MD Lifestyle

[Wylde]

Just throwing this out there, have you considered dentistry?

From what I understand dentists work about 40-50 hour weeks, optional residency, 6 figure salary, health-care field, lots of patient interaction, etc.

Dentists are one of the few professionals who average less than 60 hours a week (from what I've read/heard), you might want to look into that as another possible option.

good luck

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[luke77]

Just throwing this out there, have you considered dentistry?

From what I understand dentists work about 40-50 hour weeks, optional residency, 6 figure salary, health-care field, lots of patient interaction, etc.

Dentists are one of the few professionals who average less than 60 hours a week (from what I've read/heard), you might want to look into that as another possible option.

good luck

Yeah, but then you have to be a dentist

Seriously, the reason I've raised all these issues is because I'm genuinely interested in practicing medicine, not because I want a high-paying job. If I wanted to make lots of money I'd just stay in banking. Money is one factor to consider, but if you are doing something you dislike, even if it's only 40 hours a week, it's not worth it, IMO. I want to have my cake and eat it too - a job I'll enjoy and still only work 40 or so hours a week. I'm still looking...

 

[bashir]

I'm with you Luke, torn between wanting a fulfilling career and one that leaves enough time for other things in life, trying to figure out if both are possible simultaneously. I've given a lot of thought lately to whether I really want to work as hard and as long as it takes to become a doctor. I finally decided to bite the bullet and go for it-- I'm hoping to go into psychiatry as well. From my research into psychiatry residencies, I can tell you that there are several out there with relatively reasonable hours (say 60-70 per week), especially after the intern year. I suggest looking at a bunch of psych residency websites and trying to get a picture of the lifestyle each offers. After residency, psychiatry is supposed to be one of the more flexible specialties. If you want to work less, you probably can, though you will obviously make less. That's what I'm counting on, anyway.

 

[Law2Doc]

That's fine with me. That lifestyle sounds great. I'll even work 5 days a week from 9-5. I'll take less than six figures even. I make very few purchases, I drive a small import car for the gas mileage, and I don't take have expensive tastes at all. I just want to be able to support a family and maybe buy a big screen once in a decade. However my question is this - is this possible if you really want it, or did these people stumble into these positions? Can I search after graduating/residency and find a position like this?

These "part time" positions do exist, but are often hard to come by because our generation is much more lifestyle/family oriented than the prior generation of physicians, and thus quite a few of these jobs get snapped up fast. And it generally costs an employer more to fill an 80 hour/week job with two people rather than one because a lot of the overhead is per employee, not per hour (eg medmal insurance). A resident who is a mod on the board previously indicated in another thread that some partnerships get around this by making the part time employee pay their own medmal insurance, which I guess works, but probably takes a big hit out of earnings -- so you really have to want those shorter hours bad. As it stands now, if you are good you can probably find such a part time position in a number of specialties, with peds jumping to mind as one of the more popular for this (again noting that you will forego a lot in the way of salary and future advancement). But if reimbursements continue to decline and costs keep going up down the road, whether these jobs are still made available is going to be anyone's guess. It's hard to predict how the future will unfold, but it lately has had a bad habit of going in a direction you don't want, particularly in terms of hours/salary.

 

[MrBurns10]

However my question is this - is this possible if you really want it, or did these people stumble into these positions? Can I search after graduating/residency and find a position like this?

Of course you can. Medicine is an incredibly flexible field...as long as you'd be okay with a salary that is below your colleagues', you can definitely work the hours you seek if you look hard enough. You may not be a neurosurgeon, but you'll be a doctor.

The problem is that medicine is also a vast profession with many totally disparate fields within it. Your feelings MAY change when you get to third year and realize you love surgery, and there's nothing you can do to change that. So just be prepared that you may not be able to stand the lifestyle specialties/part-time gigs available and instead find yourself stuck pining after a job that requires 70 hours of your time per week.

 

[Law2Doc]

But I'm glad that it seems that if I do go ahead and accept an offer to attend medical school that I won't be sending myself down an irreparable path of 60 - 70 hour weeks.

Well, just bear in mind that you will significantly exceed these hours during parts of 3rd year of med school and for about 3+ years on a lot of residency paths.

