Do weekends exist in military medicine?

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adamg

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I just realized that I have forgotten to ask this question for sometime and I have mean to.

If you are in military medicine, do weekends exist or do you work 7 days/week?

I hope that not the case because then only the holidays and leave would allow for any R&R and without that burnouts seem unavoidable.

Anyone in active duty mil med that can answer this question?
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Weekends don't exist for doctors, particularly emergency doctors and those with call responsibilities for emergency departments. This includes internists, pediatricians, obstetricians, gynecologists, general surgeons, surgical subspecialists, medical subspecialists. Anesthesia and radiology usually has some call responsibilities as well.

Maybe you need to rethink not just military medicine, but medicine in general. I remember being enlightened by an MSIV I interviewed for medical school with. He asked me how many hours I thought I'd work as a med student, resident and as an attending level physician. I said something to the effect of 50/week. He laughed.

As an MS3 I worked 40-125, as a resident I worked 60-85, and as a military emergency doc (fewer hours than most specialties) I work 40-55 MOST of which are evenings, nights, weekends, and holidays. Less than 1/3 of my shifts are during bankers hours. I haven't had Thanksgiving AND Christmas off since I was an MSII.

Sometimes they don't let you take leave either. But for the most part, a staff-level military doc works less than his civilian counterpart (because it doesn't pay to work more.)
 
so doctors are basically most busy when others are off duty and vica versa?

Meaning that sick folks wait till the weekends or at night to come in for treatment and so our off duty hours are the reverse of the 9-5 work day?

We sleep while others work, and work while others sleep, is that about it?
 
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adamg said:
so doctors are basically most busy when others are off duty and vica versa?

Meaning that sick folks wait till the weekends or at night to come in for treatment and so our off duty hours are the reverse of the 9-5 work day?

We sleep while others work, and work while others sleep, is that about it?
Click to expand...
It depends on what you want to do. Med school will require alot of time, if you care about learning. The same goes for residency. If you want a more stable 9-5 job, you can have it. Here are some tips for you if you enjoy primary care:
1. Work in a clinic or practice with about 5 or more other physicians. That way your weekend and evening call schedule can be quite nice. (Of course this will be much harder to do during your time in the military, you and your fellow docs might have to fight deployment schedules)
2. Stay away from the hospital.
3. Stay away from the ED. Shiftwork is great, and your pager only goes off when your spouse needs you to pick up milk on the way home. However, as ActvDtyMD pointed out only 1/3 of your schedule is during typical work hours.
 
Heh, I still remember a conversation with a bunch of my fellow interns a couple of months ago where we were all wistfully dreaming about an upcoming elective month - ah, the luxurious lifestyle of the 40-hour work week.

But yeah, get ready for many stretches like the below, especially in internship:

Day 1
430-5 AM: Wake up.

530 - Arrive at hospital, see patients for pre-rounding.

7 - receive new patients, go over old ones with senior resident.

8 - Morning conference.

9 - Round with attending.

Noon - Lunch at noon conference.

1230 - 5 - Various patient care stuff.

During call days, you will be admitting patients throughout the day and then overnight as well. You will be sleeping in the hospital overnight, getting maybe 2-4 hours sleep if you're lucky. In the meantime you will be paged at all hours for various issues, ranging from chest pain to constipation depending on your nursing staff. Then in the morning you start the whole thing over again, hopefully leaving the hospital by early afternoon. Rinse, lather, repeat about 5-7 times a month.
 
Whatever how many people have lived through it before you? That's what has kept me going from premed til now...

Stuff isn't so bad once you get over yourself. Watch your nutrition, sleep, and work out when you can.

3rd year is gonna be rough, but I know a ton of docs that must have made it through... many of which I'd judge would snap long before me... Like anything else, it's just using inertia to get into the swing of things.

If it's family that you're worried about, becoming partner in a group practice is where it's at...

Best of luck.
 
MaximusD said:
Whatever how many people have lived through it before you? That's what has kept me going from premed til now...

Stuff isn't so bad once you get over yourself. Watch your nutrition, sleep, and work out when you can.

3rd year is gonna be rough, but I know a ton of docs that must have made it through... many of which I'd judge would snap long before me... Like anything else, it's just using inertia to get into the swing of things.

If it's family that you're worried about, becoming partner in a group practice is where it's at...

Best of luck.
Click to expand...

:laugh:

Seriously, 3rd/4th year were the best years I can remember. You get exposure to many different specialties where your only responsibility is to learn. It seemed like 1st/2nd year was trying to stay motivated until I could actually start seeing patients.

(However, word of advice for you MaximusD...Avoid rotating with Kornberg during your 3rd year Cards rotation. Seriously, being up by 0230, starting pre-rounds at 0330, and rounds at 0500 was not fun at all.
 
sethco said:
:laugh:

Seriously, 3rd/4th year were the best years I can remember. You get exposure to many different specialties where your only responsibility is to learn. It seemed like 1st/2nd year was trying to stay motivated until I could actually start seeing patients.

