Psychiatry Residency Schedules?

[OMSWeebHours]

I hear residency is supposedly less stressful for Psychiatry than some other specialties, Are hours manageable and fairly lenient?

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[kelminak]

Always depends on the program. Some are "workhorses", and others like mine arguably don't work you enough. Always best to try to feel this out gently through interviews when talking with the residents.

 

[slowthai]

Yeah it depends, but hours average between 40 and 60 at most programs, sometimes less, sometimes more.

 

[OMSWeebHours]

Always depends on the program. Some are "workhorses", and others like mine arguably don't work you enough. Always best to try to feel this out gently through interviews when talking with the residents.

Interesting to hear. What is your residency schedule like, out of curiosity?

Also, what kind of questions would I ask to give the greatest likelihood of honest feedback (I want to avoid risking a false impression for some place I match) from residents? Thanks!

 

[OMSWeebHours]

Yeah it depends, but hours average between 40 and 60 at most programs, sometimes less, sometimes more.

I see. A bit higher than a "normal" job but around 50 doesn't seem bad for residency imo. One of my main priorities next to interest in the work of a specialty, job stability, and lifestyle is to get mostly manageable residency hours (IE: Not in the range of 60-80+ on a routine basis, might happen a few times intern year but I predict doing that for years or months in a row could substantially cut into other things I value).

I know priorities and interests can change but that is certainly a factor in my decision (not the only one, of course, doing something one dislikes based only on that would probably not be wise)

 

[slowthai]

I see. A bit higher than a "normal" job but around 50 doesn't seem bad for residency imo. One of my main priorities next to interest in the work of a specialty, job stability, and lifestyle is to get mostly manageable residency hours (IE: Not in the range of 60-80+ on a routine basis, might happen a few times intern year but I predict doing that for years or months in a row could substantially cut into other things I value).

I know priorities and interests can change but that is certainly a factor in my decision (not the only one, of course, doing something one dislikes based only on that would probably not be wise)

Yeah, unfortunately everyone has to do IM intern year, usually 2-4 months, and you're very likely to have to do 60+ hours with only a day off per week, on average. It really sucks.

 

[OMSWeebHours]

Yeah, unfortunately everyone has to do IM intern year, usually 2-4 months, and you're very likely to have to do 60+ hours with only a day off per week, on average. It really sucks.

Ok, but that is over after 2-4 months? Does it include ICU and overnights?

It may be brutal for me to adjust (but that is a while away at least) but as long as it's over with soon like Surgery or OB rotations I might be able to suck it up for a brief period and can mentally prepare myself for the bump in hours (Honestly I'm thinking it might be smart just to get those rotations over right away since I will be too lazy to do it later).

Now if it is very often then I would get concerned about it cutting into my life.

 

[Osminog]

I hear residency is supposedly less stressful for Psychiatry than some other specialties, Are hours manageable and fairly lenient?

Hours aside, psychiatry can be unbearably stressful for people who aren't interested in the nature of the work. Practicing psychiatry can be extremely emotionally taxing, because you're often talking to the "difficult" patients whom physicians from other specialties go out of their way to avoid. As a psychiatry resident, much of your time is spent interacting with people from the most miserable, misunderstood, and feared segments of society.

As someone mentioned above, hours vary from program to program. The factor that probably contributes the most to this variation is call schedule. Some programs have 24-hour call shifts, for example.

 

[slowthai]

Ok, but that is over after 2-4 months? Does it include ICU and overnights?

It may be brutal for me to adjust (but that is a while away at least) but as long as it's over with soon like Surgery or OB rotations I might be able to suck it up for a brief period and can mentally prepare myself for the bump in hours (Honestly I'm thinking it might be smart just to get those rotations over right away since I will be too lazy to do it later).

Now if it is very often then I would get concerned about it cutting into my life.

Yeah, it's just for 2-4 months. No ICU. No night float either. From what I've seen, psych residents don't do long call on IM. They might do short call and/or inpatient psych call though.

 

[slowthai]

Hours aside, psychiatry can be unbearably stressful for people who aren't interested in the nature of the work. Practicing psychiatry can be extremely emotionally taxing, because you're often talking to the "difficult" patients whom physicians from other specialties go out of their way to avoid. As a psychiatry resident, much of your time is spent interacting with people from the most miserable, misunderstood, and feared segments of society.