 

[MilkmanAl]

Also keep in mind that you're going to be spending roughly that amount of time or maybe a bit less during your first two years.

 

[pianola]

I'm not disagreeing with anyone, and I'm not trying to detract from anyone's posts, but I would simply like to add an observation re: SDN advice.

I think it's a little ironic that those who would never consider quitting their futures/careers in medicine are among the most likely to discourage others.

It's like saying "Well, I'm going to do it. But you won't like it. Trust me."

This is not to say that anyone so far has had bad advice or that they have advised the OP incorrectly. It's just...ironic.

 

[MrBurns10]

MrBurns - thanks for the heads up on the specialties. That's a fear of mine as well, but if I really really enjoy something like surgery, then I'll have an even tougher decision in the future. As it stands right now (without having had direct experience with surgery) I think that my two main interests would either be surgery or an internal medicine/family practice/pediatrics gig. The surgery would, as you said, eliminate my chances of 40 hour weeks and I understand that. I guess I'll really have to get hands on and see if it's worth it to me. I've spent a lot of time working near doctors in the other fields I mentioned and I know that I'm very interested in those. I really, really love patient care. I would love to be able to sit down with patients and discuss with them how to treat their problems and what lifestyle changes they should make to prevent other illnesses and really become involved in their care and lives. That's where I feel like my heart is right now. But I'm glad that it seems that if I do go ahead and accept an offer to attend medical school that I won't be sending myself down an irreparable path of 60 - 70 hour weeks.

That's definitely a good thing that you've thought about it and are prepared to deal with it you end up falling in love with surgery. I mentioned it because I discovered I disliked a lot more specialties than I thought I would (in 3rd year), so I know it's very possible to expect to like something and then up having it not be for you (and the same goes for expecting to dislike something).

 

[DrJosephKim]

There are some really nice community family medicine residencies where you won't be working too many hours. Lifestyle balance is very important - so ask the right types of questions when you investigate different programs.

 

[NonTradMed]

Balance is definitely there in medicine but you have to work at it. I've spent quite a bit of time with physicians now and one thing I've observed is that it is a career that can eat your life up if you let it. The few female doctors I've observed had to make career sacrifices to make things work for their families (some had part time arrangments and/or took a pay hit). There is money to be made in medicine but it comes at the expense of your personal life. That's true for basically all jobs I guess but medicine just does it with more intensity.

To the premeds out there worrying about hours, I will only say this. Most professional jobs require long (er) hours now. In this country, in this economy, there are few jobs that requires little work and yield huge compensations. Pick almost any career, and there are positions within that field which requires long hours. The trick to find something you'll like, that you'll look forward to with eageness rather than dread. If medicine is that job, then pick it and find a way to make it work for your life. I believe there's enough variety in medicine for many kinds of lifestyles. But that requires years of sacrifice and hard work to make it happen.

EDIT: I found the survey by Medical Economics on how many hours physicians work. The median was 50 hours/week for 2006. They also have salary surveys which say the median income is roughly about $180k in 2004. This includes everyone so it's probably going to vary a lot by specialties, age (older docs work less), gender (there's still a small but significant gap between genders for both time and money).

Here's the site for the hours worked.

 

[gluon999]

To the OP:

In most fields in medicine, you will be working hard (50 plus hours) even after residency. But Psych is one of the easiest lifestyles once you are an attending physician. After finishing my psych rotation, I can see why many psychiatrists are so happy with their jobs. They can work 40 hours a week and still make close to 200k or more (if they do a child psych fellowship). The only two other fields I can think of with such a lifestyle are Dermatology and Ophthalmology, both of which are very hard to match into, whereas Psych is one of the easiest to match into.

 

[Law2Doc]

EDIT: I found the survey by Medical Economics on how many hours physicians work. The median was 50 hours/week for 2006. They also have salary surveys which say the median income is roughly about $180k in 2004. This includes everyone so it's probably going to vary a lot by specialties, age (older docs work less), gender (there's still a small but significant gap between genders for both time and money).

Here's the site for the hours worked.

