ER work hours

[mdapply]

Can anybody comment on the typical week or month of an ER doctor? What days do you work, when do shifts start/end, what days do you have off? Id love to see a calendar for a month in an ED and see who's working when. anyone has something like that?

---

Members don't see this ad.

 

[leorl]

um...there's not really any such thing as "typical" in an ER schedule (unless you happen to be a very high up administrator with few clinical shifts).

The schedules are very variable, anywhere between 6-8/9/10-12 hours per shift, can be as nice as 6-8 shifts a month to 16 shifts a month with clumping (ie. like 10-12 shifts in 2 weeks). It depends on each hospital's staffing. Majority of people will be scheduled at least 1 weekend per month if not more, and at least 1 major holiday. In the schedules you'll vary from morning to mid-day to night shifts.

 

[EM_Rebuilder]

As stated there is not anything that is really typical...

I would say the average is about 120 to 140 hours per month is considered 'full time'. That could be divided as 8s/10s/12s...even some 24s in a super small places.

Many 12 hour places are going to have a 7-7 and/or 6-6 (or both..AM and PM) and possible some 'swings' thrown in there which are designed to bring in a provider during busy times. (9 to 9, 12 to 12, and 3 to 3 seem to be popular times at places).

Many of the 8 hour places start at say 7AM, then bring someone in a few hours later, and slowly 'forward advance' the shifts as the day goes on. Like every 4-5 hours, a new fresh provider comes in...then prior person can kick it back a bit and tidy up their patients. This is probably the most safe and best schedule for our biological clocks... but the down side is that you have to go to work 'more days a month'.

There is not a right answer on how to hash a schedule. Its what every the group likes/enjoys working.

 

[tima]

Is it possible to work at a hospital only on the weekdays, and not weekends?

Does every EM physcian have to work on the weekends or holidays?

 

[RustedFox]

 

[deleted109597]

Is it possible to work at a hospital only on the weekdays, and not weekends?

Does every EM physcian have to work on the weekends or holidays?

If you own the group, then no, you have to work no bad shifts. However, this is rare. You see, every hour has to be covered, and if you do 12s, half your shifts are nights, half are days. If you do 8s, 1/3 are morning, 1/3 are afternoon, 1/3 are nights.

Some groups do have enough people that want to only do nights/weekends, so they have less need to cover those. However, those people go on vacation too.

 

[ccfccp]

Is it possible to work at a hospital only on the weekdays, and not weekends?

Does every EM physcian have to work on the weekends or holidays?

Sure... it's called Urgent Care.

 

[The White Coat Investor]

I work 100-144 hours a month. I have partners than work as little at 50. Some of my partners work no nights, but everyone works weekends and holidays.

Here's my October Schedule

1 Off
2 Off
3 7pm-3am
4 Off (recovering)
5 Off
6 6a-2p
7 Off
8 2p-10p
9 2p-10 p
10 10p-6a
11 Off (recovering)
12 Meetings 9a-1p
13 6a-2p
14 off
15 Off
16 11a-7p
17 7p-3a
18 7p-3a
19 7p-3a
20 off (recovering)
21 off
22 off
23 2p-10p
24 off
25 off
26 11a-7p
27 10p-6a
28 off (recovering)
29 off
30 7p-3a
31 7p-3a

Total: 15 shifts, 120 hours + ~10 hours total staying late finishing up + 4 hours unpaid meetings

There are worse ways to earn a living. But don't discount the cost of those "recovery" days.

 

[The White Coat Investor]

If you do 8s, 1/3 are morning, 1/3 are afternoon, 1/3 are nights. .

Only in a single coverage shop. In double or more there are more afternoon/evening shifts than anything else.

 

[Jack is Back]

I work 100-144 hours a month. I have partners than work as little at 50. Some of my partners work no nights, but everyone works weekends and holidays.

