Hours in radiology residency...

[link2swim06]

I am a M1 finishing my first year and am interested in radiology, but haven't found much clear information on the hours during residency.

How many hours a week would say you spend in the hospital?
How many hour outside studying?
Is there plenty of time to moonlight and/or have a some free time?
Does the work load change over the 5 years?

I get it varies per residency, but lets say the avg program.

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[colbgw02]

I work about 55 hours a week, which includes about one call shift a week. I think that is pretty average, but I'm sure a Google search or looking through FREIDA should yield a better answer.

Radiology tends to require more outside reading than many specialties, especially early on. The conventional wisdom is that you need to spend 2 hours a day studying, but I don't know anyone that actually sticks to that.

Moonlighting is certainly available, but will depend heavily on the part of the country you're in. Many residency programs don't allow moonlighting. Typically, residents don't feel comfortable moonlighting outside of their program until some time during their R3 (PGY-4) year. Some programs, particularly those at community hospitals, offer in-house moonlighting. You can also babysit a magnet and/or CT scanner for contrast reactions once you have a license.

I'm not sure the workload changes over the years as much as it just gets easier, meaning your speed increases. As an R1, there's a very steep learning curve, and the simple act of dictating is painful.

I get that residency is the next step in your career, so it's natural to concentrate on that, but try not to choose a specialty based on what the residency is like. Even a long residency is only a blip on what will likely be a career spanning many decades. Private practice radiology is largely no longer a lifestyle specialty, and that may become more true with looming reimbursement cuts. Do radiology because you enjoy it; having a relatively easy residency should just be gravy.

 

[davidjones]

at our program if you're on diagnostics day starts at 8 and ends between 6 or 7 if you're on CT, neuro, or US, unless you're on something like mammo, body MRI or nucs where it ends around on 5ish.

if you;'re on interventional you get there around 6:30 or 7 to round, then do cases, consults, occasionally see pts in clinic (predominantly that's attending driven) and then round on post-op patients, done around 6 or 7. call depends on number of people in your class, we're q7.

so on average we're working on between 64-70 hours, and the whole 2 hour reading thing is about right. though you can include reading about a case during the day. add to that any research you are doing and you are looking at about 80-90 hours a week of work.

 

[Radonkulous]

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[link2swim06]

My interest in radiology is not about the hours, but its definitely a curiosity.

So to the residents, would you say you had more free time in M1 year or now?

Again I realize radiology isnt about the hours, just interested about whats ahead if I choose this path. And I ask about moonlight bc as everyone else it would be nice to pay down loans before I am out of school for 5+ years.

 

[fun8stuff]

My interest in radiology is not about the hours, but its definitely a curiosity.

So to the residents, would you say you had more free time in M1 year or now?

Again I realize radiology isnt about the hours, just interested about whats ahead if I choose this path. And I ask about moonlight bc as everyone else it would be nice to pay down loans before I am out of school for 5+ years.

i dont know about you but as a M1 I quit going to class after a couple months... and just read the notes. Most people did. I miss M1 and M2. During M1 we only had exams once per month so I was only REALLY busy during that last week.

My hours now are more on par with what colbgw02 said. Different rotations have different hours... some rotations have 2 different shifts, but primarily it is 8-4pm or 8-5pm. Lecture and lunch every day 11:30-1pm. We have lecture 4-5pm a couple times a week. Most weekends are off, but we do have a few calls schedule throughout the year starting after R1. I think it breaks down to ~2 calls per month if you were to spread them out although some of us clump them so we can be call free for most of the year.

Fortunately, I don't mind the work for the most part. I remember as a M1 just wanting to find something with the least amount of hours. Fortunately I realized that in medicine it really doesnt get better than 40-50 hrs/week and that is too long to spend doing something you dislike. Of course, you could always work part time in most non surgical specialities... though for a pay cut.

 

[CaptKirk]

Hours also vary within each program, which makes it hard to give you an average. You'll find R1 year at many programs is perhaps fewer hours in terms of less weekends/call (particularly since you cannot take unsupervised call as an R1). However as some have alluded, the expectation is that you spend more time reading as an R1.

