Most Worked Residencies

[NinerNiner999]

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With all of the postings here about which residencies offer the best lifestyle choices, or which specialties pay the most, etc, I thought I would pose a new question: Which residency/specialty is the most demanding? Of course we hear about surgery's hours and medicine's call nights, but I am here to suggest that EM may be one of the most demanding residencies because of the hours (12 straight hours of non-stop, high volume patient contact), high stress, alternating day and night blocks, mass casualties, etc. Anyone have thoughts?

 

[HTD]

I have an opinion. Remember the flaws in my post. I trained before the 80hr week and we had no ER residency.

In my day there was no contest. General Surgery was the worst. I routinely had 100 to 120 hr weeks. I had 5 or 6 36 hour days a month. The work hour restrictions seem like the great equalizer to me now. I think all programs that are mostly "in house" work environments would be about equal now. I have seen very demanding "rural" FP programs and very easy (poor training) surgical programs. Like so many other jobs, it's more than specialty alone like the setting of that program etc.

PS 99, my peds surg buddy (Boykin) finishes this month.

 

[RxnMan]

I have an opinion. Remember the flaws in my post. I trained before the 80hr week and we had no ER residency.

In my day there was no contest. General Surgery was the worst. I routinely had 100 to 120 hr weeks. I had 5 or 6 36 hour days a month. The work hour restrictions seem like the great equalizer to me now. I think all programs that are mostly "in house" work environments would be about equal now. I have seen very demanding "rural" FP programs and very easy (poor training) surgical programs. Like so many other jobs, it's more than specialty alone like the setting of that program etc.

PS 99, my peds surg buddy (Boykin) finishes this month.

Two of my mentors used to do 100-120 hour weeks all the time. Both were IM residents, one at JH, the other at Wake Forest.

The 80-hour-week is a great equalizer. Now specialties like surgery become accessible (less daunting) to those applicants who want to have a (small) life outside of their residency. As a result, the time-intensive specialities, and general surgery is one example (thanks njbmd), are getting more competitive. I know that I have reservations about orthopedics with the 80 hour limit, but without it, I would go for a different field entirely.

 

[medgator]

Two of my mentors used to do 100-120 hour weeks all the time. Both were IM residents, one at JH, the other at Wake Forest.

The 80-hour-week is a great equalizer. Now specialties like surgery become accessible (less daunting) to those applicants who want to have a (small) life outside of their residency. As a result, the time-intensive specialities, and general surgery is one example (thanks njbmd), are getting more competitive. I know that I have reservations about orthopedics with the 80 hour limit, but without it, I would go for a different field entirely.

What some people may not realize is that, as an attending, you don't have an 80-hour work week limit in place 😉

 

[Winged Scapula]

I might caution those who think the 80 hr work week is the great equalizer to not assume so in procedural specialties or those with frequent emergencies.

If you can sign out at the end of a shift or get out of the hospital when your 80 hrs is up, fine. However, there are some specialties, and Gen Surg isn't the only one, with long cases, procedures and frequent emergencies which make it difficult to leave at a certain time. I might plan to go home at a certain hour, but if the case runs long, if a long-term patient shows up just as I'm leaving, or there is still work to be done, it cannot be signed out to someone else. Hence, the great dissatisfaction felt by many who thought residency would be easy only working 80 hrs...the shift mentality is dangerous!