MS4 mom in need of guidance

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Worried-doc

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Hello folks,MS4 graduate here.I wish to bring forth this thread to arrange the following residency fields i've mentioned based on the lifestyle.I'm pretty sure most of you will not entertain this approach,but this is a concern for many out there.I have a 2 year old son with whom i want to be able to spend how much ever time i possibly can.I understand that choice of residency should be based on one's interest and not on lifestyle during these few years but i am compelled to give it strong consideration due to my situation. We're all well aware that programs vary in their hours/calls/academic demands but i was hoping we could list them based on the typical program schedule.I'm sure a lot of you would like to preach about how it's not moral to look at residency this way,for those of you who want to give such opinions,you're entitled to your opinion and i request you to keep it to yourselves.I'm sure this is a common concern for a lot of mothers going into residency.I want to choose my residency among the following fields and this is how i see them in order of their lifestyle friendliness: PM&R=PSYCHIATRY>EMERGENCY MEDICINE>ANETHESIOLOGY> FAMILY MEDICINE=INTERNAL MEDICINE>NEUROLOGY.
Please modify that order according to your opinion.Greatfull to those who respond.
 
Worried-doc said:
Hello folks,MS4 graduate here.I wish to bring forth this thread to arrange the following residency fields i've mentioned based on the lifestyle.I'm pretty sure most of you will not entertain this approach,but this is a concern for many out there.I have a 2 year old son with whom i want to be able to spend how much ever time i possibly can.I understand that choice of residency should be based on one's interest and not on lifestyle during these few years but i am compelled to give it strong consideration due to my situation. We're all well aware that programs vary in their hours/calls/academic demands but i was hoping we could list them based on the typical program schedule.I'm sure a lot of you would like to preach about how it's not moral to look at residency this way,for those of you who want to give such opinions,you're entitled to your opinion and i request you to keep it to yourselves.I'm sure this is a common concern for a lot of mothers going into residency.I want to choose my residency among the following fields and this is how i see them in order of their lifestyle friendliness: PM&R=PSYCHIATRY>EMERGENCY MEDICINE>ANETHESIOLOGY> FAMILY MEDICINE=INTERNAL MEDICINE>NEUROLOGY.
Please modify that order according to your opinion.Greatfull to those who respond.
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How competitive are you? What was your step 1 score, and what is your general class ranking?
 
smq123 said:
How competitive are you? What was your step 1 score, and what is your general class ranking?
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Step 1:232 step2:256.Top 20 in my class.I've ruled out pathology as an option because patient contact is a big priority to me,hence not too keen about going into anesthesiology either.Dermatology didnot interest me much either,besides i dont think my scores and lack of research would make me a strong contender.
 
Smurfette said:
You're a MS4? Given that it's late November, I assume (hope) you are not looking for a position in the 2016 match or are in another country?
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No,i've taken a year off to persue clerkships in the field i eventually decide on and hope to apply for the 2017 match.I'm a citizen of canada who finished med school in georgia.My fiance is a fire-fighter here(not relevant,but i just wanted to mention).
 
Worried-doc said:
Hello folks,MS4 graduate here.I wish to bring forth this thread to arrange the following residency fields i've mentioned based on the lifestyle.I'm pretty sure most of you will not entertain this approach,but this is a concern for many out there.I have a 2 year old son with whom i want to be able to spend how much ever time i possibly can.I understand that choice of residency should be based on one's interest and not on lifestyle during these few years but i am compelled to give it strong consideration due to my situation. We're all well aware that programs vary in their hours/calls/academic demands but i was hoping we could list them based on the typical program schedule.I'm sure a lot of you would like to preach about how it's not moral to look at residency this way,for those of you who want to give such opinions,you're entitled to your opinion and i request you to keep it to yourselves.I'm sure this is a common concern for a lot of mothers going into residency.I want to choose my residency among the following fields and this is how i see them in order of their lifestyle friendliness: PM&R=PSYCHIATRY>EMERGENCY MEDICINE>ANETHESIOLOGY> FAMILY MEDICINE=INTERNAL MEDICINE>NEUROLOGY.
Please modify that order according to your opinion.Greatfull to those who respond.
Click to expand...
Residency will be busy no matter what, especially intern year. Of the specialties you mention, IM, Anesthesia, Neurology, PM&R all have IM intern years, FM intern year is just as busy (if not more so given the Ob component), and EM varies from program to program (but is still busy). Psych is basically IM/neuro for ~6 months of their intern year.

