Residency

[wildcat1988]

---

Members do not see this ad.

I have a question about residencies in general. I don't understand how it is physically possible to work 80+ hours a week every week for years on end. This would entail about 12 hours a day every day for years. How do people survive this? Do the hours ever ease or is it literally 80 hour work weeks throughout the entire residency years.

I probably sound naive, but it just seems that this kind of intensive schedule would kill most people, let alone prepare them to be caring, well-trained physicians. Any insight would be great.

 

[Isoprop]

I have a question about residencies in general. I don't understand how it is physically possible to work 80+ hours a week every week for years on end. This would entail about 12 hours a day every day for years. How do people survive this? Do the hours ever ease or is it literally 80 hour work weeks throughout the entire residency years.

I probably sound naive, but it just seems that this kind of intensive schedule would kill most people, let alone prepare them to be caring, well-trained physicians. Any insight would be great.

Residents used to work longer.
Also, the 80 hour rule isn't strictly followed. Check the residency forums: you'll read lots of residents complaining about going over their duty hours.

 

[Blesbok]

Usually this is only for part of the year say when you are on trauma for surgery, etc. It is also usually worse during certain years of residency, usually 2nd and maybe 3rd.

 

[MossPoh]

Its the same thing at every level you go. Before starting college many wonder if they can do it. Before starting med school many have the fear they can't do it. It is the same with residency. You learn to adjust.

While on a completely different spectrum, many of my friends are special forces and marines. They talked about the same worries and how they thought their body couldn't take it. Then they got through it and realized what amazing feats a person can obtain with determination. It tends to be one of those "embrace the suck" type deals. Things aren't going to change, so you might as well live with it and do the best you can with the situation at hand. Either way, I wouldn't really worry about it right now. When the time comes you will adjust and find a way just like everyone else.

 

[coldweatherblue]

I think there's a lot of value in super-intensive training where basically all you do every day is reinforce your clinical skills and knowledge. but you're right, it's probably going to suck. My friend (g-surg intern) showed me his first time-card and he had worked 240 hours in two weeks... I honestly don't understand how it's possible either but the numbers were there. Q3 is a bitch.

edit: spelling of reinforce.

 

[MrBurns10]

I know how you feel. I'm on my medicine sub-i right now, putting in 70-80 hrs a week, and I still get out earlier than the resident and don't have to deal with doing discharge paperwork during my day off. I do think it's important to remember that you're not going to be working 80 hours a week every single rotation during residency. Your outpatient and consult months will generally be more time-friendly.

That being said, I think burnout is a very real problem in medicine. I was talking with my resident about it and she just said "I live in 4 week periods." You do what you gotta do.

 

[J ROD]

I'll tell you what I was told. It's amazing what one can get used to!

Simply, you do what you have to do.

 

[Blesbok]

I'll tell you what I was told. It's amazing what one can get used to!

Simply, you do what you have to do.

This is a good way of putting it. When you know what you want to do with the rest of your life and you know what you have to do to get there, you do it, no matter how hard it is.

 

[Droopy Snoopy]

A typical medicine wards intern schedule might average like this:
8 calls x16 hours
8 postcalls x14 hours
6 shortcalls x13 hours
5 'goldens' x9 hours
4 days off

I didn't do the math, but that's surely over 80/wk. ICU months are generally q3 so that's more hours, but it's absolutely doable for several months at a time. The thing is you might only have like 7 months like this as an intern. The other months might be spent doing consults, electives, research, maybe you have a dedicated clinic month or a run at night float -- all of which are usually fewer hours due to less/no call and more off days/week.

So for most residents and physicians you're not really working 80 hours/week for years and years. It is variable by location and by specialty though, all the more reason to do well in medical school in order to give yourself options regarding both.

 

[Winged Scapula]

I have a question about residencies in general. I don't understand how it is physically possible to work 80+ hours a week every week for years on end. This would entail about 12 hours a day every day for years. How do people survive this? Do the hours ever ease or is it literally 80 hour work weeks throughout the entire residency years.