At my program R1 year is "relatively" light meaning you have very few weekends and no overnight call. R2 and R3 year are considerably busier, with 1-2 night float rotations (each of which is 12 nights of call), about 5 24-hour shifts throughout the year on non-night float months (Saturday is the only day not covered by night float), and we have residents working weekend-days... so in the end, you're working almost every other weekend in some capacity.

R4 year here has traditionally been less call with most completely done with weekend/call responsibilities by Thanksgiving. Though, with boards changing, I'm sure R4's will take more call in the future.

 

[link2swim06]

Does R1= PGY2?

Is the intern year different for radiology residents or is it basically the same for everyone except psych and surgery?

 

[fun8stuff]

Does R1= PGY2?

Is the intern year different for radiology residents or is it basically the same for everyone except psych and surgery?

yes, R1 = PGY2.

So there are like 3 main types of internship- preliminary year in medicine, preliminary year in surgery, and transitional year.

Prelim med is mostly IM months (10+ months). Prelim surgery are mostly surgery months. TYs are typically 4-6 mo of IM and the rest are electives. You can do any of them for radiology, although I believe there are certain requirements like 5 months of inpatient medicine or surgery is mandatory. Some rads program are combined with an intern year while others you do your intern year separately.

Electives can be variable. Like for me, I did rotations that I thought might be some benefit to me in radiology like pulmonary, neuro, and ortho. 1 month of ER was required. My intern year was combined, so I actually had 3 months of radiology as well. Some places will require you to have a month of IM clinic. Also, some places are less demanding and busy than other places.

There are other intern years that don't quite fit the mold above like for psych and neuro. I think they are most similar to a prelim med year, but like with psych i think there is less IM months and with neuro there are more.

 

[UCLAstudent]

It varies with the rotation, but I'm an R1 generally work 55 hours per week with one call per week. I only work one weekend out of five (12 hours on one day and 9 hours on the other day). I chose to schedule my weekends so that I'm on call both Saturday and Sunday --- it allows for more free weekends.

 

[MossPoh]

This is more of a curiosity but in the same light as the hours, but as an R1 how much dictation and reading do you guys (and gals) do versus simply learning as much as humanly possible? It feels like it is difficult for a person fresh out of their intern year to handle a workload that'd actually put a dent in the incoming cases, strictly because of how much there is to know. It seems difficult compared to a surgical subspecialty or really any other area where there appears to be more overlap. (I'm only an MS2, so I know it is likely I'm wrong with this impression)

Do you start off reading more straightforward stuff and gradually get more complex as one is able to develop that "gestalt" for the norm or are you simply thrown in the fire and whatever you get done is what gets put out and then double checked by an attending?

When you moonlight, is it similar to a nighthawk service where they just review your stuff the following day or a locum gig where you show up and crank through like an attending? (I know nighthawk is the company name and is equivalent to saying I am going to "xerox" something)

 

[colbgw02]

This is more of a curiosity but in the same light as the hours, but as an R1 how much dictation and reading do you guys (and gals) do versus simply learning as much as humanly possible? It feels like it is difficult for a person fresh out of their intern year to handle a workload that'd actually put a dent in the incoming cases, strictly because of how much there is to know. It seems difficult compared to a surgical subspecialty or really any other area where there appears to be more overlap. (I'm only an MS2, so I know it is likely I'm wrong with this impression)

I'm sure this is program dependent, but my experience is that the staff will help out when a brand new resident starts drowning in an ever-expanding list. Still, I think you'll find yourself staying late at first to finish dictating. Developing speed is part of your training though, so don't use the staff as a crutch. This is in addition to the conventional wisdom of two hours of independent studying that you ought to be doing at first. I've found that textbook studying is the way to go initially. Over time, I think taking cases and seeing more studies is a better way to learn.

Do you start off reading more straightforward stuff and gradually get more complex as one is able to develop that "gestalt" for the norm or are you simply thrown in the fire and whatever you get done is what gets put out and then double checked by an attending?

Don't worry. No one is going to expect you to start reading MRI during your first week. Typically there's a division of labor in which more junior residents read the more straightforward studies while the upper levels read the more complex stuff. Remember that you won't be taking independent call until you're a PGY-3, so you've got some time.

