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if 7 on 7off is what you desire, gas may not be the best fit. There certainly are outpatient gigs where you are 7on 7 off, BUT they usually don't pay as well. I do not think anesthesia is moving towards 7 on 7 off model in a foreseeable future (academic or private) unless you know something I don't.
 
7on/7off exists but is relatively uncommon. If income is not a priority, you can job share with another like minded anesthesiologist.
 
coffeenut0 said:
could you give an example of a typical schedule? thanks! 🙂
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I agree with Cali that one week on/off is more rare and would only work in small towns typically. Unless you want to live in a place with without stoplights this wouldnt be likely. But hey some people like that and good for them.
In many states, small towns such as this are incentivized to hire crnas instead of doctors with government kickbacks. This makes it harder to find a job with a schedule like that.
Assuming you want a job supervising CRNAs, The vacation schedule all depends on the number of anesthesiologists in the group. If you can manage to operate with two doctors, you could have three in the group and take every third week off.
The bigger the hospital/more ORs/more trauma/OB/etc, the more doctors are needed.
With more doctors, call gets split between more people but so does vacation time.

With different state laws regarding crna independence, different business setups are possible. All MD(DO) groups are typically much larger groups of docs so call and vacation are split differently. Lots of groups do a blend of supervision and case-sitting for the doctors. If set up right, these groups may also get quite a bit of vacation and take less call (albeit they may have second or third calls which put a damper on making big plans)

I work in a group of four anesthesiologists, mainly supervising, and take every 4th week off and really enjoy that schedule. Unless call intensity is very low, I think it would be hard as a group of three docs to take q2 call for two weeks then get a week off. To each their own.
 
43C53CAE-4FC3-4A74-93CA-9C159544DB46.jpeg
Here’s your competition in small towns
 
coffeenut0 said:
could you give an example of a typical schedule? thanks! 🙂
Click to expand...

Other than the minority of jobs that are GI, outpatient, or "mommy-track" 7-3 type gigs, the world of anesthesia is filled with irregular unpredictable schedules. At most places, some days you get out early, some days you get out late, sometimes you work overnight, sometimes you are on call from home, and sometimes you work on weekends/holidays.

Overall average full time job is probably around 50 hours per week including call and probably on call once per week. But that's just my ballparking an average. Some full time jobs work more like 45 hours a week, some more like 60. Some are on call q3 or q4, some are on call only once or twice a month.
 
coffeenut0 said:
Hi! I'm a final year medical student about to apply for match this cycle. I'm a foreign student who had a relatively brief exposure to IM, outpatient, and Anesthesia through some elective time I had this summer. Absolutely hated outpatient. IM was definitely a lot more interesting to me, and I actually really enjoyed rounding, but I felt that the patient interaction could be a possible turnoff (I saw some attendings who talked to patients a lot, and others less so- so I'm not sure what the norm is). I also really liked my brief exposure to gas as well- the hands on nature of it, and the OR atmosphere as well.


I'm deciding between IM and anesthesia now, and one of my priorities is flexibility. I have a lot of outside interests i genuinely want to focus on and give time to. If i do IM, i could go the hospitalist route and do 7 on 7 off, but im wary of burnout and possible low compensation if i decide to do that.

I really do like gas, and I think it lends itself to less burnout and more compensation, but I hear very mixed things about the schedule. Some say its very flexible, some say its highly unpredictable. I've also heard that it may be moving towards a 7on7off model from some anesthesiologists I talked to (albeit, few). If anyone could shed some light on what kinds of gigs i could get after a gas residency Id be super obliged- thanks!
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Foreign student? Don’t count your chickens.
With that out of the way. If you work for AMC in a relative big town/city, you may find what you need.
From the wisdoms of SDN I’ve learned. Location, compensation and time. You can usually pick two. Just have to prioritize.
 
The other thing I would add is that the 7/7 anesthesia jobs are usually not like 7/7 hospitalist jobs. When hospitalists do their 7days on, it is usually 7x12hr shifts followed by 7 days off. In the small town 7/7 anesthesia jobs, you’re usually on 24/7 for 7 consecutive days followed by 7 days off.
 
