I am currently unsure of a medical career, and one of my biggest hang ups with Medicine in general is that it is a high priority of mine to have control of my work hours (40 hours a week if not less). Keep in mind I understand that achieving this will come with a cost to my salary. I've talked to some who say this is possible, would you from what you've seen from your medical careers agree that after residency is it not possible but highly probable to be able to keep my work related hours somewhere near 40 hours a week regardless of specialty (not just derm) and without just being that one lucky guy everyone seems to know who stumbled into such a situation? Or is this a pipe dream? Also what kind of salary hit should one expect in working less? Would one recieve half normal pay for half time or is there an unproportional drop in pay based on reduced work time? Thanks for any help.
How real is the idea that you can control your hours as a doc?
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This is a very difficult question to answer, because practices vary SO much. Depending on location, specialty, the kind of practice you set up, I think it is highly possible. I mean, don't think that you can be an OB and have predictable hours! However, that also doesn't last forever. Most ob/gyn folks I know start their careers doing mostly ob cases, then move on to gyn, that by the end of one's career, you have much control of your life. Also, pediatric surgeons, or just surgeons in general, can have more difficulty. However, I think breast surgeons have predictable hours. As you can see, it varies a lot. I am in psychiatry, and not interested in academics, and all of the attendings I have worked with, work predictable hours. They sometimes work 12 hours one day, 6 the next, but they have control over that.
As for compensation, when I looked for a part-time job, the pay is prorated, that a 60% time person gets paid 60% of the full timer, in HMOs/county medicine...etc. I think if you're joining a group practice, that may be more variable.
As for compensation, when I looked for a part-time job, the pay is prorated, that a 60% time person gets paid 60% of the full timer, in HMOs/county medicine...etc. I think if you're joining a group practice, that may be more variable.
The idea is very real for those of us in fields that do shift work. I'm in residency for Emergency Medicine and one of the nice things about our field is knowing exactly when you will show up to work and when you will leave. The national average for work week hours for Emergency physicians is under 40. The only downside to our schedule is that you will be working some nights/holidays/weekends.
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If you go into a primary care field like Internal Medicine or Family Practice, you can do just outpatient medicine. You can basically set your office hours to whatever you want them to be. You then contract with a hospitalist (Internist who only wants to do inpatient medicine) to handle your patients when they have to be admitted to the hospital, that way you don't get any phone calls in the middle of the night, on weekends, during holidays, about patients who are in the hospital. You also don't have to go see them in the hospital. If you do shiftwork specialties like Emergengy Medicine, Anesthesiology, or Radiology, you basically come in at a certain time of the day, then leave at a certain time of the day when someone comes to relieve you. Fields like Pathology, Psychiatry, and Physical Medicine and Rehablitation also tend to have nice hours.
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It's not all about hours.
There are surgeons that work ninety hour weeks and wouldn't have it any other way. There are psychiatrists who sit on their tails thirty hours a week and hang themselves. Then there is everyone in between.
Loving your job is more important than number of hours. If you want to control you hours it's very possible. I work a 34 clinical hour week, although I'm signed up for more hours because I want OT.
Residency gives you little or no control of your hours. Some residencies are easier than others. After residency, it's all up to you.
There are surgeons that work ninety hour weeks and wouldn't have it any other way. There are psychiatrists who sit on their tails thirty hours a week and hang themselves. Then there is everyone in between.
Loving your job is more important than number of hours. If you want to control you hours it's very possible. I work a 34 clinical hour week, although I'm signed up for more hours because I want OT.
Residency gives you little or no control of your hours. Some residencies are easier than others. After residency, it's all up to you.
beyond all hope said:
Yes, but we all have priorities, and if the OP has already decided that he/she wants to have more time outside the hospital, then to an extent it really is all about hours for them. Seeing that comment made me think of my surgery rotation as an MS-3 where I worked with a general surgeon in his late 40's who spent at least 80 hrs each week in the hospital/clinic (so not counting home call). One night while we were finishing up around 11:00P I asked if he ever saw his family. He said, "Of course. They're just usually asleep when I see them." Kind of funny, but kind of sad. That comment definitely helped make my career choice.
beyond all hope said:
It seems like we hear this a lot but I'm not sure it's entirely true. It seems like most people need balance in life and their professional and personal happiness are usually intertwined. I agree that working a job you hate with good hours will eventually make you so unhappy at work that it spills over into your personal life. On the other hand, working a job you love that never lets you see your friends, family, daylight will eventually make you so unhappy in your personal life that you will begin to resent the job you once loved. At least that's the way I've always seen it. Obviously the best situation is to have a job you love that has good hours 👍
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I think it's very possible to do 40 hours or less once you've finished residency provided you picked the right niche, but it's a long way of hard work until you get there.