 

[MossPoh]

Thanks for the reply.

No use in being worried about it. It was more of a curiosity thing with how the workflow and structure is. Heck, as an MS2 I'm still assuming I'm going to change my mind, although I have the sneaking suspicion I'm going to narrow it to 2 or 3 specialities with radiology being one of them and then default to radiology because of my lifelong exposure to the field.

From the outside it is easier to see and understand that structure in other fields where one has a strong base going when first starting. I think the education for interpreting radiologic studies is way sub par at the majority of medical schools.

 

[Taurus]

I guess it really depends on where you go. Mine sounds pretty cush compared to others.

At my program, R1 year is around 40-45 hours a week. On most rotations, I get in by 8 a.m. and leave between 4-5 p.m, plus I have two hours of conference during those hours daily. Call where you work both weekend days like typical workdays occurs once every two weeks or so. Call has been light lately for me. I did weekend call only once in two months. Of course, R2 and R3 years have more call and are tougher.

I do a lot of outside reading at home though. It also gives me more time to participate in doing presentations and research.

Bottom line, pick your residency very carefully. Some are tougher than others.

 

[Radonkulous]

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[fun8stuff]

Seems really sweet. Self-learning, which I like, and a relatively light work week.

I have a similarly "light" schedule as a posted above, which a lot of my friends from other specialties are jealous of.... but somehow I always seem mentally drained, even compared to intern year. I may be "mentally" out of shape since I coasted with practically no real learning from end of third year until now.

Of course, my ideal schedule would be more like 4th year... 9am-12pm, 4 days/week 😛

 

[Radonkulous]

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[Taurus]

Seems really sweet. Self-learning, which I like, and a relatively light work week.

It's kinda funny. The regular workdays don't bother me much at all and I don't feel drained by them. It's the weekend calls that I fret and can't wait to get over. I think the reason why call is more taxing is 1) pace is faster 2) you are usually "it" and you have to put up a prelim note that the clinician uses to make clinical decisions. It's nerve-whacking to think that your prelim note can mean life or death for a patient and no attending is around to hold your hand. Of course, you can always call an attending for the really difficult cases but that doesn't happen often. Thank heavens call only happens once every few weeks at my program.

 

[fun8stuff]

It's kinda funny. The regular workdays don't bother me much at all and I don't feel drained by them. It's the weekend calls that I fret and can't wait to get over. I think the reason why call is more taxing is 1) pace is faster 2) you are usually "it" and you have to put up a prelim note that the clinician uses to make clinical decisions. It's nerve-whacking to think that your prelim note can mean life or death for a patient and no attending is around to hold your hand. Of course, you can always call an attending for the really difficult cases but that doesn't happen often. Thank heavens call only happens once every few weeks at my program.

my first rad call is coming up in a few weeks here... im scared ****less

 

[colbgw02]

It's kinda funny. The regular workdays don't bother me much at all and I don't feel drained by them. It's the weekend calls that I fret and can't wait to get over. I think the reason why call is more taxing is 1) pace is faster 2) you are usually "it" and you have to put up a prelim note that the clinician uses to make clinical decisions. It's nerve-whacking to think that your prelim note can mean life or death for a patient and no attending is around to hold your hand. Of course, you can always call an attending for the really difficult cases but that doesn't happen often. Thank heavens call only happens once every few weeks at my program.

I hate call so incredibly much. It's actually quite difficult to put how much I hate it into words. We never used a nightfloat system, so being up 26-27 hours in a row absolutely destroyed me for the next two days. I didn't start feeling normal again until my post-post-post call day. Luckily, I've taken my last one as a resident, and the call at my next stop is only about once every 2-3 months.

 

[fun8stuff]

I hate call so incredibly much. It's actually quite difficult to put how much I hate it into words. We never used a nightfloat system, so being up 26-27 hours in a row absolutely destroyed me for the next two days. I didn't start feeling normal again until my post-post-post call day. Luckily, I've taken my last one as a resident, and the call at my next stop is only about once every 2-3 months.

are there still rads programs that have 24-30 hr call?

