How many shifts/month in residency?

[tenfootsilence]

So I know that many people probably have differing opinions on this based on where/how you trained, so I was just curious about two things: 1- How many shifts do you prefer per month; 2- What is the relative "standard" across the board.

*Of course I know that differing # of hours/shift makes a difference, just factor that into your response.

---

Members don't see this ad.

 

[winkleweizen]

So I know that many people probably have differing opinions on this based on where/how you trained, so I was just curious about two things: 1- How many shifts do you prefer per month; 2- What is the relative "standard" across the board.

*Of course I know that differing # of hours/shift makes a difference, just factor that into your response.

Standard varies so much depending on if its 8s, 9s, 10s, 12s, etc. I would say 18-19 12s, or 22-23 8s is pretty standard for intern year though.

Im kind of split, but I think I prefer 12s better

 

[bad virus]

Standard varies so much depending on if its 8s, 9s, 10s, 12s, etc. I would say 18-19 12s, or 22-23 8s is pretty standard for intern year though.

Im kind of split, but I think I prefer 12s better

12's are pretty toxic though. None the less, a shift can usually take my whole day away anyway, even if it is 8 hours, so i rather have 4 extra days off with 12's.

 

[tenfootsilence]

Pretty sure I agree. 12s are super long, but you do have a few extra days. I think I would prefer 18-19 12s also. I guess that will be something to ask when your on the interview trail, but I definitely don't think it would be a deal breaker no matter what the shift set up is.

 

[RPedigo]

I really like the 8-9 hour shifts. I can still go to the gym, cook dinner with my fiancee, and read a little bit. Especially if you have to stay an extra hour to clean up charts, dispos, and help out a bit, the 12s really wreck your day. I do suppose having more days off would be nice, though, but I like having little bits of each day to myself more.

 

[namethatsmell]

I've been thinking about this too. During my first EM month we as med students couldn't write any notes in the EMR so things felt less hectic during the shift and I basically always got out exactly as scheduled. Throughout that month I was sold on the idea of 12-hour shifts.

During my last EM rotation we were expected to write notes on every patient...and I was surprised at how much this kicked up the pace of the things (the fact that I'm new at this and slow probably didn't help). I was much more tired walking out of these shifts and I (along with the residents and attendings) often stayed 1-2 hours after my shift to finish notes.

I think 12s could be ok, but a few things would have a big impact: Namely, are you picking up new patients for the whole shift, or is the last hour of the shift reserved for just wrapping things up with existing patients and finishing? Also, how do they schedule nights shifts and the transition to/from days?

 

[winkleweizen]

I figure if you can do 12s during residency, then however your job as an attending works shifts, youll be used to or pleasantly suprised. However, if I get used to 8s, then an attending job working 12 would suck

 

[SeekerOfTheTree]

I figure if you can do 12s during residency, then however your job as an attending works shifts, youll be used to or pleasantly suprised. However, if I get used to 8s, then an attending job working 12 would suck

Good point. Wish me luck man about to go do Step 2 in the rear.

 

[winkleweizen]

Good point. Wish me luck man about to go do Step 2 in the rear.

Good luck giving it the business!

 

[FSU2013]

Good luck giving it the business!

http://www.youtube.com/watch?v=bPz01KZi2vc

 

[UnderwaterDoc]

Where I'm at we do 9s, and IMHO that is the sweet spot. We started off intern year with 20-21 per month, now 18-19 as PGY2s. Its typical to stay 1-2 hours after shift cleaning up. I have time to read and work out on workdays, not bad at all.

I did 12s in medschool, and they sucked big time, all you have time for is work and sleep, I don't think the extra days off are worth it. It's baffling to me that some people prefer 12s, I guess if you're in a low volume place it wouldn't be so bad, but if you're staying after shift to clean up that is a terribly long day.

 

[Hercules]

The biggest factors I've seen in terms of how people feel about 8s vs 12s are commute time and single vs married (especially with kids).