As someone mentioned above, hours vary from program to program. The factor that probably contributes the most to this variation is call schedule. Some programs have 24-hour call shifts, for example.

What's your call schedule like?

 

[Osminog]

What's your call schedule like?

An average of one call shift a week... mostly overnights, some 24-hour shifts. Not great, but not terrible.

 

[slowthai]

An average of one call shift a week... mostly overnights, some 24-hour shifts. Not great, but not terrible.

I assume the call burden goes down as you progress?

 

[Cath Up]

agree with above- quite variable, but almost always less than other specialties.
My second year had 12 days of weekend work for the whole year. They’re long days, but only 12. Hours otherwise ranged from 8-1 or 8-5. It is not quite rigorous enough for me. Better to go to an academic program and work 45-60 hour weeks for a few years to achieve mastery.

 

[slowthai]

agree with above- quite variable, but almost always less than other specialties.
My second year had 12 days of weekend work for the whole year. They’re long days, but only 12. Hours otherwise ranged from 8-1 or 8-5. It is not quite rigorous enough for me. Better to go to an academic program and work 45-60 hour weeks for a few years to achieve mastery.

Very interesting that you say this. Why do you think that it's not rigorous enough for you? And are you interested in doing anything to "make up" for it?

 

[Cath Up]

Very interesting that you say this. Why do you think that it's not rigorous enough for you? And are you interested in doing anything to "make up" for it?

Perhaps most of it is limited teachers and subspecialists to learn from. I am satisfied with the pathology exposure. Otherwise not rigorous enough due to lack of robust psychotherapy training, relatively few sites and subspecialties.

Yes I am interested in making up for it as I want to be competent. I self study most days, make the most of what we have, try to improve the program, moonlight, attend psych society meetings. I am considering a psychotherapy institute. It is always tempting to just do fun things more often though. I think good psychiatry training requires more than part time work.

 

[Candidate2017]

Now if it is very often then I would get concerned about it cutting into my life.

This attitude is ok for a midlevel, but not what I'd want from a resident physician. It's not conducive to patient care, helping out other residents, and becoming a competent psychiatrist.

Psychiatry residency isn't generally very onerous. And heavy IM and neuro rotations are there for a reason. They provide valuable training because our medications can cause significant renal, hepatic, cardiac, neuro, etc. issues, and psychiatric patients tend to have many medical comorbidities.

You only get trained once, so you need to make the most of it. Any deficits in training are very hard to fill once you are out of training, especially if you don't realize blind spots. So psychiatry SHOULD BE your life for 4 years. By that, I don't mean you should work like a surgeon, but you should be invested in your training.

Yes I am interested in making up for it as I want to be competent. I self study most days, make the most of what we have, try to improve the program, moonlight, attend psych society meetings. I am considering a psychotherapy institute. It is always tempting to just do fun things more often though. I think good psychiatry training requires more than part time work.

This.

 

[OMSWeebHours]

agree with above- quite variable, but almost always less than other specialties.
My second year had 12 days of weekend work for the whole year. They’re long days, but only 12. Hours otherwise ranged from 8-1 or 8-5. It is not quite rigorous enough for me. Better to go to an academic program and work 45-60 hour weeks for a few years to achieve mastery.

8-1? Not going to lie that sounds appealing but you are probably right I might get too lazy with that to train properly🤣

45-60 would probably be an acceptable length for me. Anything but Neurosurgery or Plastics hours *shudder

 

[Dr. Basketball]

I'm neuro, not psych, but from what I hear from the psych residents at my program average around 35 hrs per week......except when they have to do their neuro rotations with us 😈

 

[OMSWeebHours]

I'm neuro, not psych, but from what I hear from the psych residents at my program average around 35 hrs per week......except when they have to do their neuro rotations with us 😈

Lol that's crazy, I heard some people say workhorse psych residencies do exist but I haven't really heard of it so crossing my fingers

And neuro rotations honestly sound pretty interesting, I would honestly enjoy having some occasionally even if they have long hours (with the caveat of it not being the norm lol). Psych is a consideration for me because I find the structure and function of the brain very interesting (it's what defines our individual identities, obviously). Neurology sounds cool in that it's very structure focused but I think overall it's much more intensive on average, right? How's your schedule in it

 

[OMSWeebHours]

Hours aside, psychiatry can be unbearably stressful for people who aren't interested in the nature of the work. Practicing psychiatry can be extremely emotionally taxing, because you're often talking to the "difficult" patients whom physicians from other specialties go out of their way to avoid. As a psychiatry resident, much of your time is spent interacting with people from the most miserable, misunderstood, and feared segments of society.