Yeah, those numbers look about right for those dates. I've seen more recent studies that show both the hours have increased, as has the average salary in more recent years, such that the average is now closer to 60 hours/week and $210k across all specialties. Continued reduction of reimbursements are forcing a lot of doctors to work more hours to maintain prior year's incomes. But what isn't indicated in these numbers is (1) that physician income has actually lost ground against inflation over the past decade, (down 7-10% as compared to other professions which have all gained ground against inflation), so your salary this year doesn't buy as much as other doctors comparable salary a few years back. and (2) the discrepancy between the specialty incomes and primary care incomes has increased, such that the average is less of a representation of what you will earn. There is a great divide in incomes -- greater than before. These days the folks in peds, FP, etc earn an average of about $140k, while the competitive specialties earn significantly more. And you cannot assume that you will end up in, or even like, a competitive specialty at the premed stage. Something to factor in. This career should let you live comfortably, but not the same kind of lifestyle doctors lived a few decades back.

 

[Law2Doc]

They can work 40 hours a week and still make close to 200k or more (if they do a child psych fellowship).

Many can, but the average hours are higher and salary lower than this in this specialty. IMHO, folks entering a career need to peg themselves to the average because most end up close to that, and a good many end up below that. The 2003 JAMA physician work hours article seen often on this website is a better starting point, because it is non-recruiter, objective data. The data is not current (both hours and salary have gone up a bit), but it gives you a bit of perspective, particularly when you won't be entering the field for a decade or so. In 2003, the average hours for psych were listed as 48/wk, and the average salary was $134k. Both are low in terms of 2008, and represent an average of the folks starting out and well established. In your years starting out in the business you will be working more hours and earning less money, and as you become established you may be able to reverse those. But make no mistake, with that kind of average (even extrapolating 2003 data to the present realities), there are many folks working 60 hours/week to barely clear 6 digits in psych. So yeah, there will be some who can work less and earn more. But you don't go down this road expecting to be that guy, you go down this road expecting to be close to average, and if things work out for you to earn more to work less, hey, you won't fight it.

 

[NonTradMed]

I've always wondered if this is really the case. I think it may be somewhat true, but I don't think the intensity is very far above any other professional career. For instance in my line of work at my place of work there are people who work 55-65 hour weeks and make around $200,000. Another example would be the OP's field. I just don't want that. I don't aspire to it or desire it in any way. I think in today's currency a salary of $80,000 would be enough to completely satisfy all my needs including savings and providing for two children - and this is if my wife was not working. I'm making $62,400 now and she is currently unemployed but looking, and I feel very, very well-off. I find however that many people are not like myself in that respect and I can understand that, but I find this in every professional field I investigate really.

Well, I'm only guessing based on my (limited) experience and those of my friends who work and my parents. Most are not making as much as a doctor but they also work fewer hours, so I was extrapolating. And I guess being in the medical bubble, we sometimes forget that there are plenty of other people who work just as hard as us.

Overall from the posts I get the feeling that I should go to medical school, find a residency that I enjoy and that there are good odds of finding a position with lower hours, and just know that it may take some time to find a position like this while realizing I won't get paid as much as I could get elsewhere. It doesn't seem like these positions are impossible to find, it's just that there are monetary and advancement sacrifices made to be in them.

That's what a few of the doctors I've spoken with have said to me. I can make a good salary as a doctor even if I cut back hours, but can I stand knowing that my fellow physicians are making 2 or 3 times more than me just because they picked a different field than me? I guess it's that age old question of, "Would you live among people who make $200k and make $100k or make $50 and live among those that make $30"?

 

[luke77]

A few additional things:

-I can't speak to the motives of a few people on this site and in this thread who seem to want to make it seem like working a "regular" schedule once someone is an established MD is difficult, but I know for a fact that this is not the case. I personally know 3 doctors who work fewer than 40 hours a week, albeit in "unprestigious" roles (community hospitals). I've discussed salary with 2 of them and they each make around $140,000 in a low cost of living area. All are in pediatrics or family practice; only one went to a top-25 med school.

