How much do yall work?

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120 hours clinically. Do a lot of admin stuff. Prior to the admin, minimum of 156 hours monthly.
 
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AlmostAnMD said:
wtf

this isn't for residents

j/k

I'm sorry man that's really ****ty. Hopefully you're at least in a chill gig. I read 215 and my hand started to sweat
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Haha, seriously. 18 12s? 21.5 10s? A mix of 9s and 10s? Either way... Gross. On the way to FIRE? Props, that's impressive.
 
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9 x 12 hour shifts at full time gig.

Usually 2 x 12 hour shifts at PRN gig.

So 132 monthly hours, probably will decrease to 120 monthly hours in 1-2 years
 
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AlmostAnMD said:
wtf

this isn't for residents

j/k

I'm sorry man that's really ****ty. Hopefully you're at least in a chill gig. I read 215 and my hand started to sweat
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Nope not chill places. But they pay well. 🙂 Hard to say no when people throw money at you.
 
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I work about 145 a month, just days at the moment (prob temporary), most of the time at a reasonable pace but not always, acuity pretty high at our shop. Gives me room to ramp up if needed. Wife doesn't really work, two kids in private school, single income family, lots of trips but no expensive hobbies.
 
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Used to be 100 hours a month and life was good. However I am moving across the country this next month so last year it has been 120-140 a month. Not a happy camper about that. I will definitely try to go back down after the move.
 
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84 hours, 8 shifts. Mix of 9's and 12's. Some months I add up to 72 hours of locums but that's rare and only if they meet my get up and get out of state price.
 
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120 hours a month, translating to 10 12hr shifts for me. Now that I'm debt free and cash flow is markedly better, probably could go down more.
 
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I’m going to flip this thread on its’ head slightly. How much you work is mostly related to how much you want to spend (in your life). This isn’t specific to EM, or even medicine. Some have tolerance for more work, and some for less, even regardless of spending level, but despite work ethic or desire, it ultimately comes down to trade offs. At some point the work in the ED gradually becomes less appealing as it is a brutal job (as far as white collar jobs go) that isn’t devoid of routine. It becomes a tipping scale with dollars on one side and work dissatisfaction on the other. It’s not the number of hours you work on average, but the total volume of patients you accumulate, your own personal tolerance of that, and your spending habits, which ultimately determine the hours you work on average over time. It’s natural to want to get a sense of what others are doing, but it’s really more about self reflection on what works best for you and where you are at in your EM career.
 
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I work a ton because I want to save a ton. I live like a middle class American with a few extras. I figure every shift I work now is worth 2-3 later on and the math is compounded even more in my favor because I work day shifts right now. This means I get to laugh and say “No” when people try to get me to work overnights/weekends/holidays later.

There is so much freedom in being able to say “No” (and mean it).
 
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Porfirio said:
I work a ton because I want to save a ton. I live like a middle class American with a few extras. I figure every shift I work now is worth 2-3 later on and the math is compounded even more in my favor because I work day shifts right now. This means I get to laugh and say “No” when people try to get me to work overnights/weekends/holidays later.

There is so much freedom in being able to say “No” (and mean it).
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Yup, so much this.

I've turned down a last minute overnight shift with a $10k bonus, because it was the weekend, and I was out spending time with family.
 
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Porfirio said:
I work a ton because I want to save a ton. I live like a middle class American with a few extras. I figure every shift I work now is worth 2-3 later on...
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When you live in a high-tax state, with net marginal taxes of ~50%, the math doesn't work that way. From a financial perspective better to work a sustainable schedule and prolong your earning years while maximizing your pre-tax deferment and keeping your spending in check.

I find that the less I work, the more I enjoy my job. ~80hrs clinical a month and ~60 teaching/admin for me. Any more and I start really disliking the job.
 
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Porfirio said:
I work a ton because I want to save a ton. I live like a middle class American with a few extras. I figure every shift I work now is worth 2-3 later on and the math is compounded even more in my favor because I work day shifts right now. This means I get to laugh and say “No” when people try to get me to work overnights/weekends/holidays later.

