benefits to being a nocturnist in general as every group is loathe to lose a nocturnist (and everyone else has more nights again).
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I currently work 8 days and 4 evenings a month. Later this year that will be 5 days and 3 evenings. It's entirely possible. Bear in mind I'm paying/leaving behind a great deal of money for this schedule. Basically, last month I worked 12 shifts and was paid for the equivalent of 11.5. A guy working all nights worked 15 and was paid for 18.5 shifts.
If you set up a market based system in your group, most docs are VERY open to the option to trade undesirable shifts for money. There are no losers in this system. It's beyond me why every group isn't set up this way.
If you set up a market based system in your group, most docs are VERY open to the option to trade undesirable shifts for money. There are no losers in this system. It's beyond me why every group isn't set up this way.
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I actually agree with that. Just like I think you shouldn't start your career working part-time. I think it's a good idea to work both full time and all shifts for the first 5 years out of residency. We make our pre-partners work all shifts (they can't do all nights even if they want to) and then once they make partner they can pick their mix. If too many people want days (or nights) we adjust the differential.
To answer the original posters question: yes it is possible; however, it will come with a big "catch." Early in your career, it will usually result in a tremendous pay cut (i.e. you will have to "sell" your night shifts to your partners) or greatly limit where you can practice (undesirable markets, undesirable groups/hospitals, etc.) or you will have to wait until you are older.
Some groups have partners as they age working fewer and fewer nights. The flip side of that is that if you want to join a group where you will have fewer/no nights later in your career, you will ironically have to work MORE nights earlier in your career to subsidize your senior partners' nights deficit.
I do agree with other posters, working nights for the most part is a fact of emergency medicine, and really a fact of most medical careers accounting for being on call. If working after 5pm is intensely undesirable to you, a career outside of healthcare may be a better choice.
The whole quoted 33-35hrs is misleading. You have shift disruption (day off my ass), you do not get paid vacation (often in the neighborhood of 4-8hrs/week when you include holidays. Lastly birdstrikes rule of 1.5xhrs.
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Unless you have a bad scheduler you shouldn't be doing rough swings also EM sucks but everything else is suckier. You can get a masters degree and end up making 60k in Cali working 60hrs a week.