Here's my October Schedule

1 Off
2 Off
3 7pm-3am
4 Off (recovering)
5 Off
6 6a-2p
7 Off
8 2p-10p
9 2p-10 p
10 10p-6a
11 Off (recovering)
12 Meetings 9a-1p
13 6a-2p
14 off
15 Off
16 11a-7p
17 7p-3a
18 7p-3a
19 7p-3a
20 off (recovering)
21 off
22 off
23 2p-10p
24 off
25 off
26 11a-7p
27 10p-6a
28 off (recovering)
29 off
30 7p-3a
31 7p-3a

Total: 15 shifts, 120 hours + ~10 hours total staying late finishing up + 4 hours unpaid meetings

There are worse ways to earn a living. But don't discount the cost of those "recovery" days.

What do you do on recovery days? Are you able to sleep straight after, or is the sleep broken up because your cycle is off?

How do you deal with your family on the recovery days, i.e. do they leave you alone more or are you constantly doing things with/for them even though in a sleep deprived haze?

 

[leorl]

Don't forget that even on day shifts, if it's very busy and you're dealing with several critical things simultaneously, you will need recovery time from those as well (because you feel like you got hit by a truck and likely stayed way past the time your shift ended). That "recovery time" isn't built into the schedule, but you will end up being rather unproductive when you actually do have your next day off.

 

[The White Coat Investor]

Here's a typical "recovery day."

0000-0700 At work
0700-0730 Drive home
0730-0800 Breakfast and read
0800-1400 Sleep
1400-1800 Fart around on the computer, my blog, SDN, play a game etc.
1800-1830 Mow the lawn
1830-2100 Dinner, dishes, get kids in bed
2100-2300 Do a few chores or get back on the computer, maybe go for a run
2300 Start trying to go to sleep. Either take an ambien or maybe just read until 0200.

The truth is the real "day off" is the prior day. Since you go to work when you would have otherwise gone to bed, you actually get that whole day to be productive or go recreate.

 

[The White Coat Investor]

How do you deal with your family on the recovery days, i.e. do they leave you alone more or are you constantly doing things with/for them even though in a sleep deprived haze?

Get yourself a stay at home mom. Tell her if the kids get near you you might kill one. Try not to be too grouchy after you get up. It helps if you do all your chores the day before before going in for the overnight shift.

 

[gutonc]

Get yourself a stay at home mom. Tell her if the kids get near you you might kill one. Try not to be too grouchy after you get up. It helps if you do all your chores the day before before going in for the overnight shift.

-1.

Get a wife who works and a good daycare/school that has hours from 0700 - 1800 or so. They can't wake you up if they're not at home.

 

[tima]

I still don't understand a "recovery day." Does this occur after 2-3 consecutive shifts or after a late night shift?

 

[EM_Rebuilder]

I still don't understand a "recovery day." Does this occur after 2-3 consecutive shifts or after a late night shift?

Next time you have 4-5 days off... stay up all night for three of those and play Wii and watch movies. Try going to bed at 7AM...make sure to get up later in the day and do it again that night.

Do this three nights and see how you feel going into the fourth where you are now 'off'.

It will suck a bit...and remember you laid in a bean bag chair watching movies which is a bit different than what you would be doing on a shift...

It will take a day or two before you are back 'normal'.... I hear it only gets worse as you get older.

 

[tima]

In the schedule listed above, there are a lot of night shifts, which I assume might be a preference.

I was interested in the 10/12 shifts that I have seen in various job listings that usually start at 6 am. In addition to a few night and weekend calls, will there be a lot of recovery time? Most of the shifts would be during the daytime.

Next time you have 4-5 days off... stay up all night for three of those and play Wii and watch movies. Try going to bed at 7AM...make sure to get up later in the day and do it again that night.

Do this three nights and see how you feel going into the fourth where you are now 'off'.

It will suck a bit...and remember you laid in a bean bag chair watching movies which is a bit different than what you would be doing on a shift...

It will take a day or two before you are back 'normal'.... I hear it only gets worse as you get older.

 

[gutonc]

In the schedule listed above, there are a lot of night shifts, which I assume might be a preference.

I was interested in the 10/12 shifts that I have seen in various job listings that usually start at 6 am. In addition to a few night and weekend calls, will there be a lot of recovery time? Most of the shifts would be during the daytime.

You assume incorrectly. ADMD's schedule is evenly split between "days" (any shift that ends before MN) and nights (any shift that includes MN in the hours). That's pretty normal.

