NO Night float/ night call residency? Does that exist?

[Mysterio123]

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Hi,

Are there any specialties/ residency programs in US which don't make residents work throughout the WHOLE night?

 

[anon6134]

Your question is not a good one

 

[redpanda]

Hi,

Are there any specialties/ residency programs in US which don't make residents work throughout the WHOLE night?

Who knows? Nights overall are to your educational benefit, especially when the training wheels come off.

 

[AMEHigh]

Yes

 

[Mysterio123]

Yes

Thank you. Can I point me to one please?

 

[HomeSkool]

The only thing that comes to mind is dermatology, but that's a relative thing: they still take call (they just don't get called as often as most other specialties) and they still have to go through an intern year that involves call responsibilities on several services. And anyway, taking call is not something only done by residents. I hate to break it to you, sport, but unless you go into a 100%-clinic practice, chances are you'll have some overnight responsibilities from time to time for the entirety of your career.

 

[Mysterio123]

The only thing that comes to mind is dermatology, but that's a relative thing: they still take call (they just don't get called as often as most other specialties) and they still have to go through an intern year that involves call responsibilities on several services. And anyway, taking call is not something only done by residents. I hate to break it to you, sport, but unless you go into a 100%-clinic practice, chances are you'll have some overnight responsibilities from time to time for the entirety of your career.

Thank you for the input

I'm considering Psychiatry because I enjoy talking to people and cheering them up. And it doesn't seem as obvious why a psychiatrist would need to work from 8pm to 8am through the night vs a ER.

It's also not healthy to stay up all night and I believe a happy, healthy doctor can make patients better and happier.
That's why I'm keen to find a psychiatry program that doesn't do night shifts.

 

[PhillyMed777]

What about path?

 

[deleted407021]

I saw your post in the psych sub-forum. It's very unrealistic to expect to not have to work nights during residency. Psychiatry being light on night call, relatively speaking, is not a sufficient reason to pick it as a specialty.

 

[ortnakas]

Thank you for the input

I'm considering Psychiatry because I enjoy talking to people and cheering them up. And it doesn't seem as obvious why a psychiatrist would need to work from 8pm to 8am through the night vs a ER.

It's also not healthy to stay up all night and I believe a happy, healthy doctor can make patients better and happier.
That's why I'm keen to find a psychiatry program that doesn't do night shifts.

Inpatient psych floors do not close at night.

 

[Mysterio123]

What about path?

I've wanted to be a psychiatrist since I was a kid. That will be my first option.

But if any residencies specialties offer programs without having to work the whole night, I will look into them because a healthier, more alert 'me' is better for the patient's outcome.

I just don't know which specialties do offer this and which don't.

 

[HomeSkool]

Thank you for the input

I'm considering Psychiatry because I enjoy talking to people and cheering them up. And it doesn't seem as obvious why a psychiatrist would need to work from 8pm to 8am through the night vs a ER.

It's also not healthy to stay up all night and I believe a happy, healthy doctor can make patients better and happier.
That's why I'm keen to find a psychiatry program that doesn't do night shifts.

You won't find one. The ED operates 24/7 and needs in-house psychiatry services to consult. Moreover, patients in inpatient psych units have overnight needs that can't be managed by the nurses without physician input.

I just don't know which specialties do offer this and which don't.

I'll make it easy for you: there are zero specialties that will allow you to go through residency without working overnight.

 

[fldoctorgirl]

Hi,

Are there any specialties/ residency programs in US which don't make residents work throughout the WHOLE night?

There's an IM program in Florida where residents don't have to take night call-- they have a specific night float team for that.

"No overnight call. We have a Night Float team which takes over from the day team in the evening and hands off in the morning."

Internal Medicine Residency Program

 

[ndafife]

Thank you for the input

I'm considering Psychiatry because I enjoy talking to people and cheering them up. And it doesn't seem as obvious why a psychiatrist would need to work from 8pm to 8am through the night vs a ER.

It's also not healthy to stay up all night and I believe a happy, healthy doctor can make patients better and happier.
That's why I'm keen to find a psychiatry program that doesn't do night shifts.

You're not going to find one.

Some are going to be busier/lighter than others. Some may allow home vs in house call. But every psych residency is going to have an inpatient unit. Some resident is going to be on call for those patients overnight. Every psych residency is going to have some resident on call for the ER (people have psych emergencies outside of a nice 9-5 schedule).

 

[HomeSkool]

There's an IM program in Florida where residents don't have to take night call-- they have a specific night float team for that.

"No overnight call. We have a Night Float team which takes over from the day team in the evening and hands off in the morning."

Internal Medicine Residency Program

I'd be interested to know whether the night float team is composed of residents or midlevel providers. Some programs consider night float to be different from overnight call since it involves a predictable schedule of non-24-hour shifts. In those cases, their residents still work overnight shifts, they just don't "take call" in the traditional sense.

 

[fldoctorgirl]

I'd be interested to know whether the night float team is composed of residents or midlevel providers. Some programs consider night float to be different from overnight call since it involves a predictable schedule of non-24-hour shifts. In those cases, their residents still work overnight shifts, they just don't "take call" in the traditional sense.