There is so much freedom in being able to say “No” (and mean it).
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Agree here but i dont think it is a zero sum game. Ive been doing this a while. I work as much as im comfortable with regards to my family. Some of the younger docs want some of my shifts and I happily give away shifts that dont work well for me and my family. They want to work i dont mind giving up “bad” shifts but i also dont mind working them.

Some of the “math” mentioned here is like a zero sum game. I work way more than i need and save way more than I ever planned to. I can give up shifts cause it doesnt matter. I hit my savings financial goals and just save whatever else I have left over. I think this is the way. Work for more than what you need. I also agree that compound interest is real and working that shift today is worth 2-3 shifts more later on in life.. heck maybe more. I am still of the belief that wages in EM will go down. All those “exciting” new residencies are adding to the supply. I dont believe EM volumes are up and no one is really building new hospitals (best I can see). I think the mass proliferation of FSEDs is behind us. Surely in some small pockets there is perhaps growth but nationally i am not seeing it.

All those new young residents generally seem to want to work less than people did when I graduated and importantly they will need to work for a long time due to high student loan burdens and lack of other options. All those people who did US fellowships quickly realizing no one cares. I think the ICU fellows are able to get jobs but many are 2nd class citizens since they dont do pulm / bronchs (mostly) and dont do sleep / clinic etc which is where many of the pulm/cc guys go.

All the other fellowships like pain/EMS/hyperbarics/peds etc have either limited spots or limited need.
 
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EctopicFetus said:
All those new young residents generally seem to want to work less than people did when I graduated and importantly they will need to work for a long time due to high student loan burdens and lack of of other options
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I think modern EM can be divided into two eras, pre- and post-covid. Pre-covid i had seasoned nursing staff with no turnover. Physician staffing was better. Pay/inflation issues weren't so bad.

I was planning on buying into my SDG but it basically ate itself when all these things came to a head. I'm sure there's regional variance but don't expect to work in my Midwest region and expect leadership to care about nurses constantly trying to kill patients.

I started working 220ish hours. Then backed down to 140 when my loans were paid off. Then when things went to **** I backed down to 96 hours.

But I still hated every moment of my constant high acuity, high volume and low competency environment.

For me, the right number of shifts/month was zero. Got out.

Today is father's day. I don't work weekends anymore. So last year I was working nights during it, this year I'm just chilling with the family. Family definitely takes priority over time as well.
 
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AlmostAnMD said:
I think modern EM can be divided into two eras, pre- and post-covid. Pre-covid i had seasoned nursing staff with no turnover. Physician staffing was better. Pay/inflation issues weren't so bad.

I was planning on buying into my SDG but it basically ate itself when all these things came to a head. I'm sure there's regional variance but don't expect to work in my Midwest region and expect leadership to care about nurses constantly trying to kill patients.

I started working 220ish hours. Then backed down to 140 when my loans were paid off. Then when things went to **** I backed down to 96 hours.

But I still hated every moment of my constant high acuity, high volume and low competency environment.

For me, the right number of shifts/month was zero. Got out.

Today is father's day. I don't work weekends anymore. So last year I was working nights during it, this year I'm just chilling with the family. Family definitely takes priority over time as well.
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All true. That being said even with bad / weak nurses I dont stress. I can help, I have been at my job long enough I can get things done. It is one of the nice things about working most of my shifts at busy places where there are very strong nurses. If I end up getting stuck with a crappy one, I go to my experienced strong friend nurse and ask them to help or go to charge and let them know. Working 2-3 8 hour shifts a week takes nothing out of me and I do few nights because the incentives are there for people to work nights. I think so much of it depends on your group tbh. Some are such parasites im not sad they fail. The CMGs have caused a major illness in peoples heads. People dont want to learn about or understand about the business of EM. They want to remain separated from the money part of it. I find it pathetic and sad. If you really want to be so dissociated from it then work for low wages and just donate the rest. Being a financial idiot should not be allowed for someone who is well educated and earns 300k+ a year.

@AlmostAnMD what are you doing now.. im also looking at some non EM options but my goal is to hit the lottery (not actually but to make a ton) not find a work replacement.
 