Unless you are a senior partner in a large group you are likely to spend 1/3 - 1/2 of your time working swing/nights. There are groups with folks who prefer nights (and probably get paid to work more of them) and will take some 10p-6a pressure off the group but somebody has to staff the place all the time.

 

[dchristismi]

What he calls "recovery days" I refer to as "Grumpy Days."

I have a friend from residency who refers to these as DOMAs. (Day-off My-Ass.)

They suck. The day before you work is actually your day off. I would generally get home around 9, grab a bite to eat and crash. If I'm working another night, I try to sleep at least 5-6 hours. If I'm not, I only sleep around 4 and spend the rest of the day in a half-awake, slightly nauseated daze, so I can try to get to sleep again before midnight, usually with the help of some sort of pharmacology. If I have a couple days off, I'll usually be up until at least 3, or whenever I get tired.

Here's my schedule for October:

1 off
2 11a-7p
3 off
4 3p-11p
5 11p-7a
6 off (grumpy day)
7 off
8 5p-1a
9 off
10 9a-5p
11 3p-11p
12 3p-11p
13 11p-7a
14 off (grumpy day)
15 3p-11p
16 3p-11p
17 off
18 off
19 3p-11p
20 off
21 off
22 11p-7a
23 11p-7a
24 off (grumpy day)
25 off
26 11a-7p
27 5p-1a
28 11p-7a
29 off (grumpy day)
30 off
31 3p-11p

I HATE early morning shifts, so ask not to be scheduled for the 7a.

There are always going to be more evening shifts than daytime shifts in a multi-shift setup - that's when the volume comes in. For example, my group, which double to triple covers has 7 shifts a day, all lasting 8 hours (plus whatever you stay late) at 7a, 9a, 11a, 3p, 5p, 8p, and 11p.

Banker's hours are not an option. And yes, we all work weekends and holidays.
Grumpy days are what we get for being pager-free.

 

[Pinner Doc]

If it helps, here's another schedule. I currently work 12 eight-hour shifts a month. (On Mondays we come in an hour early and work in triage to help patient flow.) Our sign-out culture is such that you stick around and dispo your patients, so I'm usually staying an additional 2 hours after my shifts. (After my night shift this month, I was there FIVE hours past - that was painful. But it was like an episode of House - medical mysteries, multiple procedures, patient's crashing... very weird!).

Oct 1: 6a-2p
Oct 2: 6a-2p
Oct 3: 5p-2a
Oct 4,5: off
Oct 6: 10p-6a
Oct 7: off (recovery)
Oct 8: off
Oct 9: 6p-2a (stayed on till 5a, but had a meeting in the hospital at 11a that same morning, so crashed in an empty patient room at the hospital)
Oct 10: meeting, then recovery
Oct 11, 12: off
Oct 13: 2p-10p
Oct 14: 2p-10p
Oct 15: off
Oct 16: 6p-2a
Oct 17: 5p-2a
Oct 18: 6p-2a
Oct 19: off (recovery)
Oct 20: 4p-12a
Oct 21: 4p-12a
Oct 22-25: off
Oct 26: 8a-4p
Oct 27-31: off

As you can see, of my 12 shifts, three were daytime: two were 6a-2p (which involved me getting up at 4:30 to shower and drive in, and also involved me staying till around 4p that evening), and one 8a-4p. It's not typical to have mostly day time shifts... especially for those like me, just out of residency.

 

[boogabear]

You guys posting your shift schedules has been extremely insightful and helpful. Thank you!

 

[DeLaughterDO]

One thing I learned from this thread is that I am working too damned hard. Twelve 8s a month? I am scheduled for 16 10 hour shifts this month, not counting meetings, etc. No wonder I'm so tired...

 

[Jack is Back]

It is very possible that all these burned out ER docs that I hear about are just working too much with poor schedules (or chose the wrong specialty?). It seems like those who get good scheduling may be able to avoid burnout.

You guys posting your shift schedules has been extremely insightful and helpful. Thank you!

Agreed, thanks for posting schedules.

 

[Jack is Back]

In the schedule listed above, there are a lot of night shifts, which I assume might be a preference.

