MD & DO Other specialties with "weekends routinely off" during residency

[StatistPriceControlsFail]

I only know of one specialty that routinely has Mon-Fri work weeks (with no expectation of doing either Saturday or Sunday unless you are on call): pathology. Are there others like pathology?

NOTE: I'm not counting being on call. Every other specialty I've encountered very frequently (not necessarily always) expects you to work Saturday and/or Sunday for inpatient rotations--even when you're not officially on call. Basically, they expect you to maximize your days on while satisfying the ACGME rule of 1 day off in 7 averaged over 28 days. This is often a surprise for non-surgery/OB PGY1s (the surgery and OB residents tend to know what they are getting into) when they see their schedules or show up on an inpatient rotation. "What? You just increased how many days I expected to work by 20%."

---

Members don't see this ad.

 

[deleted480308]

I only know of one specialty that routinely has Mon-Fri work weeks (with no expectation of doing either Saturday or Sunday unless you are on call): pathology. Are there others like pathology?

NOTE: I'm not counting being on call. Every other specialty I've encountered very frequently (not necessarily always) expects you to work Saturday and/or Sunday for inpatient rotations--even when you're not officially on call. Basically, they expect you to maximize your days on while satisfying the ACGME rule of 1 day off in 7 averaged over 28 days. This is often a surprise for non-surgery/OB PGY1s (the surgery and OB residents tend to know what they are getting into) when they see their schedules or show up on an inpatient rotation. "What? You just increased how many days I expected to work by 20%."

Anyone who is surprised by weekends on an inpatient rotation is an *****

 

[aSagacious]

Bunch of specialties which work M-F in general, with varying frequency of weekend call: derm, family med, neuro, ophtho, PM&R, path, psych, radiology, rad onc

Even larger number of subspecialties (especially medical) which are primarily clinic based.

Even within a particular (sub)specialty you can significantly tailor your practice to be lifestyle oriented if that's your focus. Definitely wouldn't choose your specialty based on residency work hours.

 

[Scrubs101]

Our IM program is 5days/wk excluding call and house shifts for interns, and im pretty sure even our GS program only keeps 1 resident on over the weekends (but also like q2-3call). I feel like for a lot of specialties these programs are out there, theyre just typically smaller community programs if I had to guess.

 

[operaman]

Yeah this will be much more program specific than field specific.

Even within ENT there are vastly different setups. Mine is pretty sweet where I rarely work a weekend at all, call or otherwise, but others do more the 6 on 1 off thing.

This is definitely something to figure out when you interview so you can compare programs. This is definitely something I didn’t think mattered much as a Med student but in retrospect would be a major part of my decision now if I had to do it again.

 

[Long Way to Go]

This is often a surprise for non-surgery/OB PGY1s (the surgery and OB residents tend to know what they are getting into) when they see their schedules or show up on an inpatient rotation. "What? You just increased how many days I expected to work by 20%."

Is this genuinely a surprise to residents at your institution? I cannot believe that people managed to get through four years of medical school without either observing that residents worked 6 days a week or without themselves working 6 days a week.

 

[longhaul3]

In most of the programs I know of, especially in surgery, you work M-F and only work weekends when you are on call...but you're on call Q3 or Q4 as a junior, which means you're working pretty much every weekend.

This was also the case on the medicine teams I was a part of as a med student. Mostly Q4.

 

[Dantrolene FC]

Anesthesia

 

[Mass Effect]

If lifestyle is important to you, I can't recommend psych enough. Weekend call in residency was q6weeks - q8weeks. No weekday call (but you were expected to do 2 week or 4 weeks of M-F nightfloat, depending on your residency year). As an attending, there are tons of jobs you can tailor to what you want - lots of 4 day work weeks, lots of 7 days on/7days off, lots of pick your own schedule. For many jobs, 32 hours a week is considered full time with no call. You can work call to increase your salary, but you're not required to. Pay ranges from 200K on the low end (usually academics) up to 400K for rural 7 day on/7 day off. Most people get between 250K - 350K.

 

[deleted393595]

I only know of one specialty that routinely has Mon-Fri work weeks (with no expectation of doing either Saturday or Sunday unless you are on call): pathology. Are there others like pathology?

Admin

Edit: Also find it hilarious that @sb247 was the first to respond to a guy whose username implies ire with centralized econ planning

 

[aldol16]

PMR.

I mean, as an attending you can set your own hours. At a certain point.

 

[deleted480308]

Admin

Edit: Also find it hilarious that @sb247 was the first to respond to a guy whose username implies ire with centralized econ planning

Even libertarians can ask dumb questions every now and then

 

[Fission Chips]

In most of the programs I know of, especially in surgery, you work M-F and only work weekends when you are on call...but you're on call Q3 or Q4 as a junior, which means you're working pretty much every weekend.

