Part Time?

[doctoritis]

EM is one of the better known 'life style' fields that offers great schedule flexibility, and I find the pace of the EM and its environment very appealing/exciting - so it is definitely one of the fields that I'm considering based on academic interest.

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[Cynic]

.

 

[Groove]

I just love these millennial medical students. Dude, you should have gone to dental school.

 

[doctoritis]

It's a fair question --- I don't really think it's the craziest expectation in this world to work hard somewhere between the hours of normalcy. We have all worked hard enough in medical school to choose a working environment that fits us, and I respect that for some people, working nights is not problematic, but for me it is. I'm not really ashamed of my opinion, nor do I intend on caring any less about my patients or being any worse of a doctor. In fact, I believe that the better rested that I am and the happier I am with my work environment, the better doctor that I will be.

 

[two guys]

This has been covered a few times, most recently in the "hours to make 100k "thread.

People are put off by the question, and I understand where they are coming from for sure. Nonetheless, I do think its a fair question. I'd rather you get the answer now than once you've committed 250k and 7 years and can't back out.

The short answer is no. You will have a lot of trouble finding a job in a desirable location that wants to pay you a normal rate while only working days and no weekends. Probably not impossible, but I doubt if any of us have EVER heard of someone in this position.

If what you're really asking is, "Is EM a speciality that I can work less than the average physician and make decent money" than the answer is yes. But you either trade working less for working nights and weekends with an unpredictable schedule or you trade working more (ie adminsitrative stuff that you won't get imeediately out of residency and likely wont tant given your question) for some schedule regularity and little/no nights and weekends.

There are actual lifestyle specialties that don't have nights and weekends. If you're pretty against nights and weekends you will be unhappy in EM.

You can only be happy with shift work if you value having times off that most people don't (ie getting to go to your kids lunch at school or getting to go biking, climbing, skiing on the weekdays when no ones there) as much or more than you value weekends off and no nights. If you don't have a way to find some silver linings in the schedule, you will be miserable.

No need to be ashamed to ask the question. You don't owe anybody anything. Might as well be informed now, than regret it later.

 

[BoardingDoc]

I keep vacillating between trying to give you an honest answer and writing something incredibly snarky. I'll just do both.

1: If you're willing to work in BFE? It's probably possible. Want to live somewhere nice? Not a chance. There are too many other applicants there who are willing to do the work that you are not.

2: In line with Groove's response: good god you sound like the quintessential entitled millennial. I'm ok with EM, but I don't want any of the drug seekers, drunks or psychotic patients. Where do I sign up for that? Oh, I can't because life doesn't cater to whatever whims I deem reasonable? Shocking.

 

[doctoritis]

Very fair answers, thank you. I appreciate it. I think it's what I expected to hear ... but just wanted to confirm it, before not considering EM further based on a maybe faulty assumption. Scheduling aside I am interested in EM medically speaking, however, for me that is not the only priority in choosing a specialty. I appreciate the honesty (and sarcasm ).

 

[Groove]

Pray tell what are these "many other specialties" that only require part time work, no nights (i.e. no call), and no weekends? Moreover, where are these group practices willing to pay your overhead (mal, insurance, benefits), work their asses off yet welcome you with open arms fresh out of residency wanting a work schedule that only their senior partners enjoy?

You're certainly not the first med student to post this sort of question on here but good grief I'm sick of hearing them at this point. We have a few posters that pat kids like you on the back and say "here, here... don't feel bad, dry your tears, it's a fair question..." but am I the only one wondering why you enrolled into medical school and incurred 200-300K in debt to go into what is certainly one of the more arduous and stressful professions out there when all you wanted in life was to work 15hrs a week and make 6 digits? Why not pick something more in line with your life goals instead of treating and taking care of sick pts?

In short, no... EM is not really a stress free or "life-style" friendly specialty. I mean, it is... but not really. Good luck finding any practice environment like what you described where your partners wouldn't be cursing your name when they see it on the schedule unless you've got a bunch of dedicated nocturnists and docs who just loooove to work weekends and holidays.

 

[Mad Jack]

Not that I'm an expert on the matter, but in the ED I worked in, even the part-timers and people that were primarily academics were expected to work a mix of nights, weekends, and holidays. You can't just not share in those coverage responsibilities, it just doesn't work that way in >99% of EM practices.

