EM Without The Night Shift!?

[SportsJunkie25]

Is it possible to be an EM Physician w/o working the night shift?

I want to be a Peds EM Physician but I, 100%, don't want to work nights. Of course, I'm up for working nights to get through med school and residency but I know I don't want a career that's centered around working nights. I'm up for working at 5am, 6am, etc but nights...not so much.

I've heard it's really hard to get an EM day shift position; any truth to this? Also, I heard the day shift is based on seniority?

Thanks!

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[southerndoc]

Our peds ER is only open from 9a-3a. If you can find a private peds EM gig like ours, chances are the peds ER will not be open 24 hrs.

 

[Apollyon]

Our Peds ED is open 24/7, and, despite there being 2 docs who work only nights, still, everyone has to work some nights. Then again, ours is a little out of the ordinary, as it is a community ED with 4 board-certified Peds EM docs.

 

[EvoDevo]

Doesn't Christiana do something where you work one month of nights per year and then it's day/evening shifts for the rest of the time?

 

[BobA]

Alternatively, you could consider PICU/NICU work. You'll have to take some call, but maybe not as much as most ED's (in general).

 

[SportsJunkie25]

Thanks for the responses! Definitely something for me to think about...

 

[Medstudentquest]

Is it possible to be an EM Physician w/o working the night shift?

I want to be a Peds EM Physician but I, 100%, don't want to work nights. Of course, I'm up for working nights to get through med school and residency but I know I don't want a career that's centered around working nights. I'm up for working at 5am, 6am, etc but nights...not so much.

I've heard it's really hard to get an EM day shift position; any truth to this? Also, I heard the day shift is based on seniority?

Thanks!

Not to sound harsh, but isn't the availability of having medical professionals at night one of the reasons why EM exists, and why EM docs are supposed to work nights? Otherwise, if the EM is just open during the day, what would be the advantage? What's the point of having EM if you only work days? You'll likely be able to go to your regular doc if that were the case.

 

[tkim]

You'll likely be able to go to your regular doc if that were the case.

You ever try to get a 'same day' appointment with your primary? I guarantee you'll be told to go to the ED.

 

[Apollyon]

You ever try to get a 'same day' appointment with your primary? I guarantee you'll be told to go to the ED.

Not in Hawai'i and South Carolina (at least).

 

[Medstudentquest]

You ever try to get a 'same day' appointment with your primary? I guarantee you'll be told to go to the ED.

Absolutely. And I have even been told that they reserve a couple of appointments, particularly early in the day, for urgent type cases. If your regular doc is not available, it is very much possible to see another doc same day. I've only gone to the ED on two occasions-and both have been at night.

I think the point of EM would lose a great deal of value if ED's were closed at night.

 

[Jeff698]

Our peds ER is only open from 9a-3a. If you can find a private peds EM gig like ours, chances are the peds ER will not be open 24 hrs.

Strange how we become the experts in all manner of specialties after hours.

Take care,
Jeff

 

[tkim]

Not in Hawai'i and South Carolina (at least).

Really? Hawaii? My mom lives there - I used to as well. On the occasions that she's tried to make a same day, she's been told to go the ED. Perhaps it's PMD and geography specific, but why do you bring up Hawaii as an example?

 

[tkim]

Absolutely. And I have even been told that they reserve a couple of appointments, particularly early in the day, for urgent type cases. If your regular doc is not available, it is very much possible to see another doc same day. I've only gone to the ED on two occasions-and both have been at night.

I think the point of EM would lose a great deal of value if ED's were closed at night.

I think the point is that the OP doesn't want to work at night, not that there's a possibility that EM would become a daytime only gig.

Anyway, for the OP. I don't know how this would work for Peds EM, but I've seen jobs posted for regular EM where there are people who work all nights and weekends in the group by preference, and therefore the rest of the group is responsible for 6-10 night/weekend shifts for the year. Not exactly what you're looking for but such situations may be out there for you.

 

[jazz]

Otherwise, if the EM is just open during the day, what would be the advantage? What's the point of having EM if you only work days? You'll likely be able to go to your regular doc if that were the case.

i would venture to say that 99.9% of ER's are busier during the day than the night...

as for the OP, you will have a better chance of not working nights as Peds EM at most community hospitals don't have a 24 hour peds ER. your hours won't be 7a-3p either though, b/c pediatric ER's are staffed for the busiest times for peds... thus something like noon-midnight... or two shifts of 11a-7p and 7p-3a... something like that .... there is definitely a pediatric lull in the AM and a peak in the afternoon/early evening..

there are also pediatric urgent care centers designed to cover the hours after primary pediatrics close (like 4pm and on..)