The cushiest physician schedule I know is an anesthesiologist in California who works for 3 months and then takes one month off throughout the year. She is private yet doesn't have her own office or staff to pay when she's on vacation. She has somehow managed to work when she feels like it by scheduling surgeries at times she wants to work and not scheduling them when she doesn't. She doesn't take call or do emergency procedures.
The cushiest physician schedule I know is an anesthesiologist in California who works for 3 months and then takes one month off throughout the year. She is private yet doesn't have her own office or staff to pay when she's on vacation. She has somehow managed to work when she feels like it by scheduling surgeries at times she wants to work and not scheduling them when she doesn't. She doesn't take call or do emergency procedures.
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neutropenic said:
Great slide, but I would tend to disagree 🙂 For example, it has IM and FP as uncontrollable. Well, it CAN be uncontrollable, if you don't control it! For instance, at the hospital I did my clinical rotations at, there were IM guys who were doing outpatient and seeing inpatients, and teaching, etc. There hours weren't too controlled. Then there were the hospitalist IM who were doing shift work, and pretty nice shift work it was, too. Essentially one week 8AM-5PM, the next week 8AM-12 (they had double coverage in the AM), and then I think they had a week of nights, but there was one internist who preferred nights, so took a lot of those weeks, and then off for a week. So, even in the same hospital there was a difference in how "controllable" the work schedule was. Of course, compensation varied.
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This is probably one of the best posts that I have seen on SDN. So many people always just post "love your field, not the money, not the hours." However, all of those things are intertwined into happiness. I actually liked my gen surg rotation and thought that deciding whether or not you had to go to the OR at 2 am was interesting and exciting, but to be honest entering the field was never a big desire of mine. This is because I thought most of my attendings were mainly happy only at work, got almost no sleep, and had family problems that were job related. I knew that those were things I did not want in my life and steered far clear. Thanks for the post though, I think your response may help young docs think a little more when they choose a residency.Hercules said:
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DRDARIA said:
Absolutely.
I've been out of residency for over five years, and have never worked more than 40 hours/week, by choice. I'm in ambulatory family medicine.
I also think the average income figures shown in that article are low, but they're three years old.
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KentW said:
As an aside, have you really been out of residency for 5+years? Wow...time does fly (and me still in training).
BTW, whats a 40 hr work week? 😉
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Kimberli Cox said:
I know...it's hard for me to believe, too. 😉
Actually, I just cut back from 4.5 days/week to 4, since we've added a partner and I want him to get busy quickly. So now, I'm only working around 36 hours/week. 🙂
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KentW said:
Obviously a typo...you mean 36 hrs a DAY right?
Right??? 😛
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Kimberli Cox said:
Not since my internship. Work to live, not the other way 'round. Didn't they teach you that in Australia? 😉
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KentW said:
If you don't mind telling, how much do you earn? ...Thanks.
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neutropenic said:
The number of graduate medical education years in the table are wrong for radiology. It should be 5 not 4.
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why is the urology lifestyle uncontrollable? apart from torsion i can't see any other emergencies...
and which non-surgical specialties are clearing 7 figures?! that's unheard of.
and which non-surgical specialties are clearing 7 figures?! that's unheard of.
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TheWowEffect said:
The average income for the primary care physicians in my group is above the MGMA average*. I can't be any more specific than that, sorry.
*Per the 2005 survey based on 2004 data, the mean compensation for non-hospital owned FPs was $158,721.
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anon-y-mouse said:
Acute urinary retention, paraphimosis, priapism, trauma...
I think the term "uncontrollable" is something of a misnomer, anyway, as anyone can manage their schedule to at least some extent regardless of their specialty. Having partners to cross-cover for you helps a great deal.
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KentW said:
Is that private practice? What about the ratio of outpatient v/s inpatient?
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anon-y-mouse said:
Yes, it IS probably unheard of to you, because the real money makers in medicine live in the shadows...I know of one who made a confirmed 10 million/yr in private practice in a non-surgical field. Surgery isnt where the real money is..look deeper young jedi...deeper.
http://www.sfgate.com/news/special/pages/2005/ucsalary/
Philip E. Leboit
Professor of Clinical... UC San Francisco $91,306 $1,516,451
AND
http://www.dermatology.ucsf.edu/faculty/leboit.aspx
*Please Note McCalmot is also a pathologist.(believe is no.3 or no.4 for the UC system, also at 1.5 million/yr)
**Also note both these work roughly 1wk/mo or 25% time.
Thank you for smoking.
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TheWowEffect said:
Private practice, yes. Most of us do not do hospital.