Yeah, I was actually thinking about that myself-- it seems more probable that residents still work overnight shifts during a period of time when they're on 'night float'. I think getting rid of night shifts all together wouldn't be too good for education regardless, especially in a field like IM.

 

[ThrowawayShmoaway]

If you don’t mind me asking OP, what year in school are you? Maybe it’s just me, but your comment of “I'm considering Psychiatry because I enjoy talking to people and cheering them up,” kind of sounds like you don’t actually have much experience with Psychiatry

 

[Kuratz]

You chose a 24/7 profession. Night call comes with the territory. Psych might be the most benign residency of them all. A couple weeks of night call where you sleep most of the night anyway is pretty damn humane. Kinda have to just suck it up.

 

[CherryRedDracul]

Radiology has night float so you can scratch that off your list.

 

[FindMeOnTheLinks]

OP sounds like a premed tbh

 

[y123]

Night shift is great. Like it better than day shift. What is your issue with working at night?

 

[Redpancreas]

Medicine never sleeps. Also, someone mentioned Dermatology...even they have residents through an IM intern year with night call...Also, I've seen them take call even on their own services.

 

[deleted407021]

Night shift is great. Like it better than day shift. What is your issue with working at night?

Apparently the negative impact on health.

 

[Stagg737]

But if any residencies specialties offer programs without having to work the whole night, I will look into them because a healthier, more alert 'me' is better for the patient's outcome.

I just don't know which specialties do offer this and which don't.

No offense, but this is a terrible reason to pick a field. Pick something you enjoy and deal with the crappy parts through residency. Once you're an attending you can practice how you want, but if you never want to work night shifts again you'll take a major hit to your job prospects in some fields. If you want to do psych for legitimate reasons then outpatient PP is a good choice for never having to work nights again after residency (and I'm considering this). However, choosing a field to avoid night shifts is a really poor reason and just setting yourself up for a less than desirable career path.

 

[CharlieBillings]

.

 

[mrbreakfast]

On my EM rotation we probably averaged at least suicidal ideation per shift. Psych has to go see them regardless of when it happens.

I think many/most residencies have transitioned to a night float anyway, so all it means is you just sleep during the day instead.

I'm considering Psychiatry because I enjoy talking to people and cheering them up.

Are you a premed? If so, you should seriously consider psychology. You'll have a nice lifestyle, save a lot of time/money, and actually work at cheering people up by talking to them. The patients you will see as a psychiatrist are well beyond this, and you will find you cannot have a meaningful conversation with many of the patients you will see, particularly on inpatient.

 

[siliso]

Not that I’m aware of. Maybe ones where you’re less likely to be called in...derm? I’ve almost never called a derm resident after hours. Path? Maybe surgeons call them overnight. Other than that the only specialties I can think of never calling after hours are subspecialists who’ve already gone through night call in IM or surgery. And even then...I’ve at least once called in even the endo fellow late at night. So you put up with it a few years. No one calls me at night now except occasionally when I’m staffing inpatient wards. Very occasionally.

 

[siliso]

But even the derms do an intern year with night call. I think it’s the wrong profession if you’re not willing to stay up all night even for a few months of a year.

 

[qwerty89]

UC Riverside Psychiatry (also has amazing moonlighting)

Kaiser LA for Radiology has no overnight in-house diagnostic call. Per their website brochure “Residents perform on-call Radiology duties in house during the evening and overnight they are on home call. On-call duties are taken with and supervised by faculty and staff, including general and interventional radiologists and a neuroradiologist. A remote teleradiology service is available daily from 7 p.m. to 7 am.”

 

[siliso]

Do these not have intern year requirements? Of course they do.

 

[qwerty89]

As an attending in DR you can do a normal 9-5 x5days a week schedule though right?

If you do 100% mammo its not uncommon to do 8-5 M-F no nights, weekends or call with some larger groups. Obviously no partnership that way.

For all other diagnostic sub specialties expect to participate in the general call pool for evenings (not necessarily overnight) and weekends.

Nights will either be handled by telerads or dedicated night people. Not uncommon for night jobs to be 9-10 hr shifts 7 on and 14 off.

 

[qwerty89]

Do these not have intern year requirements? Of course they do.

As far as I know UCR psych had no in house caller requirements INCLUDING the 3 required months of medicine...

That being said its a very new program and may have changed.

 

[CharlieBillings]

.

 

[ndafife]

Any general idea how much call one would expect from a general call pool? Like on weekend call once a month or 3 times a month?

Depends on the size of your group

 

[siliso]

Radiology also requires a PGY 1 not in radiology. You might could land a cush TY but wouldn’t bank on it. But really your days of doing nights can be over in a matter of a year or three. And there are programs even in IM that have night float but no 28hr calls (I preferred call rotations to night float personally though).

Your best hope of never spending the night in the hospital would probably be pathology. And there’s no separate PGY1 for that.

 

[sloop]

I am a psych resident. While overall as a field psych will, on average, involve less call than other fields, you will still have to take call.