I was interested in the 10/12 shifts that I have seen in various job listings that usually start at 6 am. In addition to a few night and weekend calls, will there be a lot of recovery time? Most of the shifts would be during the daytime.

This is kind of funny.

This is the second time you've asked if EM can have a day shift schedule like an 8-5pm job M-F (or possibly you are trying to say 6-3pm).

Anything is possible, but to assume that EPs are preferring to work overnight instead of working a M-F day shifts is pretty comical. Have you never heard that EM has to cover over night and work weekends/holidays typically? When do you think more people are willing to work, overnight, weekends, holidays or M-F day shifts?

I'm only a medical student, but I think the attending would back me up in saying, if you want to work M-F day shifts then EM is probably not the best specialty to chose.

 

[tima]

Take it easy.

I was just asking a question on what I saw at my med school's hospital, and trying to relate it to the real world. There are certain EP that prefer overnight because of lesser traffic and greater pay at my school's EM department.

The opinions on this thread have shown me that many work late shifts.

Asking a question two times is to get more opinions, aka bumping the thread.

This is kind of funny.

This is the second time you've asked if EM can have a day shift schedule like an 8-5pm job M-F (or possibly you are trying to say 6-3pm).

Anything is possible, but to assume that EPs are preferring to work overnight instead of working a M-F day shifts is pretty comical. Have you never heard that EM has to cover over night and work weekends/holidays typically? When do you think more people are willing to work, overnight, weekends, holidays or M-F day shifts?

I'm only a medical student, but I think the attending would back me up in saying, if you want to work M-F day shifts then EM is probably not the best specialty to chose.

 

[Pinner Doc]

One thing I learned from this thread is that I am working too damned hard. Twelve 8s a month? I am scheduled for 16 10 hour shifts this month, not counting meetings, etc. No wonder I'm so tired...

<<shrug>>

12 a month for me is good, at least to start out with. i'm studying for the boards, etc.

for full disclosure, however, i'm taking 2 shifts a month at the local VA for a chance to oversee EM residents. so you can bump me up to 14.

 

[Pinner Doc]

The opinions on this thread have shown me that many work late shifts.

Asking a question two times is to get more opinions, aka bumping the thread.

Trust me, I do NOT prefer to work late shifts! 8-4 or 10-6 would be my preference. I've had approximately three of those shifts (including the one this month) since I started my job at the beginning of August.

I think what might rub people the wrong way is that a person comes on here, asks how a typical schedule works, we show or describe that typical schedule... and through rose-colored glasses, states that perhaps it's our 'preference' that we are working such odd hours. We're trying to lay it out there - these hours need to be covered, and if you're in EM, you'll do your fair share of it. (not speaking to 'you' - i mean the general 'you.')

 

[The White Coat Investor]

We're trying to lay it out there - these hours need to be covered, and if you're in EM, you'll do your fair share of it. (not speaking to 'you' - i mean the general 'you.')

Or pay someone else to work those shifts.

Come to think of it....I kind of am working a lot of nights lately. Grrrrr.....

Low man on the totem pole for a few more months til I make partner. Then if I work more nights at least I'll be paid for it.

 

[WilcoWorld]

An academic EM schedule for someone with a moderate/high amount of protected time:

1 - Off
2 - 8a-4p
3 - Teaching 8a-12p
4 - 11am 1 hour meeting then 11p-7a
5 - 11p - 7a
6 - Grumpy day
7 - 3-5 "office hours" (research/curriculum development)
8 - 7p-1a
9 - 2 hours of meetings, otherwise off
10 - Teach 8a-1p, faculty meeting 1-3ish
11 - 11a-1p meeting (more research work)
12 - 7a-3p
13 - 7a-3p
14 - 4p-12a
15 - 7p-1a
16 - prepare lecture, otherwise off
17 - 8a - 4p
18 - Teach 1230p-5p
19 - 23rd vacation
24 - 4p-12a
25 - 7p - 1a
26 - off
27 - On 24hr back up call, 2 hours of meetings
28 - 11p-7a
29 - 11p-7a
30 - Grumpy day
31 - off

PS: Grumpy & nauseated is the best description of the post-overnight experience I've ever read.