 

[gman33]

The question is fine, the answer was already given. It will be near impossible to find this type of job.
You could work in urgent care. If you actually like EM, this will be a terrible compromise.
You could likely find a part-time EM job if you are willing to work mainly nights and/or weekends.
This may sound terrible, but working 6-8 overnight shifts a month wouldn't be terrible if you were off all the other days.

 

[circulus vitios]

Pray tell what are these "many other specialties" that only require part time work, no nights (i.e. no call), and no weekends? Moreover, where are these group practices willing to pay your overhead (mal, insurance, benefits), work their asses off yet welcome you with open arms fresh out of residency wanting a work schedule that only their senior partners enjoy?

Would groups be okay with hiring someone who wants to work crazy hours, like 50-60 hours a week?

 

[Birdstrike]

EM is one of the better known 'life style' fields that offers great schedule flexibility, and I find the pace of the EM and its environment very appealing/exciting - so it is definitely one of the fields that I'm considering based on academic interest. However, honestly, I'm looking to go part-time soon out of residency and am wondering, is a part-time gig with no over-night shifts and minimal weekend responsibilities realistic in EM?

(Excuse my honesty, and I respect all those that are able to pull off the nights, but I just don't foresee myself being able to switch my rhythm from days to nights on a regular basis too far out of residency ... and I'm wondering how much of a barrier to practicing EM this would be. I feel like this is just not a realistic expectation on my end and am looking for some of you in the EM job-market to prove me wrong, if possible!)

Don't feel bad for wanting to enjoy life and not wanting to be work-stressed to death. If you can find stable part time work in EM, God bless you. You will not regret it. But do expect to always be pressed to work more. Also expect to repeatedly be hired for "x" amount of hours, yet after you've signed your contract, signed a lease, and gotten your first schedule, it's "x + 30%" for "oh just until we add 1 guy" which could be one year or never due to turnover or increasing patient load.

Realistically, think more about Derm or one of the fields that actually is "lifestyle cushy," if that's what you're looking for. Good luck.

EM is one of the better known 'life style' fields that offers great schedule flexibility

Edit: will add that you're right it's known as that, but that it's so, so wrong. How can so many "brilliant young med students" be consistory and repeatedly wrong despite having all the information available to them? I don't know, but they are on this one. Those that constantly switch shifts, suffer repeated circadian rhythm upheaval and work hours opposite to all other important members in their life so the sick and feeble can get care are my heroes. Thank God there are those that do it, but a positive lifestyle feature, it is not.

 

[VA Hopeful Dr]

The urgent care I work at employs most EPs. We have one who is a 0.8 FTE, works 8-9, 12 hour shifts per month which includes 1 weekend. Not exactly what you're gunning for, but probably closer than you will get actually doing EM.

 

[e30ftw]

However, honestly, I'm looking to go part-time soon out of residency and am wondering, is a part-time gig with no over-night shifts and minimal weekend responsibilities realistic in EM?

I would say, no, that is not realistic in most long-term jobs in semi-desirable locations (ie. medium to large sized cities with any sort of >30k ED.)

You can work part time, sure.

You can work part time and only nights, absolutely. You can work part-time and only weekends, no problem.

You probably can't work part time no nights/weekends, especially as a new grad. How is this fair to everyone else?

You could probably find some place in BFE to do locums say 5 weekday shifts in a row, once a month, and be able to fly/drive a few hundred miles, but even then you'd probably be pressured into doing nights/weekends.

Why not just work part time doing only nights or volunteer 1 weekend/mo out of your ~8-10 shifts? what is the big deal about nights/weekends?

The only thing that differentiates time is whether or not you're working. The days marked "weekends" and your position on earth relative to the sun do not matter. brainwash yourself this idea if you want to work EM..

 

[RustedFox]

The only thing that differentiates time is whether or not you're working. The days marked "weekends" and your position on earth relative to the sun do not matter. brainwash yourself this idea if you want to work EM..

Quoted for truth.

 

[RustedFox]

Would groups be okay with hiring someone who wants to work crazy hours, like 50-60 hours a week?

Anyone who walks into a job interview stating this is going to raise eyebrows, and not in the right way; because the interviewer knows that burnout is just around the corner for this fellah.

