Physician work load

[maldini99]

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Hello everyone,

I am currently a pre-med and I will hopefully be starting medical school in the fall of next year. While I have become familiar with the practice and general lifestyle of medical students and residents I really do not know much about the process that begins once residency is over. I am talking about recruitment, interviews, and general job selection.

I am interested in several specialties that are incredibly fascinating but have very long working hours (60+). Is it necessary for these doctors to work that much? For instance, can a ortho surgeon do less cases per week? Money is not that much of an issue for me because I would earn it either way, but having free time is pretty important.

So are there positions out there that let you take on a lighter load od work in order to have some more free time?

 

[J-Rad]

Moving to pre-allo.

 

[DrBowtie]

Hello everyone,

I am currently a pre-med and I will hopefully be starting medical school in the fall of next year. While I have become familiar with the practice and general lifestyle of medical students and residents I really do not know much about the process that begins once residency is over. I am talking about recruitment, interviews, and general job selection.

I am interested in several specialties that are incredibly fascinating but have very long working hours (60+). Is it necessary for these doctors to work that much? For instance, can a ortho surgeon do less cases per week? Money is not that much of an issue for me because I would earn it either way, but having free time is pretty important.

So are there positions out there that let you take on a lighter load od work in order to have some more free time?

What does the bolded mean?

And second of all if we are talking about being a surgeon, cases are only a small part of their workload. There must be time for pre-op and post-op clinic as well as rounding on your inpatient patients post op.

 

[CodeBlu]

OP probably meant that he could just go into investment banking or something.

Vampires those investment bankers...

 

[deleted357625]

Hello everyone,

I am currently a pre-med and I will hopefully be starting medical school in the fall of next year. While I have become familiar with the practice and general lifestyle of medical students and residents I really do not know much about the process that begins once residency is over. I am talking about recruitment, interviews, and general job selection.

I am interested in several specialties that are incredibly fascinating but have very long working hours (60+). Is it necessary for these doctors to work that much? For instance, can a ortho surgeon do less cases per week? Money is not that much of an issue for me because I would earn it either way, but having free time is pretty important.

So are there positions out there that let you take on a lighter load od work in order to have some more free time?

Yes, you can have free time. One of these girls I know her father is an orthopedic surgeon.

They travel every single break possible. They live the life and constantly on the go. Owns a Ferrari, BMW M3, Maserati, classics. Has a lake house/boat and constantly goes down there. Nice house and all that good stuff.

Like I said they are constantly traveling etc.. So I'm sure you will have a lot of free time.

 

[danzman]

Yes, you can have free time. One of these girls I know her father is an orthopedic surgeon.

They travel every single break possible. They live the life and constantly on the go. Owns a Ferrari, BMW M3, Maserati, classics. Has a lake house/boat and constantly goes down there. Nice house and all that good stuff.

Like I said they are constantly traveling etc.. So I'm sure you will have a lot of free time.

But this is simply not the norm. Everyone know a few physicians that drive Lambo's and work ten hours a week, just as I know a cop who does the same, but without knowing each ones situation its just too easy to generalize. And most of these stories are about docs that are in their 50s, or who's family has a ton of cash too. OP, this topic has been beaten to death. As a medical student/resident you will generally be forced to work more than 60hr/week. As an attending you can technically work as little or as much as you want. Trouble comes when you are looking for a job and start telling people that you only want to work 20hrs with four days off a week. Not many groups are willing to hire someone like this unless they are looking for part time help. Obviously certain specialties lend themselves to less hours and others are almost guaranteed to exceed a "normal" workload.

 

[Law2Doc]

... Trouble comes when you are looking for a job and start telling people that you only want to work 20hrs with four days off a week. Not many groups are willing to hire someone like this unless they are looking for part time help...

this. You in all probability won't be working for yourself, and thus won't be setting your own hours. In the early years you will be toiling long hours because your bosses need to pay their mortgages. When you are older you will have more control, but by then perhaps more expenses. So plan on working a ton of hours in medicine. Most of the attending level physicians I know log about as many hours as residents.