As someone mentioned above, hours vary from program to program. The factor that probably contributes the most to this variation is call schedule. Some programs have 24-hour call shifts, for example.

Ah, yeah that is an excellent point to mention. I personally like dealing with mental health as well, one thing I truly enjoy in my spare time is watching a variety of shows/playing games/reading books that are story based. Often these kinds of stories (even if overly fantastical or implausible) have conflicts involving serious hardships, issues, or fears people face to varying degrees and seeing how they opt to process or get through it (or sometimes fail to) is not dull. Human life is not always sunshine and roses and honestly I like that Psych treats a "deeper" level of the self for many that is often not seen on a regular basis. And like many problems, it requires patience. Many serious issues take time to get through and solutions are not always clear cut as opposed to surgeries, which is definitely an understandable reason many may be dissuaded.

Also, the prestige and pay is obviously not as high compared to many other physicians, but the type of work and schedule flexibility both counterbalance that to me personally. I'm not one who has ever been naturally great at procedures or fine handiwork anyway. I have always done better with teaching and explanations.

Yes, there may be some patients that are harder to treat or occasional safety concerns (ER docs often see many supposed "difficult" patients as well but end up more stressed since they don't always have the resources to treat them) but the fact that Psychiatry is specialized means that I would generally have the resources to work out a treatment plan or send a referral for tests or another physician if there is a possible physical issue (thyroid, etc.).

As a bonus, I have taken several career and values related tests and Psychiatry ranked very highly when compared to my values and the kind of work I can see myself doing. A&I was there too which I like but it's currently not the same level of interest.

 

[DOswag]

Psych residencies tend to be friendlier to the total # hours and call shifts worked compared to other programs but yes dependent on the individual program. Most are setup somewhat like this:

Inter year:
2-4 months of IM/neurology (my program was 2 months inpatient IM and 2 months neuro)
1 month ER
1 month psych ER
6 months inpatient psych (we had 3 different inpatient psych units our program covered. Level 1 trauma center big university hospital with very busy and active inpatient unit. Lots of SMI, great experience and really enjoyed it. A very busy and large VA hospital which I actually like working at the VA. Level 1 trauma center military hospital where inpatient was busy but very healthy and young population majority in training just wanting to get out of the military.)
IM far and away the heaviest months working 80+ hrs every week and was brutal. ER was shift work but not too terrible. Neuro months were good learning and not too terrible with the hrs like 50ish maybe. Psych ER was at the VA and I enjoyed that month other than many of the veterans being monthly repeats saying they were suicidal to get a bed a meals for a few days but hours pretty good. Inpatient psych more 50-60 depending on how busy the unit was and how quickly you got your work done. Intern year was heaviest year of hours and each subsequent year got better. Call intern year at our program was just weekend, no overnight, and you were with a higher up resident. I think now they do overnights with interns at my program with a higher up resident since I graduated in 2019. Can’t remember the total call shifts as an intern but PGY-2 was the heaviest call and then it got better each year and you had more choice over your call schedule as a senior resident.

PGY-2:

Better than intern year as far as total hours and you’re pretty much doing all psych rotations, no more IM/neuro/ER or other specialties.

Mostly all hospital again with a change. Something like 4-6 months of consult service where patients admitted to IM/FM/surgery/ICU with psych problems they’ll consult you with a question. Actually interesting interacting with other resident services embracing the suck of residency training with you and you learn a lot. You also learn a lot about how other specialities view psychiatry as some seem to have no idea what we do or are even capable of, or think we have a magic wand to fix something in a few days in the hospital that takes intense psychotherapy for years. Also you’ll get very good at capacity evaluations and very good at explaining to other services the difference between capacity and competency, also that the 80 yr old delirious uti pt with no psych hx did not suddenly develop late onset schizophrenia overnight.

Our program had a 3 month block that was split between child and adolescent, geriatric psych rotating through different settings, outpatient, nursing home, juvenile detention center etc.

