PM&R Hours

[the prodogy]

What are the hours like for a PM&R doc. The thing that drove me away from the other specialties was the hours and the possible late night calls. I've always seen myself as a family person, so a job with a restrictive schedule usually makes me turn the other way. So what are the hours of a PM&R? Do they just work the usual 40 hours a week? How about vacation time? Are they flexible with vacation time? I figured that med school and residency will take away a big portion of my life. How are the residencies for PM&R by the way? Is it like others, 80 hrs/week?

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[SCIronMike]

I don't want to be a jackass, but there are MANY considerations that should be more important to you than work hours. Starting your medical education / career with that as your priority isn't going to get you very far. You also won't make many friends in the field if you choose a specialty, NOT because it is rewarding and intellectually stimulating, but because it is EASY.

 

[topwise]

The hours are pretty good for PM&R residency, compared with some other specialties. In my entire residency, there have been very few weeks when I worked more than 50 hours. But 50 hours a week of doing something you don't like is a lot of hours, so make sure the field is for you.

Also, any residency is still a lot more hours than a lot of other jobs that might pay better. You still have to do an internship, which is usually kind of rough. If lifestyle is the most important thing to you, you might want to avoid medicine entirely.

 

[PMR 4 MSK]

If lifestyle is the most important thing to you, you might want to avoid medicine entirely.

 

[Nico47]

Prodogy, I think this a fair question. Better to know these things about yourself first before making the HUGE commitment of becoming a doctor.

I will answer the part about residency.

My program does home-call (answering your pager from home), which is a definite perk. Not all PM&R programs have this, but it's more common than in other specialties. I did do an intern year of medicine that had me clocking in 80hrs during the roughest parts, so going from that to a 8:30AM-4PM week with weekends off has been delightful. This of course is an average, some of the in-patient months can keep you in-house longer. Vacation time is also flexible, especially for life events.

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As a side-note, I just want to submit that not everyone who asks about duty hours does so because s/he is lazy. There are a lot of women out there who realize they will have to bear a heavier burden of being a student/physician, wife, and mother all at the same time. This may be the only setting in which their questions about these issues can get answered.

 

[Xardas]

PM&R residents generally have it easy and get a little spoiled.

Attendings in any field have to work harder in general, PM&R is not excluded.

If lifestyle is important to you, you need to consider what the field is like as an attending and not as a resident.

 

[PMR 4 MSK]

Attendings in any field have to work harder in general, PM&R is not excluded.

If I did twice as much RVU's per year now as my academic attendings did, I'd only be making half what I do now...

 

[Xardas]

If I did twice as much RVU's per year now as my academic attendings did, I'd only be making half what I do now...

Which is why there are different standards for academic physicians and private physicians for RVU's. Academic physicians are paid to teach and do other activities as well. All my private buddies work more than me and make more than me.. but that is true for any field, hospitalist, etc.

But my point to the original poster is that your life as a resident is not indicative of your life as an attending. its generally different.

 

[Ludicolo]

Which is why there are different standards for academic physicians and private physicians for RVU's. Academic physicians are paid to teach and do other activities as well. All my private buddies work more than me and make more than me.. but that is true for any field, hospitalist, etc.

We get paid to teach?

Check out: Peters AS, et al. How important is money as a reward for teaching? Acad Med 2009 84:42-46.

 

[Xardas]

We get paid to teach?

Check out: Peters AS, et al. How important is money as a reward for teaching? Acad Med 2009 84:42-46.

In theory yes. at least I teach; I do take that seriously. Of course yes the lines are blurring and every month there is mention being made of the financial aspect and how to increase our productivity.

Academics is what it is.. it is less efficient, more cumbersome, and collects less.

Sure I can see 3 encounters in the time it takes me to staff a resident but there are other things I like about what I do. Is it perfect? No. But then again I view my position as giving me certain skills I hope to achieve other goals in my career.. so its not permanent.

However having said that it does have its advantages and to completely ignore the positives of going into an academic position is not a good thing.. there are plenty of negatives of private life as well.

In the end its all about what you eventually want to do, and what you're willing to put up more with!!