 

[danzman]

this. You in all probability won't be working for yourself, and thus won't be setting your own hours. In the early years you will be toiling long hours because your bosses need to pay their mortgages. When you are older you will have more control, but by then perhaps more expenses. So plan on working a ton of hours in medicine. Most of the attending level physicians I know log about as many hours as residents.

Its funny because this is the aspect of medicine that I feel people understand the least. That they will have to work their way up in a practice. I spoke to a gen surgeon that told me flat out in gen surg you should expect to work resident hours for 5-10 years post residency with not-to-great money. His wife was an EM doc on the other hand that had a solid gig lined up out of residency, so it is field dependent.

 

[235788]

Well go family medicine if free time is a must.

 

[danzman]

Well go family medicine if free time is a must.

This is absolutely false. One of the problems facing FM as a career is all the extra paperwork/etc' that you do not get paid for. They tend to have better, more predictable schedules but still many work a ton of hours. If you want free time its EM, Derm, or Hospitalist.

 

[DrBowtie]

Its funny because this is the aspect of medicine that I feel people understand the least. That they will have to work their way up in a practice. I spoke to a gen surgeon that told me flat out in gen surg you should expect to work resident hours for 5-10 years post residency with not-to-great money. His wife was an EM doc on the other hand that had a solid gig lined up out of residency, so it is field dependent.

A lot of this relates to buying into practice assets. EM has few if any tangible assets while the Surgeons might have a surgery center and equipment that you must buy into before you get a full partner share.

It also relates to building your patient base. EM doesn't have their own patients to recruit.

 

[AntiHouseMD]

One thing that I've always thought of is that in any career, those who truly want to become an important employee need to work a lot of hours. In medicine, everyone has to fit that profile.

 

[Law2Doc]

A lot of this relates to buying into practice assets. EM has few if any tangible assets while the Surgeons might have a surgery center and equipment that you must buy into before you get a full partner share.

It also relates to building your patient base. EM doesn't have their own patients to recruit.

I think It mostly has to do with the concept of shift work. If 4-5 twelve hour shifts is the norm for the practice, then that's what they will expect you to work. Thus the key difference in a shift work field as you move from more junior to more senior is whether your shifts end up being overnights and weekends.

 

[boobelle]

I am interested in several specialties that are incredibly fascinating but have very long working hours (60+). Is it necessary for these doctors to work that much? For instance, can a ortho surgeon do less cases per week? Money is not that much of an issue for me because I would earn it either way, but having free time is pretty important.

So are there positions out there that let you take on a lighter load od work in order to have some more free time?

If you consider 60 hours a "very long" work week, you really should consider alternate careers. Really. Many attendings would consider that either average or a short week. (This is part of the criticism from attendings about the 80-hour week restrictions for residents, since many work more than that and feel that residents won't be prepared to handle the increased hours and workload.)

Also, you should probably learn more about how surgery works. After the first couple of years most surgeons earn money based on their caseload...you only earn what you bring in and are not salaried. While you would negotiate your work hours with the group you join (since most docs work in the group model), most would be unwilling to take on a new doctor demanding a light caseload. So if you can find a group that will take you on, doing fewer cases will mean earning less money. But the more important point is that, particularly in surgery, you're only as good as the number of cases you do (and continue to do) to keep up your skills.

 

[unhappytnt]

If you consider 60 hours a "very long" work week, you really should consider alternate careers. Really. Many attendings would consider that either average or a short week. (This is part of the criticism from attendings about the 80-hour week restrictions for residents, since many work more than that and feel that residents won't be prepared to handle the increased hours and workload.)

Woah I didn't know that. Is this only for surgery or does it apply to every specialty? (perhaps not for ROAD?)

 

[boobelle]

Woah I didn't know that. Is this only for surgery or does it apply to every specialty? (perhaps not for ROAD?)

