Psychiatry Residency Hours

[504196]

I've posted on this forum before about deciding between psych and gen surg. Anyways, just curious what the lifestyle is like in psych residency? How many hours a week typically? You get weekends off ever? How much vacation time? I know this is very dependent on the institution but just trying to get a general idea of what it would be like.

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[Attending1985]

In my residency on service we worked Monday through Friday 8-5 and one weekend a month alternating day and night call. Hours are definitely not bad. My advice is don’t be short sighted and choose your career based on residency lifestyle. It’s a very small portion of your life. Just do what want. Residency goes by fast and even faster if you actually like what you’re doing.

 

[UTsksk]

Psych residency hours can vary. During interviews some programs kind of bragged about their chill hours while others were super vague. Matched at a program that really didnt talk about hours or call so I'm pretty sure I'll be working a good amount especially since they mentioned their psych ER is very busy. An upper told me to expect inpatient to be 10+ hours daily with 4 guaranteed days off a month but eventually you get the hang of things and can leave earlier. They said it was still doable with a family.

Friend of mine in surgery interviewed at a place that bragged they had low hours at 65 to 70. He interviewed at plenty of places that said to expect 80.

Psych hours rarely match surgery

 

[Mad Jack]

My intern hours were listed as 80 a week in FREIDA and they didn't really talk about them during the interview so that's what I'm expecting.

 

[COXblocker]

I work at a very busy psych residency. My worse months hours wise were still Medicine and Neuro, and I feel sorry for those residents. But as an intern the "worst" inpatient rotation was 7a-5p, with one or two 4hr calls 5p-9p during the week, and weekend call three weekends consisting of either a 14hr single day, two 5hr days, or a 9p-7a Saturday night.

Overall I got to work out 3-4 days per week, see my kids most days (even on call days I'd come home for dinner if I could), have at least a day off on the weekend. The actual work days inpatient were busy until 2-3pm but then usually died down. Some residents would alternate being "on" that day and the other would leave early and be available in emergencies. I usually hung around and got all my reading and stuff done so home was home.

I'm sure there's some gem residencies out there, and EM seems like the hours are similarly low, but psych really does have the best hours by far.

 

[TexasPhysician]

I worked 40 hours/week regardless of rotation.

 

[NickNaylor]

I would say during our inpatient years (PGY-1 and 2 for us), I would typically work 50-60 hours a week. It would be closer to 80 hours a week for the off-service rotations, especially inpatient medicine wards.

During the current outpatient year (PGY-3), I barely work 40 hours a week.

 

[MedMan80]

Depends where you do your residency, for us PGY-1, psych rotations which were call heavy could get you close to 80, second year onwards psych ER was 60+, other psych rotations were 65+, of course medicine was getting close to 80 hours a week intern year..

 

[NontradCA]

My program is Q5 24hr call intern year and am told usually 8-4, so that’s 60+ hours there at least. This is heavy for a psych residency, but I think it averages to one weekend a month, 8 days off a month.

 

[Mass Effect]

We work 40-50 hours a week. You get most weekends off. Weekend call is q6 weeks during PGY 2 year and q8 weeks as a PGY 3. Or you can request to cluster all your call and chill the rest of the year.

 

[DisorderedDoc417]

We work 40-50 hours a week. You get most weekends off. Weekend call is q6 weeks during PGY 2 year and q8 weeks as a PGY 3. Or you can request to cluster all your call and chill the rest of the year.

We work 40-50, on the weekends we are on call you hit close to 70ish, but this is one out of 6 weekends on average. If you’re unlucky and have a nearby weekday call you could hit 80, but this rarely happens. Call is a little worse pgy2, then almost none pgy3/4.

 

[Candidate2017]

I've posted on this forum before about deciding between psych and gen surg. Anyways, just curious what the lifestyle is like in psych residency? How many hours a week typically? You get weekends off ever? How much vacation time? I know this is very dependent on the institution but just trying to get a general idea of what it would be like.

Surgery is not for you if you are asking these questions.

 

[uhmocksuhsillen]

Surgery is not for you if you are asking these questions.

Seriously. Don't take this as a knock either OP...I find those that have no interest in anything outside of work to be the weird ones.

