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Rank the difficulty of each residency

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FunnyDocMan1234

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in terms of hours, environment, physical toll, etc. PM&R most cush, neurosurg most grueling?
 

ActinicKeratosis

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Generally anything tied to the operating room (surgery) is going to be more grueling than mostly clinic medicine (dermatology). Of course there are exceptions but I think this is for the most part true.
 

_atlas

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Ranking all of that is a grueling task you can do the research lol

Something that you may want to look at, not sure if this helps you at all but I feel as though it can be beneficial!

Residencies and Specialties
 
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235009

Don't discount the amount of independent studying you have to do for some specialties. Derm, ophtho and radiology may have relatively short hours but there is a lot of reading to be done, especially early on, as they are very dense specialties you get little background in during med school.


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194342

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If you don't count fellowships post-general surgery (transplant, cardiac surgery,etc) neurosurgery is my vote for most grueling. Going over the work hours limit is common and you still had to present for grand rounds and study to prepare for surgical cases/boards. I'm not complaining, I love my job but the hours and expectations can be exhausting.


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Psai

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If you don't count fellowships post-general surgery (transplant, cardiac surgery,etc) neurosurgery is my vote for most grueling. Going over the work hours limit is common and you still had to present for grand rounds and study to prepare for surgical cases/boards. I'm not complaining, I love my job but the hours and expectations can be exhausting.


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Neurosurgery easily. When you stay late and come in early enough for me to think that you're also night shift, that's some ridiculous hours
 
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ACSurgeon

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in terms of hours, environment, physical toll, etc. PM&R most cush, neurosurg most grueling?

A more useful thing for you is to figure out what you enjoy and then once you have a short list of specialties, we can discuss how they rank, or more accurately give you pros and cons for you to rank.
 

operaman

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Even if you could make such a list, you'd need to further break it down by program within each field. And even if you could do that, you would need to further break it down by ability and efficiency of each individual resident. You'll see residents constantly breaking 80 hours each week while others in the same program are not even close because they're just more efficient. This cuts across disciplines too - I know people in clinic based cushy fields who are still doing notes at home until 10 or 11 while others in the same program have theirs done before they leave at 5 or 6.
 
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Merely

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Even if you could make such a list, you'd need to further break it down by program within each field. And even if you could do that, you would need to further break it down by ability and efficiency of each individual resident. You'll see residents constantly breaking 80 hours each week while others in the same program are not even close because they're just more efficient. This cuts across disciplines too - I know people in clinic based cushy fields who are still doing notes at home until 10 or 11 while others in the same program have theirs done before they leave at 5 or 6.

True but it's probably a fair question to ask since broad generalizations still hold true, i.e the hardest derm program is still easier than the cushiest neurosurgery program..
 

psychMDhopefully

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Neurosurgery easily. When you stay late and come in early enough for me to think that you're also night shift, that's some ridiculous hours


Sad way to live life too, no time to sleep, exercise, see loved ones, relax, and anything else that keeps people human for 7 years? The million dollar salary they get isn't worth it.
 

194342

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Sad way to live life too, no time to sleep, exercise, see loved ones, relax, and anything else that keeps people human for 7 years? The million dollar salary they get isn't worth it.

There is time for those things, just less available than other fields. A life worth living is different based on personal beliefs and needs. What you need is different from what I need.


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operaman

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True but it's probably a fair question to ask since broad generalizations still hold true, i.e the hardest derm program is still easier than the cushiest neurosurgery program..

Broadly speaking yes, but probably not as big a difference as you think. And again, much of it depends on the efficiency and ability of the individual resident. There's also the strength of the team you're working on -- how much fellow residents help each other out. Just this last year I remebmer seeing some people on other services talk about consistently hitting 100+ hour weeks, but when I got to those services I was somewhere in the 60s. Maybe they were just getting slammed at the time, but I also had very strong co-residents working with me and we would endeavor to be efficient and to get each other out as early as possible. Some days I would go home even earlier than all the derm residents! But others I would end up staying really late after sending my colleagues home and later getting lit up with consults and floor stuff.

I would also echo the above poster who mentioned the amount of at-home study required of something like derm.
 
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fantasty

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Just throwing out a couple of commonly ignored specialties: occupational medicine and preventive medicine. Both are not particularly "strenuous" during residency - probably "easier" than PMR. OM would have more clinical time, and both would have "academic" time as you do coursework for your MPH. But, on a week-by-week basis, very (VERY) manageable.
 

fantasty

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How about Oncology, with it's constant exposure to mortality? Geriatrics?
Both fellowships. But, I'd put them more in the category of mental/emotional toll more than physical toll. Hem/Onc has as much time on call as a lot of other IM specialties, whereas geriatrics would be primarily be clinic.

Another fellowship in the same thread (not bad for hours or physical toll, but hard emotionally yet fulfilling) would be palliative & hospice medicine.
 
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Brahnold Bloodaxe

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I heard some of those Nurse Practitioner residencies can be damn brutal. Rumor has it they take the 3-5 years of MD residency training and compress it into just a few months. I'm not sure how those nurses do it!
 