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Found what appears to be a unicorn utilization job. WFH. High end pay for advising, only a slight pay drop from my FT EM work with 99% stress reduction, paid vacation (none at sdg, "work it out with your schedule"), and no med mal because advising status/ patient flow is not something you can be sued for.

I'll post a big write up eventually but I'm only half a year in. But I've been doing it long enough to cut the cord and switch my abem cert to non clinical.

While I was burning out I was wondering how long I would have to work. Now i.....sort of enjoy work???.....new feeling....so if I retire in 4 years or 40 at this point I don't really care
 
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AlmostAnMD said:
Found what appears to be a unicorn utilization job. WFH. High end pay for advising, only a slight pay drop from my FT EM work with 99% stress reduction, paid vacation (none at sdg, "work it out with your schedule"), and no med mal because advising status/ patient flow is not something you can be sued for.

I'll post a big write up eventually but I'm only half a year in. But I've been doing it long enough to cut the cord and switch my abem cert to non clinical.

While I was burning out I was wondering how long I would have to work. Now i.....sort of enjoy work???.....new feeling....so if I retire in 4 years or 40 at this point I don't really care
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Good stuff. Congrats.
 
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150-170 hours/mo ranging from 15-17 shifts. I'm contracted for 140 but we seem to always be short docs in my area which is not a bad thing for job security. I've worked on average 140-160 for most of my career. I'm very close to getting burned out again but manage to contain it since I'm much more efficient these days compared to my earlier career and virtually never have any work to do once I leave. It's honestly not the hours, it's the overnights that contribute most to my fatigue.

My goal is to bust ass for another 3 years at which point I should have enough saved to theoretically be able to retire completely but will probably cut back to 8 shifts/mo or so and see how that feels for another few years.

Ideally, I'd love to just keep my feet wet in EM for any doomsday scenarios where I might need to scale back into work and I'd prefer to spend most of my time investing/trading.
 
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I’m about 110 hr a month (11-12x 8-9hr shifts on the schedule, but i nearly universally make them 9hr in practice, sometimes 10). This is a recent reduction I was doing more like 13/mo.

On top of that probably 80hr of admin monthly (ed chief and pres of med staff). It’s not really the total time of admin, it’s the assumed 24:7:365 availability. Granted with zoom bloat, people think you just need a million standing meetings on all topics… but it’s the constant interruptions and the fact I almost never have a day completely off. That single stroke committee meeting at 11a just gets me 😆.

I’ve had TWO weekends in 2025 where I didn’t work clinically AND I had zero interface with the hospital via phone / zoom regarding some disaster/issue.
 
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Janders said:
I’m about 110 hr a month (11-12x 8-9hr shifts on the schedule, but i nearly universally make them 9hr in practice, sometimes 10). This is a recent reduction I was doing more like 13/mo.

On top of that probably 80hr of admin monthly (ed chief and pres of med staff). It’s not really the total time of admin, it’s the assumed 24:7:365 availability. Granted with zoom bloat, people think you just need a million standing meetings on all topics… but it’s the constant interruptions and the fact I almost never have a day completely off. That single stroke committee meeting at 11a just gets me 😆.

I’ve had TWO weekends in 2025 where I didn’t work clinically AND I had zero interface with the hospital via phone / zoom regarding some disaster/issue.
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That's what broke me in admin.

Pre-pando, it was easy to say no to back-to-back meetings because I physically couldn't make it from one to the other (I was responsible for 5 clinical sites associated with 3 hospital systems). Post-pando, on my admin days, I'd have 5 or 6 meetings in a row and just get completely fried.
 
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I like the Tim Ferris strategy about meetings. I do a lot of admin. 90% of my meetings are stupid and a waste of time. I try to do meetings when I am driving to work. I almost never schedule meetings in the middle of my day. If I have an important meeting I’ll fill it in but most of the time I do it when it is convenient for me and that’s usually around when I am driving to or from work.
 
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EctopicFetus said:
I like the Tim Ferris strategy about meetings. I do a lot of admin. 90% of my meetings are stupid and a waste of time. I try to do meetings when I am driving to work. I almost never schedule meetings in the middle of my day. If I have an important meeting I’ll fill it in but most of the time I do it when it is convenient for me and that’s usually around when I am driving to or from work.
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I try, but I don’t get to pick some committee meeting times. And now its stroke, and radiology, and lab, and chiefs, and hospitalist and system-EM-EPIC (2x a month) and and and… *sigh*

I love a commute meeting though. Do a lot of my one-offs like that.
 