It does vary by specialty, and it's often tied to whether you're paid on a salaried basis (e.g. hospitalist, ED, inpatient psych) or if you're paid by the number of procedures/operations performed...or the number of patients seen. It also depends on seniority...as other posters have noted, as a doctor fresh from residency you can probably expect to work longer hours for less money than the docs who have been in practice for a few decades.

My sense is that the surgeons/proceduralists often work longer hours since their pay is often more directly related to number of cases, but I've also seen primary care/office based doctors working crazy hours because they're (under)paid by the patient and need to see a ton of patients....not to mention all of the un-reimbursable work in primary care sector. But it also occurs in medicine...e.g. some of our critical care attendings think the 16-hour intern restriction is ridiculous considering the hours the critical care fellows and attendings work. On the flip side, some of those hours can be either done at home (e.g. charting) or are call that can be taken at home...it restricts what you can do and where you can go in your free time, but at least it's not spent in the hospital. At least in my experience, the attendings I've seen working part-time hours can do so because their significant other is the main bread-winner of the family....or are the attendings who have taken on a majority of administrative work (or outright seniority) and can get away with more typical hours.

The hours thing is one of the reasons why everyone says that you really, truly should only go into medicine if it's your passion...and the good news is that if it *is* your passion, you're going to be happy (and not mind as much) the long hours required.

 

[deleted357625]

But this is simply not the norm. Everyone know a few physicians that drive Lambo's and work ten hours a week, just as I know a cop who does the same, but without knowing each ones situation its just too easy to generalize. And most of these stories are about docs that are in their 50s, or who's family has a ton of cash too. OP, this topic has been beaten to death. As a medical student/resident you will generally be forced to work more than 60hr/week. As an attending you can technically work as little or as much as you want. Trouble comes when you are looking for a job and start telling people that you only want to work 20hrs with four days off a week. Not many groups are willing to hire someone like this unless they are looking for part time help. Obviously certain specialties lend themselves to less hours and others are almost guaranteed to exceed a "normal" workload.

True

 

[maldini99]

If you consider 60 hours a "very long" work week, you really should consider alternate careers. Really. Many attendings would consider that either average or a short week. (This is part of the criticism from attendings about the 80-hour week restrictions for residents, since many work more than that and feel that residents won't be prepared to handle the increased hours and workload.)

Also, you should probably learn more about how surgery works. After the first couple of years most surgeons earn money based on their caseload...you only earn what you bring in and are not salaried. While you would negotiate your work hours with the group you join (since most docs work in the group model), most would be unwilling to take on a new doctor demanding a light caseload. So if you can find a group that will take you on, doing fewer cases will mean earning less money. But the more important point is that, particularly in surgery, you're only as good as the number of cases you do (and continue to do) to keep up your skills.

i was speaking in the reference to the world outside of medicine, where 60+ hours is a very long workweek.

and I dont know much about how surgery works and how they get paid . how should I? that is why I asked the question in first place, genius.

anyways, in the OP I took ortho surgery just as an example. my original question actually refers to any specialty out there.

 

[danzman]

i was speaking in the reference to the world outside of medicine, where 60+ hours is a very long workweek.

and I dont know much about how surgery works and how they get paid . how should I? that is why I asked the question in first place, genius.

anyways, in the OP I took ortho surgery just as an example. my original question actually refers to any specialty out there.

Fair enough. In my personal opinion it will be very hard for any surgeon, in any type of field to work a 40hr a week schedule. Some of this is due to how they get paid (per procedure) some is due to the nature of how they get patients (referral base) and some of it is just due to the unpredictable nature of the field. I know a handful of surgeons who work around 40-50 per week but they have been able to do so because they are extremely senior in their groups or have created a practice that allows for this (mind you it takes the aforementioned 5-10yrs to build up the practice). Remember that this is all very specialty dependent, every cardiologist I have ever met worked like crazy, yet most of the internists worked pretty normal hours and really liked their jobs.