Lots of variability. In my market, most jobs are PP. Group contracts to cover the OR schedule, whatever that entails. Some early days, some late days, some overnights, some weekends. Some jobs average 40 hrs/week, some 60. Other places have more shift work, especially outpatient/GI/eyeball centers. Even with limited surgical schedules, somebody has to stay at the surgery center until the last patient leaves, and if they're having pain/nausea/can't pee/etc then you can be stuck there for a minute.

I have a good PP job and don't work a ton of hours/nights/weekends overall, but I still have trouble scheduling anything (appointments, dinner reservations, concert tickets, etc) because of the tremendous unpredictability/variability of the OR schedule. In the same position in our peel-off order, I can swing several hours in either direction, depending on the schedule that day. Late add-on heart? Get out at 6:00 instead of 3:00. C/S called as you're walking out the door? 8:00 instead of 7:00. And there's really no way to "guarantee" you'll be out at a certain time. In the end, you just have to be comfortable missing stuff (soccer games, birthday parties, flights, etc).

now the filpside of all this is making a top 1% income and getting a ton of vacation time. Works for me, but not for everybody. most anesthesia jobs will never have a schedule on the super predictable side of things. in the end, you gotta do you.
 
7 on. 7 off means. Working like my friend 645am-5-6pm daily. 10-20% chance of being called back working 8-10pm potentially for 7 days. Elective cases on Saturday maybe working 7-3pm outside of emergency. Sunday only true emergency

But still “on call” beeper for 24 hours straight for 7 days.

Than get 7 days “off”

These jobs usually pay 360-400k for 26 weeks “on”. 26 weeks “off”

Most people think it’s 7am-7pm for 7 days but it’s not. Being “on call” sucks cause ur mind is different cause u have to be within a 30-45 minutes radius if called back so ideally u want to live close by.

Critical care docs have 7 on. 7 off. But many places have the NP/PAs “nocturnists” in house doing the scut work for them.
 
You should look at EM. It sounds like you want a job that is more hands on than medicine, but more flexible than gas. It’s definitely got its drawbacks, but it’s something that may work for you.
 
I came across a 7 on 7 off job north of Houston a couple of months ago. It was 7-5 everyday plus 24/7 call for the week. I emailed the recruiter that I can do it for 400k. She said the hospital is willing to pay 140k because the work is minimal. I countered with 420k and 7-3 just to piss them off, knowing that I wouldn’t hear back anyways.

My reasoning was that you’re paying me for my time. It doesn’t matter how much or little work there is. It’s not like I can travel or do as I wish even if I’m on call - I still have to be available and responsive.

Anyways.
 
neutro said:
I came across a 7 on 7 off job north of Houston a couple of months ago. It was 7-5 everyday plus 24/7 call for the week. I emailed the recruiter that I can do it for 400k. She said the hospital is willing to pay 140k because the work is minimal. I countered with 420k and 7-3 just to piss them off, knowing that I wouldn’t hear back anyways.

My reasoning was that you’re paying me for my time. It doesn’t matter how much or little work there is. It’s not like I can travel or do as I wish even if I’m on call - I still have to be available and responsive.

Anyways.
Click to expand...

140? They hiring an anesthesiologist or a sedation nurse?
 
neutro said:
I came across a 7 on 7 off job north of Houston a couple of months ago. It was 7-5 everyday plus 24/7 call for the week. I emailed the recruiter that I can do it for 400k. She said the hospital is willing to pay 140k because the work is minimal. I countered with 420k and 7-3 just to piss them off, knowing that I wouldn’t hear back anyways.

My reasoning was that you’re paying me for my time. It doesn’t matter how much or little work there is. It’s not like I can travel or do as I wish even if I’m on call - I still have to be available and responsive.

Anyways.
Click to expand...
400k is about right

My friend is getting 380k for 26 weeks 1099. Small hospital. 1:3 coverage 7-3pm. Than MD in room
Solo to finish the day plus calls beeper from
Home.