I think we had 3 more months of inpatient psych as well. Call second year was more intense with the most overnight and weekend shifts. It was something like 25-30 call shifts if I remember and so many of them had to be a Saturday or Sunday 24 hr call, and a certain number were 12 hr overnight call. All of our call was in house, had to stay at the hospital. One of our months of inpatient this year was 1 week with the day team inpatient and then 3 weeks of night float. Attendings typically very helpful and responsive and we were required to call overnight if we were discharging someone home from the ER. Also started a half day per week of psychotherapy in second year.

PGY-3:

Outpatient. Less call but still more than 4th year. Mix of straight adult outpatient, child and adolescent outpatient, geri psych that we did at the VA I think both of these were a half day per week. Half day per week of psychotherapy. 2.5-3.5 days per week of adult outpatient and some other half day I’m forgetting in there. Call was more like 20-25 call shifts, mix of weekend 24 hrs, overnight 12 hrs, holidays etc. you get a little more flexibility with this in 3rd year as 4th years got first dibs on the call schedule and got to pick the better holidays but there were some flexibility on this for what was leftover for the third years. Second years there just really wasn’t much left so you just kind of had to take what you were given which typically meant a Christmas, thanksgiving, or new year it was yours.

PGY-4:

Best year. I think half our year was electives, half the year was being a Sr resident on inpatient or consults with jr residents doing the majority of the work. Call was like 14 shifts and you got to pick what days you wanted with your classmates. Some dront loaded their call in the first month or 2 which sucked but didn’t have to worry about it the rest of the year. I think I picked July 4th as my holiday and got that knocked out at the beginning of the year.

Military staff psychiatrist:

Better than being a resident but the military is just soul crushing in a different way and I could not wait for my payback to be complete and separate. Got paid much more than a resident but much less than civ counterparts. No call, nights, weekends though. Got to live in a cool place for 3 years. Separated summer 2023.

Civ psychiatrist:

Living the dream now working 4 days per week, 3 day weekend every weekend. Making much more than mil time, no nights, weekends, holidays, call. 😎

 

[slowthai]

Psych residencies tend to be friendlier to the total # hours and call shifts worked compared to other programs but yes dependent on the individual program. Most are setup somewhat like this:

Inter year:
2-4 months of IM/neurology (my program was 2 months inpatient IM and 2 months neuro)
1 month ER
1 month psych ER
6 months inpatient psych (we had 3 different inpatient psych units our program covered. Level 1 trauma center big university hospital with very busy and active inpatient unit. Lots of SMI, great experience and really enjoyed it. A very busy and large VA hospital which I actually like working at the VA. Level 1 trauma center military hospital where inpatient was busy but very healthy and young population majority in training just wanting to get out of the military.)
IM far and away the heaviest months working 80+ hrs every week and was brutal. ER was shift work but not too terrible. Neuro months were good learning and not too terrible with the hrs like 50ish maybe. Psych ER was at the VA and I enjoyed that month other than many of the veterans being monthly repeats saying they were suicidal to get a bed a meals for a few days but hours pretty good. Inpatient psych more 50-60 depending on how busy the unit was and how quickly you got your work done. Intern year was heaviest year of hours and each subsequent year got better. Call intern year at our program was just weekend, no overnight, and you were with a higher up resident. I think now they do overnights with interns at my program with a higher up resident since I graduated in 2019. Can’t remember the total call shifts as an intern but PGY-2 was the heaviest call and then it got better each year and you had more choice over your call schedule as a senior resident.

PGY-2:

Better than intern year as far as total hours and you’re pretty much doing all psych rotations, no more IM/neuro/ER or other specialties.

Mostly all hospital again with a change. Something like 4-6 months of consult service where patients admitted to IM/FM/surgery/ICU with psych problems they’ll consult you with a question. Actually interesting interacting with other resident services embracing the suck of residency training with you and you learn a lot. You also learn a lot about how other specialities view psychiatry as some seem to have no idea what we do or are even capable of, or think we have a magic wand to fix something in a few days in the hospital that takes intense psychotherapy for years. Also you’ll get very good at capacity evaluations and very good at explaining to other services the difference between capacity and competency, also that the 80 yr old delirious uti pt with no psych hx did not suddenly develop late onset schizophrenia overnight.

Our program had a 3 month block that was split between child and adolescent, geriatric psych rotating through different settings, outpatient, nursing home, juvenile detention center etc.