This was also the case on the medicine teams I was a part of as a med student. Mostly Q4.

Out of curiosity, how does q3/q4 end up working pretty much every weekend? Do those programs just consider your work week to be Monday through Sunday, and you're on call every 3rd day?

I'm heading into Urology... at my (future) program that means juniors take one weekend in 3 or one weekend per month, in addition to one or two nights during the week (M-F). Seniors are backup. You'd usually round at 6 depending on the census, and go home when the work was done, generally between 4 and 6 if not on call. I'm sure its program dependent though because I rarely saw a resident leave my home program before 7 on my sub-I, many times not leaving until 10 or 11 when they're doing 3 RALPs that day.

 

[longhaul3]

Out of curiosity, how does q3/q4 end up working pretty much every weekend? Do those programs just consider your work week to be Monday through Sunday, and you're on call every 3rd day?

I'm heading into Urology... at my (future) program that means juniors take one weekend in 3 or one weekend per month, in addition to one or two nights during the week (M-F). Seniors are backup. You'd usually round at 6 depending on the census, and go home when the work was done, generally between 4 and 6 if not on call. I'm sure its program dependent though because I rarely saw a resident leave my home program before 7 on my sub-I, many times not leaving until 10 or 11 when they're doing 3 RALPs that day.

The work week was still M-F, but the call schedule was obviously still 7 days. The non-surgical programs at my med school had "admitting teams" that admitted during the day and then presented the patients on rounds the next day, so being on call meant coming in for rounds the next day, despite having night float. q3 meant you were on Friday, Saturday, or Sunday, and if you were on Friday you still had to come in and round Saturday, so there were never any true golden weekends. Only a couple services were q3. Most of the services were q4, so 1/4 weekends was golden.

There is a ton of variability in the call schedules in my surgical subspecialty. I would say most programs are q3/q4 24h on average for junior residents; call is just split between whoever is on the main service and therefore in the jr. call pool (this depends heavily on how many different hospitals the program covers and how big the program is). The people who aren't on call are off on the weekend, but either way you still work most weekends because on a q3 schedule there's only a 1/3 chance of having Sat-Sun both off. Usually the juniors have the discretion to make their own call schedule, though, so a lot of people will do 24s on Friday and Sunday to have a whole weekend off the next weekend.

Some also have night float with one junior on nights and the intern/pgy2 carrying the pager during the day. One day a week, usually Saturday or Sunday, someone is on 24h so the night resident gets a day off. The other weekend day float is either rotated among the juniors weekly or covered by someone on research or another rotation.

 

[RangerBob]

Certainly a lot of variability between programs. My PM&R residency was a bit lighter than average-weekend call once a month for PGY2, and every 2 months or so as a PGY 3 and 4.

Weekend call meant going in at 7:30-8:00, rounding and doing any new admits or consults. On a good day we were out by 10-11. On a “bad” day I could be there till 5pm. That’s really not that bad a day...

Still, you have to like what you do. You couldn’t pay me enough to do path or derm, just as you couldn’t pay plenty of docs to do PM&R

 

[Dantrolene FC]

You should choose the specialty because you're dedicated to it. But If you care about lifestyle, you have to look at what the attending lifestyle is, not the resident lifestyle.

I'd still choose anesthesia if it required me to work 110 hours per week for 3 years.

 

[Splenda88]

Our IM program is 5days/wk excluding call and house shifts for interns, and im pretty sure even our GS program only keeps 1 resident on over the weekends (but also like q2-3call). I feel like for a lot of specialties these programs are out there, theyre just typically smaller community programs if I had to guess.

Impressive! Where is that IM program located?

 

[deleted50541]

Yeah this will be much more program specific than field specific.

Even within ENT there are vastly different setups. Mine is pretty sweet where I rarely work a weekend at all, call or otherwise, but others do more the 6 on 1 off thing.

This is definitely something to figure out when you interview so you can compare programs. This is definitely something I didn’t think mattered much as a Med student but in retrospect would be a major part of my decision now if I had to do it again.

The call schedule was definitely something I asked about and compared when I was matching gen surg. But I knew what I was in for as a med student and routinely worked weekends in my third and fourth years.

I worked at multiple hospitals in residency with some variation in the call schedule, but it was mostly q3 or every other weekend depending on the site. Like someone else posted, the golden weekend was a rarity. If you were on-call Friday for 24 hours and post-call Saturday, you still came in Sunday as pre-call to round. Eventually, the rules changed and the pre-call team no longer had to round on weekends and the on-call team covered their service that day. Life was a little easier, though I might still pop in when I was chief resident to check on a patient I operated on.

I don't mind working weekends and accepted it early on as a part of my chosen profession. But I realize that's not for everyone.