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miamidoc101 said:
On average per month, how many shifts/hours are you working?
Im personally at about 15 shifts 140 hours
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Roughly 0.5 clinical (70ish hours) and 0.2 administrative. After 15 years in EM, and slowly whittling down my hours, it still feels like too much to me, so I’m leaving for an HPM fellowship. Interestingly, I have fewer weekends (and no nights) as a fellow than I did as a 0.5 FTE EM attending. Can I be a fellow forever? 🙂
 
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Fellowship 15 years in? Baller decision. I was only 5 years in when I left for UM and that still felt like a hard decision, I bet doing a fellowship 15 years out was a rough choice.
 
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Pinner Doc said:
Roughly 0.5 clinical (70ish hours) and 0.2 administrative. After 15 years in EM, and slowly whittling down my hours, it still feels like too much to me, so I’m leaving for an HPM fellowship. Interestingly, I have fewer weekends (and no nights) as a fellow than I did as a 0.5 FTE EM attending. Can I be a fellow forever? 🙂
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Choose the right job and it gets even easier after. The wrong one can be harder, but it will never even touch the level of an easy Saturday day shift, much less a Monday night.

Having said that, it’s all relative. I get pissy about the dumbest stuff now, wouldn’t have even noticed before
 
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Pinner Doc said:
Roughly 0.5 clinical (70ish hours) and 0.2 administrative. After 15 years in EM, and slowly whittling down my hours, it still feels like too much to me, so I’m leaving for an HPM fellowship. Interestingly, I have fewer weekends (and no nights) as a fellow than I did as a 0.5 FTE EM attending. Can I be a fellow forever? 🙂
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Oh God, the no nights thing has me spoiled for life. I feel like I could work forever in my current environment.
 
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xaelia said:
Oh God, the no nights thing has me spoiled for life. I feel like I could work forever in my current environment.
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No nights for the win for sure.

Also, I'm now officially down to 0 a month forever. Worked my last shift this past Sat. Had 3 people actively being dogpiled and restrained by security, two of which were simultaneous, the 3rd was less than 5 minutes later. All are constantly screaming profanity and the things that they're going to do to me/staff. One would alternate fake seizing and shouting profanity and was surprisingly resistant to droperidol. She got ketamine eventually to STFU. Add that to the litany of psychosomatic complaints, demented gomers with "weakness" who didn't know why they were there and the revolving door of our frequent flyer drunks who continually reintroduce themselves to the concept of gravity. Honestly, it was probably the best way I could think of to cap off a career in the ED.
 
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120/mo.

Already way too much. It's semi tolerable and I'm stockpiling cash. It lets me provide a nice life for my family.

I have a mental timeline for when I'm exiting this trash field that I tricked myself to go into.

EM is essentially a clinic that anyone can walk into at any time, pay zero dollars, and make demands and abuse staff.
 
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I don't even really care about nights that much. It's more the swing shifts and weekends / holidays. I really don't know what 25 year old me saw in this field.
 
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Currently working nights and have been crunching data with AI and realizing that I really don't need to kill myself anymore with these 140-160 hours, especially now that I've entered my 50s. I had been thinking of waiting a couple years and dialing back to 6-8 shifts but I think I may just cut my hours back to 120 immediately and see how that feels? That would only be about 12-13 shifts per month for me and wouldn't really significantly impact my retirement savings. Hmmm.
 