A burned-out doc is no good to anyone, least of all his/herself.

 

[jaeida8]

Don't consider EM a lifestyle field. In most places you will have to work nights, weekends and holidays. If you refuse to work your fair share, your colleagues will not like you.

 

[Hercules]

The only thing that differentiates time is whether or not you're working. The days marked "weekends" and your position on earth relative to the sun do not matter. brainwash yourself this idea if you want to work EM..

Unless of course you have a family/spouse/child/friends who are on a regular schedule. That differentiates your time for you. Not trying to be a wet blanket but this always needs to be pointed out.

 

[e30ftw]

the OP was from a medical student perspective.

I would 1000x rather work 9-5 m-f and consistently be able to coordinate with my wife/friends/family who are all on normal schedules.

It sucks when you tell people that, in fact, you are working thanksgiving and christmas (2 yrs and counting..). They can't understand. People think you are blowing them off when, no, you're just working the schedule w/o being difficult.

There is no argument that having an irregular schedule causes significant life problems, including social consequences and overall decreased life expectancy. You will die sooner by working in EM.

The only way for a new trainee to accept these facts is to realize that, for the time being, and likely for much longer, working nights and weekends is an uncontrollable reality. Perhaps years from now you can become involved in admin and the powers that be will deem it necessary for you to work days/swings.

until then, if you want to be happy, accept it.

 

[deleted547339]

look into derm

 

[gutonc]

I will just say that, unless you have connections or money already, it is really difficult to establish a PT position in just about any specialty other than Psych (where all you need is 2 chairs, a desk, a phone and a computer to set up a practice) or doing locums/UC work. Especially straight out of training.

I was very, very lucky to do so in my specialty but out of the roughly 80 other people in this specialty in my town, I'm one of 3 that I know of (and I know most of them) that have a similar (3/4 time) position.

But in general, starting off PT is hard. Moving to PT is also hard, but much easier. And it doesn't take 10+ years to do so, just focus and dedication.

Finally, just so we're clear...you may think you worked hard in med school. That's laughable for those of us anywhere on the other side of the Match.

 

[RustedFox]

Finally, just so we're clear...you may think you worked hard in med school. That's laughable for those of us anywhere on the other side of the Match.

Granted, I agree with 99/100 of your posts/ideas, amigo -

We did work hard in med.school. We all did. We all just worked infinitely harder in residency/fellowship. Harder still.

... and for what reward?

... who the hell else works that hard ?

Nobody that I can think of.

I really believe that its time to demand more out of our job for what we invested in it. I don't mean in terms of cold-hard cash, or cush-hours... but rather "the big two" of debt forgiveness and malpractice reform.

I'll be the first guy to sign up to grind out a nighttime-weekend shift. But dammit, man - I don't want to squeeze into my fifth one this week because "hey, those loans need to be PAAAIIID", and "Watchout! all those customer-service-suckers are looking to steal your livelihood; make with the RVUs, man."

 

[gutonc]

I will say that I work about 50% as hard now as I did during my training. But med school? That s*** was a joke. Sure, long hours, sitting around with your thumb up your butt, but no actual hard work.

Look, I work 3/4 time on purpose. I'm not suggesting one needs to grind out shifts/RVUs because that's the way it's supposed to be done. I was just pointing out that if 3rd year is considered "hard work" then "life" is going to be a horrible shock.

 

[Perrin]

The only thing that differentiates time is whether or not you're working. The days marked "weekends" and your position on earth relative to the sun do not matter. brainwash yourself this idea if you want to work EM..

Seconded

Here's a short list of the people who get to "define" their schedule;
1. The group partners, admin, or president.
2. The nocturnist
3. The doc who works mostly weekends
4. The doc who is willing to frequently pick up or swap shifts in an emergency or short notice

Dictating your schedule typically requires you to make up for it in some meaningful way.

You'd be much more likely to try and get a set schedule, but after you've been there a year. Perhaps get 3 nights in a row with 3-4 days off one week and 4 days the next week with a full weekend covered. Some schedulers are happy to have docs with set schedules as it makes the schedule easy. However, hoping your partners are going to permanently inconvenience themselves to accommodate your lifestyle isn't going to fly in most places.

