Feel like I have to decide between an academic program or having a life...

[cameraGEEK]

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I am at a top school, and have done very well in med school. Everyone tells me if I want to do a fellowship, or get a good job later, I should go to a residency in an academic program... yet, I find myself looking more at the community programs because all the academic ones I have seen on Freida have 65-75 avg hours per week.

I am feeling like I have to decide between going to an academic program and seeing my kids for the next three years. Does anyone else feel this way?

Are there academic, well-regarded programs that also have good hours?

 

[cameraGEEK]

I am at a top school, and have done very well in med school. Everyone tells me if I want to do a fellowship, or get a good job later, I should go to a residency in an academic program... yet, I find myself looking more at the community programs because all the academic ones I have seen on Freida have 65-75 avg hours per week.

I am feeling like I have to decide between going to an academic program and seeing my kids for the next three years. Does anyone else feel this way?

Are there academic, well-regarded programs that also have good hours?

 

[disorder]

I am at a top school, and have done very well in med school. Everyone tells me if I want to do a fellowship, or get a good job later, I should go to a residency in an academic program... yet, I find myself looking more at the community programs because all the academic ones I have seen on Freida have 65-75 avg hours per week.

I am feeling like I have to decide between going to an academic program and seeing my kids for the next three years. Does anyone else feel this way?

Are there academic, well-regarded programs that also have good hours?

You're going to work hard where ever you go. In my very limited knowledge, I have the impression that the newer ACGME regulations have made programs more similar than dissimilar as for as work hours. Pick the program you like and pick the program that's going to fit you best. It's "only" three years.

Think about future career goals once you're there and pick accordingly (i.e. don't go into interventional cardiology etc etc if you want a life).

If anything, I'd pay attention to how many inpatient months your program puts you through to determine the "rigor".

 

[jdh71]

I am at a top school, and have done very well in med school. Everyone tells me if I want to do a fellowship, or get a good job later, I should go to a residency in an academic program... yet, I find myself looking more at the community programs because all the academic ones I have seen on Freida have 65-75 avg hours per week.

I am feeling like I have to decide between going to an academic program and seeing my kids for the next three years. Does anyone else feel this way?

Are there academic, well-regarded programs that also have good hours?

65-75 are "good hours" in residency. Fellowship will be worse than that, at least the first year in almost any fellowship that has a significant in-patient load/consult service. So if you are thinking about fellowship, get used to working hard for a few years.

Why do I get so sick by the entitled, spoiled, and lazy attitudes of this millennial generation. It's three years. Afterwards find your lifestyle job. Suck it up. Anywhere that is only making you work 40-50 hours per week will probably turn out a sub-par internist, and you won't feel comfortable working on your own, not for a long time. You WANT to be fairly busy in a supervised fashion in training to see what you need to see with all of the formal teaching and feedback mechanisms built into residency before you head out in the real world. It's the only way to develop enough competence to begin to work on your own.

I promise, once you're done with residency, you'll quickly realize that your three years were just barely adequate on so many levels to someone getting out and working on their own.

 

[DIce3]

I not only agree with jdh71 but think the above statement is too light hearted even. Plan to work hard in residency to be the very best internist possible for the full 80 hours per week + reading at home or do something else. I mean no disrespect to anyone but there is a pretty huge difference between what I personally do and what the average family physician or mid level handles on their own. Three years of training in the old unregulated days was barely enough to get newly trained internists ready for private practice full service general internal medicine. It constantly amazes me how few primary providers take care of even diabetes any more without an endocrine consult.

 

[Instatewaiter]

First, 65 hours? Ha. Those freida hours are always way off.

 

[Instatewaiter]

I am at a top school, and have done very well in med school. Everyone tells me if I want to do a fellowship, or get a good job later, I should go to a residency in an academic program... yet, I find myself looking more at the community programs because all the academic ones I have seen on Freida have 65-75 avg hours per week.

I am feeling like I have to decide between going to an academic program and seeing my kids for the next three years. Does anyone else feel this way?

Are there academic, well-regarded programs that also have good hours?

The frieda hours are wrong. They are waaaay low. Even at 80 hours, you can have a life.

I would like to echo what JDH and others have said. I can tell you, having finished IM, it takes a lot of extra work above and beyond just showing up to work to become a good internist. Subtract 15 hours a week and you are left with a subpar internist.

 

[Reimat]

I am at a top school, and have done very well in med school. Everyone tells me if I want to do a fellowship, or get a good job later, I should go to a residency in an academic program.

I am feeling like I have to decide between going to an academic program and seeing my kids for the next three years. Does anyone else feel this way?

Are there academic, well-regarded programs that also have good hours?

As the above posters have stated, there is no easier medicine residency. At the med school -> residency transition, if you want to be able to have more control over your home life you need to pick a more lifestyle friendly specialty. The simple truth is that in IM we are taking care of sick (sometimes the sickest) patients in the hospital and that limits how much you get out early or take days off.

IF medicine is what you are doing (and it is a great choice), you are best served by interviewing at the best academic programs +/- a few community programs. You will work hard at academic programs, but you will also work hard at community programs. You will have many days where you do not get to spend the time (or any time) with your kids, but this is going to be true pretty much anywhere.

The reason academics is likely a better choice is that at the end of your training, if you are at a good academic center and have performed well, most have great opportunities for academic hospitalist work or outpatient positions that will give you a lot of flexibility. You will also be a strong candidate for non-academic jobs. If you decide on fellowship (and I am on the fellowship interview trail now) program directors will tell you they are looking at a candidates track record, and going from a top med school to a community residency program looks like a move in the wrong direction. As jdh71 said, fellowship is often harder than residency - but academic fellowships often are 1-2 years clinical with 1-2 years research vs community programs which are 3 years of busy clinical responsibilities.

