Looking for a residency with flexiblity in hours

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inep

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Preface this with I know little about EM. I'm a new MS4 planning on applying for something competitive with longer training than EM. I'm at a crossroads because during med school I've built a side business that I greatly enjoy and for the time being is very rewarding financially, and I see a lot of potential for it in the future if I were to focus on it. I don't want to give this up, but see no option but to outright abandon it come PGY1 if I continue down my current path. My work requires 15-30 hours a week and is done from home whenever I like. During med school I would do piecemeal, 30 minutes here, 30 minutes there when I had time, which excepting surgery, was usually not a problem to handle my workload. My only other interest in 3rd year was FM, which I have thought may make what I'm trying to do possible given its shorter training and ability to work part time.

I was told that EM may also fit the bill. I understand it would be possible to work one or two shifts a week in this field, which would be perfect for me because it would allow me to divide my time between my other career. My question is if I can maintain what I'm doing now through a 3 year EM residency. Is this realistic (obviously some programs are more flexible/cushier than others) or would FM be more likely to fit this bill? If not, I am faced with the prospect of either dropping out now before 4th year tuition is due or finishing with an MD and no residency. It would be preferable to not have wasted an enormous sum of money and effort and still be able to use the MD as a fallback to earn a living if/when my other work dries up. I have been led to believe that this is impossible without residency training, and it would need to be training in a field that allows for part time work. My current choice, in spite of how much I like the field, pretty does not allow for part-time practice. I know this is probably insulting to some of you, but I'm really looking for a solution that doesn't require me completely throwing away med school. At this point, I am very open to suggestions that don't require me to choose one or the other.
 
If you're picking your specialty based on how much time you'll have to work on your other business, you're doing it wrong.
 
Pick your specialty on what you believe you will be happiest in for the LONG hall. You would be surprised at the disparity of the workload between different programs. There are even surgery programs out there that are surprisingly laid back. If you really want to make both work you will find a way.

Survivor DO
 
I'm sorry, this is a more specific, but also totally different question off of that post based on a response saying I should look at EM or another field with more flexible residency hours instead of abandoning my degree. The other thread was asking whether I could stop after getting an MD and potentially start residency way on down the road, which is not at all what I'm asking here since everyone pretty well answered that question for me and emphasized that it would be far better to leave after completing a residency and potentially better to practice part-time after completing residency, leading me to seek out residencies with med-school type of hours and workload.

If anybody could provide me a general idea of what can be expected at a 'laid-back' program, it would be helpful. If you want to encourage me to quit medicine fine, but It would be helpful to say why and why EM won't work for what I'm trying to do. If there are multiples specialties that could offer this possibility, of course I would choose the one that I enjoy the most.

I'm trying to salvage my medical degree into something that could be potentially useful in the future should I need it and provide me with flexibility in terms of the kind of work I do. It would be preferable to put it to some sort of use, and the unique thing it brings to the table is stability. Would I pursue med school again for this purpose? No, way too much effort for a fall-back. But here I am now about to graduate, so that kinda changes things.

Medicine on the whole, and especially medical training, seems to be extremely unwelcoming for people with career or personal interests in other areas. I understand that for whatever reason, there will be people who will respond with hostility towards anyone like this who wants to work in medicine without giving it 100% of their attention. But I know there are people on the other end who do it. And while I'm totally fine with the prospect of only earning in the <5th percentile, that's not practical unless I can find a way to become be/bc.
 
As I said to you in the other thread, EM might work for you. You can certainly find places that would let you work 8 shifts a month, especially if they are longer 10-12 hours shifts.

What won't work is having a full time business and EM residency. Residency is more than a full time job.

Medicine on the whole, and especially medical training, seems to be extremely unwelcoming for people with career or personal interests in other areas.

Remember that medicine is a trade. All most all people who go to medical school actually want to be doctors and treat patients. The training reflects that.
 