 

[goodoldalky]

You will find that all fields of medicine with almost no exception have their obnoxious aspects to deal with. Those pain in the rear things are the reason we get paid money.

In emergency medicine, we work less and get paid more per hour than most docs. Why? Nights/weekends/holidays, volume, unpredictable patients, pace, lack of control over ancillary staff.

You may be able to find some sort of PT limited N/W/H gig, but don't be surprised when the powers that be only push 100k back across the table to you.

For me EM has been the right choice but you will need to weigh these factors for yourself. Every field will be different.

 

[DreamingTheLive]

How your group schedules can be HUGE in mitigating these factors.

I've talked with groups where everyone basically picks the days they want off in advance and more or less everyone is relatively granted their wish and they have a good amount of freedom, however, their circadian rhythms are crazy bad because of the sheer randomness of their respective schedules. On the other hand, I've talked with groups where they take away a lot of this flexibility and have you essentially work the same shift for "blocks" of 1-2 weeks and then rotate to a different shift. Sure, much less control over your schedule but on the flip side MUCH easier on your circadians.

 

[Birdstrike]

You will find that all fields of medicine with almost no exception have their obnoxious aspects to deal with. Those pain in the rear things are the reason we get paid money.

In emergency medicine, we work less and get paid more per hour than most docs. Why? Nights/weekends/holidays, volume, unpredictable patients, pace, lack of control over ancillary staff.

Every field will be different.

In other words, "Choose your poison."

 

[sloh]

FWIW, i found the responses in this thread informative and I appreciate the raw and unadulterated input current residents/attendings have to offer

 

[RustedFox]

I will say that I work about 50% as hard now as I did during my training. But med school? That s*** was a joke. Sure, long hours, sitting around with your thumb up your butt, but no actual hard work.

Look, I work 3/4 time on purpose. I'm not suggesting one needs to grind out shifts/RVUs because that's the way it's supposed to be done. I was just pointing out that if 3rd year is considered "hard work" then "life" is going to be a horrible shock.

I see what you're saying. - Sounds like you had a blast during med.school though. Good on yah.

I work "harder" now than I did during my on-service months in residency, but infinitely "less hard" than off-service months in residency.

 

[Birdstrike]

The Birdstrike Manual of Specialty Choice

The most realistic chance at a lifestyle oriented or pseudo-part time job as a doctor is to find,

1. An entirely outpatient, non-hospital based, specialty.

Anything inpatient will inevitably get you roped into emergencies, curbside consults, crashing patients, on call duties or other services that need your help at times you don't want to help.

2. A specialty where you take care of few if any acutely sick people.

Anytime you do the fun and "exciting stuff" taking care of acutely sick patients (MI, airways, open fractures, exploding appendices, bleeding brains, car vs Humpty Dumpty, baby needs out) will mean your lifestyle will suck.

Always.

And forever.

No exceptions.

No if's, and's, butts.

Do not pass go, do not collect 200 dollas'.

That means working nights, weekends, holidays and/or sh¡tty call, and always being pressured to work more than you want by some person, entity or employer. Once the thrill is gone, the nights, the weekends, the call and the crappy shifts remain.

Write this on the chalkboard 700 times and read aloud 700 times right now, please:

"If I take care of sick people (or babies) who need me RIGHT NOW, my lifestyle WILL always suck."

3. A specialty that is procedure oriented.

Even considering recent reimbursement cuts, procedures are (and always have been) reimbursed at a higher RVU per hour (dollars per hour) ratio, since fee for service has existed. Despite all the BS talk about "getting rid of fee for service" and "pay for performance" (which no one can define), absolutely no one has come up with a viable way of replacing fee for service that will come to pass in any of out lifetimes. Only single payer will do it and going to single payer after the ACA will be nearly impossible given the complexity of our system and entrenched interests. And despite all the feel good talk about paying primary care as much as specialists that have trained longer, it's just not going to happen.

Point: getting reimbursed more for elective procedures (Monday-Thursdsy) makes a 4-day work week (as opposed to 5-7) doable.