 

[Pinner Doc]

PS: Grumpy & nauseated is the best description of the post-overnight experience I've ever read.

Yes!

 

[Indryd]

I worked nights for 6 years before starting college, then worked nights for my first three years of college. Aside from the last three where I was working full-time and school full-time (hated life), I loved working nights. I thrived.

I have no doubt I will be "that night guy".

 

[Jack is Back]

I worked nights for 6 years before starting college, then worked nights for my first three years of college. Aside from the last three where I was working full-time and school full-time (hated life), I loved working nights. I thrived.

I have no doubt I will be "that night guy".

It doesn't seem like that bad of an option.

No grumpy days and consistent circadian rhythm.

 

[turkeyjerky]

It doesn't seem like that bad of an option.

No grumpy days and consistent circadian rhythm.

You're still gonna have those grumpy days unless you work every day, in which case you'd be pretty grumpy anyway.

 

[Pinner Doc]

It doesn't seem like that bad of an option.

No grumpy days and consistent circadian rhythm.

So... on the days you are off (about 15-20/month), would you still stay up all night and sleep during the day?

 

[Apollyon]

So... on the days you are off (about 15-20/month), would you still stay up all night and sleep during the day?

That's what I do. (What I'm doing right now - it's before 8am in Hawai'i.)

 

[Jack is Back]

So... on the days you are off (about 15-20/month), would you still stay up all night and sleep during the day?

That's what I do. (What I'm doing right now - it's before 8am in Hawai'i.)

Sounds great to me (or better than flipping the clock constantly).

Sleep 10am-4pm everyday.

 

[vandyam]

Wait, I'm a little confused. Maybe it's because I'm still in my early 20's...I start med school next year and am hoping to go into EM (I have worked in an ED since I was 18), and I'm currently in school full time (16 hrs) at a competitive undergrad. I work ~150 hrs (7p-7a) per month and am in school (day time hours) 2 days/wk for 19 hrs/wk. I don't mind the work at all (and 150 hours is considerably less than 120). What's with the exhaustion/complaints with working so much? I switch from day to night shift all the time (sleep schedule wise) and while I have to sometimes take an ambien, I don't mind it. I can't imagine just working and not having school...I'd be bored.

Is this just an age thing? Or is it an "I've worked my ***** off through residency and get killed at work, so it takes a lot out of me?" Just curious what I'm in for, I guess... in my mind, it doesn't seem too shabby.

 

[Jack is Back]

Wait, I'm a little confused. Maybe it's because I'm still in my early 20's...I start med school next year and am hoping to go into EM (I have worked in an ED since I was 18), and I'm currently in school full time (16 hrs) at a competitive undergrad. I work ~150 hrs (7p-7a) per month and am in school (day time hours) 2 days/wk for 19 hrs/wk. I don't mind the work at all (and 150 hours is considerably less than 120).

150 is considerably less than 120?

What's with the exhaustion/complaints with working so much? I switch from day to night shift all the time (sleep schedule wise) and while I have to sometimes take an ambien, I don't mind it. I can't imagine just working and not having school...I'd be bored.

Is this just an age thing? Or is it an "I've worked my ***** off through residency and get killed at work, so it takes a lot out of me?" Just curious what I'm in for, I guess... in my mind, it doesn't seem too shabby.

It's a different kind of work. Remember that full time school UG is pretty much a joke compared to med school even at a competitive UG. It's UG. Being in school during the days at UG is like a vacation basically, you don't really have to listen and you can cram when tests come while still getting all A's.

Your work isn't like a EPs work either. You don't have to work nearly as hard, think nearly as much, and you have little training/responsibility/liability comparatively. Basically, you are putting in the time but not the equal effort, hence it doesn't seem so bad. It's not exactly the time spent working, it is what you're doing.

Here's some questions: What courses are in your 16 units? What is your job title that you work 150 hrs a month as? What do you do during these 150 hrs? Answer those questions.

Plus, (and I'm only critical because you opened yourself up for it by saying the schedules seem easy), you aren't exactly killing it in UG.