I would recommend that you talk to your school's advising dean first before doing anything else. Realize that any residency program is going to require that you put in many hours of work each week, both clinically as well as outside reading. As for your specific question, there are many specialties that have shorter in-hospital hours:

Physical medicine and rehab
Derm
Rads
Psych (at some places)
Preventive medicine

For EM, your schedule is constantly switching from days-to-nights-to-days with little chance for recovery. Do a rotation in the ED first to get a feel for the difficulty of shift work. You can run a business on the side as an attending, but doing it as a resident is going to be awfully difficult. Also, on your application and during interviews don't ever tell anyone that you have a side business. If programs don't think that you'll dedicate 100% of your time to studying medicine, they'll drop you immediately.
 
There's not going to be a residency that's going to be easy to perform another job while training. I'm not sure if you could find a split residency (typically done for childcare reasons). There are times in residency that you will be exhausted and have no energy for anything else. Nobody is going to be cool with you not giving appropriate effort because you've been working your side gig. I don't think that an extra 15-30 hrs is going to be doable for large chunks of intern year. You're also unlikely to become a good physician with so much time devoted to another career.
 
Thanks, that all makes sense. I was surprised when EM was mentioned because I thought the residency had grueling hours. Everytime I ventured down there, the same residents were always there. I feel that FM residency might be possible based on my interaction with those residents and would hopefully provide the part time shift flexibilities at urgent care and rural ERs to do that kind of thing. I also remember being told by a rads resident that their resident on-time wasn't too bad. It's a field I haven't thought about, but I could see the possibilities of working 10-20 hours a week in diagnostic as well. The 5 years of training doesn't fit too well with my goals though.

I do like treating patients. I don't like making it the only thing in my life and not being able to determine how much work I can take on.

Anyway thanks for clearing this up. It's unfortunate that there are not decelerated programs that would give people like me and people with families or other commitments the option to train for twice as long with half the hours. It would probably be beneficial too to have the training spread out rather than crammed in and dumping doctors out asap. I think this is the way it is done in europe (40 hour weeks for residents, but time to independent practice is longer). Of course they don't have the debt burdens driving most people have so I'd imagine there would be no interest here.
 
Residency first, THEN your business can be done on the side. But not during residency. You need a solution- make the business smaller, hire help, automate it more, put it on the shelf for a while.
 
It seems that you're attempting to choose your specialty based solely on schedule flexibility. I've seen it with some of my colleagues where this occurs and they are just miserable because while the schedule might fit, their personality/work style does not mesh with that particular specialty. I won't echo what you've already been told about medicine but choosing a specialty well based on more than schedule will be more preferable than entering a residency in one specialty and ending up either hating it or switching halfway through.

If you are interested in EM for the schedule then definitely take the advice of the above posters about the shift switches. While the shift #s may be low, the times will be varied. In addition, you will be likely working the whole shift as opposed to other specialties so working before or after your shift may not be an easy option.
 
I find myself attracted to a wide variety of medical specialties, excluding emergency medicine and surgery. Given this and my strong belief in a balanced lifestyle (i.e. not 70 hour work weeks) as means for an enjoyable education and quality care for patients, I would also like to know what other specialties or programs offer flexible hours during residency.
 
I find myself attracted to a wide variety of medical specialties, excluding emergency medicine and surgery. Given this and my strong belief in a balanced lifestyle (i.e. not 70 hour work weeks) as means for an enjoyable education and quality care for patients, I would also like to know what other specialties or programs offer flexible hours during residency.

If you've excluded EM, this seems an odd place for that question.
 
I find myself attracted to a wide variety of medical specialties, excluding emergency medicine and surgery. Given this and my strong belief in a balanced lifestyle (i.e. not 70 hour work weeks) as means for an enjoyable education and quality care for patients, I would also like to know what other specialties or programs offer flexible hours during residency.

Psych hours are on the low end, but Arcan raises a great point...
 
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