4. Reset goal to a 4-day per week job (as opposed to a true 20-hr per week part time job).

The feasibility of a Monday-Thursday job as a specialist is very doable. The 20 hr per week doctor is completely unattainable in private practice. There's too much over head. In hospital employed practice and academics it may be possible, but infinitely harder to find than a full timer. Reason: Nobody, I mean nobody wants to hire a residency grad that wants to work part-time, when they can hire a full-timer. Nobody. Only after paying serious dues, for years, in the trenches, does anyone want to let anyone work "part time."

Anything that doesn't fit into the above profile will not be a lifestyle specialty. Anything that does, just might be.

 

[Groove]

Would groups be okay with hiring someone who wants to work crazy hours, like 50-60 hours a week?

See RustedFox's response. Sure, they'd be "o.k.", maybe even thrilled if you worked for a CMG like me in a city where it's difficult to attract EM docs in spite of a good salary, but nobody can keep up that pace and not blow a gasket. I'm working 170h this month and that's well above avg for my group. Most work about 135h. You're talking about close to 200h a month and that's just nuts man. Those kinds of hours are MUCH easier with 7-5 type jobs.

 

[Birdstrike]

Would groups be okay with hiring someone who wants to work crazy hours, like 50-60 hours a week?

The most desperate jobs would jump at it in a heartbeat, knowing they were hiring a clueless lunatic-soldier who would maybe get them the coverage of two bodies for the short term, knowing exactly that it would be short term, and that they'd be rehiring after he went down in battle.

Most quality shops would see it as the red flag of either a lunatic, a clueless new grad or financially ruined post divorcee headed for a flameout.

Don't do this.

 

[RustedFox]

See RustedFox's response. Sure, they'd be "o.k.", maybe even thrilled if you worked for a CMG like me in a city where it's difficult to attract EM docs in spite of a good salary, but nobody can keep up that pace and not blow a gasket. I'm working 170h this month and that's well above avg for my group. Most work about 135h. You're talking about close to 200h a month and that's just nuts man. Those kinds of hours are MUCH easier with 7-5 type jobs.

Yeah; let me amend my response.

If you walked into a job interview, and your interviewer is excited to have you volunteer 150+ hours every month... then your interviewer realizes one thing:

"Great! Another sucker! We'll abuse him for as long as we can until he's toast. Hopefully by then the next one will come along. Burn, baby, burn."

 

[WilcoWorld]

Forgive me, as the following is a little wooly, even for my tastes:

I understand the desire to do so, but I think working part time straight out of residency is a bad idea. Many of us have heard of Malcolm Gladwell's 10,000 hours hypothesis - you only become expert at something after having done it for 10,000 hours. He cites The Beatles and Bill Gates as examples. I think it applies to EM as well. While I didn't know more pathophys or EBM 3 years after residency than I did as an EM-3, I was a much better doctor. I found that it took a lot less mental effort to wrap my head around odd presentations. Where I used to have to laboriously slog through details to figure out a case of AMS, after several years of hard work experience I started to be able to walk into a room and after only a couple of minutes I'd think, "Huh, smells like digoxin toxicity."

Now, some might argue that one can reach 10,000 hours as a part-timer, it'll just take longer. But I think that there's more to it than the absolute # of hours. I think there is a certain density of experience required to have the lessons sink in. Anyone who's practiced EM for awhile knows that you get rusty after only a couple weeks away from the ED. If, as a new grad, you're always shaking off the cobwebs after coming back from a break, you won't reach that concentration of experience that really solidifies the learning.

However, once people reach a certain point (I don't know when that point is) I think that they can slow down. That's because they've already formed the patterns/habits/neural networks of a good clinician. If you slow down before that your neural networks will never get the density of reinforcement they need to galvanize.

I hope that the Millenial doctors who will be treating me when my telomeres are getting too short will have put in the necessary time before cutting back to part time.

 

[dotcb]

In EM you can control the total number of hours you work, but not reliably when during the day you work. ED's are busiest from 11am-1am, so shifts are concentrated during these times. New hire part timers at my job do 8 shifts a month, 4 of them are nights, no benefits. Full timers do 14 shifts, 3 nights, w/ benefits. Part time EM works well if you actually like working evenings and nights. Several women and men w/ small children have found a rhythm that works for their families w/ evening/night work.

 

[Old_Mil]

However, honestly, I'm looking to go part-time soon out of residency and am wondering, is a part-time gig with no over-night shifts and minimal weekend responsibilities realistic in EM?