(However, word of advice for you MaximusD...Avoid rotating with Kornberg during your 3rd year Cards rotation. Seriously, being up by 0230, starting pre-rounds at 0330, and rounds at 0500 was not fun at all.
Click to expand...

Thanks... yeah Kornberg's a ball buster.

I know personally I'll like 3rd and 4th year better in the end, but I'm told 3rd year can be flat-out exhausting.
 
adamg said:
I just realized that I have forgotten to ask this question for sometime and I have mean to.

If you are in military medicine, do weekends exist or do you work 7 days/week?

I hope that not the case because then only the holidays and leave would allow for any R&R and without that burnouts seem unavoidable.

Anyone in active duty mil med that can answer this question?
Click to expand...

Some specialities have every single weekend off and essentially 8-5 jobs add to that your 30 days of paid leave/yr, and some training holidays (another 4-5 days/yr). Even those who get slammed in the outpatient world i.e. FP, IM, OB, have call schedules so when they are off, they are off (exception being OB if they have private patient's they want to deliver). Surgeons likewise work weekends in proportion to the number of colleagues taking call. ER docs have set schedules (shift work) so when they are off they are off. Usually they work 4, at most 5, 12 hours shifts/wk.

They docs who get a raw deal are those in single doctor shops like Nephrology, Rheumatology, who essentially end up carrying a pager 24/7, just like many civilian private practice physicians.
 
Tired said:
Worst deal I've heard of is my former ICU fellow, who is now the sole attending staff in the ICU at one of the NMCs. He is always on-call, and responsible for the ICU patients 24hrs/day.
Click to expand...
Anchors away my boy!
 
a1qwerty55 said:
They docs who get a raw deal are those in single doctor shops like Nephrology, Rheumatology, who essentially end up carrying a pager 24/7, just like many civilian private practice physicians.
Click to expand...

While it sucks to be on call 24/7, you have to keep in mind that some specialties are so rarely called that it isn't too big of a deal. I mean, Rheum? Who consults Rheum emergently?

I feel worse for radiologists in a two-doc shop. When one deploys, or takes leave, or goes TDY, you're screwed. Every CT, every US, every radiologic procedure etc etc etc. Now that's a 24/7 job.
 
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http://www.thefreedictionary.com/homonym
hom·o·nym (hm-nm, hm-)
n.
1. One of two or more words that have the same sound and often the same spelling but differ in meaning, such as bank (embankment) and bank (place where money is kept).
2.
a. A word used to designate several different things.
b. A namesake.

vs.

http://www.thefreedictionary.com/homophone
hom·o·phone (hm-fn, hm-)
n.
One of two or more words, such as night and knight, that are pronounced the same but differ in meaning, origin, and sometimes spelling.

Classic SDN. Chastizing someone for bad grammar then doing it yourself 😀
 
MaximusD said:
http://www.thefreedictionary.com/homonym
hom·o·nym (hm-nm, hm-)
n.
1. One of two or more words that have the same sound and often the same spelling but differ in meaning, such as bank (embankment) and bank (place where money is kept).
2.
a. A word used to designate several different things.
b. A namesake.

vs.

http://www.thefreedictionary.com/homophone
hom·o·phone (hm-fn, hm-)
n.
One of two or more words, such as night and knight, that are pronounced the same but differ in meaning, origin, and sometimes spelling.

Classic SDN. Chastizing someone for bad grammar then doing it yourself 😀
Click to expand...

Alright, since you went there: Isn't a homophone a specific type of homonym? 😉
 
Since we're completely hijacking this thread with our debate, I thought I'd share a bit from one of my favorite movies:

Dr. Evil: I like to see girls of that... caliber.
[pause]
Dr. Evil: By "caliber," of course, I refer to both the size of their gun barrels and the high quality of their characters... Two meanings... caliber... it's a homonym... Forget it.
 
Tired said:
Dude, remember the policy is "Don't Ask, Don't Tell".
Click to expand...

Do I sense a heterographic homophobe? :laugh: There is nothing wrong with a straight man who enjoys the finer details of the English language. I'll prove it: "To whom do those beautiful breasts, upon which I would love to rest my head, belong?"

Ok, that's enough thread jacking for one day.
 
MaximusD said:
I'm glad to see that this thread has degraded nicely due to the fact that i'm a *****.
Click to expand...

Glad to help in any way I can.

By the way, to get back to the original topic... weekends anywhere in medicine are hard to come by. Weekends in the military are hard to come by. Combine the two, and you're pretty much hosed.

Today I talked to one of my buddies who is still in (and counting down) and got called in both Saturday and Sunday.
 
BomberDoc said:
Glad to help in any way I can.

By the way, to get back to the original topic... weekends anywhere in medicine are hard to come by. Weekends in the military are hard to come by. Combine the two, and you're pretty much hosed.