After that initial period, it really varies. There's super busy psych programs where you have frequent call, and there's less busy ones. EM is the only specialty that has a lower work hour cap than normal, but even then working 60 hours a week is not uncommon. And work hours during residency correlate poorly to work hours in practice.
 
Raryn said:
Residency will be busy no matter what, especially intern year. Of the specialties you mention, IM, Anesthesia, Neurology, PM&R all have IM intern years, FM intern year is just as busy (if not more so given the Ob component), and EM varies from program to program (but is still busy). Psych is basically IM/neuro for ~6 months of their intern year.

After that initial period, it really varies. There's super busy psych programs where you have frequent call, and there's less busy ones. EM is the only specialty that has a lower work hour cap than normal, but even then working 60 hours a week is not uncommon. And work hours during residency correlate poorly to work hours in practice.
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Thankyou for that clear response .I've been told by many that PM&R is the most lifestyle friendly residency after the intern year,also one can do a transitional year(if they can match into it offcourse).1 year of IM isn't a problem for me.Looking beyond the intern year,how would you arrange that order?As well as the approximate no. Of hours with frequency of call would help.
Also i've heard that EM residency is pretty predictable and has less hours and more off days.Is this because of fixed shifts?I would think that shifts would be the routine for attendings and not residents,as residency is the prime period for learning.
 
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Worried-doc said:
Thankyou for that clear response .I've been told by many that PM&R is the most lifestyle friendly residency after the intern year,also one can do a transitional year(if they can match into it offcourse).1 year of IM isn't a problem for me.Looking beyond the intern year,how would you arrange that order?As well as the approximate no. Of hours with frequency of call would help.
Also i've heard that EM residency is pretty predictable and has less hours and more off days.Is this because of fixed shifts?I would think that shifts would be the routine for attendings and not residents,as residency is the prime period for learning.
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The amount of call that you take depends on the program. It also depends on which year you are, within the program.

Out of curiosity, do any of these fields actually interest you? I understand wanting to have a life outside of work while you are a resident, particularly as you have a young family, but you also have to actually DO this for the rest of your career....
 
smq123 said:
The amount of call that you take depends on the program. It also depends on which year you are, within the program.

Out of curiosity, do any of these fields actually interest you? I understand wanting to have a life outside of work while you are a resident, particularly as you have a young family, but you also have to actually DO this for the rest of your career....
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All of these fields interest me almost equally,more focus on neurology,PM&R and psychiatry,emergency medicine(in order of preference).I've seen neurology residents working and contrary to common belief,i realised that neuro residency is a bit more demanding than IM.Emergencies are common and residents were on call atleast twice a week during PGY3.My second options would be PM&R or psychiatry but we all know there are stigmas and social attributes to these fields,hence i would'nt want to regret "settling" for them in future.I would really like to know how one with adequate knowledge about all the fields i mentioned would arrange them in the manner i did.If there isn't SIGNIFICANT difference between them,then i would go ahead with neurology.Emergency medicine also seems like an attractive choice to me as once out of residency i'l have to work in shifts ranging frm 12-14 days,which means i can get to spend whole days with my family.Internal medicine and family medicine are my least favoured options,i never enjoyed my rotations in them.
 
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If you don't have a really compelling interest in working with the mentally ill, please avoid psychiatry. Yes, the hours are shorter than in many fields, but oh sweet lord you will be miserable if you are the kind of person that does not cope well with the more extreme ends of human behavior. Your family is not going to benefit much from your presence if you truly hate your life.

Edit: I say this based on interacting with people who did go ahead and pick psych because it was "easy" or they felt they couldn't get into anything else.
 
clausewitz2 said:
If you don't have a really compelling interest in working with the mentally ill, please avoid psychiatry. Yes, the hours are shorter than in many fields, but oh sweet lord you will be miserable if you are the kind of person that does not cope well with the more extreme ends of human behavior. Your family is not going to benefit much from your presence if you truly hate your life.

Edit: I say this based on interacting with people who did go ahead and pick psych because it was "easy" or they felt they couldn't get into anything else.
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Shortly put,i would LOVE working with the mentally ill,but i donot have a compelling interest like you said.I'm multi-faceted,i love multiple fields.
 
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Can somebody just arrange that order and write the hours/call schedule of a typical residency of those mentioned fields.
 