 

[piii]

Radiology for sure. Most program structures are like this:

R1 (PGY2)
- M-F 8-5
- no weekends or nights for first half of year
- second half of the year you take evening call once every week or two from 5-10PM on top of normal schedule and you maybe do 2-4 weeks of night float and a few weekend day calls

R2 (PGY3)
- M-F 8-5
- heavier call schedule with maybe 5-10 weeks of night float and 1/3 to 1/2 of your weekends you do a weekend day call

R3 (PGY4)
- similar R2 call schedule for first half of year - no call second half of year and a really light last 2-3 months for board studying (some programs give 2 months off or half days for the CORE)

R4 (PGY5)
- mini fellowhips
- call and weekends usually very light unless doing IR

 

[Chlorophyll Oracle]

Does anyone know the usual schedule for IM residents?

 

[Mass Effect]

Does anyone know the usual schedule for IM residents?

Of the 4 programs I've seen, it was like this on wards:
6:30 or 7 am - 5 or 6 pm

You always start on time (or earlier) and 99% of the time you won't sign out on time. Intern year, 12-hour days were much more common. You work 6 days a week when you're on the wards. The places I've seen all had a night float system versus a q-whatever call.

Outpatient months are much more chill, typical 8 - 5 and sometimes you leave early if no patients are scheduled or if patients cancel.

Someone in IM can tell you more. Personally, I've never witnessed what was described above such as interns leaving at 2 pm or whatever. That's unheard of at the places I've been.

 

[PhillyMed777]

Of the 4 programs I've seen, it was like this on wards:
6:30 or 7 am - 5 or 6 pm

You always start on time (or earlier) and 99% of the time you won't sign out on time. Intern year, 12-hour days were much more common. You work 6 days a week when you're on the wards. The places I've seen all had a night float system versus a q-whatever call.

Outpatient months are much more chill, typical 8 - 5 and sometimes you leave early if no patients are scheduled or if patients cancel.

Someone in IM can tell you more. Personally, I've never witnessed what was described above such as interns leaving at 2 pm or whatever. That's unheard of at the places I've been.

Did a prelim intern year
This is quite accurate
Only thing I noticed is that earlier in intern year I used to come even earlier to make sure everything was squared away by rounds. Second thing is that electives can be very chill sometimes with minimal effort needed but that depends a lot on the elective/hospital/attending

 

[MisterKitty]

My intern year in psych has been super chill

 

[Mad Jack]

Psych I'm doing one weekend out of four, three weekends off a month isn't bad.

 

[Kuratz]

I know the question is not about Gen Surg because everyone knows it’s not a lifestyle friendly residency, but to give contrast to Rads:

Prelim GS:
- Always in by 4:45, out earliest 5:30.
- Always work one of the weekend days.
- Some rotations like trauma, vascular, or cardiac often start a little earlier and can go until 7-8.
- It’s like this the entire year except for 3 electives which are then more 7-5 but still cover weekend call.

In contrast to the Radiology PGY2 schedule I was just sent:
- 7:30-5 with protected daily lunch conference
- Zero weekend shifts
- Zero night shifts (no R1 short call at my prog)
- One half day per week of “academic time”

The call ramps up for R2/3 obviously (Will ultimately have q8 short call and q4 weekend call) but comparatively I can’t imagine it’s anywhere near GS. The midlevel/senior residents here in GS still work ~5:30-5:30 (or later) basically 6 days per week.

 

[MisterKitty]

Psych

7:30-4:30 M-F for PGY1/2. Call is typically one weekend per month or every other month.

8-3pm during PGY 3/4 with minimal call. Maybe 4 weekends a year.

 

[hallowmann]

Psych

7:30-4:30 M-F for PGY1/2. Call is typically one weekend per month or every other month.

8-3pm during PGY 3/4 with minimal call. Maybe 4 weekends a year.

Highly program dependent. The program here (granted known to be higher hour place) will have weekend call that's 1-2x/mo for all of PGY1-2 when on services that don't do 6 days on, 1 day off. The upside is that PGY3-4 is home call (O/N or weekend) 2-3x/mo and you rarely get called. Schedule for PGY1-2 on in-service rotations is 8-5pm, and probably rounding 2-3 weekend days a month (in addition to your call shifts). PGY3 is 8-5pm, and PGY4 is mostly 8-5pm, but depends on how you spend your electives.

 

[Candidate2017]

Psych I'm doing one weekend out of four, three weekends off a month isn't bad.

I'd rather work one weekend every month than have to work 12 straight days every month. Oh wait, they're the same thing.

 

[Candidate2017]

Someone in IM can tell you more. Personally, I've never witnessed what was described above such as interns leaving at 2 pm or whatever. That's unheard of at the places I've been.