This is the problem I have with the pre-med forums, when college sophomores argue about how they are going to do Ortho or pediatric neurosurg. Not only do they have almost no idea of what any of that means, they are far too young to know what will be important in their lives in the future.

Somewhere there is a post by Wingedscapula on a fourm about how females can be surgeons and still "have it all". The entire conversation is a bunch of premeds giving their advice, when she, and actual attending surgeon shows up and says nope, you cant have it all, that there will be huge sacrifices and that you will miss out on a lot. None of the premeds gave her any credit....

 

[boobelle]

i was speaking in the reference to the world outside of medicine, where 60+ hours is a very long workweek.

and I dont know much about how surgery works and how they get paid . how should I? that is why I asked the question in first place, genius.

anyways, in the OP I took ortho surgery just as an example. my original question actually refers to any specialty out there.

That's also probably not as true as you think. A 60 hour workweek is also on the short side for most of the other professions with a comparable income to medicine...e.g. my friends working in law or on wall street work much longer hours than I do. Also, your OP stated that "several specialties that are incredibly fascinating but have very long working hours (60+)", which read as in the context of medicine, not the rest of the world. I was pointing out that 60 hours is average or if anything a short work-week for ANY medical specialty And, since you insisted that you would make money as a surgeon regardless of how many cases you did per week--implying you had some knowledge of the system--I was simply stating that is not very realistic. Perhaps your original post wasn't as clear as you thought it was, since other posters didn't understand you either.

The people who are miserable in medical school, residency and in medicine (and often ultimately drop out or change careers after getting hundreds of thousands of dollars in debt) are the people who had unrealistic expectations about the work demands and lifestyle sacrifices, and thought they could be the exception to the rule.

I simply said that if having that much time per week completely free is very important to you, then medicine is probably not the best choice as you *will not* have that much protected free time. That's a perfectly valid choice, and it's better to recognize that about yourself before sinking the time and money into a career that does not suit your life goals. If you decide your passion for medicine is more important than having a ton of free time, that's great and go for it. Also, you might want to try to chill out a bit when getting an answer you don't want to hear or about receiving feedback...being defensive or having a hot temper will do you no favors when it comes to interviewing for med school or surviving on the wards. That advice will also probably piss you off, but it's actually intended to help you out just like the rest of my posts.

 

[AntiHouseMD]

When did you guys have to decide whether you were going to go for a career in medicine? I mean that did you have to decide early on in college (freshman/sophomore year) whether to go to med school with pre-regs, or did you have more time to make your decision?

 

[boobelle]

When did you guys have to decide whether you were going to go for a career in medicine? I mean that did you have to decide early on in college (freshman/sophomore year) whether to go to med school with pre-regs, or did you have more time to make your decision?

You can decide at any time. It's easier if you figure it out early in college, so you can take all of the prereqs as part of your BA or BS degree. But if you decide later in college or after you graduate, you can take the prereqs "a la carte" (not as part of a degree) or through what's called a "postbaccaulaureate" program. There's no "penalty" for not applying straight from college...in fact, the average age of a first year med student is 25, meaning that a large number of people take some time off between college and med school (some because they decided late, others because they couldn't get in the first time around). Since you have enough interest to find this site, I'd suggest starting the prereqs to see if you like (and can handle) the sciences and also start clinical volunteering/shadowing to get first-hand exposure to the career....your college's premed advisor(s) can point you in the right direction with both.

 

[AsianPersuasion]

60hrs a week is really not that bad. I'm currently working as a CNA 7-7 M-F. It goes by very quickly when your busy. I would imagine being a physician/surgeon it would go by even quicker!