1. What do you mean by "order"? Do you mean rotation order?

2. Is there such a thing as a "typical" call schedule? Many programs do things very differently, and just because someone shares what their program does, it doesn't mean it will be reflective of your life as a resident.
 
woo said:
Peds works their residents hard. A lot harder than most specialties.
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Depends entirely on the program. The peds program at my medical school seemed a lot less stressful than the IM program at the same school, but my residency program definitely works us harder than everyone other than the surgical peoples.
 
Peds at big, busy places can be very time consuming, especially if you're not efficient in your patient care duties. And unlike surgical specialties or more heavily outpatient focused specialties, where weekends may offer a little respite or at least a significantly slower pace (e.g. rare to have scheduled surgeries on a Saturday or Sunday), kids get sick at all hours and if you go to a place with a busy Peds ED, you may work harder on the weekends than during the week.

However, peds programs tend to be far more understanding and accommodating particularly when it comes to kids/family both from a program and co-resident perspective. We like kids, we understand kids, and we tend to, (in my opinion) on the whole, be kinder and gentler groups of people - which is often why peds residents seem less stressed than their adult medicine colleagues.

Further,benefits at peds programs can be very child-friendly as well. Free standing children's hospitals quite often have on-site daycare (usually run with input from child life specialists and behavioral/developmental pediatricians), which can be a huge asset for working parents. Post residency, part-time positions in general pediatrics are more common than in other fields too, which is something to consider as well.

Now, all that said, keep in mind that if you don't like working with kids, this is all moot.


Lastly, I strongly, STRONGLY recommend that you do not base your decision on this 3-5 year period of time. I know you love your child and this is why you are thinking this way, but loving your career post-residency should still be important to you. Do not lose sight of what gets you excited about patient care and the type of medicine you'll practice in the future. Medical school and residency present an extremely narrow view of what medicine is and what life is like in the "real world". There is a lot more flexibility out there than students typically realize - with the obvious caveat that you'll have to make sacrifices in other areas (usually $$$, location or patient population) to get that flexibility.
 
I don't know how many people have knowledge of the true hours/call schedules/etc for all of these specialties. Even if
someone did for their hospital, this is all so so program dependent that you couldn't extrapolate that info to the specialty as a whole, necessarily. For example, the neuro residents at my hospital have really small classes, so they're on q 4 call, and miserable. They often have 5+ consults pending in the ED at a time, and have an unofficial arrangement to come in and help each other out on their days off because it is so miserable otherwise. That's probably not the case of neuro everywhere.

Also, different rotations can vary widely. I am a second year EM resident. Our difficult blocks have us in the hospital from 5a-7p ish 6 days per week with 30 hour call days. The lightest rotations are 8 hour shifts about 4-5 days per week. No matter what specialty you do, there will be times when you're stretched thin, and times you can enjoy family life more. You (and your SO) will have to be prepared for lots of single parenting when you're busy, probably with daycare/backup child care, etc if your SO works too. In the grand scheme of things, you should base your choice off of what you want to do and the lifestyle it'll give you as an attending. I am going back to work after maternity leave on Monday, so I understand the need to see your kid and be there for the milestones, but you'll get through whatever you have to do to survive a few years until you can get on with your real life as an attending.
 
Another option is a "shared/part time" position. Basically you match with another person, and share the slot. It takes you twice as long to graduate, but you only work 50% of the time. Let's be clear that in an arrangement like this, you are working 100% half of the time, and 0% the other half. You don't work a 1/2 day. You can find programs like this on FREIDA -- just put "shared" in as a keyword during the search. There are not many programs like this, however.
 
I think one reason people haven't given you a list is that while there are sine generalities, you will find more variation between programs than between specialties. Have you been on the frieda website? For the programs that put up more than the most basic data they include average number of hours per week.

Also, would you be happier somewhere you worked 60 hours every week or 80 hours half the time and 40 hours half the time. Because different people will prefer one versus the other. Just one example of why there may not be the objective data you are looking for.
 
You should STRONGLY give PM&R a look.

Many programs require a medicine heavy PGY-1 year...but not all. And I don't think that there is any question that for PGY-2 to PGY-4 that PM&R has one of the best resident (and attending) lifestyles.

Your stats should be competitive for PM&R if you do the appropriate rotations...have a strong speciality LOR...and a PS that demonstrates interest.

PM me if you have any specific questions.
 
smq123 said:
1. What do you mean by "order"? Do you mean rotation order?