 

[Celexa]

Surgery is not for you if you are asking these questions.

I agree...psychiatry is many, many fewer hours than surgery in both residency and as an attending. The details aren't really relevant.

 

[FlowRate]

Best weeks were barely over 25 hours, worst weeks were 70+. Average with call probably 50-60 in pgy 1 and 2.

 

[milesed]

It will completely vary by program and what area you are training in. My worst hours were in Neurology as we rounded every day regardless of call. The easiest program I interviewed for was UK as they only covered a small inpt unit for psyc call and often had no calls at all during the night. I don't see how you could learn much with that set up.

 

[clausewitz2]

It will completely vary by program and what area you are training in. My worst hours were in Neurology as we rounded every day regardless of call. The easiest program I interviewed for was UK as they only covered a small inpt unit for psyc call and often had no calls at all during the night. I don't see how you could learn much with that set up.

Things at UK changed a bit when they finished moving Eastern State Hospital and residents started doing most of their inpatient psych rotations there. Agree though that it did not seem at all good for learning or developing a sense of autonomous practice.

 

[clausewitz2]

My worst hours by far were on our consult service. Easily over 60 hours every week, rotating home pager call q3weeks, black call weekends trying to cope with 10-14 consults a day...

I am much happier now that this is behind me forever.

 

[NontradCA]

Things at UK changed a bit when they finished moving Eastern State Hospital and residents started doing most of their inpatient psych rotations there. Agree though that it did not seem at all good for learning or developing a sense of autonomous practice.

On the interview trail one senior resident told me flat out not to go there because the training was subpar. I was shocked, but also appreciated it.

 

[NontradCA]

I have a question for anyone who would answer. I do have Q5 call intern year, with a post call day. It sounds heavy, but I’m realizing I’ll have a lot of days off during those inpatients month. What’s so bad about it?

 

[Amygdarya]

I have a question for anyone who would answer. I do have Q5 call intern year, with a post call day. It sounds heavy, but I’m realizing I’ll have a lot of days off during those inpatients month. What’s so bad about it?

You're about to find out

 

[NontradCA]

You're about to find out

My body is ready.

 

[Amygdarya]

My body is ready.

I wish I were as confident about my nontrad body

 

[DisorderedDoc417]

I have a question for anyone who would answer. I do have Q5 call intern year, with a post call day. It sounds heavy, but I’m realizing I’ll have a lot of days off during those inpatients month. What’s so bad about it?

Run!

 

[NontradCA]

Run!

And go where? I’m cucked.

 

[Merovinge]

I would say during our inpatient years (PGY-1 and 2 for us), I would typically work 50-60 hours a week. It would be closer to 80 hours a week for the off-service rotations, especially inpatient medicine wards.

During the current outpatient year (PGY-3), I barely work 40 hours a week.

Look at you fancy pants hit 40 hours a week on outpatient year. I suppose I did too if you count the several hours a week reading SDN and playing flash games on my computer...

 

[NickNaylor]

Look at you fancy pants hit 40 hours a week on outpatient year. I suppose I did too if you count the several hours a week reading SDN and playing flash games on my computer...

Lol, I was being generous. In actuality I think I do... probably 30 hours of actual, bona fide clinical work on a given week. Of course, I log 45 hours/week for duty hour purposes... can’t have the program getting suspicious.

 

[Dharma]

I've posted on this forum before about deciding between psych and gen surg. Anyways, just curious what the lifestyle is like in psych residency? How many hours a week typically? You get weekends off ever? How much vacation time? I know this is very dependent on the institution but just trying to get a general idea of what it would be like.

Pick surgery.

 

[Dharma]

Surgery is not for you if you are asking these questions.

Although psychiatry may not be for him if lifestyle is his motivator...

 

[Marasmus1]

Average 50-60 hours a week. I follow up 10 patients on the floor with average 2 admissions and 2 discharges everyday. Overnight calls Q4. On average ER + consults 15 new patients during overnight call. C/L hits closed to 70 h. average 15-20 consults a day only one resident covering.

So in my program workload wise Derm<FM<Psych<IM<Ob?gyn<Surgery.