At the end of the day, go to the different academic programs, talk to the residents (particularly ones with kids) to get a sense of which ones are more supportive than others, and pick one that you think is a good fit. If lifestyle control is very very important, consider applying to a different specialty or leaving clinical medicine completely. Hope that helps.

 

[flipmd]

If you want a cush life later on, go to an academic program now. It's a good investment that will open doors and give you lots more choices when you start looking for jobs in the future. People like name brands.

 

[happygilmore]

The frieda hours are wrong. They are waaaay low. Even at 80 hours, you can have a life.

What if you worked only 40 hrs a week? Super life?

I not only agree with jdh71 but think the above statement is too light hearted even. Plan to work hard in residency to be the very best internist possible for the full 80 hours per week + reading at home or do something else. I mean no disrespect to anyone but there is a pretty huge difference between what I personally do and what the average family physician or mid level handles on their own. Three years of training in the old unregulated days was barely enough to get newly trained internists ready for private practice full service general internal medicine. It constantly amazes me how few primary providers take care of even diabetes any more without an endocrine consult.

Wow, so like 90-100 hrs a week working? No thanks.

 

[Raryn]

First, 65 hours? Ha. Those freida hours are always way off.

I don't know. Probably not that inaccurate overall for my program.

If you were to average all of the electives we're at 55-60 hours, our clinic block we're at 45-50 hours, and the wards/ICU blocks we're at 75-80, I think you'd get to about 65-70 hrs/week over the course of the year. And most programs have as much (or at least close to as much) elective time.

 

[KnuxNole]

What if you worked only 40 hrs a week? Super life?



Wow, so like 90-100 hrs a week working? No thanks.

You'll be VERY hard pressed to find any residency that you'll work 40 hours. Maybe derm...however they have to do a lot of reading out of work.

After all, it's common knowledge that you'll work a lot in residency, but also common knowledge that you'll be provided training so that when you are out of the safety net as an independent attending, you won't be a bumbling fool.

 

[happygilmore]

You'll be VERY hard pressed to find any residency that you'll work 40 hours. Maybe derm...however they have to do a lot of reading out of work.

After all, it's common knowledge that you'll work a lot in residency, but also common knowledge that you'll be provided training so that when you are out of the safety net as an independent attending, you won't be a bumbling fool.

90-100 hrs a week on medicine is over doing it though. Especially if you commute, that could push 105 hrs/wk.

 

[gutonc]

Merged duplicate threads.

 

[DIce3]

90-100 hrs a week on medicine is over doing it though. Especially if you commute, that could push 105 hrs/wk.

80 is the standard maximum hour requirement per week but I would add 3 to 7 extra for reading/ preparation which brings to a total of probably closer to 85 hours per week not including commute time. This is about right for the PGY 1 year but some PGY 2 and 3 months will be less, sometimes considerably less.

 

[jackets5]

I'm 3 months into IM residency at a University program and while on wards I think my shortest week has been 71 hours, longest has been 93. Usually stay in the high 70's to low 80's in the hospital. You can still have a life, no your not going to have the same life as someone who works a regular 9-5, m-f job. I still manage to get to the gym 3 times a week, go out to dinner 1-2x a week, get around 6 hours sleep a night. Supposedly it gets better 2nd and 3rd year but its not that bad. Even if its awful its only 3 years

 

[jerseytrash]

First, 65 hours? Ha. Those freida hours are always way off.

I go to a university program that's considered very strong (not "SDN top 20" or whatever but still quite good) and we have a reputation for being a pretty tough program. All the same we work on average 70-75 hours a week, with maybe 80-85 when it's a tougher rotation. The FREIDA hours downplay it a little because they average them, but there are certainly rotations where you work 40-50 hour weeks as well (ambulatory, electives, etc). Usually that's counterbalanced by spending time reading/doing research as well, but 65/wk is not that crazy.

Worth noting also that as an intern my hours are definitely worse than as a PGY-2/3 - typically seniors come in later in the morning and when we all get out is a matter of our own efficiency.

 

[jerseytrash]

65-75 are "good hours" in residency. Fellowship will be worse than that, at least the first year in almost any fellowship that has a significant in-patient load/consult service. So if you are thinking about fellowship, get used to working hard for a few years.

Why do I get so sick by the entitled, spoiled, and lazy attitudes of this millennial generation. It's three years. Afterwards find your lifestyle job. Suck it up. Anywhere that is only making you work 40-50 hours per week will probably turn out a sub-par internist, and you won't feel comfortable working on your own, not for a long time. You WANT to be fairly busy in a supervised fashion in training to see what you need to see with all of the formal teaching and feedback mechanisms built into residency before you head out in the real world. It's the only way to develop enough competence to begin to work on your own.

I promise, once you're done with residency, you'll quickly realize that your three years were just barely adequate on so many levels to someone getting out and working on their own.

It's not unreasonable for someone to want to have a good lifestyle outside of work, especially if they're married/have kids/for health reasons. But I agree, putting in the hard work now = results and rewards later.

Also, pulm/cc or straight cc fellows definitely work their butts off here, taking q2 long call on their 2 week ICU stints.

 

[Instatewaiter]

I go to a university program that's considered very strong (not "SDN top 20" or whatever but still quite good) /QUOTE]

I'm pretty sure such a place doesn't exist. It's either top 10 or it's midtier.

 

[disorder]

our program has 9-10 months inpatient intern year.
we average easy 80-90hr work weeks during those months.

 

[jerseytrash]

.