Hey guys, new to the forum. I am an IM resident at a medium sized university program and have a few general questions about hospitalist medicine. I am mostly just wondering about the structure of the hospitalist jobs and if it is possible to negotiate a contract with a hospital about doing 14 on 7 off structure or if that is just not done? Also if I could hear back from a few hospitalists about their experience with "burn out" that would be amazing! Thanks!!!
Hospitalist structures
- Thread starter brm12
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It would be tough to negotiate that structure specifically but you could certainly pick up extra shifts to create such a schedule.
For the 6 months before you put a bullet in your head.
dont do that.
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i've actually interviewed at a couple of hospitals now and none of them have the typical schedule of 7 on/7 off that i've heard about with hospitalist positions (all of the hospitals are in the dallas area), most of them are based on a working mon-friday schedule and working every 3rd weekend and occasional days off.
7 on 7 off sounds like a great idea... but most hospitalists tell me that 7 days on straight is too grueling to do for the rest of your life (you are frequently called at night as well). 7 on 7 off sounds great in your 20's but not when you have a family and want some regularity (it also means you are working every other weekend).
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It depends if you are interested in an academic career or not. If you are applying for an academic position, I would recommend you look at a recent JAMA article comparing 2-week vs. 4-week attending structures. If you are not going into academics, anything less than 7 days in a row leads to too little continuity and, I think, less optimal patient care.
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I am working as a hospitalist and can say that working 14 shifts in a row in the same hospital is killing, you will be burnt out. However, You can do it f you work in different system.
You will feel tired and boring if you only work in 1 hospital.
In my group, Most of us become tired at shift 5-6-7. In order to refresh, we do locum or IC or part time at other hospitals.
After my 7 day block, I work in other hospital and feel refreshed again.
You will feel tired and boring if you only work in 1 hospital.
In my group, Most of us become tired at shift 5-6-7. In order to refresh, we do locum or IC or part time at other hospitals.
After my 7 day block, I work in other hospital and feel refreshed again.
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I've done quite a bit of hospitalist moonlighting through fellowship. After a weekend, I've had my fill. I've done a few three-day weekends, and once I did four days in a row. And by day four, I was very, very ready to be done. Theoretical days 5, 6 and 7 would have been extremely rough. Theoretical days 7-14 would have been tantamount to self-flagellation of the most desperate sort.
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Many residents are psychologically unprepared when they show up for their first day as a hospitalist and somebody hands them a list of 17 patients that are now theirs and theirs alone. Four of them need to have discharges arranged and meanwhile four more need to be admitted, and you are being paged about patients 4, 7, 11, and 16... Time management skills become paramount. I spend the first five minutes of the day just simply triaging every patient on my list, from "people I should see in the next two hours" to "people I just need to see at some point before I go home."
depends on where you work but at my hospital I was told:
day shift people: 2 are admitting, rest are rounding/taking calls on their own patients. 2nd shift people round/take admits, and 3rd shift people either do cross cover or do admits.
17 seems kind of a lot. I would avoid that hospital if you can...most places I've heard of (or at least the more chill ones) max out at 15 and you are not the only person rounding and admitting during that time.
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i would beg to differ...having been through a few hospitals (though all big academic institutions) in different parts of of the atlantic seaboard, 17-20 is not that unusual if all you do is round...if you are rounding and admitting, you may only have 15, but 18 give or take seems to be the norm (even if the programs tell you 12-15! 🙂 )
the 6, 7th days of a 7 day stretch are exhausting and the fact that you can see the end of the week coming makes it all the more exhausting...
Thanks everyone for the insight. I know there have been some forums before about hospitalist vs specialty but I figured I would re ask because it seems there are quite a few attendigns that posted on this thread. I love both general medicine and cardiology right now. I am having a very hard time deciding which to pursue as I think I would be happy doing both. How do you guys (and gals) who have been attendings for any period of time feel about your decision to do hospitalist work? If you could, would you go back and specialize after seeing what you have?
that's kind of an interesting mix right there. when you do your cardiology rotations, you'll notice its very...cardio so to speak. lots and lots of the same thing over and over again with mostly chest pain rule outs. you either love it or you don't.