You probably aren't going to have the best selection of jobs if you aren't willing to work nights and weekends. You will either have to take something with a bad location, bad patient mix, or bad malpractice environment. Clinic/urgent care will do a better job of protecting you from nights and weekends.

Sent from my Z10 using Tapatalk

 

[deleted480308]

there are some groups that offer a pay premium to night shift and you can "buy" your way into the day shifts...I think @The White Coat Investor mentioned it

 

[da8s0859q]

The Birdstrike Manual of Specialty Choice

The most realistic chance at a lifestyle oriented or pseudo-part time job as a doctor is to find,

1. An entirely outpatient, non-hospital based, specialty.

2. A specialty where you take care of few if any acutely sick people.

3. A specialty that is procedure oriented.

Anything that doesn't fit into the above profile will not be a lifestyle specialty. Anything that does, just might be.

So, lots of not-EM-at-all-mkay things there. Do you think that EM is even a quasi-lifestyle specialty based on the hours, reimbursement, etc?

 

[Birdstrike]

So, lots of not-EM-at-all-mkay things there. Do you think that EM is even a quasi-lifestyle specialty based on the hours, reimbursement, etc?

No.

It's as much a "quasi-lifestyle" specialty as I am quasi-pregnant.

 

[deuist]

OP, this whole thread has got me thinking, what if a Navy SEAL were to ask, "After I finish with BUDS, do you think I can take it easy for the rest of my life? I mean, all these wars can't be that hard, can they?" If you are really looking forward to an easy lifestyle in emergency medicine, you can pick up occasional part-time shifts with a contract management group in an undesirable location, but you won't get any benefits. All of the money you make through your earnings will likely go toward paying your health insurance and retirement investments. If you aren't dead set on EM, then look into some other 9-to-5 specialties such as rheumatology, endocrinology, allergy/immunology, dermatology, outpatient pediatrics, outpatient psychiatry, outpatient plastic surgery, preventive medicine, medical genetics, and the list goes on. There are certainly lots of ways to earn a decent living while working not too many hours, but many of the exciting specialties are going to have their doors closed to you.

 

[Hercules]

I can tell you my 8 doc SDG would not hire a PT new grad looking for all weekday shifts. What's in it for us? We have a senior partner who works part time. His arrangement is 8 shifts/month with 3-4 of those as nights. He also pays a full-time share of the operating expenses (payroll tax, midlevel salaries, scribe costs, bank fees, etc) while not utilizing them which makes this deal palatable to the group. Despite this he still makes more per hour than else would with a CMG and gets to keep practicing in the ED he spent the last 25 years in. It's a win for everybody.

 

[Lysinee]

Work fewer hours early in your career and you will be one of those older docs working more hours.

 

[GeneralVeers]

Drink coffee. Wear Pajamas. See patients. No nights or weekends.

 

[goodoldalky]

So, lots of not-EM-at-all-mkay things there. Do you think that EM is even a quasi-lifestyle specialty based on the hours, reimbursement, etc?

To be honest, most of medicine is not a lifestyle choice. Most fields are needed 24/7 and it's hard work. Most real jobs outside medicine are also hard work. Work is hard and you'll spend a lot of time and energy doing it. That's why people get paid money to go to work.

I think too many people get caught up in the whole - what job has the least hours least work most money possible mindset. I mean, I get that, but you're going to drive yourself nuts unless you find a winning lotto ticket.

On this forum you can probably learn a lot about what real emergency medicine jobs are like. You need to decide if that lifestyle is good or bad in your book.

 

[da8s0859q]

To be honest, most of medicine is not a lifestyle choice. Most fields are needed 24/7 and it's hard work. Most real jobs outside medicine are also hard work. Work is hard and you'll spend a lot of time and energy doing it. That's why people get paid money to go to work.

I think too many people get caught up in the whole - what job has the least hours least work most money possible mindset. I mean, I get that, but you're going to drive yourself nuts unless you find a winning lotto ticket.

On this forum you can probably learn a lot about what real emergency medicine jobs are like. You need to decide if that lifestyle is good or bad in your book.

For sure. Did a lot of poking around for that before going through the match. Always curious to hear from the attending SDNers who think EM is -- and isn't -- a "lifestyle specialty" in any way. Most people I know chose it in at least part because of some of the lifestyle-ish aspects.