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Pathman1000

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I heard some of those Nurse Practitioner residencies can be damn brutal. Rumor has it they take the 3-5 years of MD residency training and compress it into just a few months. I'm not sure how those nurses do it!

They're simply superior. In addition to functioning as equivalents, they also manage to connect meta-spiritually with the patient and take a 2 hour lunch. Talk about efficiency!
 
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<L>

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Both fellowships. But, I'd put them more in the category of mental/emotional toll more than physical toll. Hem/Onc has as much time on call as a lot of other IM specialties, whereas geriatrics would be primarily be clinic.

Another fellowship in the same thread (not bad for hours or physical toll, but hard emotionally yet fulfilling) would be palliative & hospice medicine.

Geri is one of those "do it if you want, but you're probably sacrificing income to do the fellowship" situations. The media talks all the time about the shortage of geri providers but because of such a shortage it's not exactly required to have the fellowship if you want a job working with that population. If you want to work with geri patients, do 3 years of IM/FM and move to Florida.
 

Instatewaiter

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in terms of hours, environment, physical toll, etc. PM&R most cush, neurosurg most grueling?

It is so dependent on program. For instance, I would argue my medicine residency was much more greuling and had longer hours than my friend's ortho residency. But many people in medicine have gentler residencies than I had and many in ortho have much harder residencies than he had. Realize that there is overlap between most specialties in terms of hours, stress and physical toll. I suspect that even in PM&R there are programs that have longer hours and take more of a phsyical toll than many residencies in traditionally more greuling specialties.
 

Dires

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in terms of residency ortho is up there
 

bannie22

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notice how everyone who says their residency is light mentions how efficient they are. and those that mention how gruelling their residency mentions how tenancious they are. ahahaha

everyone just here to talk big. lol.
 
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sloop

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I am waiting to hear about psychiatry...

Psychiatry has to be one of the most lifestyle fields there is. Recently I witnessed my attending and resident team up against another resident to get her to take a break because it was nearly 2 PM and she hadn't taken a lunch break. The resident even offered to help with whatever work she was doing if that would make her less anxious about taking a break.

Not the main reason I love the field, but it's a definite perk. The general culture is pretty warm and fuzzy in my experience.
 
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Merely

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Psychiatry has to be one of the most lifestyle fields there is. Recently I witnessed my attending and resident team up against another resident to get her to take a break because it was nearly 2 PM and she hadn't taken a lunch break. The resident even offered to help with whatever work she was doing if that would make her less anxious about taking a break.

Not the main reason I love the field, but it's a definite perk. The general culture is pretty warm and fuzzy in my experience.

LOL
 

mcloaf

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I am waiting to hear about psychiatry...

It was the only rotation where I saw a resident get extra time off on Friday because she had to see an extra clinic patient earlier in the week...

Also the only time I've ever heard seeing five patients in a day described as a "packed schedule."
 
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Merely

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It was the only rotation where I saw a resident get extra time off on Friday because she had to see an extra clinic patient earlier in the week...

Also the only time I've ever heard seeing five patients in a day described as a "packed schedule."

Omg lol I can't take this it's so funny psychiatry is starting to look a hell of a lot more appealing...
 
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Pathman1000

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Omg lol I can't take this it's so funny psychiatry is starting to look a hell of a lot more appealing...
The hardest part of psych is dealing with your colleagues.
 
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Taddy Mason

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Psychiatry has to be one of the most lifestyle fields there is. Recently I witnessed my attending and resident team up against another resident to get her to take a break because it was nearly 2 PM and she hadn't taken a lunch break. The resident even offered to help with whatever work she was doing if that would make her less anxious about taking a break.

Not the main reason I love the field, but it's a definite perk. The general culture is pretty warm and fuzzy in my experience.
It's dependent on the region. Psych is largely underserved where I'm from and it's pretty common for the attendings who do both inpatient and outpatient to show-up at 5-6am, not leave until ~8pm, and have to take overnight call 2-3/week. The attendings who do only inpatient, or only outpatient have it better though - especially the outpatient only ones...
 
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sloop

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It's dependent on the region. Psych is largely underserved where I'm from and it's pretty common for the attendings who do both inpatient and outpatient to show-up at 5-6am, not leave until ~8pm, and have to take overnight call 2-3/week. The attendings who do only inpatient, or only outpatient have it better though - especially the outpatient only ones...

I'm sorry, but this is not a common gig for an attending psychiatrist, and those who do it probably do it because they want to (and are likely compensated for their lifestyle sacrifice). Maybe your region is underserved, but whatever the situation is there, it is anomalous rather than the rule. It is simply not typical for attending psychiatrists to work 15 hour days and take call 3 times a week.
 
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Taddy Mason

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I'm sorry, but this is not a common gig for an attending psychiatrist, and those who do it probably do it because they want to (and are likely compensated for their lifestyle sacrifice). Maybe your region is underserved, but whatever the situation is there, it is anomalous rather than the rule. It is simply not typical for attending psychiatrists to work 15 hour days and take call 3 times a week.
I was honestly just pointing out an anomaly. There's a high turnover rate of psychiatrists here because of it. The salary range for psych is close to that of general surgery, but it tends to attract people right out of residency who leave as soon as their loans are paid off.
 
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