Residency and lack of sleep

[pandemicpremed97]

Im starting med school in a few months and I’ve been watching too many videos on “a day in the life of a resident.” I have a serious concern about lack of sleep now, because I’ve always slept 8 hours a night. I’m thinking perhaps EM (obviously this is subject to change). I know EM residency is around 60 hours most weeks but for about a month a yr it’s like 80 hour week. During these 80 hour weeks will I ever have down time to close my eyes/take a nap during a shift?
Thanks in advanced

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[Chads2]

You’re getting way ahead of yourself, first of all. Residency is a good 4 years away and even clinical rotations are 2 years away. Med school is a ramp up.

That being said, though, 8 hours of consistent nightly sleep is a pipe dream. I believe there is supposed to be an 8 he minimum between the time you leave the hospital and when you return though that have changed since my residency data. (My program stretched that to a 10 hour off period). So get used to sleeping the entire time you’re Not on duty.

 

[Redpancreas]

Im starting med school in a few months and I’ve been watching too many videos on “a day in the life of a resident.” I have a serious concern about lack of sleep now, because I’ve always slept 8 hours a night. I’m thinking perhaps EM (obviously this is subject to change). I know EM residency is around 60 hours most weeks but for about a month a yr it’s like 80 hour week. During these 80 hour weeks will I ever have down time to close my eyes/take a nap during a shift?
Thanks in advanced

Agree with above about it being a ramp up. Many of those videos are not really meant to be informative as much as they're meant to be self-promotional like most influencer fodder.

That being said, you're really misjudging the situation due to your lack of experience and suggest you just experience the system and learn as you go instead of trying to get ahead of the game in this respect unless you have a medically proven sleep dosorder. EM is one of the the worst fields to pick if you value quality sleep. You may not work as much but your shifts as a resident/attending are not consistent. One week you'll be working days 7am-3pm but maybe the next week it will be 3pm -10pm, and then the week after that it may be 10pm-5am...Rinse and repeat. The best field for sleep is truly Family Medicine or Outpatient Internal patient which is most like a normal 9-5 job with a decent amount of weekends off. Chances are that's not what you're looking for. You'll get more of an understanding of resident lifestyle in your clerkship years.

 

[PugsAndHugs]

I’ll offer a different perspective than the people above. I don’t think you need to be sleep deprived or over worked to become an amazing physician. Just because this is what we may be used to, doesn’t mean it is right.

I, like you, also value my sleep very much. If I don’t get at least 7 (preferably 8), I don’t feel well during the day. That’s why when I was interviewing at Internal Medicine programs last year, I always asked what their schedules were like. I was lucky enough to find a program that does absolutely ZERO 24 hour shifts for the entirety of residency (the longest schedule shift we have is actually 14 hours). I’m 10 months into residency now, and I am happy to say that I have had at least 7 hours of sleep every single night.

This is just one of the few reasons that I ranked this program above the more “prestigious” institutions I interviewed at. I’m telling you this because there are programs out there that actually care about their residents and make actual changes to directly impact the “wellness” of residents instead of just saying they care about wellness. When you are interviewing, don’t be afraid to ask questions about scheduling, golden weekends, benefits, etc. Ask if the program is receptive to feedback, snd ask for specific examples. Residency should be hard, but it should not be miserable.

I do agree with certain fields comes particular scheduling (like the above mentioned scheduling inconsistencies with EM). But look around - maybe there are programs now that have you do certain shifts together instead of constantly having to shift your sleep cycle.

 

[seeinghowitgoes]

Agree with everything above.

1a) worry about this once you’re doing clinicals - you’ll get a much better feel for the schedules of different specialties and what you can handle then.

1b) ^that said, it’s really hard to predict what you’re going to want schedule-wise in residency. I am also at a program that has almost no 24-hr call (picked it on-purpose because I too value lifestyle and sleep) - I did a rotation with 24 hr call and realized I preferred it and tried trading into more. This is just to say don’t stress about this too much because until you’re in residency it’s hard to know exactly how you’re going to feel about the job (an unfortunate fact my colleagues and I discuss often).

2) if you MUST have 7-8hrs of sleep a night, most specialties are still open to you except for most surgical fields.

3) No you will never sleep on an EM shift. Also switching from days to nights will mess with your sleep. If you’re truly prioritizing sleep schedule I don’t know many people who would say EM is the way to go despite the fact that you work 60 hr weeks for much of residency.

 

[pandemicpremed97]

I’ll offer a different perspective than the people above. I don’t think you need to be sleep deprived or over worked to become an amazing physician. Just because this is what we may be used to, doesn’t mean it is right.

I, like you, also value my sleep very much. If I don’t get at least 7 (preferably 8), I don’t feel well during the day. That’s why when I was interviewing at Internal Medicine programs last year, I always asked what their schedules were like. I was lucky enough to find a program that does absolutely ZERO 24 hour shifts for the entirety of residency (the longest schedule shift we have is actually 14 hours). I’m 10 months into residency now, and I am happy to say that I have had at least 7 hours of sleep every single night.