From your MDapps:

MCAT: BS 7, PS 8, VR 10, R
Overall GPA: 3.49
Science GPA: 3.30

Those stats are very mediocre, so I guess school is pretty easy when all you are getting is mostly B's. I'm sure most of us who've made it into medical school could have skated by with a 3.3 sGPA without studying at all, except the night before the exam. UG even with a 4.0 was easy, UG with a 3.3 is vacation.

 

[Pinner Doc]

Those stats are very mediocre, so I guess school is pretty easy when all you are getting is mostly B's. I'm sure most of us who've made it into medical school could have skated by with a 3.3 sGPA without studying at all, except the night before the exam. UG even with a 4.0 was easy, UG with a 3.3 is vacation.

This is getting a little uncomfortable here.... who's to say how hard someone worked for where they are? I always agreed with that phrase that says, "Your circumstances in life are half luck. So are everybody else's."

To answer the original question, I don't know that people are complaining about being exhausted by the work schedule so much as the days after a night shift. I think that's inevitable. I think the main point we're trying to drive home is that the EM lifestyle isn't necessarily cush, and that it's hard to join on working no nights or weekends.

 

[Jack is Back]

This is getting a little uncomfortable here.... who's to say how hard someone worked for where they are? I always agreed with that phrase that says, "Your circumstances in life are half luck. So are everybody else's."

To answer the original question, I don't know that people are complaining about being exhausted by the work schedule so much as the days after a night shift. I think that's inevitable. I think the main point we're trying to drive home is that the EM lifestyle isn't necessarily cush, and that it's hard to join on working no nights or weekends.

I'm very grateful for all my circumstances and know that I'm very blessed to be where I am, much more than 50%, I'd say 97% considering everything.

The point I'm making, and the thing that confuses me sometimes is when people go around and say things like, "Oh, med school is easy." Then I ask them how they are doing and they say, "Well, I'm just barely passing." I have NOTHING against passing, BUT before you gain the right to create a paradigm on how medical school should be viewed by others and to call the process easy, then I think you should be doing well.

If I went around SDN saying, Step 1 is easy, I didn't mind preparing for it at all. Then I finally told everyone I scored a 190, I don't think that would be received well.

Or if a pro bodybuilder is telling me squats and lifting are tough and I say, "What are you complaining about?! Lifting is easy. And squats are super easy. I do them everyday."

"How much do you squat?"

"Oh, I just use the bar, I don't like to add an extra weight."



I'm grateful that people were willing to take time out of their schedules to post on here to help interested people like myself, so when people come and criticize that, it's annoying.

 

[Indryd]

Listen dude.

I worked 40+ hours a week through 5 years of undergrad, got a BA and a BS, and was top 10% in my class. I scored in the 91st percentile on my MCAT.

I breezed through the medschool application process. I had my pick of the top schools in the country. I got letters asking me to reconsider when I turned down interviews and/or made my final choice of where to matriculate.

And no joke, other than extraneous non-academic stressors, it was easy. EASY.

I only say all this so I can convey a point. I was a top dog coming into medical school, and what you need to know is MEDICAL SCHOOL IS HARD. It is the hardest thing I have ever done.

And it's not the quantity of hours I put in. I actually have had more free time in medical school than I ever did in undergrad.

It's the INTENSITY of the time put in that makes it hard.

And guess what. 90% of residents say medical school is a joke compared to residency. These are EM residents who maybe juggle 5 - 10 patients at a time. Attendings where I am juggle 20 - 30 at a time.

So let's see.

Double degree + full-time work <<<<< medical school <<<<< residency <<<<< attending.

With your stats and your attitude, I think you are in for a rude awakening, and you have no place condescendingly comparing your situation to being an EP.

 

[leorl]

If you don't mind the switching and the odd hours and are already somewhat used to it, you may be naturally well-suited to EM. Other people know that they can't do it or can't "function" without a regular schedule. The work is demanding and physically can be draining, and there are definitely points usually every shift where my cortisol / adrenaline level goes a littler higher than I want it to, so you need to take that into account. But I will gladly take it over when I was working on call for 36 hours straight with no sleep and no food and being incessantly molested by the pager - I consider my schedule now as way better than that.