 

[the prodogy]

I'm pretty sure medicine is what I want to do. Although physical therapist was also something I was a bit interested in. What I figured was, if I wanted to be a physical therapist, why not just go into PM&R and gain the extra knowledge medicine has to offer. I like going to school and I like learning, but after residency, I wouldn't want work to be my life. I want to have a life outside of work where I can enjoy time with the family and take 2-3 week vacation perhaps once a year. Also I wouldn't want to be working over 55 hours a week, for me, that me be too stressful for the rest of my life. If I had to do that in residency, I wouldn't mind, seeing how it's only temporary.
Also, as a PM&R, will you get called or paged to come into the office early in the morning? The way I see it, there would never be a reason for a PM&R to come in due to an emergency.

 

[topwise]

I'm pretty sure medicine is what I want to do. Although physical therapist was also something I was a bit interested in. What I figured was, if I wanted to be a physical therapist, why not just go into PM&R and gain the extra knowledge medicine has to offer. I like going to school and I like learning, but after residency, I wouldn't want work to be my life. I want to have a life outside of work where I can enjoy time with the family and take 2-3 week vacation perhaps once a year. Also I wouldn't want to be working over 55 hours a week, for me, that me be too stressful for the rest of my life. If I had to do that in residency, I wouldn't mind, seeing how it's only temporary.
Also, as a PM&R, will you get called or paged to come into the office early in the morning? The way I see it, there would never be a reason for a PM&R to come in due to an emergency.

Dude, I think you have to do a lot more research about the field of medicine in general. Being a physiatrist is NOT equivalent to a "physical therapist who has a little extra medicine knowledge". If you go to med school, medicine is going to become your life. I completely understand wanting to have a job with decent hours, but it's concerning to hear you focusing so much on this before even starting med school. If medicine is the path you want to take, you are going to be working your ass off for the foreseeable future.

Think hard about this choice now, before you're a quarter of a million dollars in debt.

 

[Ludicolo]

I'm pretty sure medicine is what I want to do. Although physical therapist was also something I was a bit interested in. What I figured was, if I wanted to be a physical therapist, why not just go into PM&R and gain the extra knowledge medicine has to offer. I like going to school and I like learning, but after residency, I wouldn't want work to be my life. I want to have a life outside of work where I can enjoy time with the family and take 2-3 week vacation perhaps once a year. Also I wouldn't want to be working over 55 hours a week, for me, that me be too stressful for the rest of my life. If I had to do that in residency, I wouldn't mind, seeing how it's only temporary.
Also, as a PM&R, will you get called or paged to come into the office early in the morning? The way I see it, there would never be a reason for a PM&R to come in due to an emergency.

I'm happy for you that you decided to pursue medical school. I hope you make it. But I’m concerned you may be putting the cart before the horse here. You likely won’t get exposed to PM&R until late M3/early M4 year. Medical school is demanding. Internship is demanding. Will you make it until then?

Based on your other questions here on this forum (What are the hours? Is PM&R competitive? Will I get paged?) – it appears that you are looking to get into rehab for all the wrong reasons. I don't know your background or your experiences, but I haven't seen any posts from you regarding other facets of PM&R that attract you to the field. I may be mistaken, but you seem to be looking for the easy way out. Despite appearances, our field is not easy. It can be intellectually challenging. Emotionally draining. Choose a field for the wrong reasons, you’re stuck and disgruntled. Then you bring that home with you. To your family. It becomes a grind. Stressful. Exactly the thing you wanted to avoid in the first place. The lifestyle in PM&R is good, no denying that. But it should never be the only factor to consider.

That being said, I can't imagine myself doing anything else. I have my reasons. What are yours?

I suggest contacting physiatrists in your area. Shadow. Learn yourself.

 

[the prodogy]

I'm happy for you that you decided to pursue medical school. I hope you make it. But I’m concerned you may be putting the cart before the horse here. You likely won’t get exposed to PM&R until late M3/early M4 year. Medical school is demanding. Internship is demanding. Will you make it until then?