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Groove said:
Currently working nights and have been crunching data with AI and realizing that I really don't need to kill myself anymore with these 140-160 hours, especially now that I've entered my 50s. I had been thinking of waiting a couple years and dialing back to 6-8 shifts but I think I may just cut my hours back to 120 immediately and see how that feels? That would only be about 12-13 shifts per month for me and wouldn't really significantly impact my retirement savings. Hmmm.
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I think that’s helpful. I have found this one thing to be true and I’ll say someone told me this early in my career. Once you cut your hours it is really hard to go back up. I have incredibly slowly trickled down my work. I made one big jump down when I started doing admin work and cant imagine ever working more even if i cut back my admin work which is what I am more likely to do than i am to cut back on clinical work. Admin work is interesting but it is much more of a 24/7 thing than punching in to my shift. I have been at my current gig ~10 years. I find it not stressful, it pays well and I dont think working less would make any difference in my life. I have been able to shift where I work few if any nights, work extra mornings which means even fewer evenings as well. My weekend shifts are unchanged and sometimes the young guys will ask for a shift of mine and if it is on the weekend i will almost always give it up.
 
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Groove said:
Currently working nights and have been crunching data with AI and realizing that I really don't need to kill myself anymore with these 140-160 hours, especially now that I've entered my 50s. I had been thinking of waiting a couple years and dialing back to 6-8 shifts but I think I may just cut my hours back to 120 immediately and see how that feels? That would only be about 12-13 shifts per month for me and wouldn't really significantly impact my retirement savings. Hmmm.
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I can't imagine even doing 100 hrs my 50s
 
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WhatJobDoIPick said:
I can't imagine even doing 100 hrs my 50s
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I have a question. First I realize im an incredibly boring human. What else is there to do? I admit the financial rewards of work play a huge role for me. Take away EM pay and im not working.. But lets say you are in your early 50s, kids are still at home (lets pretend) what is it that you do if you dont work? 100 hours a month is basically 12-8s or 8-12s or 10-10s. So lets call it 8-12 days a month of work. That leaves 18-22 days off a month.

Docs I know, golf, fish etc. I like some of those things.. However, it becomes a chore. I dont know how people spend their time. When I retire I want to travel and do it well but like most things I can only do so much. I know some people have very time consuming hobbies. I dont. Perhaps this is my issue?
 
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EctopicFetus said:
I have a question. First I realize im an incredibly boring human. What else is there to do? I admit the financial rewards of work play a huge role for me. Take away EM pay and im not working.. But lets say you are in your early 50s, kids are still at home (lets pretend) what is it that you do if you dont work? 100 hours a month is basically 12-8s or 8-12s or 10-10s. So lets call it 8-12 days a month of work. That leaves 18-22 days off a month.

Docs I know, golf, fish etc. I like some of those things.. However, it becomes a chore. I dont know how people spend their time. When I retire I want to travel and do it well but like most things I can only do so much. I know some people have very time consuming hobbies. I dont. Perhaps this is my issue?
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I think we tend to dance around this issue in this and other topics.

The answer probably lies in your practice environment. My old shop was so horrifically and dangerously understaffed/underqualified even a single shift was a liability. So 8-9 shifts a month was doing some serious gambling during those shifts.

If I was at a place that was chill, had seasoned veteran staff who knew workflow and could recognize critically ill patients (instead of what happened to me ALL THE TIME, nurses just charting vitals....BP 120/80.....100/60........70/40......), place IVs, etc I wouldn't have left EM. It burned me out so badly I'd be suicidal if I was still doing EM in my 50s.

I don't mind "working." I felt incredibly unsafe and burned out. If you're in an environment where you can chill and vibe with your staff with good staffing numbers this job is probably--and likely--doable into 50s and 60s.
 
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EctopicFetus said:
I have a question. First I realize im an incredibly boring human. What else is there to do? I admit the financial rewards of work play a huge role for me. Take away EM pay and im not working.. But lets say you are in your early 50s, kids are still at home (lets pretend) what is it that you do if you dont work? 100 hours a month is basically 12-8s or 8-12s or 10-10s. So lets call it 8-12 days a month of work. That leaves 18-22 days off a month.

Docs I know, golf, fish etc. I like some of those things.. However, it becomes a chore. I dont know how people spend their time. When I retire I want to travel and do it well but like most things I can only do so much. I know some people have very time consuming hobbies. I dont. Perhaps this is my issue?
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So much.

My hobbies/past times currently:
-Learning golf
-Video games (Nintendo switch 2 is a blast)
-Reading about modern Iranian history
-Lifting
-Running
-Board gaming
-Hiking w dog
-planning a trip to Europe

Literally would rather do anything else than work in the ED.
 
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