I probably sound naive, but it just seems that this kind of intensive schedule would kill most people, let alone prepare them to be caring, well-trained physicians. Any insight would be great.

Many of us have survived (and under even longer hours than 80/week) and you will too. For my specialty it was indeed throughout the entire residency.

 

[Neuronix]

Many residencies do not require 80 hour weeks. Many specialties average 40-60 hours a week for most of the training. Also, several of these are not competitive. Choose wisely.

 

[mercaptovizadeh]

Many residencies do not require 80 hour weeks. Many specialties average 40-60 hours a week for most of the training. Also, several of these are not competitive. Choose wisely.

Derm, rad onc, rads, ophtho. PMR. of those, PMR is the only easy-to-get one.

 

[Neuronix]

Derm, rad onc, rads, ophtho. PMR. of those, PMR is the only easy-to-get one.

Add:

Psychiatry, easy to get. There's some medicine involved, but most of the residency is not bad.

Pathology, not that competitive, doesn't even require an internship. There's some surg path involved, which can be high hours, but it's not that much of their total residency unless that's what they choose.

Nuclear Medicine, easy to get.

Emergency, not that competitive, 100% shift work. Ok, the EM docs want to state their shifts are really hard. That is true. But they still are averaging less than 60 hours/week on service at the programs I've seen most weeks.

Internships are often tough. You have to look for the specialties that allow you to do the cush transitional years and hope you can land one of those. Or find a specialty that doesn't require a separate med/surg year and isn't looking for warm bodies to prop up the charity hospital during that first year.

 

[mercaptovizadeh]

Add:

Psychiatry, easy to get. There's some medicine involved, but most of the residency is not bad.

Pathology, not that competitive, doesn't even require an internship. There's some surg path involved, which can be high hours, but it's not that much of their total residency unless that's what they choose.

Nuclear Medicine, easy to get.

Emergency, not that competitive, 100% shift work. Ok, the EM docs want to state their shifts are really hard. That is true. But they still are averaging less than 60 hours/week on service at the programs I've seen most weeks.

Internships are often tough. You have to look for the specialties that allow you to do the cush transitional years and hope you can land one of those. Or find a specialty that doesn't require a separate med/surg year and isn't looking for warm bodies to prop up the charity hospital during that first year.

Psych is so out there, I barely consider it the same kind of medicine as the other above-mentioned.

Nuclear medicine: heard it's a difficult job market.

Pathology: ditto. heard the job market is getting quite bad.

EM: OK, but I'd wager they work more intensely during their shifts than ophtho/rad onc/rads/derm.

I think the whole TY thing is somewhat interesting. These ultracompetitive applicants who are scared to death of a medicine or surgery intern year at a major academic center, doing some unheard of community program TY and then run off to their derm residency at MGH.

 

[SoCuteMD]

Add:

Psychiatry, easy to get. There's some medicine involved, but most of the residency is not bad.

Pathology, not that competitive, doesn't even require an internship. There's some surg path involved, which can be high hours, but it's not that much of their total residency unless that's what they choose.

Nuclear Medicine, easy to get.

Emergency, not that competitive, 100% shift work. Ok, the EM docs want to state their shifts are really hard. That is true. But they still are averaging less than 60 hours/week on service at the programs I've seen most weeks.

Internships are often tough. You have to look for the specialties that allow you to do the cush transitional years and hope you can land one of those. Or find a specialty that doesn't require a separate med/surg year and isn't looking for warm bodies to prop up the charity hospital during that first year.

EM is actually fairly competitive. Programs vary, but I'd put mine in the middle of the pack as far as on service work hours. As an intern, I'm working about 220 hours/4 weeks when in the ED, plus 5 hours a week of conference (that is included in the 80 hours for other specialties) plus another 15 hours of signout/wrapup. The medicine residents who rotate through the ED at my program have told me that it's one of their toughest months, even though the hours look like less on paper.