That hospital north of Houston won’t be even staffing crna with that low ball offer.
 
neutro said:
I came across a 7 on 7 off job north of Houston a couple of months ago. It was 7-5 everyday plus 24/7 call for the week. I emailed the recruiter that I can do it for 400k. She said the hospital is willing to pay 140k because the work is minimal. I countered with 420k and 7-3 just to piss them off, knowing that I wouldn’t hear back anyways.

My reasoning was that you’re paying me for my time. It doesn’t matter how much or little work there is. It’s not like I can travel or do as I wish even if I’m on call - I still have to be available and responsive.

Anyways.
Click to expand...

15 call days a month for 140k? WTF are these people smoking
 
Thats nothing - so far this takes the cake because they wasted so much of my time and made me fill out a 'pre application':

This is an offer I posted about not too long ago, from a self titled "well reputed" PP in one of the metro TX areas for 300K w/o benefits, with no PTO, 7-5 PM work, back up call one week at a time without "rarely getting called back" (whatever that means), and "eligible for partnership" at 2 years.
No information on compensation years 2 or so. No guarantee on sharing accounting. Wont let me credential with them so I can do a 'working interview' during locums or work on my own time (i even offered 1-2 days without pay). They wouldnt let me talk to my replacement lol.

This kinda garbage makes AMC jobs look a lot more desirable sometimes. Atleast you dont have to deal with these money hungry dinosaurs ripping you off and determining your schedule.

As they say, there is a sucker born every minute. I pity the un-informed soul.
 
neutro said:
No information on compensation years 2 or so. No guarantee on sharing accounting. Wont let me credential with them so I can do a 'working interview' during locums or work on my own time (i even offered 1-2 days without pay). They wouldnt let me talk to my replacement lol.
Click to expand...

Can you explain this part more? Thanks.
 
neutro said:
Thats nothing - so far this takes the cake because they wasted so much of my time and made me fill out a 'pre application':

This is an offer I posted about not too long ago, from a self titled "well reputed" PP in one of the metro TX areas for 300K w/o benefits, with no PTO, 7-5 PM work, back up call one week at a time without "rarely getting called back" (whatever that means), and "eligible for partnership" at 2 years.
No information on compensation years 2 or so. No guarantee on sharing accounting. Wont let me credential with them so I can do a 'working interview' during locums or work on my own time (i even offered 1-2 days without pay). They wouldnt let me talk to my replacement lol.

This kinda garbage makes AMC jobs look a lot more desirable sometimes. Atleast you dont have to deal with these money hungry dinosaurs ripping you off and determining your schedule.

As they say, there is a sucker born every minute. I pity the un-informed soul.
Click to expand...
I almost didn't have the biggest problem considering it didn't sound like it was in-house call until I re-read and saw "no benefits".
 
Twiggidy said:
I almost didn't have the biggest problem considering it didn't sound like it was in-house call until I re-read and saw "no benefits".
Click to expand...
No benefits, no pto, no malpractice.
300.k for 52 weeks without benefits is same category of ‘what are they smoking’ as 140k for 26 weeks. The only difference is that work is longer and the employer is more shady.
 
It’s not just AMCS and hospitals.

People often simply don’t know the market. I interviewed out of residency in a small southern town where partners were making mid 200’s and seemed content, which is great. But they still wanted a 2 year track at 130 and 150k! They admitted having trouble recruiting. I was too young and nice to explain things to them.

I ended up making over $500 my fist year out by taking extra call with an immediate financial parity group. I really wanted to go back and tell those guys that I 4x’d their offer.
 
neutro said:
I don’t know what’s their to explain except they weren’t very transparent.

That’s a red flag.
Click to expand...

Just trying to understand, that you’re working at the site and they won’t give you an interview?
And while you were working there, they won’t let you take another job?
I can see they’re shady with that offer, but just trying to figure out their motivation so I can deal with it effectively in the future.
Thanks.
 
caligas said:
It’s not just AMCS and hospitals.

People often simply don’t know the market. I interviewed out of residency in a small southern town where partners were making mid 200’s and seemed content, which is great. But they still wanted a 2 year track at 130 and 150k! They admitted having trouble recruiting. I was too young and nice to explain things to them.