I think we had 3 more months of inpatient psych as well. Call second year was more intense with the most overnight and weekend shifts. It was something like 25-30 call shifts if I remember and so many of them had to be a Saturday or Sunday 24 hr call, and a certain number were 12 hr overnight call. All of our call was in house, had to stay at the hospital. One of our months of inpatient this year was 1 week with the day team inpatient and then 3 weeks of night float. Attendings typically very helpful and responsive and we were required to call overnight if we were discharging someone home from the ER. Also started a half day per week of psychotherapy in second year.

PGY-3:

Outpatient. Less call but still more than 4th year. Mix of straight adult outpatient, child and adolescent outpatient, geri psych that we did at the VA I think both of these were a half day per week. Half day per week of psychotherapy. 2.5-3.5 days per week of adult outpatient and some other half day I’m forgetting in there. Call was more like 20-25 call shifts, mix of weekend 24 hrs, overnight 12 hrs, holidays etc. you get a little more flexibility with this in 3rd year as 4th years got first dibs on the call schedule and got to pick the better holidays but there were some flexibility on this for what was leftover for the third years. Second years there just really wasn’t much left so you just kind of had to take what you were given which typically meant a Christmas, thanksgiving, or new year it was yours.

PGY-4:

Best year. I think half our year was electives, half the year was being a Sr resident on inpatient or consults with jr residents doing the majority of the work. Call was like 14 shifts and you got to pick what days you wanted with your classmates. Some dront loaded their call in the first month or 2 which sucked but didn’t have to worry about it the rest of the year. I think I picked July 4th as my holiday and got that knocked out at the beginning of the year.

Military staff psychiatrist:

Better than being a resident but the military is just soul crushing in a different way and I could not wait for my payback to be complete and separate. Got paid much more than a resident but much less than civ counterparts. No call, nights, weekends though. Got to live in a cool place for 3 years. Separated summer 2023.

Civ psychiatrist:

Living the dream now working 4 days per week, 3 day weekend every weekend. Making much more than mil time, no nights, weekends, holidays, call. 😎

Thanks for this. What's your practice setting?

 

[DOswag]

Thanks for this. What's your practice setting?

Currently working straight outpatient adults ages 18-65, med management, TMS, IV ketamine. The practice I work for gives doctors a lot of flexibility with our schedule, just has to be 40 hrs. A lot of psychiatrists in our practice work 4 days, 10 hr days. I work 10’s mon-Thurs. No nights, weekends, call, or holidays. See about 15-20 patients most days. We get paid a salary with bonus based on rvu production which TMS does generate a good # of rvu’s so the potential for bonus every quarter is definitely there. The practice has clinics in multiple states and is continuing to grow. Some psychiatrist make 6-700K, average is more like 3-400K.

 

[slowthai]

Currently working straight outpatient adults ages 18-65, med management, TMS, IV ketamine. The practice I work for gives doctors a lot of flexibility with our schedule, just has to be 40 hrs. A lot of psychiatrists in our practice work 4 days, 10 hr days. I work 10’s mon-Thurs. No nights, weekends, call, or holidays. See about 15-20 patients most days. We get paid a salary with bonus based on rvu production which TMS does generate a good # of rvu’s so the potential for bonus every quarter is definitely there. The practice has clinics in multiple states and is continuing to grow. Some psychiatrist make 6-700K, average is more like 3-400K.

What made you choose outpatient over other settings?

 

[DOswag]

What made you choose outpatient over other settings?

I liked inpatient as well as outpatient when I was in residency so I could’ve seen myself doing either. I had to do outpatient when I was military and got pretty comfortable with it so when I started looking for jobs when I was separating, this one was open and I applied and got hired in an area my wife and I were looking in. There are some good inpatient gigs out there that pay well like 3-350K and you get to go home when the work is done. Come in at 8am and leave by 1-2 and be available by phone for a few more hours. Typically require you to work some weekends though.

 

[DOswag]

I liked consults in residency but knew I didn’t want to do it long term. Typically doesn’t pay nearly as well. Er psych can be good if you like shift work and the population. Usually either very ill and give emergency meds and admit, truly suicidal and imminent risk of harm to self and admit, substance induced stuff, or malingerers. There’s various other stuff in there as well but ultimately it’s a decision to admit or not and then figure out discharge plans. I knew I couldn’t do child. Working with children is very cool and seeing them grow and impacting their life is wonderful, but I couldn’t handle the sad stories of trauma and dealing with parents (though now I get to hear those stories just when they’re an adult telling me about their childhood). Geri psych wasn’t for me dealing pretty much with dementia patients all the time with psych conditions. Forensics is interesting and can pay very well, but I don’t want to be in a court room getting grilled all the time lol. I didn’t necessarily dislike the other options when I was in residency but knew I couldn’t do it for long term as a career. I like outpatient and the relationships I get to build with patients. I could see myself doing inpatient though I’m not actively looking to switch to that or anything because I feel I have a pretty good gig.