Also, although, on average, psych call is less stressful and an average call day is less “intense” than a call day in another specialty, this is highly variable depending on where you train.

The first thing to mention about this is that often times the reason call can be less frequent than other specialties is that it is sometimes assumed that psych patients are more medically stable than on other services in the hospital so at some places call coverage can involve responsibility for many more patients than on other hospital services. At my hospital inpatient call coverage involves responsibility for ~80 beds + admissions + emergency inpatient consults. This already makes call pretty busy.

The other thing to consider with regards to what call may involve is the medical capabilities of your inpatient units. Call at a stand-alone psych hospital will generally be less stressful than at a major psych hospital that is part of a med/surg hospital. Departmental philosophy and resultant resources also play into what the psych unit may be capable of. A more medically capable psych unit will make call more stressful. My hospital’s psych units are capable of oxygen, IV medications/fluids, blood transfusions, non-ICU post-op care (with involved consultants of course), etc. Our patients have a variety of known medical problems and with covering about 80 of them overnight, odds of unexpected issues are relatively high. Our capability to care for these patients is a point of pride for us but it makes call quite stressful and you have to be really good at medicine. To be honest, behavioral emergencies don’t really phase me much anymore because that’s my specialty and I’ve gotten really good at handling them. The medical stuff can be very stressful and decisions can be complicated because they involve knowing exactly what can and can’t be done on our relatively capable psych floors.

So I guess overall what I will say is that call in psych is variable but you will always have to take some call. Do be careful to consider what call entails when making your decisions about residency because there are psych programs out there where the intensity of call may be more akin to what call is like in other specialties than the average psych residency. These programs are great (I love mine) but if you want something cush and wind up in them, you will be totally miserable.

 

[Cawolf]

Occupational Medicine
AOEC - OEM Training and Education

Just an example, highest hit in google. We have one of these 2 year residencies at my location and it seems pretty.....easy? It does require a PGY-1 year though, where I imagine call will be required in some form.

Occupational Medicine Residency | USF Health

"Highlights of our program include:

• No call, no nights, no weekends, no pagers – Work/clinic hours are 8a-4p on most rotation, guaranteeing you have ample time to balance work with graduate courses, research, and leisure activities"

 

[getdown]

Here's the easy answer: Don't do medicine. Save yourself, your patients and your colleagues the hassle of having to deal with you whining about your "health" and "availability" and just do a job outside of medicine.

 

[y123]

Pathology has no nights

 

[MedicineZ0Z]

For services that are operational overnight, not having residents do night call/float is a huge missed educational opportunity. That's when you have your peak autonomy and do a lot of your learning.

 

[evilbooyaa]

Radiation Oncology doesn't really have overnights

 

[siliso]

But radonc (and most other non-night speciality) also requires a PGY1 first. Could you OP tolerate some nights during a few months of one year? Three years? Or no nights ever? Are you already in medical school or just thinking about it?

 

[Mad Jack]

Who knows? Nights overall are to your educational benefit, especially when the training wheels come off.

But like, why? Most people will never work a night in their life and weekend shifts have most of the increased workload that make nights a valuable experience without disrupting your circadian rhythm

 

[Mad Jack]

Inpatient psych floors do not close at night.

There is also very little to do on said floors that requires you to be physically present at night, which is why a great number of programs have either no night call or call from home

 

[OrthoTraumaMD]

Don’t do medicine.

 

[Candidate2017]

But like, why? Most people will never work a night in their life and weekend shifts have most of the increased workload that make nights a valuable experience without disrupting your circadian rhythm

Nights are when the poop hits the fan and you ARE the doctor with no backup for all practical purposes. There are many times you will be scared poopless. There are many times you will make mistakes. There are times you will have enough faith in your medical judgment to stand up to attendings from other services and advocate for the patient. You will never, ever forget those moments. Those learning moments are seared in your memory forever. It gives you humility, lets you know how much more you need learn, contributes to your confidence and growth as a doctor.

 

[Mad Jack]

Nights are when the poop hits the fan and you ARE the doctor with no backup for all practical purposes. There are many times you will be scared poopless. There are many times you will make mistakes. There are times you will have enough faith in your medical judgment to stand up to attendings from other services and advocate for the patient. You will never, ever forget those moments. Those learning moments are seared in your memory forever. It gives you humility, lets you know how much more you need learn, contributes to your confidence and growth as a doctor.

Fair. Medicine is a different world than mine

 

[Candidate2017]

Fair. Medicine is a different world than mine

Oh no, this is psych.

 

[sloop]

There is also very little to do on said floors that requires you to be physically present at night, which is why a great number of programs have either no night call or call from home

This is definitely not the case at my program. My night floats on IM as an intern and my psych calls as a PGY-2 have involved about the same level of overnight activity.

 

[Mad Jack]

Oh no, this is psych.

Odd, I've had plenty of 12+ hour shifts on weekends with no attending backup where I was functionally alone and had patients threatening the lives and safety of themselves and my staff and I never felt in over my head. And throwing down with attendings from other specialties is par for the course, I don't see it as being intimidating at all