I occasionally left around 2-3 PM during my IM months because I had a good team. We'd give sign out early to the long-call intern who would be there until late evening. If we got paged, we'd relay it to the long-call intern who would take care of it.

 

[Mass Effect]

I occasionally left around 2-3 PM during my IM months because I had a good team. We'd give sign out early to the long-call intern who would be there until late evening. If we got paged, we'd relay it to the long-call intern who would take care of it.

Yeah, pretty sure in most programs passing off your work to others would be frowned upon. I would bet that in the majority of the programs, unless your shift actually ends at 3, you wouldn't be bouncing out and counting on the long-call intern, who is likely already overworked, to "take care of" your pages.

 

[Mad Jack]

I'd rather work one weekend every month than have to work 12 straight days every month. Oh wait, they're the same thing.

12 straight days isn't bad when your days are 9 hours long

 

[Candidate2017]

Yeah, pretty sure in most programs passing off your work to others would be frowned upon. I would bet that in the majority of the programs, unless your shift actually ends at 3, you wouldn't be bouncing out and counting on the long-call intern, who is likely already overworked, to "take care of" your pages.

No, we were team players. Everyone takes one for the team if it's a manageable day. It's not like we took off. The long-call intern was the one who would tell us to get the F outta there, if appropriate. Good times.

 

[timeflies]

Yeah, pretty sure in most programs passing off your work to others would be frowned upon. I would bet that in the majority of the programs, unless your shift actually ends at 3, you wouldn't be bouncing out and counting on the long-call intern, who is likely already overworked, to "take care of" your pages.

The only instance I saw of an intern leaving early was if the senior told the intern to go home and would cover. I've never seen a weekday sign-out to the call team.

And the only time I ever saw this was for a prelim intern, I've never seen a categorical intern get told to go home early.

 

[Mass Effect]

No, we were team players. Everyone takes one for the team if it's a manageable day. It's not like we took off. The long-call intern was the one who would tell us to get the F outta there, if appropriate. Good times.

I'd argue that isn't being a team player. Being a team player is doing your own work so no one else gets stuck with it.

 

[HowAreYaNow]

I occasionally left around 2-3 PM during my IM months because I had a good team. We'd give sign out early to the long-call intern who would be there until late evening. If we got paged, we'd relay it to the long-call intern who would take care of it.

So at my med school's main hospital there were four IM teams that had residents. Each team, one day per week, would have a non-admitting day (we called it a "routine day'). On those days the list would usually (of course not always) run on the low side by mid-afternoon, so we made it our goal on that day to get our work done by 2-3 PM and then we would sign out to one of the other three teams. The interns and sub-I and M3's were usually sent home at that time and the resident would stay a little later to tie up any loose ends but to my knowledge would still get to leave early because our list was covered by what we referred to as our "sister team." It was always reciprocal; we would do for other teams, other teams would do it for us.

I'd argue that isn't being a team player. Being a team player is doing your own work so no one else gets stuck with it.

I hear what you're saying, but this was an instance where there was an understanding by all the teams that everyone would have their turn to have a lighter day and that it would be repaid in kind.

 

[hallowmann]

I occasionally left around 2-3 PM during my IM months because I had a good team. We'd give sign out early to the long-call intern who would be there until late evening. If we got paged, we'd relay it to the long-call intern who would take care of it.

Honestly, I'm hearing a lot of IM (the ones not covering COVID) and Peds inpatient teams doing that right now in our system. They are alternating interns to stay late and take sign out from the rest after rounding because the census is so small that the whole list has as many as one intern would take on a normal pre-COVID day. When you've got 5-6 patients on a team of 3 juniors that typically has 15-20, it doesn't make sense for everyone to stay. I never experienced it on those services, but I'm glad some people get to go home early.

 

[Mad Jack]

The only instance I saw of an intern leaving early was if the senior told the intern to go home and would cover. I've never seen a weekday sign-out to the call team.

And the only time I ever saw this was for a prelim intern, I've never seen a categorical intern get told to go home early.

We once had an intern ask to leave early because Sam's Club was having a sale. Needless to say, she was stared at wordlessly by the senior until she realized the error of her ways

 

[Candidate2017]

OP, here we are on the weekend and a bunch of psych folks have hijacked your thread with a debate about IM schedules. Looks like you've got your answer as to which specialty routinely has weekends off.

 

[Mass Effect]

OP, here we are on the weekend and a bunch of psych folks have hijacked your thread with a debate about IM schedules.

You say that like you're not a psych resident yourself.

 

[hallowmann]

You say that like you're not a psych resident yourself.

I assumed he was counting himself in that debate about IM.

 

[Mass Effect]

I assumed he was counting himself in that debate about IM.

That makes more sense.