 

[VoiceofReason]

I'm also curious about this.

I'm tending to like emergency medicine more and more as I go through school but the only real reservation I have at the moment is the prospect of nights.

I would be totally fine with working either all evenings, all days, or a combination of days/evenings. I just hate the idea of working nights. I don't like feeling jetlagged because I'm a physically active person and when I don't get good exercise (at least minimally rested before the exercise) I get a little unhappy.

I'm not really sure I see anyone explicitly answer the question here but is a combination of evenings/days more plausible or are nights really hard to avoid no matter what you do?

 

[tkim]

I'm also curious about this.

I'm tending to like emergency medicine more and more as I go through school but the only real reservation I have at the moment is the prospect of nights.

I would be totally fine with working either all evenings, all days, or a combination of days/evenings. I just hate the idea of working nights. I don't like feeling jetlagged because I'm a physically active person and when I don't get good exercise (at least minimally rested before the exercise) I get a little unhappy.

I'm not really sure I see anyone explicitly answer the question here but is a combination of evenings/days more plausible or are nights really hard to avoid no matter what you do?

Three posts up. It's possible.

 

[digitlnoize]

It's possible, but it depends on your group.

For example, at the ED I worked in, the night duties were rotated around fairly equally, without (much) regard for seniority. Everyone wound up doing ~2 nights a month. Nights here meaning OVERnight. You still did many late shifts (until 1pm-11pm or 3pm-1am).

I've heard of other groups that hire people specifically to cover the nights. That's their job. If you can find the people willing to do nights for a little extra cash, then that makes everyone else's life easier.

Ultimately, it just depends on how your group does it, but options are available.

 

[deleted65604]

Sure, there are 1-3% of ER jobs that are day only, but those are usually obtained by old gray-haireds who have put in their time for 20 years and run the group. In order to get to that point, usually, you will have to put in your dues and work hundreds, if not thousands of nights.

Why not do family practice and work at some urgent care? Seems the perfect job for you.

The last thing we need are ER residents walking around ruining the morale, by complaining incessantly of night shifts and dreaming of the glorious day when they can have a 9-5 week-day job working in the ER. (We've all seen the piss-poor morale among internal medicine residents as a result of 50 % of them being prelim gas, radiology, etc, and the rest of them dreaming of fellowships when they can stop being the dumping ground for the ER and lazy sub-specialists).

Night shifts are part of ER. Expect them. If you can't do them, then you won't survive residency, let alone practice. Heck, you should have expected nights as part of just being a doctor. Much worse than night shifts are nights where you get calls all night and then have to do clinic all day, or operate on patients.

You could get out of working nights by going into research.

 

[DeLaughterDO]

Sure, there are 1-3% of ER jobs that are day only, but those are usually obtained by old gray-haireds who have put in their time for 20 years and run the group. In order to get to that point, usually, you will have to put in your dues and work hundreds, if not thousands of nights.

Why not do family practice and work at some urgent care? Seems the perfect job for you.

The last thing we need are ER residents walking around ruining the morale, by complaining incessantly of night shifts and dreaming of the glorious day when they can have a 9-5 week-day job working in the ER. (We've all seen the piss-poor morale among internal medicine residents as a result of 50 % of them being prelim gas, radiology, etc, and the rest of them dreaming of fellowships when they can stop being the dumping ground for the ER and lazy sub-specialists).

Night shifts are part of ER. Expect them. If you can't do them, then you won't survive residency, let alone practice. Heck, you should have expected nights as part of just being a doctor. Much worse than night shifts are nights where you get calls all night and then have to do clinic all day, or operate on patients.

You could get out of working nights by going into research.

This is what we signed up for, folks: nights, weekends, and holidays - hopefully in a somewhat proportional manner.

 

[KYTNOH]

It's absolutely possible, but there are financial drawbacks. Right now there are so many positions for EM trained people that you can pretty much write your own schedule if you want to. One of the faculty here does this. He said he hated working nights, so he went around to all the hospitals and basically told them that if they wanted his services that he would only be willing to work between certain hours. Since there was a tremendous demand he had takers. The financial downside is that I'm sure partners in a group would be less than willing to give any benefits and/or profit sharing if you don't equally share the shift load, but if you would rather take the financial hit than work nights then I say do it.