I ended up making over $500 my fist year out by taking extra call with an immediate financial parity group. I really wanted to go back and tell those guys that I 4x’d their offer.
Click to expand...

I had an interview not long ago, the offer was 5 year partnership. At approximately 1/2 of the market rate. It was blatantly obvious they have a tiered partner structure. AND the ice on the cake at the end was, even when One makes partner, will not have any shares of the company. i.e. i have no voting rights, I just profit share. Sounds great! GFY.
 
IMGASMD said:
Just trying to understand, that you’re working at the site and they won’t give you an interview?
And while you were working there, they won’t let you take another job?
I can see they’re shady with that offer, but just trying to figure out their motivation so I can deal with it effectively in the future.
Thanks.
Click to expand...
Not exactly. I offered to get an idea of the practice by working a few days with them without pay. I asked them I can get credentialed with them so I can do this without signing a contract and if we want, both parties can walk away or sign an official contract. Essentially I offered to be locums without pay to see if this practice would be right for me. IMO That’s the best way to get a feel for the practice without signing up. They out right declined that.
 
neutro said:
Not exactly. I offered to get an idea of the practice by working a few days with them without pay. I asked them I can get credentialed with them so I can do this without signing a contract and if we want, both parties can walk away or sign an official contract. Essentially I offered to be locums without pay to see if this practice would be right for me. IMO That’s the best way to get a feel for the practice without signing up. They out right declined that.
Click to expand...

That's very interesting and I'm surprised more practices don't allow "trial periods" but to play devil's advocate, I bet some practices are worried that the candidate would go on, say, places like SDN and potential bad mouth them. The anonymity plays into the candidates favor. That's just a theory.
 
neutro said:
Not exactly. I offered to get an idea of the practice by working a few days with them without pay. I asked them I can get credentialed with them so I can do this without signing a contract and if we want, both parties can walk away or sign an official contract. Essentially I offered to be locums without pay to see if this practice would be right for me. IMO That’s the best way to get a feel for the practice without signing up. They out right declined that.
Click to expand...


If it’s an open staff, maybe they see you as a threat. You could in theory just start working there taking cases away from them.
 
nimbus said:
If it’s an open staff, maybe they see you as a threat. You could in theory just start working there taking cases away from them.
Click to expand...

I personally think it’s maybe more of the logistic to credential someone just for a few days. Most practice may want to squeeze some work more than a few days from you. That’s why some places will advertise 30-60 day out clause when you’re signing. “At least” both parties can get out with no hard feelings?
 
nimbus said:
If it’s an open staff, maybe they see you as a threat. You could in theory just start working there taking cases away from them.
Click to expand...
Yeah I’m
Going to fly 400 miles and steal their surgeons and cases in 2 days.
 
IMGASMD said:
I personally think it’s maybe more of the logistic to credential someone just for a few days. Most practice may want to squeeze some work more than a few days from you. That’s why some places will advertise 30-60 day out clause when you’re signing. “At least” both parties can get out with no hard feelings?
Click to expand...
I just didn’t think that they were negotiating in the right spirit. I am in no hurry to relocate nor am I desperate for a job as I’m happy with my current position except for location, so I make that clear right off the bat. What they were looking for is a quick decision and replacement because they needed to fill a spot as they were losing business. I said well let’s talk about it and I want to see how much work there is so I can get an idea as to what the compensation should be. They weren’t open to that so I said ok. I just wished I didn’t waste my time on preapplication and talking tonthe recruiter.
 
neutro said:
I just didn’t think that they were negotiating in the right spirit. I am in no hurry to relocate nor am I desperate for a job as I’m happy with my current position except for location, so I make that clear right off the bat. What they were looking for is a quick decision and replacement because they needed to fill a spot as they were losing business. I said well let’s talk about it and I want to see how much work there is so I can get an idea as to what the compensation should be. They weren’t open to that so I said ok. I just wished I didn’t waste my time on preapplication and talking tonthe recruiter.
Click to expand...

There were two AMC jobs which made me fill out their applications. Essentially made me “theirs” and no recruiters can ever claim me.
 
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