 

[MisterKitty]

i always heard if you are deciding between surgery and something else, pick something else. If you are deciding between psych and something else, pick psych. Psych vs surgery is a no brainer homie

 

[NITRAS]

So many odd questions on SDN. Surgery vs Psych?! Like opposite ends for how to practice medicine.

 

[MisterKitty]

So many odd questions on SDN. Surgery vs Psych?! Like opposite ends for how to practice medicine.

Annecdotally, I've met quite a few people whose specialty choice came down to psych vs surgery

 

[NickNaylor]

So many odd questions on SDN. Surgery vs Psych?! Like opposite ends for how to practice medicine.

For what's worth, in another life I would've been a surgeon. I absolutely loved surgery. But being married and wanting to have kids, the lifestyle just wouldn't have worked.

 

[Mass Effect]

Average 50-60 hours a week. I follow up 10 patients on the floor with average 2 admissions and 2 discharges everyday. Overnight calls Q4. On average ER + consults 15 new patients during overnight call. C/L hits closed to 70 h. average 15-20 consults a day only one resident covering.

So in my program workload wise Derm<FM<Psych<IM<Ob?gyn<Surgery

I would run so fast from a program like this. If you're seeing 15 new people/consults a night during call (which presumably also includes being paged about existing patients), I don't see how it's possible to provide good care. Same for the poor resident who is seeing 15-20 consults a day. You don't learn anything on consults if you're seeing that many new consults.

The trick to education is having volume that isn't overwhelming so you can actually read up on your patients and research things you don't know and have time to thoughtfully come up with recommendations/plan. Programs in which you're seeing that many patients give you no time to do either.

 

[ridethecliche]

Although psychiatry may not be for him if lifestyle is his motivator...

Go on....?

Are you strictly speaking from a salary point of view?

So many odd questions on SDN. Surgery vs Psych?! Like opposite ends for how to practice medicine.

Surgery would have been really high on my list as well if certain life things didn't make it untenable.

 

[Splenda88]

Medicine here!

Are you guys really residents? The only time I work 40 hr/week is when I am in ambulatory and this is like 4 wks out of the whole year as a PGY1 ... Even when I am off service (cardio, ID etc...), I still work 60+ hours/wk.

 

[michaelrack]

When I was a med psych combined resident, my hours typically doubled when I switched from a psych rotation to a medical rotation..... this was from 1997 to 2002

 

[clausewitz2]

Medicine here!

Are you guys really residents? The only time I work 40 hr/week is when I am in ambulatory and this is like 4 wks out of the whole year as a PGY1 ... Even when I am off service (cardio, ID etc...), I still work 60+ hours/wk.

Typically our PGY-3 is 100% ambulatory/outpatient. This explains some of the discrepancy.

 

[Monocles]

Medicine here!

Are you guys really residents? The only time I work 40 hr/week is when I am in ambulatory and this is like 4 wks out of the whole year as a PGY1 ... Even when I am off service (cardio, ID etc...), I still work 60+ hours/wk.

For some of our chiller rotations we start our days at 9 am and our attendings will let us leave around lunch (inpt at low acuity community hospitals, etc). I was on a rotation once where they were in the middle of some major construction so half the unit was shut down for safety seasons and I had like 3 pts who were suuuuper stable and had zero med change in the last three months.... needless to say I got through a huge chunk of my gaming backlog during that month...

 

[DisorderedDoc417]

Medicine here!

Are you guys really residents? The only time I work 40 hr/week is when I am in ambulatory and this is like 4 wks out of the whole year as a PGY1 ... Even when I am off service (cardio, ID etc...), I still work 60+ hours/wk.

40-50 for 11 patients daily on average in the inpatient. One weekend a month bumps that week to 60-70.

 

[calvnandhobbs68]

Average 50-60 hours a week. I follow up 10 patients on the floor with average 2 admissions and 2 discharges everyday. Overnight calls Q4. On average ER + consults 15 new patients during overnight call. C/L hits closed to 70 h. average 15-20 consults a day only one resident covering.

So in my program workload wise Derm<FM<Psych<IM<Ob?gyn<Surgery.

Dude they aren’t getting 15-20 new consults a day. Probably a few new consults and mostly follow ups. Our psych program didn’t get that many new consults a day in a 1000 bed hospital.