-I also know a few hospitalists who work precisely 40 hours a week, because this is stated in their contract. Only one has required call. Since hospitalists see only patients at the hospital, they do not have to deal with much of the bureaucracy/paperwork that normal MDs do. I don't know their salaries but I'd guess around $150K.

-Locums jobs allow for any kind of lifestyle you want.

-Finally, I know a doctor who works in medical consulting. She is in developmental pediatrics, works only from home, and works as much or as little as she wants. Basically she reviews and evaluates cases for people involved in litigation. She is not required to travel usually because she doesn't testify; she simply offers her opinion in writing. Don't know exact salary but I do know that she makes a TON of money.



My personal knowledge of people with these jobs make me skeptical of those who say that med school and residency require hellish hours universally, because these same people talk abut how difficult it is to work any less than 50-60 hours a week. But I digress...


Anyways, I've still been giving this a lot of thought, and I'm wondering if anyone can comment on training as a PA. I have known (in the past) a few PAs who had good, 40 hour/week lifestyles, made decent money, and basically performed the same duties of an MD. I think the main thing that keeps people away from being a PA is the perceived lack of prestige, something that doesn't really concern me. S I guess my question is, what is training like as a PA? I'm sure that the material is similar to that in med school, but what about clinical training? Do PA programs require residency/internship-type hours when going through training, or is it less intense?

Basically, I know that there are jobs with a decent lifestyle in both the PA and MD profession, so I'm only concerned about the intensity of training to get there. This may seem like a moot point to some (just suck it up for a few years, right?) but this past year in banking I've worked residency-type hours and worse, and it made me clinically depressed, so I don't want to risk putting myself in that position again. I can live with 60 or probably even 70 hour weeks, but I don't want to commit to anything that will require more than that...

 

[MrBurns10]

Anyways, I've still been giving this a lot of thought, and I'm wondering if anyone can comment on training as a PA. I have known (in the past) a few PAs who had good, 40 hour/week lifestyles, made decent money, and basically performed the same duties of an MD. I think the main thing that keeps people away from being a PA is the perceived lack of prestige, something that doesn't really concern me. S I guess my question is, what is training like as a PA? I'm sure that the material is similar to that in med school, but what about clinical training? Do PA programs require residency/internship-type hours when going through training, or is it less intense?

Basically, I know that there are jobs with a decent lifestyle in both the PA and MD profession, so I'm only concerned about the intensity of training to get there. This may seem like a moot point to some (just suck it up for a few years, right?) but this past year in banking I've worked residency-type hours and worse, and it made me clinically depressed, so I don't want to risk putting myself in that position again. I can live with 60 or probably even 70 hour weeks, but I don't want to commit to anything that will require more than that...

To get into PA school you first have to do a certain number of hours working in healthcare (usually substantial, at least a year full-time). PA school itself is 2 years, with one being basic sciences and one being clinical. They rotate through all the rotations med students do. As far as I know, the only PA "residency" is a one-year surgical internship for surgical PAs. The rest of the PAs can practice out of school. Salaries for PAs I think range from about 60K to 150K for surgical PAs (but they're definitely not working 40 hours). Hope that helps.

 

[luke77]

To get into PA school you first have to do a certain number of hours working in healthcare (usually substantial, at least a year full-time). PA school itself is 2 years, with one being basic sciences and one being clinical. They rotate through all the rotations med students do. As far as I know, the only PA "residency" is a one-year surgical internship for surgical PAs. The rest of the PAs can practice out of school. Salaries for PAs I think range from about 60K to 150K for surgical PAs (but they're definitely not working 40 hours). Hope that helps.

Thanks, yeah I''m actually familiar with the PA curriculum. I guess I'm wondering what it's like, though, during the clinical year. Is it like the clinical years during med school or residency (ie long hours, lots of call, etc.) or is it more like a traditional educational schedule, or like nursing clinical training (which I have heard is much more relaxed compared to med school clinicals).

 

[MrBurns10]

Thanks, yeah I''m actually familiar with the PA curriculum. I guess I'm wondering what it's like, though, during the clinical year. Is it like the clinical years during med school or residency (ie long hours, lots of call, etc.) or is it more like a traditional educational schedule, or like nursing clinical training (which I have heard is much more relaxed compared to med school clinicals).

