Shift preferences in acaedmia vs community

[tdavie]

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Hello, I'm a 3rd year medical student strongly considering A career in EM, and I have a quick question regarding how your shifts are scheduled. At my institution (academic), it appears that everyone receives equal preference when it comes to selecting their shifts (nights, weekends, holidays), regardless of how long they've been on staff.

I'm wondering how this differs in a community/private hospital. I have heard that in some hospitals, once you have been there for a few years, you begin to have “partner” status, which allows you to get the “better” shifts.

Does anyone have thoughts on this? Thanks! 🙂

 

[Greenbbs]

I work exclusively days and evenings (7a-4p, 9a-6p, or 3p-midnight), and I'm in my first year out of residency. My shop has a dedicated night staff, so I dont have to do any nights.

There are plenty of opportunities out there where you don't get shafted on the shift schedule. You just have to find them.

 

[DrMom]

My group covers multiple hospitals and has has night shift only people who get a pay differential for not working any days. The rest of the group is days/evenings (7-7, 10-10, 11-11, or 1630-0130) and work 1-2 nights/month. No difference in scheduling based on seniority or age.

 

[Arcan57]

Hello, I'm a 3rd year medical student strongly considering A career in EM, and I have a quick question regarding how your shifts are scheduled. At my institution (academic), it appears that everyone receives equal preference when it comes to selecting their shifts (nights, weekends, holidays), regardless of how long they've been on staff.

I'm wondering how this differs in a community/private hospital. I have heard that in some hospitals, once you have been there for a few years, you begin to have “partner” status, which allows you to get the “better” shifts.

Does anyone have thoughts on this? Thanks! 🙂

Don't go into EM with the thought that you're going to somehow avoid the circadian disruptions that are a hallmark of the specialty. You're going to work nights, weekends, and holidays. You may find a job that has you working less of one of the three, but to completely avoid any of them is rare. To find a job that avoids 2 out of 3 usually means you're the director.

If seniority allows better shifts schedules, that means that the fresh meat is working a schedule that is heavily loaded with "undesirable" shifts. Given that the average EP's first job lasts ~2 yrs, that's not usually a good thing.

 

[alreadylernd]

Don't go into EM with the thought that you're going to somehow avoid the circadian disruptions that are a hallmark of the specialty. You're going to work nights, weekends, and holidays. You may find a job that has you working less of one of the three, but to completely avoid any of them is rare. To find a job that avoids 2 out of 3 usually means you're the director.

If seniority allows better shifts schedules, that means that the fresh meat is working a schedule that is heavily loaded with "undesirable" shifts. Given that the average EP's first job lasts ~2 yrs, that's not usually a good thing.

I totally agree. I'd be weary of any group that creates a class system between it's partners and non-partners because it creates another incentive to deny partnership in the future and requires a continuous input of "fresh meat" to work those undesirable shifts. In my group, there's schedule equality starting from day#1, we work on average every-other weekend (basically 2 weekends/month) with ability to request which weekends we want off. We have a few night-only people leaving the rest of the group to work ~2 overnights a month (though we have a late night shift - until 2 am - too).

 

[Greenbbs]

Exactly. Avoid the class system. In my group, everyone gets paid the same yearly salary, but the nights only people (i.e. the 7p-4a, and the 11p-8a's) work 12 shifts/month, where we daytimers work 16.

 

[corpsmanUP]

The best groups I have encountered have dedicated night shift people who get paid more to work nights. Then everyone else works an equal number of weekends and the remaining necessary nights.

Academics is much different because every faculty member may have a different number of required clinical hours based on their other non clinical hours. For instance, where I am starting, at a big academic EM program, the guys who do more for the program in terms of resident training and who give more hours to the medical school for non-clinical hours work less shifts. I think it's rather fair. Over time in academics if you make yourself worth more to the program in terms of education, research, administration, you can basically "buy down" your clinical time. That's about all I know so far since I have not started my academic job, but it seems to be the norm. It seems the right way to handle it.

 

[omgwtfbbq?]

I don't see how weekends and holiday's disrupt your circadian rhythm. There seem to be plenty of groups out there with nocturnists and limited nights. True you can't avoid weekends and holidays completely, but that doesn't disrupt your sleep schedule, just your life to a minor degree.... but even that depends on what your life is like.

Don't go into EM with the thought that you're going to somehow avoid the circadian disruptions that are a hallmark of the specialty. You're going to work nights, weekends, and holidays. You may find a job that has you working less of one of the three, but to completely avoid any of them is rare. To find a job that avoids 2 out of 3 usually means you're the director.

If seniority allows better shifts schedules, that means that the fresh meat is working a schedule that is heavily loaded with "undesirable" shifts. Given that the average EP's first job lasts ~2 yrs, that's not usually a good thing.

 

[Dwindlin]

I don't see how weekends and holiday's disrupt your circadian rhythm. There seem to be plenty of groups out there with nocturnists and limited nights. True you can't avoid weekends and holidays completely, but that doesn't disrupt your sleep schedule, just your life to a minor degree.... but even that depends on what your life is like.

I think he was making two separate points...that 1) You will most likely have your circadian rhythm disrupted frequently, and 2) You will work weekends/holidays.

 

[omgwtfbbq?]

I find working, in general, to be disruptive

 

[Arcan57]

I think he was making two separate points...that 1) You will most likely have your circadian rhythm disrupted frequently, and 2) You will work weekends/holidays.

Correct, it's my generic spiel to people that think of EM as a lifestyle specialty.

 

[gobulls2012]

Correct, it's my generic spiel to people that think of EM as a lifestyle specialty.

i'm sorry but EM is a lifestyle specialty. working just 11p-7am 12x a month and no weekends. Banking about 270k...that's amazing!

 

[WilcoWorld]

i'm sorry but EM is a lifestyle specialty. working just 11p-7am 12x a month and no weekends. Banking about 270k...that's amazing!

Believe what you want, but disregard Arcan's warning to your own peril...

 

[tkim]

i'm sorry but EM is a lifestyle specialty. working just 11p-7am 12x a month and no weekends. Banking about 270k...that's amazing!

Sorry, but you don't get it.

 

[alreadylernd]

i'm sorry but EM is a lifestyle specialty. working just 11p-7am 12x a month and no weekends. Banking about 270k...that's amazing!

1. Being exclusive nights doesn't necessarily get you out of weekends - at least in my group. Our nights-only people still do every-other weekend, just like everyone else. They are still on the hook for every-other holiday too. They get a slight pay differential made up for with a few less shifts each month. That's it.

2. Have you run a string of 2-3 nights and then tried to recover? I'm a zombie for at least a day and resetting to a "day" schedule is tough. Imagine having to do that continually (assuming friends and family don't also work 11p-7am and you have some intention of seeing them for longer than just crossing paths.)

3. Have you ever worked an overnight, single coverage when the waiting room is full at midnight?