This is just one of the few reasons that I ranked this program above the more “prestigious” institutions I interviewed at. I’m telling you this because there are programs out there that actually care about their residents and make actual changes to directly impact the “wellness” of residents instead of just saying they care about wellness. When you are interviewing, don’t be afraid to ask questions about scheduling, golden weekends, benefits, etc. Ask if the program is receptive to feedback, snd ask for specific examples. Residency should be hard, but it should not be miserable.

I do agree with certain fields comes particular scheduling (like the above mentioned scheduling inconsistencies with EM). But look around - maybe there are programs now that have you do certain shifts together instead of constantly having to shift your sleep cycle.

Thank you for this. I think switching from am to pm won’t really be bad because I’ll prob be tired enough to fall asleep and can take melatonin. But I care about getting 7-8 hrs a night, since I feel bad when I don’t. When the time comes I’ll def ask about wellness initiatives. Thank you again

 

[pandemicpremed97]

Agree with everything above.

1a) worry about this once you’re doing clinicals - you’ll get a much better feel for the schedules of different specialties and what you can handle then.

1b) ^that said, it’s really hard to predict what you’re going to want schedule-wise in residency. I am also at a program that has almost no 24-hr call (picked it on-purpose because I too value lifestyle and sleep) - I did a rotation with 24 hr call and realized I preferred it and tried trading into more. This is just to say don’t stress about this too much because until you’re in residency it’s hard to know exactly how you’re going to feel about the job (an unfortunate fact my colleagues and I discuss often).

2) if you MUST have 7-8hrs of sleep a night, most specialties are still open to you except for most surgical fields.

3) No you will never sleep on an EM shift. Also switching from days to nights will mess with your sleep. If you’re truly prioritizing sleep schedule I don’t know many people who would say EM is the way to go despite the fact that you work 60 hr weeks for much of residency.

Thank you sorry if I sound a bit naive w this next question but residents in the icu don’t really use the on call rooms?

 

[Redpancreas]

I’ll offer a different perspective than the people above. I don’t think you need to be sleep deprived or over worked to become an amazing physician. Just because this is what we may be used to, doesn’t mean it is right.

I, like you, also value my sleep very much. If I don’t get at least 7 (preferably 8), I don’t feel well during the day. That’s why when I was interviewing at Internal Medicine programs last year, I always asked what their schedules were like. I was lucky enough to find a program that does absolutely ZERO 24 hour shifts for the entirety of residency (the longest schedule shift we have is actually 14 hours). I’m 10 months into residency now, and I am happy to say that I have had at least 7 hours of sleep every single night.

This is just one of the few reasons that I ranked this program above the more “prestigious” institutions I interviewed at. I’m telling you this because there are programs out there that actually care about their residents and make actual changes to directly impact the “wellness” of residents instead of just saying they care about wellness. When you are interviewing, don’t be afraid to ask questions about scheduling, golden weekends, benefits, etc. Ask if the program is receptive to feedback, snd ask for specific examples. Residency should be hard, but it should not be miserable.

I do agree with certain fields comes particular scheduling (like the above mentioned scheduling inconsistencies with EM). But look around - maybe there are programs now that have you do certain shifts together instead of constantly having to shift your sleep cycle.

Agree with this about prioritizing a sleep friendly residency if you value sleep because some are more thoughtfully arranged than others.

Things to ask in residency program evaluation when you get there are

1) Are there any overnight calls? These are the ones where you’re expected to be up longer than you probably ever have doing important work.

2) Does the service have a dedicated DAILY night float? (Q2 nights are terrible because you’re up 16+ hrs which is basically the same endurance as a call).

I am LOLing about your comment brushing off warnings about EM and how you’re going to “just take a melatonin” but are simultaneously asking if you can sleep on an ICU call (no) and are posting about this specific issue nearly 3 years before it will even apply to you. What experience do you have working non-business hours? If it’s none, I would not be so nonchalant about how the circadian rhythm chaos EM puts on you.

 

[Dave1980]

Im starting med school in a few months and I’ve been watching too many videos on “a day in the life of a resident.” I have a serious concern about lack of sleep now, because I’ve always slept 8 hours a night. I’m thinking perhaps EM (obviously this is subject to change). I know EM residency is around 60 hours most weeks but for about a month a yr it’s like 80 hour week. During these 80 hour weeks will I ever have down time to close my eyes/take a nap during a shift?
Thanks in advanced

8 hours of sleep is possible in many fields including rads, path, pm&r, psych, radonc

 

[seeinghowitgoes]

Thank you sorry if I sound a bit naive w this next question but residents in the icu don’t really use the on call rooms?

highly variable by program and depending how busy the shift is. If it happens it’s usually a couple hours max. Would not make any choices about specialty assuming you’re going to get to sleep on icu call shifts.

 

[Redpancreas]

highly variable by program and depending how busy the shift is. If it happens it’s usually a couple hours max. Would not make any choices about specialty assuming you’re going to get to sleep on icu call shifts.

ICU never has a dead period. Given the frequency of monitoring and obligation nurses feel/have to report things, you really won’t get the chance to sleep if you’re carrying the pager. Floor rotations with a senior/intern, maybe... especially if you’re a white cloud with no admissions.