It's the same as it is for medical school. I had several PA students on my rotations.

Also, I'll add that the "long hours" of the clinical year aren't the same for every rotation. The rotations with the most hours are surgery, medicine, OB, and sometimes peds...family med and psych have better hours and few, if any weekends.

 

[daniellema13]

To the OP--
This is slightly off topic and i'm in no way an expert in the matter, but it seems reasonable that your depression may have been in large part due to the fact that you didnt like the work you were doing AND were devoting so much time to it. Working hellish hours for a few years in medicine may not put you back in such a bad position if you find you truly enjoy the work. You've probably considered this. If you are dreading the hours alone (of medicine), then it's likely not a good decision for you unless you are up for a few years of sacrifice. If it is what you want to do, try not to approach with dread...

 

[captainnerd]

Spend a few years in I-Banking and you'll never have to worry about med school debt.

Not if you're an ibanker who has recently been socialized into the government and you now make a public employee salary.

Haha, I'm not sure that will come to fruition but it will be interesting to incentivize the perks of being an iBanker and working for a company that is regulated up to the neck and profits are distributed back to the investor (the public).

But back to the original poster, have you thought about optometry or pharmacy or dentistry school?

 

[Hallm_7]

You can definitely work 40 hours a week in just about any specialty if you are willing to make less money and/or work at smaller hospitals. I rotated with a general surgeon at a 26 bed hospital for one of my rural rotations and he averaged 40 hours or so a week when he worked a full week (he takes several 3 day weekends and half days and such). He would typically have 3-4 surgeries a week and a handful of colonoscopies/endoscopies along with his 3-4 half days of clinic. He doesn't make anywhere near what people at larger hospitals, but he is completely content with making what he does (I'm guessing $100-120,000 a year). The only downside (other than money) to his situation is that he is on-call 24/7 since he's the only surgeon, but he very, very rarely gets called in emergently (a couple times a month at most for an appy or acute abdomen).

Emergency physicians can work as little as they want once they are out on their own. If you wanted to work 5 shifts a month then you could, but your income will be a fraction of what your partners' salaries are. On the flip side you could work 20 shifts a month and make considerably more than your partners. Hospitalists also have a very flexible lifestyle since they are on shift work.

Most specialties are like this. The exceptions are your super-specialized fields (pediatric surgery, hand surgery, colorectal surgery, etc) because only large hospitals support these specialists and there are typically only a coulple at these hospitals. You're kind of forced to work long hours because you depend on the primary docs/less specialied surgeons sending patients your way (if you only see 10 patients a week then they'll be forced to send patients elsewhere and your referral base shrivels).

Most doctors work long hours because they choose to work long hours. I think most people view working 20 hours a week after all the work you put in for school as a waste. Most doctors also love what they do even thought they don't always admit it.

 

[motherof4]

You are wrong. I work, per month, as a third year Emergency Medicine resident 14 eight-hour shifts and four 12-hour shifts which comes out to about 45 hours per week if you count conferences and other mandatory residency functions.

It all depends on your specialty.

Dear Husband,

You make it sound so easy. You are forgetting to tell your friends that an 8 hour shift turns into a 10 hour shift and a 10 hour shift turns into a 12 hour shift. Or does it really?

You are never home at a regular time after your shifts. It is a nightmare. Your shifts are poorly laid out so that most of the days off you are recooperating from an overnight or attending a manditory conference. You are always tired. Or are you?

Your wife

 

[niranjan162]

Dear Husband,

You make it sound so easy. You are forgetting to tell your friends that an 8 hour shift turns into a 10 hour shift and a 10 hour shift turns into a 12 hour shift. Or does it really?

You are never home at a regular time after your shifts. It is a nightmare. Your shifts are poorly laid out so that most of the days off you are recooperating from an overnight or attending a manditory conference. You are always tired. Or are you?

Your wife

this is a good point. One Doc I know works 24 hour shifts, he only does 3 of them a week, but when he gets home hes so tired that all he does is sleep for most of the day. So really he only has one day during the week where he has significant amount of time to do something.

However hes very good at functioning on very little sleep so i guess he has more time than I would were I working those hours.