How many new floor consults (outside the ED) can you possibly get during overnight call? Maybe a 24hr weekend day will pick you up new consults but outside of an emergency capacity consult or agitation consult, there are pretty much no floor consults outside the ED that HAVE to be done overnight in psych. Again, our 1000+ bed tertiary care hospital doesn’t yield even 1 emergency consult a night on average.

 

[DisorderedDoc417]

Dude they aren’t getting 15-20 new consults a day. Probably a few new consults and mostly follow ups. Our psych program didn’t get that many new consults a day in a 1000 bed hospital.

How many new floor consults (outside the ED) can you possibly get during overnight call? Maybe a 24hr weekend day will pick you up new consults but outside of an emergency capacity consult or agitation consult, there are pretty much no floor consults outside the ED that HAVE to be done overnight in psych. Again, our 1000+ bed tertiary care hospital doesn’t yield even 1 emergency consult a night on average.

I was thinking the same thing.

 

[Monocles]

You should not be buried in the white coat. The proper ceremony involves draping the white coat over the casket. The coat is then folded into a triangle and presented to your spouse or next of kin. This is to be accompanied by a 21 gunner salute, which as it sounds, involves 21 cut-throat students from your med school class showing up to your funeral and saluting you. Ceremonies conclude with an M&M conference regarding your death.

Unrelated but your signature is amazing. Sadly many of our faculty would probably seriously demand this sort of treatment due to their entitled nature...

 

[NickNaylor]

Dude they aren’t getting 15-20 new consults a day. Probably a few new consults and mostly follow ups. Our psych program didn’t get that many new consults a day in a 1000 bed hospital.

How many new floor consults (outside the ED) can you possibly get during overnight call? Maybe a 24hr weekend day will pick you up new consults but outside of an emergency capacity consult or agitation consult, there are pretty much no floor consults outside the ED that HAVE to be done overnight in psych. Again, our 1000+ bed tertiary care hospital doesn’t yield even 1 emergency consult a night on average.

Our consult service simply doesn't see new consults overnight. The resident on call will provide recommendations over the phone, but we don't have in-house coverage. However, we also have a separate and busy psychiatry ED service which covers the ED and is available to cover acute agitation elsewhere in the hospital if it develops.

 

[clausewitz2]

Dude they aren’t getting 15-20 new consults a day. Probably a few new consults and mostly follow ups. Our psych program didn’t get that many new consults a day in a 1000 bed hospital.

How many new floor consults (outside the ED) can you possibly get during overnight call? Maybe a 24hr weekend day will pick you up new consults but outside of an emergency capacity consult or agitation consult, there are pretty much no floor consults outside the ED that HAVE to be done overnight in psych. Again, our 1000+ bed tertiary care hospital doesn’t yield even 1 emergency consult a night on average.

Our C&L service easily gets 20 consults a day at our main campus due to our steadfast unwillingness to ever refuse any consult for any reason and some quirks of PA law and nursing home placements (i.e. everyone who had ever looked at a psych medication needs a full psych eval before they got to a SNF).

Ain't nobody seeing new consults overnight, though, outside of really rare emergent capacity evals for surgeries that need to happen RIGHT NOW.

During the day we also have multiple residents and a nurse clinician with multiple attendings splitting up that workload.

 

[Merely]

why Are we doing capacity evals? Cant they be done by any physician?

 

[clausewitz2]

why Are we doing capacity evals? Cant they be done by any physician?

Because if your friendly neighborhood C&L service really wants to generate business other services are quite happy to offload a conversation that often takes a lot of time and is uncomfortable.

 

[hamstergang]

Because if your friendly neighborhood C&L service really wants to generate business other services are quite happy to offload a conversation that often takes a lot of time and is uncomfortable.

I don't fully buy this as it seems nearly universal that Psychiatry does capacity evals. This isn't about individual departments, it's the expectation throughout medicine. I don't know how/why this came to be.

 

[Merely]

I don't fully buy this as it seems nearly universal that Psychiatry does capacity evals. This isn't about individual departments, it's the expectation throughout medicine. I don't know how/why this came to be.

We have an attending here that refuses them. He tells the person consulting that capacity evals are not psych specific and that he would be willing to come down and teach how to do them but that we won’t continue to do them as a consult