Based on your other questions here on this forum (What are the hours? Is PM&R competitive? Will I get paged?) – it appears that you are looking to get into rehab for all the wrong reasons. I don't know your background or your experiences, but I haven't seen any posts from you regarding other facets of PM&R that attract you to the field. I may be mistaken, but you seem to be looking for the easy way out. Despite appearances, our field is not easy. It can be intellectually challenging. Emotionally draining. Choose a field for the wrong reasons, you’re stuck and disgruntled. Then you bring that home with you. To your family. It becomes a grind. Stressful. Exactly the thing you wanted to avoid in the first place. The lifestyle in PM&R is good, no denying that. But it should never be the only factor to consider.

That being said, I can't imagine myself doing anything else. I have my reasons. What are yours?

I suggest contacting physiatrists in your area. Shadow. Learn yourself.

Despite all things, PT and PM&R do have its similarities. I've done some research and although I know I could do more, this field looks very interesting, which is why I'm here, to get the inside on actual PM&R's. Who better to get information from right? I'll shadow one within the near future (within the next month).
About the whole working hard thing and the debt and residency blah blah blah, I totally understand. I know the hard work that is to come and I welcome it with open arms. I'm actually looking forward to it, I guess I'm weird. I want to be challenged in school and in work, but after all that's said and done, I want to have a job where "helping people" is a big part of it, as cheesy as that sounds. PM&R sounds like a specialty where, as a doctor, I get to work close with patients.
I know my questions about hours and pagers may concern you guys, but I don't think it's the easy way out. I simply want to have a job that will allow me to raise a family while being there for my kids. This may be far in the future, but I don't see myself as a person that will put my job before my family. I don't mind working hard while I'm at work, actually that's what I expect. I don't want a job where all I do is sit down and do nothing. I want my education to go to use. Basically, I just don't want a job that is "too time oriented". As for everything during medical school, residency, internships and fellowships that may come, I'll more than gladly take on the challenge.

 

[MSKalltheway]

Despite all things, PT and PM&R do have its similarities.

Barely...there is little more overlap than the fact that both fields have word "physical" in the name. I wont get into it, but there really isnt a whole lot more the two fields share, and med school is a big part of that.

The reason why everyone is concerned that you are focused too much on lifestyle already is because medical school itself is not a lifestyle choice. Your first two years will demand many 12+ hr days between class and studying, often more than that if an exam is looming. I'm knee deep in 3rd year and my week isn't often less than 60hrs. 40hrs a week is a vacation. I'm currently on inpatient medicine and dont get a day off until next saturday...that will give me 12 days of work straight, all around 10hrs per day on average.

I'm not saying any of this because I have it so hard...actually I dont. My 3rd year has actually been pretty mild compared to students at many other institutions. Also, I love what I'm doing and dont mind being in the hospital for long hours. The thing you have to know before going into this is that there is virtually no way not to spend long hours away from family/friends no matter what specialty you go into. The others on the board are saying that going into medical school with the mindset of lifestyle will leave you disappointed in the end. Deciding your 4th year of med school that you dont want to work neurosurg/trauma surg hours is one thing; being a pre-med saying you desire easy work hours in medicine is a different ball game. PM&R offers a better lifestyle than almost all other medical specialties, but its still not a better lifestyle than many non-medical fields.

Even if you were to start school in the fall and do a PM&R residency, you wont be an attending until 8-9 years from now. Things may be completely different by then. You could be massively in debt, and healthcare could change to an extent which the only way out is to work a ton of hours.

Physical therapy school and a subsequent career in it is more conducive to a better lifestyle than med school to PM&R.

 

[the prodogy]

Barely...there is little more overlap than the fact that both fields have word "physical" in the name. I wont get into it, but there really isnt a whole lot more the two fields share, and med school is a big part of that.

The reason why everyone is concerned that you are focused too much on lifestyle already is because medical school itself is not a lifestyle choice. Your first two years will demand many 12+ hr days between class and studying, often more than that if an exam is looming. I'm knee deep in 3rd year and my week isn't often less than 60hrs. 40hrs a week is a vacation. I'm currently on inpatient medicine and dont get a day off until next saturday...that will give me 12 days of work straight, all around 10hrs per day on average.