Today I talked to one of my buddies who is still in (and counting down) and got called in both Saturday and Sunday.
Click to expand...

Yeah, but guys, it really totally depends on your choice of specialty above all else. As a pathology resident, I usually get all of my weekends off, unless I'm on call (which is only 8 weeks a year). Granted, I don't know as much about pathology in the military, but I'd bet they're not working 7 days a week.
 
ActiveDutyMD said:
Weekends don't exist for doctors, particularly emergency doctors and those with call responsibilities for emergency departments. This includes internists, pediatricians, obstetricians, gynecologists, general surgeons, surgical subspecialists, medical subspecialists. Anesthesia and radiology usually has some call responsibilities as well.

Maybe you need to rethink not just military medicine, but medicine in general. I remember being enlightened by an MSIV I interviewed for medical school with. He asked me how many hours I thought I'd work as a med student, resident and as an attending level physician. I said something to the effect of 50/week. He laughed.

As an MS3 I worked 40-125, as a resident I worked 60-85, and as a military emergency doc (fewer hours than most specialties) I work 40-55 MOST of which are evenings, nights, weekends, and holidays. Less than 1/3 of my shifts are during bankers hours. I haven't had Thanksgiving AND Christmas off since I was an MSII.

Sometimes they don't let you take leave either. But for the most part, a staff-level military doc works less than his civilian counterpart (because it doesn't pay to work more.)
Click to expand...

Does it mean that as a military EM attending (assuming you work about as much as a resident) you can have 15 12hr shifts per month? So can you basically work 7days straight and then have 7days off without using any leave time? btw, civilian EM docs normally work <15 12hr shifts. so it's not true that they work more.
 
a1qwerty55 said:
Some specialities have every single weekend off and essentially 8-5 jobs add to that your 30 days of paid leave/yr, and some training holidays (another 4-5 days/yr). Even those who get slammed in the outpatient world i.e. FP, IM, OB, have call schedules so when they are off, they are off (exception being OB if they have private patient's they want to deliver). Surgeons likewise work weekends in proportion to the number of colleagues taking call. ER docs have set schedules (shift work) so when they are off they are off. Usually they work 4, at most 5, 12 hours shifts/wk.

They docs who get a raw deal are those in single doctor shops like Nephrology, Rheumatology, who essentially end up carrying a pager 24/7, just like many civilian private practice physicians.
Click to expand...

4-5 12hr shifts/wk?? thats like 18days/month. civilian attendings may have only 12 12hr shifts/month.
 
Where I'm at, the ER docs are doing 9-12 twelve hour shifts per month depending on TAD/deployments, and not counting moonlighting. And not counting collateral duties. Doing more than a few 12 hour shifts in a row is pretty brutal if you're in a busy ED.
 
Yellowstone said:
Where I'm at, the ER docs are doing 9-12 twelve hour shifts per month depending on TAD/deployments, and not counting moonlighting. And not counting collateral duties. Doing more than a few 12 hour shifts in a row is pretty brutal if you're in a busy ED.
Click to expand...
wow thanks. How come there is such a large disparity between hospitals? Are there EM physicians in Spain or in Greece?
 
If you are in a Navy FS/GMO billet, you have weekends off for the most part, unless your unit is deployed or on a field exercise/boat exercise.

Obviously, i can't speak for those people who are in deeper (finished residency), but as much as my work is Boring with a capital B, I barely scrape the 40-hour mark, and I am at work more than any of the other FS providers I work with.

The operational units cut out every day at 1600, have 3x/week PT sessions that count as work, etc. Friday afternoon after 1500, good luck finding anyone on my base. They're just not around, except me, because medical can't close for PT or other military functions.
 
I'm sure your question has been answered plenty by now (in addition to other random thoughts by our less mature audience) but...when I finish residency here in 2 months (pediatrics) I will have at home call about every 5th or 6th week. This of course means that the other weekends I will have off! I really can't wait...still seams like a dream to me.
 
stud247 said:
Does it mean that as a military EM attending (assuming you work about as much as a resident) you can have 15 12hr shifts per month? So can you basically work 7days straight and then have 7days off without using any leave time? btw, civilian EM docs normally work <15 12hr shifts. so it's not true that they work more.
Click to expand...

Shifts do vary by base. You basically take the shifts that need covered, divide them up by the number of docs, give the flight commander and/or medical director a few shifts worth of credit for admin duties, and that's what's left.

A civilian emergency doc works what he wants. Some work 8 shifts a month, some work 25 shifts a month. But in general, yes, they work fewer hours than military emergency docs. But for most specialties, you work more as a civilian because you get paid for it. I've had some months where I worked 260 hours, including moonlighting, but I routinely work around 200 including moonlighting. I anticipate working 120-150 as a civilian. OB and Peds work more at my place, at least if you count in-house call for our busy labor deck. It's interesting...the contractors do their call in-house and the active duty do theirs at home. I bet you can figure out why.
 
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