 

[maldini99]

That's also probably not as true as you think. A 60 hour workweek is also on the short side for most of the other professions with a comparable income to medicine...e.g. my friends working in law or on wall street work much longer hours than I do. Also, your OP stated that "several specialties that are incredibly fascinating but have very long working hours (60+)", which read as in the context of medicine, not the rest of the world. I was pointing out that 60 hours is average or if anything a short work-week for ANY medical specialty And, since you insisted that you would make money as a surgeon regardless of how many cases you did per week--implying you had some knowledge of the system--I was simply stating that is not very realistic. Perhaps your original post wasn't as clear as you thought it was, since other posters didn't understand you either.

The people who are miserable in medical school, residency and in medicine (and often ultimately drop out or change careers after getting hundreds of thousands of dollars in debt) are the people who had unrealistic expectations about the work demands and lifestyle sacrifices, and thought they could be the exception to the rule.

I simply said that if having that much time per week completely free is very important to you, then medicine is probably not the best choice as you *will not* have that much protected free time. That's a perfectly valid choice, and it's better to recognize that about yourself before sinking the time and money into a career that does not suit your life goals. If you decide your passion for medicine is more important than having a ton of free time, that's great and go for it. Also, you might want to try to chill out a bit when getting an answer you don't want to hear or about receiving feedback...being defensive or having a hot temper will do you no favors when it comes to interviewing for med school or surviving on the wards. That advice will also probably piss you off, but it's actually intended to help you out just like my other points.

i was actually trying to say that I would make enough money to live comfortably, with the proportional decrease in income to the decrease in hours.

look i appreciate your response, lets move on now...

 

[AsianPersuasion]

BTW are you a female?

Inb4 the females are wasting spots in med school/residency debate!

 

[danzman]

When did you guys have to decide whether you were going to go for a career in medicine? I mean that did you have to decide early on in college (freshman/sophomore year) whether to go to med school with pre-regs, or did you have more time to make your decision?

I decided after two years of college, knocked out the required courses and then took a year off after college. I think it is easier if you have some idea early on, if only so you can spread out the pre-reqs a little. I took one semester of 22hrs of solid science classes that could have been avoided if I had planned a little better. My token advice to incoming freshmen is to major in something other than biology/chem but to start taking two pre-reqs per semester. This way if you fail out of ochem you can always have a backup (and who really wants to take plant biology..) Also, try to shadow early on. This is tough to do, and even then its tough to get a real feel for medicine.

 

[Mornhavon]

.

 

[Law2Doc]

i was actually trying to say that I would make enough money to live comfortably, with the proportional decrease in income to the decrease in hours....

as mentioned, this is often not an option in medicine -- you can't just say to a potential employer, "I only want to work 40 hours per week, so just pay me 30% less." it doesn't work that way. Overhead expenses are largely the same for your employer whether an employee works 40 hours per week or 60+, so if an employer can get someone who will work 60+ instead of you, that just makes better business sense. Also as mentioned, the concept of leverage exists in medicine where the older partners make money off the young guns, so youngsters who want the same relaxed schedules as the guys at the other end of their career are not in demand.

I agree with the notion that 60+ hours is the norm for professionals. You are going to be hard pressed to find a young lawyer seeking partnership or an investment banker looking to work his way up the ranks who puts in less than 80. The 9 to 5 crowd tend not to be professionals.

 

[danzman]

as mentioned, this is often not an option in medicine -- you can't just say to a potential employer, "I only want to work 40 hours per week, so just pay me 30% less." it doesn't work that way. Overhead expenses are largely the same for your employer whether an employee works 40 hours per week or 60+, so if an employer can get someone who will work 60+ instead of you, that just makes better business sense. Also as mentioned, the concept of leverage exists in medicine where the older partners make money off the young guns, so youngsters who want the same relaxed schedules as the guys at the other end of their career are not in demand.

I agree with the notion that 60+ hours is the norm for professionals. You are going to be hard pressed to find a young lawyer seeking partnership or an investment banker looking to work his way up the ranks who puts in less than 80. The 9 to 5 crowd tend not to be professionals.

The truth