I'm not saying any of this because I have it so hard...actually I dont. My 3rd year has actually been pretty mild compared to students at many other institutions. Also, I love what I'm doing and dont mind being in the hospital for long hours. The thing you have to know before going into this is that there is virtually no way not to spend long hours away from family/friends no matter what specialty you go into. The others on the board are saying that going into medical school with the mindset of lifestyle will leave you disappointed in the end. Deciding your 4th year of med school that you dont want to work neurosurg/trauma surg hours is one thing; being a pre-med saying you desire easy work hours in medicine is a different ball game. PM&R offers a better lifestyle than almost all other medical specialties, but its still not a better lifestyle than many non-medical fields.

Even if you were to start school in the fall and do a PM&R residency, you wont be an attending until 8-9 years from now. Things may be completely different by then. You could be massively in debt, and healthcare could change to an extent which the only way out is to work a ton of hours.

Physical therapy school and a subsequent career in it is more conducive to a better lifestyle than med school to PM&R.

I understand the sacrifices I'll have to make during med school and residency, and I'm willing to make them. What I'm trying to figure out specifically was what the hours were like for an attending PM&R, and although it's far in the future and things may change, it won't hurt to plan ahead. I never necessarily asked for "easy" hours, just something decent. What drives me away from certain specialties is knowing that it requires a tremendous amount of hours. Working 50 hours a week would totally be fine by me. Also, are PM&R's on call? Do they get calls early in the morning telling them to come in?

 

[topwise]

I think you're failing to understand that PM&R is a very diverse field. If you work on an inpatient rehab unit, you could definitely get called in during the "early morning hours" as an attending. Some practices require call, some don't. All PM&R attendings don't have the exact same job. If the most important thing to you is not having to get a call in the early morning, I'm sure that you could find some job where that wouldn't happen.

 

[PMR 4 MSK]

... What I'm trying to figure out specifically was what the hours were like for an attending PM&R, ...Also, are PM&R's on call? Do they get calls early in the morning telling them to come in?

I know physiatrists who work part time 20 hours per week, and I've known guys who work 60 - 80/wk. Most of us are in b/w likely 40-50 most common.

Call dpends on inpt vs outpt work. Inpt means you are on call at least for your own patients every day, unless you have a group with rotating call - 4 physiatrists = call q4d. PM&R call usually involves taking pages for med questions and patient complaints. Rarely does one need to go in at night, but it happens. As sicker pts go to rehab than previously, this becomes more likely. Rehab admits don't normally happen after 9-5 hours.

When I ran my own 12 bed unit, I only went in after hours about 6-8 times over a 2 year period. You expience may vary.

 

[MSKmonky]

Hey Prodigy, I think I know where you're coming from. Sometimes even true passion for a job may be compromised if you feel it's coming in the way of your family life or if it is way to stressful to the point that you are not enjoying it.

You are Premed so you're somewhat early in the game. I would echo what everyone else has been saying about getting to know the field itself and making sure you enjoy it before making any decisions. That being said, you have to like medicine also (like it enough that you are going to go through 4 years of school plus at least a year of internship in General Medicine...or surgery). Medical school is pretty grueling (especially 2nd year!!), but it's also pretty fun at times.

The questions of Hours, Lifestyle, Call Schedule, and Free time are somewhat "poo-poo'ed" at times because it can convey the wrong idea (that you are choosing the field based on these parameters only and not for the right reasons). I trust you're a decent student so you will do your homework before choosing a field when the time comes, but your decisions should come in a step-wise fashion. First decide if medicine is what you want to train in for the rest of your life (who knows.. you could really like finance.. or dentistry.. etc..). Then after being somewhat exposed, you can make a much better and more informed decision on a field.
That informed decision will encompass everything from desire of practice, interest, and the parameters above (lifestyle especially).

PMR usually affords a more chill lifestyle than most but you can have a great lifestyle doing a lot of things (ophtho, anesthesia, derm, allergy/immuno subspeciality, etc..). But of Musculoskeltal/sports medicine, Rehabilitation, Spinal cord injury, and Pain medicine are your interests... stick with PMR. Shadow a couple PMR docs (since the field is so wide you will have to shadow a couple in each discipline to get the full idea).