Over the course of my residency I'll spend about a year on other services, where the 80 hour rule (and those other services' loose interpretation of it 🙄) applies rather than my own program's rule.

 

[Jeff05]

I have a question about residencies in general. I don't understand how it is physically possible to work 80+ hours a week every week for years on end. This would entail about 12 hours a day every day for years. How do people survive this? Do the hours ever ease or is it literally 80 hour work weeks throughout the entire residency years.

I probably sound naive, but it just seems that this kind of intensive schedule would kill most people, let alone prepare them to be caring, well-trained physicians. Any insight would be great.

some residencies are more difficult. however, it is pretty bad. it does prepare one to be good technically, but it is true - medical education/training definitely can cause "burnout." add to those hours decreased job satisfaction from everyone from insurance companies to administrators telling you how to do your job, uncertain economic future, and definite falling wages - and it doesn't feel great.
chose carefully.

 

[DrJosephKim]

80 hrs/week includes all the calls that you spend at night. In some (or many) situations, you may get a few hours of sleep during that night shift.

 

[dragonfly99]

Agree with drkim.
You count all the hours you are physically in the hospital, even if you're at lunch, sleeping (if you're very lucky), sitting in an educational lecture, etc.
But yes, it can be VERY tiring.

For most residencies you won't work 80hrs/week every week. If you do some types of surgery you may. I went to a pretty demanding IM program but even there I was not hitting 80 hrs most monts during my PGY2/3.
I worked >100 sometimes as a med student, specifically on surgical rotations.

 

[KluverB]

...You count all the hours you are physically in the hospital, even if you're at lunch, sleeping (if you're very lucky), sitting in an educational lecture, etc.....

That's not *strictly* true, but correct me i I'm wrong... You count all the hours you are involved in "clinical duties", and yes conferences, didactics, lunch, call, sleeping on call do count, as long as you are "on service" and thus, are expected to be called upon any minute do actually perform your duties. If you're physically present in the hospital because you're doing certain aspects of your research, or if you're preparing for a conference, reading, etc. but you're not actually on duty, these hours do not count.

 

[gutonc]

That's not *strictly* true, but correct me i I'm wrong... You count all the hours you are involved in "clinical duties", and yes conferences, didactics, lunch, call, sleeping on call do count, as long as you are "on service" and thus, are expected to be called upon any minute do actually perform your duties. If you're physically present in the hospital because you're doing certain aspects of your research, or if you're preparing for a conference, reading, etc. but you're not actually on duty, these hours do not count.

True. Pedantic and "the exception that proves the rule" ... but true.

 

[TopSecret]

I have a question about residencies in general. I don't understand how it is physically possible to work 80+ hours a week every week for years on end. This would entail about 12 hours a day every day for years. How do people survive this? Do the hours ever ease or is it literally 80 hour work weeks throughout the entire residency years.

I probably sound naive, but it just seems that this kind of intensive schedule would kill most people, let alone prepare them to be caring, well-trained physicians. Any insight would be great.

Even after residency you could find yourself working about 70-80 hours per week. Many doctors work between 60 and 70 hours per week when you count all the hours that they are on call. That is how misinformed they are.

Also, most people don't care how many hours a doctor works so long as their own doctor has had enough sleep before seeing them. People just don't care about the quality of life of residents. People think they're already making six figures.

 

[Ashers]

Even after residency you could find yourself working about 70-80 hours per week. Many doctors work between 60 and 70 hours per week when you count all the hours that they are on call. That is how misinformed they are.

Also, most people don't care how many hours a doctor works so long as their own doctor has had enough sleep before seeing them. People just don't care about the quality of life of residents. People think they're already making six figures.

Too true. My dad worked 80hrs/week in private practice in California, so we moved to Hawai'i, so he'd have more time with us, he went down to 60hrs/week at the beginning and 70hrs/week by the time he retired.

About a week before I got my second paycheck of residency, like 2 weeks ago, I had friends from college write me to ask for money for their missionary work prefacing the letter with a reference to me now being a doctor.