2. Is there such a thing as a "typical" call schedule? Many programs do things very differently, and just because someone shares what their program does, it doesn't mean it will be reflective of your life as a resident.
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No sir,i meant the order of those specialties i mentioned according to the lifestyle they offer during residency.
 
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My sincere thanks to all of you for giving me your valuable guidance.I wasn't aware of the shared program arrangement.For some reason the FREIDA website wont accept my name/student id for me to register.I guess i might find all the info i need on the site.I'l find a way to look it all up. I have to say i'm a little overwhelmed by the detailed and polite responses.
 
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Worried-doc said:
Hello folks,MS4 graduate here.I wish to bring forth this thread to arrange the following residency fields i've mentioned based on the lifestyle.I'm pretty sure most of you will not entertain this approach,but this is a concern for many out there.I have a 2 year old son with whom i want to be able to spend how much ever time i possibly can.I understand that choice of residency should be based on one's interest and not on lifestyle during these few years but i am compelled to give it strong consideration due to my situation. We're all well aware that programs vary in their hours/calls/academic demands but i was hoping we could list them based on the typical program schedule.I'm sure a lot of you would like to preach about how it's not moral to look at residency this way,for those of you who want to give such opinions,you're entitled to your opinion and i request you to keep it to yourselves.I'm sure this is a common concern for a lot of mothers going into residency.I want to choose my residency among the following fields and this is how i see them in order of their lifestyle friendliness: PM&R=PSYCHIATRY>EMERGENCY MEDICINE>ANETHESIOLOGY> FAMILY MEDICINE=INTERNAL MEDICINE>NEUROLOGY.
Please modify that order according to your opinion.Greatfull to those who respond.
Click to expand...

Psych is most family friendly. PM&R is good too and can have higher salary after graduation. I think any basic fields like Family Med and Internal Medicine are very stressfull (hence why you see lowest career satisfaction scores). On top of this the general fields (FM& IM) not only have low satisfaction but lower pay. I suggest to go into specialty right away instead of a general field with plan to do fellowship.
Whatever residency you choose the following are important to be successful (i.e. not get stressed out due to child-care issues): (1) supportive spouse (2) good and reliable childcare (3) supportive parents (4) supportive program director


Here is medscape lifestyle report 2015:
http://www.medscape.com/features/slideshow/lifestyle/2015/public/overview
Burnout Top-5: Critical Care, IM, FM, EM, General Surgery
Lowest are: Psych, Derm, GI, Ophtho

Medsacpe Salary Report 2015
http://www.medscape.com/features/slideshow/compensation/2015/public/overview
 
Emergency Medicine can have a great worklife balance, especially if you have a supportive spouse with a flexible schedule. That said find one of the senior (Graduating) residents (as they should have no motivation to lie at this point) with a spouse, and if you already have kids, find one with kids. Ask them about their experience. Personally, I went to Stanford, most of the spouses do not even attend the social events as they feel the program is oppressive and abusive, and they generally don’t feel welcome, the people with children seem to have it even worse than us married folk. There seems to be zero accommodations made for those who are married, even less for those with kids.

I have friends that went to other programs, and they have had quite a different experience. Residency is hard, if you have complicating factors such as a spouse or kids, pick a program that values and respects that. If you’re already married, or have kids, your family will matter to you after residency, your program will not. If your a single mom or dad, find a residency that is honest and willing to work with you. Be up front about it, and ask the program, and the residents, or find a program that has got one through, I can’t imagine how hard that would be.

And don’t come to stanford!



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MarthaFocker said:
Emergency Medicine can have a great worklife balance, especially if you have a supportive spouse with a flexible schedule. That said find one of the senior (Graduating) residents (as they should have no motivation to lie at this point) with a spouse, and if you already have kids, find one with kids. Ask them about their experience. Personally, I went to Stanford, most of the spouses do not even attend the social events as they feel the program is oppressive and abusive, and they generally don’t feel welcome, the people with children seem to have it even worse than us married folk. There seems to be zero accommodations made for those who are married, even less for those with kids.

I have friends that went to other programs, and they have had quite a different experience. Residency is hard, if you have complicating factors such as a spouse or kids, pick a program that values and respects that. If you’re already married, or have kids, your family will matter to you after residency, your program will not. If your a single mom or dad, find a residency that is honest and willing to work with you. Be up front about it, and ask the program, and the residents, or find a program that has got one through, I can’t imagine how hard that would be.

And don’t come to stanford!



Sent from my iPhone using Tapatalk
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