In medicine (in essentially every specialty) almost any working hours are possible if you're willing to make less overall than your colleagues and you have a willingness to travel to a certain area or hospital.

I would venture to say that a small majority of peds EDs are not open 24 hours a day, so it would be pretty easy to find a job with no nights if you are peds EM trained.

Personally, I've always seemed to enjoy the night shift. It seems the acuity of patients goes up and there's often some downtime (obviously not always) unless you're in a place that dramatically cuts staffing at night.

 

[ArkansasRanger]

Not in Hawai'i and South Carolina (at least).

Not around here either.

 

[boo2]

At Christiana the residents do six weeks total(1 mo + 2 weeks) of nights sunday-thursday, then the rest of the EM blocks we have about 2 overnights/block to cover the weekends. It gives you a flavor for the life of a night doc- probably the most regular schedule in EM, with weekends off, but it can be tough on the system.

There are dedicated night attendings for the weekdays.

 

[FullThrottle]

EM without nights is like peanut butter without the jelly...

 

[SportsJunkie25]

Ok. Well, I was just wondering. It seems like some people say it's possible and some people say it's not. I definitely want to do PedsEM if I do EM so we'll see. Who knows, I may fall in love w/ the night shift?? You never know...

I need to focus on getting in, first!

EM without nights is like peanut butter without the jelly...

Wow! You couldn't resist huh?

 

[Perrotfish]

Related question from a curious med student: how possible is it, in y'all's experience, to get major holidays of for EM if that's important for you? I know it won't work in residency, but as an attending would it be possible to get Christmas Eve, Christmas, and Easter off reliably?

 

[edinOH]

Of course it is possible. You better not choose the field with the expectation that you can find a job where you will never work nights though. You should approach it with the mindset that you may very well have to work your fair share of nights but that you could possibly find a position where you don't. Anything else is unrealistic and you are setting yourself up for a severe disappointment.

 

[Apollyon]

Related question from a curious med student: how possible is it, in y'all's experience, to get major holidays of for EM if that's important for you? I know it won't work in residency, but as an attending would it be possible to get Christmas Eve, Christmas, and Easter off reliably?

In our group, you get off Thanksgiving and New Year's one year, and Christmas the next (5 days at each one).

You can get holidays off, but, virtually always, it won't be the same one every year - 'cause, if you want it off, so does someone else. It will be a trade-off (and that is a damn sight better than everyone coming in for 4 hours on each holiday - that sucks).

 

[docB]

Related question from a curious med student: how possible is it, in y'all's experience, to get major holidays of for EM if that's important for you? I know it won't work in residency, but as an attending would it be possible to get Christmas Eve, Christmas, and Easter off reliably?

In my group it's not too hard to get Christmas and Easter off. About half the group wants those and the other half wants off for Hanukkah (sorry if spelled wrong) and Passover so it works out.

 

[beriberi]

My group pays $300 bonus per night worked. (As a prev poster said, a "night" is 10-7 --not the 5-2a or 2p-11p shift). We have two docs who work 10/month, I work 5-7/month and a few other docs pick up 2-3. Some don't work nights at all--and lose money because of it. (The night bonus comes from money that is taken from everyone's paycheck and redistributed). I like working nights because the disruption is worth $300 to me. Other people don't agree.

In short, the gigs are out there. I came to this group straight from residency. We are managed by one of the gigantic EM overlords. So, if this is what is for you, looking to a big corporate group may help you identify an appropriate opportunity.

Also, I think I could have Christmas off every year if I was going to work every Thanksgiving and New Year's. I don't find that many people care about Easter.

 

[docB]

In short, the gigs are out there. I came to this group straight from residency. We are managed by one of the gigantic EM overlords. So, if this is what is for you, looking to a big corporate group may help you identify an appropriate opportunity.

That's a really good point. I too toil in the service of a gargantuan corporate master. It seems like the corps tend to pay extra for nights and weekends (often called shift differentials) while the indie groups tand to mandate a certan number of nights and weekends. The down side of paying for nights and weekends is you make less if you don't work them. The downside of the indie groups is that they frequently have things set up so that the senior docs don't have to work the bad shifts.