If you have a 45 min commute to work you're likely going to prefer something like 12 twelves because it means your total commute for the month is 18 hours. If working eights you'd be doing 18 of them for 27 hours of commute time.

Single people tend to like twelves because as stated they get more days off and can plan fun trips, events, etc. Married people with kids don't like twelves because a string o them means you don't see your spouse and children for 4 days. Then you get an off day and your family is away at school/work. Whereas with an 8 you're much more likely to have time (and energy) to spend playing with the little ones and enjoying your spouse's company.

These are just generalities but after 4 years in residency and 3 in practice they seem to be the main variables that affect people's preference.

 

[bad virus]

The biggest factors I've seen in terms of how people feel about 8s vs 12s are commute time and single vs married (especially with kids).

If you have a 45 min commute to work you're likely going to prefer something like 12 twelves because it means your total commute for the month is 18 hours. If working eights you'd be doing 18 of them for 27 hours of commute time.

Single people tend to like twelves because as stated they get more days off and can plan fun trips, events, etc. Married people with kids don't like twelves because a string o them means you don't see your spouse and children for 4 days. Then you get an off day and your family is away at school/work. Whereas with an 8 you're much more likely to have time (and energy) to spend playing with the little ones and enjoying your spouse's company.

These are just generalities but after 4 years in residency and 3 in practice they seem to be the main variables that affect people's preference.

Thanks for the viewpoint. That was very insightful.

 

[Dane07MD]

We do 12s. Interns do 18-19/month. By senior year, you do 14-15/month. Seems fine to me. 8 hour shifts go by super fast, but I also feel like you hardly have time to fully work up and disposition many patients in a shift like you can with a few extra hours. With 8s (in med school) seemed like we always signed out a bunch of question marks by shift change.

A wise man told me that residency is time for 12s. As an attending, you do the 8s and 9s (and get scribes...)

It's all personal preference.

 

[SoCuteMD]

My program
Intern year: 18 12s
Second year: 17 shifts, mix of 10s and 12s (my 2nd year it was 16 12s)
Third year: 17 shifts, mix of 9s with overlap, 10s, 11s with no overlap
Fourth year: was 19 9s with overlap, but we are often scheduled for vacant 10s and 11s. We are now going to 17 shifts, with 12s on the weekends and 9s during the week. I'm sure we'll still be filling in 10s and 11s, too.

 

[KiloAxe]

I think 8s versus 12s depend on how fast you can move patients through the department. I work 9s and can easily start, complete and dispo a ton of patients. If radiology is backed up 3 hours certainly makes seeing patients alot harder. Asking residents how many patients they see in a shift can be helpful to figure out what you prefer. I would be completely wiped after a 12 hour shift but I often don't even have time for dinner or a piss break during my 9 hour shifts

 

[cofcemt]

We do 19-21 9's as interns and gradually goes down from there. I think 9 hours is the sweet spot and I usually only end up staying about an hour after to finish things up. I think most of the 3rd years are seeing like 20-22 in a shift; which still boggles my mind.

I think I'll opt for 12s as an attending, just to have more days off with family. And I'm sure that will cahnge as I age and so do my kids.

 

[Snelgrave]

Our residency used 10 hour shifts with 9 hours of chart pick-up for PGY1-2, and 8 hours of chart pick-up for PGY3s. Number of shifts - PGY1: 21-23, PGY2: 20-22, PGY3: 18.

I don't like 12s for above mentioned reasons. I have a wife and a toddler and 12 hour shifts at my new job wreck my day.

 

[ORL10]

In our program interns do 18 10's, with 1.5 hours of overlap. (see new patients for 8.5 hours and 1.5 hours of cleaning up) Interns usually stay an hour after that (total 10-11hrs), seniors usually out half hour before that (9-10hrs).

3rd years usually do 16-17 shifts, and almost all do internal moonlighting (2-3/month) for a total of 18-20 shifts with 2-3 being paid (700/shift). Others do external moonlighting on their own license ($120-180/hr).

Much better than our surgery colleagues.