Wait, I'm a little confused. Maybe it's because I'm still in my early 20's...I start med school next year and am hoping to go into EM (I have worked in an ED since I was 18), and I'm currently in school full time (16 hrs) at a competitive undergrad. I work ~150 hrs (7p-7a) per month and am in school (day time hours) 2 days/wk for 19 hrs/wk. I don't mind the work at all (and 150 hours is considerably less than 120). What's with the exhaustion/complaints with working so much? I switch from day to night shift all the time (sleep schedule wise) and while I have to sometimes take an ambien, I don't mind it. I can't imagine just working and not having school...I'd be bored.

Is this just an age thing? Or is it an "I've worked my ***** off through residency and get killed at work, so it takes a lot out of me?" Just curious what I'm in for, I guess... in my mind, it doesn't seem too shabby.

 

[Nervous Ned]

Come on, there's no need for you guys to be so mean about it. She asked a question because she's young and she doesn't have any experience with being in med school or residency; she didn't insult you and your mother. Give her a break.

vandyam, yes, I think the age difference does have a lot to do with it, as do the different priorities that tend to go along with getting older. Speaking as someone who started residency in my late 30s, I just don't bounce back from an all-nighter as quickly as I did when I was a college student. In college, I used to take an exam, stay up all night writing lab reports, go to class all day the next day, and be fine. Or I'd stay up Friday night hanging out with friends and then go to the gym in the morning, take a short nap, and do the same thing again on Saturday night. If I tried to do that now that I'd be a zombie.

The other thing is that your priorities change. A lot of people get married during medical school and residency. (Congrats on your wedding, btw.) Especially if you have kids too, it makes it hard to spend time with them when you're working nights and weekends because those are the times that your family has off. If your kids are in school, you will sometimes be going to work before they get up and sleeping when they get home. Then by the time you get up, they've already gone to bed. Plus when you are home on your "grumpy days," you are often too grumpy to enjoy spending time doing things with your family.

(Fwiw, I love that phrase and intend to co-opt it!)

 

[Jack is Back]

Come on, there's no need for you guys to be so mean about it. She asked a question because she's young and she doesn't have any experience with being in med school or residency; she didn't insult you and your mother. Give her a break.

I don't think I was hard on her. My single point is that you should be doing well at something before telling everyone that it's easy or a light workload.

The question was, "why does it not seem so bad?" And the answer is because UG / easy jobs are... easy. Med school / being a physician is hard.

Edit: I found it funny reading your response to her, then reading your current blog entry:

I Hate My Schedule
"The only reason I'm coming out here tomorrow is the schedule says I have to."
-Sparky Anderson

This was my first week back in the ED, and I'd be lying if I said that I was sorry to be done with OB. Yeah, ok, I have to admit that the OB rotation wasn't as bad as I expected. But it still wasn't my idea of fun, either. I also have to admit that working two weeks of night float wasn't as bad as I expected, and I even felt pretty well adjusted to the schedule by the end of last week. So why, then, am I so annoyed about the fact that I had to work nights in the ED this whole week?

I don't really have a logical answer to that question. On the surface, it seems like I should be happier with my schedule. I am working fewer hours (11-12 hours per shift instead of 13-14 hours), and fewer days (4-5 days per week instead of 5-6 days). But somehow, I'm grumpier about it anyway. Maybe it's because the work is much more stressful and intense. Maybe it's because I feel like I'm expected to love it. Or maybe it's because I know that some other people aren't working as many overnights as I am.

Ah, yes, that is the key sticking point. When everyone is working the same overnight schedule as a team, there is a sense of camaraderie born out of shared misery. But when you know that you're working twice as many overnights as one of your fellow interns, suddenly it makes your schedule seem relatively a lot worse, even though it's better in absolute terms. I do feel a little bad about almost biting someone's head off for commenting that it seems like I'm always working nights. But really, I don't need anyone else's sympathy, because I feel sorry enough for myself.

The thing is, everyone hates their schedule. We all feel like we work too many hours. We all wish we had fewer night shifts or morning shifts or afternoon shifts, depending on which one is burning us out the most at the moment. (Personally, I wish I had fewer of all three types of shifts!) We all have a block or two where we get shafted, but other blocks where we come out ahead. And in spite of my pity party about having so many night shifts, there is a significant bright side: I have two fewer shifts overall for the month than the other intern who is working fewer overnights has. Well, when I look at it that way, maybe my schedule isn't quite so bad after all....