 

[slowthai]

I liked consults in residency but knew I didn’t want to do it long term. Typically doesn’t pay nearly as well. Er psych can be good if you like shift work and the population. Usually either very ill and give emergency meds and admit, truly suicidal and imminent risk of harm to self and admit, substance induced stuff, or malingerers. There’s various other stuff in there as well but ultimately it’s a decision to admit or not and then figure out discharge plans. I knew I couldn’t do child. Working with children is very cool and seeing them grow and impacting their life is wonderful, but I couldn’t handle the sad stories of trauma and dealing with parents (though now I get to hear those stories just when they’re an adult telling me about their childhood). Geri psych wasn’t for me dealing pretty much with dementia patients all the time with psych conditions. Forensics is interesting and can pay very well, but I don’t want to be in a court room getting grilled all the time lol. I didn’t necessarily dislike the other options when I was in residency but knew I couldn’t do it for long term as a career. I like outpatient and the relationships I get to build with patients. I could see myself doing inpatient though I’m not actively looking to switch to that or anything because I feel I have a pretty good gig.

Awesome, thanks for all the details!

 

[Drrrrrr. Celty]

Ok, but that is over after 2-4 months? Does it include ICU and overnights?

It may be brutal for me to adjust (but that is a while away at least) but as long as it's over with soon like Surgery or OB rotations I might be able to suck it up for a brief period and can mentally prepare myself for the bump in hours (Honestly I'm thinking it might be smart just to get those rotations over right away since I will be too lazy to do it later).

Now if it is very often then I would get concerned about it cutting into my life.

Can I remind you that you only do residency once. It's preparing you to take care of patients and care for them.
If you're not going into residency to be your best physician you're one step behind everyone else.

 

[DOswag]

Can I remind you that you only do residency once. It's preparing you to take care of patients and care for them.
If you're not going into residency to be your best physician you're one step behind everyone else.

Agree. One of the purposes of residency is to put stress on you to be a better physician, to learn and grow. To the OP, it's not going to be easy. Lifestyle of a certain specialty is definitely something to take into consideration when you are deciding what you're going to do for the rest of your career. Don't let the residency difficulty steer you away from it though. Residency is supposed to be difficult. Psychiatry tends to be a little less demanding than others in terms of hours (or a lot less if you're comparing it to most surgical residencies lol), but there are still times that are pretty stressful and longer hours.

 

[Tangerine123]

Depression ward: 8:00 to 18:00
Addiction ward: 8:30 to 15:00
Closed/acute ward: 8:00 to 17:00
Teenager ward: 8:30 to 18:00

All of those are averages.

24 hour call 2-3 times a month with the next day free.

 

[OMSWeebHours]

Depression ward: 8:00 to 18:00
Addiction ward: 8:30 to 15:00
Closed/acute ward: 8:00 to 17:00
Teenager ward: 8:30 to 18:00

All of those are averages.

24 hour call 2-3 times a month with the next day free.

Wait a minute, there are separate wards for addiction and depressive symptoms?
Was this in a big hospital?

 

[OMSWeebHours]

But @Tangerine123 that program schedule sounds pretty good all things considered. I'd also like to be in a place where I can get many rotations with patient variety, are you satisfied with the training and experience you get at that program for the time?

 

[OMSWeebHours]

Agree. One of the purposes of residency is to put stress on you to be a better physician, to learn and grow. To the OP, it's not going to be easy. Lifestyle of a certain specialty is definitely something to take into consideration when you are deciding what you're going to do for the rest of your career. Don't let the residency difficulty steer you away from it though. Residency is supposed to be difficult. Psychiatry tends to be a little less demanding than others in terms of hours (or a lot less if you're comparing it to most surgical residencies lol), but there are still times that are pretty stressful and longer hours.