Sure, it's not derm, but I feel like we could have chosen so much worse.

 

[EctopicFetus]

Its definitely not a true lifestyle specialty. I doubt you would find ONE attending who believes it is. That being said I like knowing I am off more days in a month than I am on. If you consider days off valuable, can sacrifice working weekends, holidays, evenings and nights and that not be a huge negative then maybe you could consider it a lifestyle specialty.

I think you would be happiest if you found a field you enjoyed (not loved). With this you can tolerate whatever BS comes with it.

 

[RustedFox]

Drink coffee. Wear Pajamas. See patients. No nights or weekends.

This should be stickie'd.

 

[The White Coat Investor]

Oh come on guys. You need to talk to some other doctors some time. EM is a lifestyle specialty with a few really crappy downsides.

I work 15 eights. That's 120 hours a month, or 28 hours per week. 28 hours per week. That leaves me 140 hours to do whatever I want. Yes, I lose a day or two every month to the dreaded DOMA (Day Off My Ass- the day after your last night shift). Yes, I miss a lot of evening activities with the kids. But I also still have 13-14 real days off every month, most weekday mornings off to do anything I want, and an enviable hourly rate. Heck, I've got another job on the side, how bad can this one be?

If EM is so bad, why don't you do something else? Oh yea, because it sucks even more to go to clinic for 55 hours a week and talk to people about their diabetes or kidney failure or COPD or chronic back pain. And the only thing worse than calling someone at 2 am to come in and take care of a patient is receiving that call and having a full day of surgeries/clinics the next day.

Of course, I might be biased. I just got back from two weeks in France where I spent with reckless abandon (and had no decrease in pay since I still got all my shifts in.) How many specialties can do that?

 

[The White Coat Investor]

OP-

Part time is doable, even right out of residency, but I wouldn't recommend it. I think it takes at least a couple of years of full-time work to solidify skills and reputation. Tough to combine with a "mommy-track" when the biological clock is ticking, but that's the way it is.

 

[DreamingTheLive]

Oh come on guys. You need to talk to some other doctors some time. EM is a lifestyle specialty with a few really crappy downsides.

I work 15 eights. That's 120 hours a month, or 28 hours per week. 28 hours per week. That leaves me 140 hours to do whatever I want. Yes, I lose a day or two every month to the dreaded DOMA (Day Off My Ass- the day after your last night shift). Yes, I miss a lot of evening activities with the kids. But I also still have 13-14 real days off every month, most weekday mornings off to do anything I want, and an enviable hourly rate. Heck, I've got another job on the side, how bad can this one be?

If EM is so bad, why don't you do something else? Oh yea, because it sucks even more to go to clinic for 55 hours a week and talk to people about their diabetes or kidney failure or COPD or chronic back pain. And the only thing worse than calling someone at 2 am to come in and take care of a patient is receiving that call and having a full day of surgeries/clinics the next day.

Of course, I might be biased. I just got back from two weeks in France where I spent with reckless abandon (and had no decrease in pay since I still got all my shifts in.) How many specialties can do that?

Agree. If you're dead set on being the ultimate family-man/woman and NEVER missing a dinner, one of your kids evening or weekend sporting events or weeknight engagement with your significant other moving forward than EM is most definitely NOT going to be lifestyle friendly for you.

However, if you want to potentially work LESS than 180-200 days a year, with pretty good pay (well, at least until we finish marginalizing ourselves and this becomes "planet of the noctors"), and a handful of nice random weekdays off every month to do whatever your heart desires AND you're ok with missing out on some of these family-related activities (I like my in-laws, but being able to work selected holidays at an increased rate....I'm just saying)....Then, YES......EM is boomtown.

Now, I had several short but very real career stints prior to medical school, some with "meh" pay and some that were very high-paying, but for me at least, the daily grind of 7a - 5p day-in and day-out and trying to hold out for the weekend was excruciating month after month. I just finished my intern year and worked more clinical hours than I ever will again, am involved in several relatively time-intensive research projects, residency activities, etc., etc. and I STILL thought that this past year was relatively lifestyle friendly.

If you've never worked a day in your life outside of studying for some tests and perhaps a couple local weeknights at your local Coldstone Creamery in high school or college, well, good luck.