 

[Nervous Ned]

I don't think I was hard on her. My single point is that you should be doing well at something before telling everyone that it's easy or a light workload.

I know I'm going to regret bothering to get into this debate with you, but I will anyway. Yes, you were hard on her. It's jerky to post someone's stats from her MDApps and call her out because of them when she's asking an honest question.

The question was, "why does it not seem so bad?" And the answer is because UG / easy jobs are... easy. Med school / being a physician is hard.

She wasn't asking you; she was asking people who are working as EPs. You're two months into your M1 year. That means you have exactly two months more experience with medical school than she has, and you yourself have no idea how hard or easy most of medical school is going to be! And how do you know that being a physician is so hard? It's not like you've ever been one. What would you say if I told you that being a resident is easier than being a med student? Because in certain ways, it is. Since you like reading my blog, go back a few entries to the one where I talked about why my residency OB rotation was better than my med school OB rotation was, and there's an example. As another example, it's also nice to be paid for what you do rather than borrowing money and watching your debt go higher and higher.

Edit: I found it funny reading your response to her, then reading your current blog entry:

I'm finding it funny that the people who are getting all bent out of shape about a pre-med asking why working overnights is harder than it seems are med students, but the people who are actually working this schedule aren't insulted by it.

Be that as it may, I'm done with derailing this thread. Feel free to PM me if you want to continue the discussion.

 

[EctopicFetus]

Working in EM is hard. I have long had a theory that dont believe you are the smartest or hardest working person out and learn from others.

There is a reason why people who come out and work 200 hours a month burn out really quickly. I worked in business (Mgmt consulting) prior to med school and once billed 84 hours in a week to a client. That was a "hard week" for that job but nothing compared to my shifts now.

I work a decent bit 140-160 per month as an community doc at 3 hospitals my group staffs. I work all nights (by choice).

Working nights is hard, the patient population is challenging, if your kids wake you up, or the dog or the mailman or anything else that happens while you are sleeping you can be thrown off. I choose to work 12's so i have more days off every month.

The job is hard because there is stress coming at you from all angles. Whether it is admin, or patients the job is hard. Juggle 9 + patients, traumas, social disasters, violent agitated patients, psych patients etc. This seems easy for the unexperienced but the job is challenging. For the most part the "medicine" isnt hard. STEMI, NSTEMI, CVA, Sepsis, Hypoxia, COPD. Those things for the most part arent that hard. The social problems, patients refusing to leave, patients refusing to allow themselves to be cared for, the drunks etc. Thats what makes a bad shift for me. The I came here for a 3rd opinion for my chronic "fill in the blank" pain after seeing 2 subspecialists and Im not leaving until I have an answer.

With experience you learn how to manage these patients without your press ganey going into the toilet. Thats what makes the job hard. Meeting 30 strangers who expect you to cure their fibromyalgia every shift makes the job hard.

Now that im done with that, I will say I love what i do. I have learned to compartmentalize the unpleasant interactions so they dont affect my enjoyment of my job. I think in that way I am fortunate.

 

[EctopicFetus]

For those wondering.. Here is my schedule. Note I volunteered to pick up 3 day shifts this month which is unusual for me.

Oct 5,6,7, 6p-6a

oct 10 On call backup
Oct 11 9-5p
12 8-5p
13 9-5p
14 6p-6a
15 off
16,17,18,19 6p-6a

25,26 6p-6a

One guy does 3 runs of 4 12s a month, leading to 144 hours and a guaranteed week off somewhere.

 

[tima]

When working nights shifts, does the hourly rate increase slightly when compared to day shifts? I heard it's a few percent higher.

 

[EctopicFetus]

i work at a place where the differential is ~30% most decent places its $40-$60/hr for the differential

 

[dchristismi]

Some places do offer a night differential. My shop doesn't, but we all share nights. If you're trying to recruit a night guy (or 2 or 3), a differential in pay might be the trick. This, along with every other variable you can imagine, varies by shop.