 

[colbgw02]

are there still rads programs that have 24-30 hr call?

I'm sure there are. Mine still does, for one, but only until the end of the academic year. Doing nightfloat at smaller programs can be difficult, especially when the staff don't like to cover any part of the day without a resident.

 

[MrBurns10]

are there still rads programs that have 24-30 hr call?

I interviewed last year and 2/15 programs I visited still had 24 hour call. One was going to a nightfloat system by this year, however. The other program swiftly went to the bottom of my list.

 

[cowme]

So how much of a difference does program size actually make in determining call? I know on average, bigger classes equate to less call, but when I interviewed at some big programs (like upmc, UW), they seemed to take just as much call as 5 person classes.

These classes had 50 residents, buts were covering like 4 hospitals overnight with a different resident at each, while smaller programs had less residents, but only covered one hospital. It just seemed like either way, you are covering a similar amount of weekend calls (with a couple less night float weeks at big programs). Am I wrong about this?

 

[fun8stuff]

So how much of a difference does program size actually make in determining call? I know on average, bigger classes equate to less call, but when I interviewed at some big programs (like upmc, UW), they seemed to take just as much call as 5 person classes.

These classes had 50 residents, buts were covering like 4 hospitals overnight with a different resident at each, while smaller programs had less residents, but only covered one hospital. It just seemed like either way, you are covering a similar amount of weekend calls (with a couple less night float weeks at big programs). Am I wrong about this?

There are some exceptions as you listed above, but in general bigger program = less call.

 

[Taurus]

So how much of a difference does program size actually make in determining call? I know on average, bigger classes equate to less call, but when I interviewed at some big programs (like upmc, UW), they seemed to take just as much call as 5 person classes.

These classes had 50 residents, buts were covering like 4 hospitals overnight with a different resident at each, while smaller programs had less residents, but only covered one hospital. It just seemed like either way, you are covering a similar amount of weekend calls (with a couple less night float weeks at big programs). Am I wrong about this?

Yeah, be careful of programs with big classes but covering a ton of hospitals, ie, UPMC.

My system has multiple hospitals too but residents only cover two hospitals. Even covering two hospitals, where one is a level 1 trauma center and the other is a community hospital, is a pain in the ass.

 

[txguy]

I'm also a current R1 and my schedule is on the "cushier" side. I work between 40-50 hrs/week, usually 8a-5pm. I'm on buddy call about once per month (night float does not begin until R2). As far as studying goes, 1 hr/night is a considered a good night...as others have said above, I'm much more mentally drained after the workday, and lately I just don't have the energy to study when I come home. I definitely didn't use my brain as much during my intern year!

-tx

 

[MossPoh]

Do residents have PACS at home for call or is it the old school version of call where you actually have to head in to the hospital to read a study? (Probably program dependent like everything else)

 

[cowme]

Do residents have PACS at home for call or is it the old school version of call where you actually have to head in to the hospital to read a study? (Probably program dependent like everything else)

Not only are radiology residents ALWAYS In house when on call (at every program), but they work nonstop. I've never heard of a radiology resident sleeping while on call. This is not really program dependent. Any program covering an ER (every program), will have plenty of overnight studies.

 

[fun8stuff]

Do residents have PACS at home for call or is it the old school version of call where you actually have to head in to the hospital to read a study? (Probably program dependent like everything else)

Call is in house and work is pretty much non-stop as stated above. Most programs divide call up into different shifts: short call during the week (i.e. 5 - 9pm), weekend call (i.e. sat /sun 7am - 9pm), and 1 week midnight shift blocks (i.e. friday - thursday 9pm - 7am). Some programs still have 30 hr call, which foruntely won't be for much longer because the rules are changing.

Some places also have 1 week blocks of optional (paid$$) or equally divided interventional or CT-procedure weekend & evening call that is from home where you only come in only if there is a procedure. I think at some places fellows take home call. Of course, also some rads in private practice will be on call from home... but the direction is moving toward what is described above where there is a radiologist in house 24/7.... american healthcare is addicted to imaging and it is becoming harder for them to function without us.