I don't expect it to be a walk in the park necessarily or to be some normal schedule. I am perfectly fine with some intense bursts, but the big thing is I don't want the ICU rotations to be most or all of residency. The difference imo is whether it is consistently way over the top or at the cap with 65-80+ weeks and little to no breathers.

But you do bring up a good point that schedule shouldn't be the sole focus with a long term vision, you are right that I do also need to focus on really benefitting from residency and getting trained to be a good physician to treat my patients.

 

[Drrrrrr. Celty]

I don't expect it to be a walk in the park necessarily or to be some normal schedule. I am perfectly fine with some intense bursts, but the big thing is I don't want the ICU rotations to be most or all of residency. The difference imo is whether it is consistently way over the top or at the cap with 65-80+ weeks and little to no breathers.

But you do bring up a good point that schedule shouldn't be the sole focus with a long term vision, you are right that I do also need to focus on really benefitting from residency and getting trained to be a good physician to treat my patients.

You're not on ICU all or most of residency even as a medicine resident.
65 hour weeks are pretty reasonable for a heavy medicine ward rotation.
ICU for 80 hours a week is not unusual for one or two weeks.

I would just hesitate to choose a psych or any residency where they want you to work for like 40 hours a week, never cover nights, never do weekends, and basically live under the white coat of your attending without any internal autonomy.

Back in Med school I rotated at a psych residency location and honestly they barely did any work at all. It was a Risperdal prescription mill. No thought. People saw like 5-8 patients. Were done with notes by 2 or 3. etc.
I don't think the folks who graduate are going to be innovators or great psychiatrists. They're gonna be passable.
I don't think that's what you should aim for.

 

[OMSWeebHours]

You're not on ICU all or most of residency even as a medicine resident.
65 hour weeks are pretty reasonable for a heavy medicine ward rotation.
ICU for 80 hours a week is not unusual for one or two weeks.

I would just hesitate to choose a psych or any residency where they want you to work for like 40 hours a week, never cover nights, never do weekends, and basically live under the white coat of your attending without any internal autonomy.

Back in Med school I rotated at a psych residency location and honestly they barely did any work at all. It was a Risperdal prescription mill. No thought. People saw like 5-8 patients. Were done with notes by 2 or 3. etc.
I don't think the folks who graduate are going to be innovators or great psychiatrists. They're gonna be passable.
I don't think that's what you should aim for.

Is it because the heavier load places have more case variety or just more training time

 

[Drrrrrr. Celty]

Is it because the heavier load places have more case variety or just more training time

There are plenty of residencies that very much are RVU factories for attendings. Residencies that exist to fulfill the bottom line for a hospital system. And Residencies that truthfully scrap by and are at risk of being shut down when their 10 year ACGME review comes around.

A university tier program almost certainly not only is going to have better meat, it'll also try to involve psychiatry in consults in the hospital for more than just addicted populations.

You can ask more specific questions or look up things in the Psych forum.

I'm personally an IM subspecialist. But I am happy I was worked hard and trained in an environment where we were encouraged to be independent and make our own decisions.

 

[OMSWeebHours]

There are plenty of residencies that very much are RVU factories for attendings. Residencies that exist to fulfill the bottom line for a hospital system. And Residencies that truthfully scrap by and are at risk of being shut down when their 10 year ACGME review comes around.

A university tier program almost certainly not only is going to have better meat, it'll also try to involve psychiatry in consults in the hospital for more than just addicted populations.

You can ask more specific questions or look up things in the Psych forum.

I'm personally an IM subspecialist. But I am happy I was worked hard and trained in an environment where we were encouraged to be independent and make our own decisions.

How would I be able to tell the depth of what's covered in the residency? Would asking directly clarify or is it more just location/academic center dependent?

Also, I don't think I am allowed to post on the psych forum lol

 

[annoyedpsychiatrist]

Its all dependent on the program- some are way more relaxed than others. When i was in residency a little over 3 years ago, my first year there were months where I worked 13 days straight and on the weekend call i was at the hospital by 5:30-6 and rounded on 20-30 patients as an intern. Though ironically a year later they did away with this when the hospital unit closed, which ended up being a positive.. Second year I did near a month of basically 24 hour calls and 2 months of 12 hour night shifts. Third year was basically 8:30-5 sorta deal, and 4th year was a joke.

I would say not to let this influence your decision on residency, go in the field you want to do for 20 years, and the program that has the best chance of making you good at your job. Hard work will come for you, even if you try to run from it.