Specialties with best lifestyle in residency

[predodoc]

The reason Im asking is because Im doing the gen surgery rotation now and these people work 100+ hours(80 in their records) and are always tired and just overworked. The time they do spend at home is probably asleep. I really dont want to live my life like that.


So I was curious of what everyone thinks to be the specialties with the better lifestyles in residency. By that I mean Hrs/wk, workload, call ,ect. I know every residency program is different(even within certain specialties) but still theres got to be some generally easier residencies.

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[GatorMedMan]

Psych's pretty laid back, with the exception of the six months of non-psych stuff during intern year. Often no call 3rd and 4th year, with the opportunity to double if not triple your salary by moonlighting if it is allowed/available.

I hear path's pretty easy also.

 

[exmike]

derm. 9-5. no weekends. no call (well, nothign that you'd really call "call").

 

[exmike]

ws

 

[funkless]

psych path rads derm

 

[MagicalTrevor]

Try Frieda Online for hours of various residencies. From what i've seen Radiation Onc, Derm, Path, and Psych all have nice hours

 

[Reaganite]

derm, radonc (not rads! rads has call, and it can be very intense), path. Those are about the only legitimately call-free (for the most part) residencies I can think of. Some might include psych too, but at least at my old institution, psych residents took call and were actually quite busy.

 

[Chimed]

Psych's pretty laid back, with the exception of the six months of non-psych stuff during intern year. Often no call 3rd and 4th year, with the opportunity to double if not triple your salary by moonlighting if it is allowed/available.
.

In general, you're correct. But most of the strong psych programs have tougher first and second years. At my program, for example, we're q4 even during the psych months and push the 80 hours every week. But the trade off is that we only take 6 weekend calls the entire second year and average 9 to 10 hour days 5 days a week. Third and fourth year is be pretty much 8 to 5 with about 3 calls per year. So, it's pretty nice after the first year and a couple long days in the second year.

 

[BADMD]

The reason Im asking is because Im doing the gen surgery rotation now and these people work 100+ hours(80 in their records) and are always tired and just overworked. The time they do spend at home is probably asleep. I really dont want to live my life like that.

I have to mention EM here. EM has a more restrictive work hours limit (60 clinical hours per week). When on an ED month, there really isn't "call." However, you work a heck of a lot of nights and overnights and there is rarely time to eat (or visit the bathroom). Working a week of 12 hour shifts can be brutal. I found that I had lots of days where I could sleep in (we worked 10 hour shifts), but I was rarely home for dinner and was often completely off schedule from my spouse.

I did feel like I got an extra day or two off a week, compared to my medicine collegues.

 

[Llenroc]

Physical Medicine and Rehabilitation

4 year residency. 1 year of medicine (that has call), followed by 3 years of PM&R with very light home call. 9 hour days. Very little rounding on weekends.

It's probably the only specialty that approaches the workload of Dermatology and Radiation Oncology during residency, and perhaps even exceeds them in certain programs.

 

[unoriginal]

according to freida,

anesth 60 hrs/wk
derm 45
EM 54.5
opth 50.7
path 49.8
PM&R 53.4
psyh 54.6
radonc 47.9
radiology 52.3


derm < radonc < path < optho <rads < pm&r < em < psych < anesth
so besides derm and anesth, most are about 50 hrs/week on avg. sounds good to me, compared to FM/IM/surgery that are all 60-80+hrs/week.

 

[yaah]

I'm in path and I work 60-70 hrs/week on average. Take call 2-3 days/nights per week (24 hour blocks of time). It is a lot of work because pathology covers so much material and it requires lots of studying and work outside of "doing your job." It is definitely NOT the field for someone looking for a cush lifestyle. That can be done, of course, and I know residents who do it, but they are not going to be successful pathologists. Anyone who calls ANY residency in medicine "easy" is delusional. Some are more stressful in certain areas (either time commitment, pressure, volume of material, difficulty of managing time, etc) but all are significant commitments of time and energy.

The real answer is that the hours (for any specialty) are too much if you are in the wrong field. If you are in the right field, you can handle it. If you start out by picking your field by looking at the hours you will be working, you're in trouble already. Many people look at this once they gauge their interest and use it as a factor, which is ok, but it still shouldn't be a huge factor.

 

[predodoc]

thanks everyone for the responses. I just wanted to get an idea. I know any field is going to be hard but to have a family and work 100 hr./wk ( being tired when ever you are home) is not my idea of living. I could handle 60-80 if I enjoyed it and the hours were somewhat consistant. I think the biggest reason I asked is b/c I dont care much for surgery.

 

[LADoc00]

Depends also on WHERE you go. there are path programs with 80/hr weeks and there are others with 30/hr weeks on a similar type rotation.

The lowest of any accred. program Ive heard of was a derm one, ~20hrs/week with the expectation that time outside that was spent reading/doing research..which I dont think anyone did.

There are fellowships that are very cush and individual residency rotations where people leave to spend 3 months in Tahoe skiing while still on salary as well.

I even once ran into a guy doing a "fellowship" on his laptop at a Starbucks. Sure enough every morning he was faithfully there, typing away doin something for about 2-3 hours.

 

[p53]

Radiologists make twice as much as Dermatologists and ENT Surgeons.

Go for LIFESTYLE and $$$$.

 

[Lonestar]

I am an anesthesia resident and i can tell you most anesthesia residencies fall btwn 65-75 hrs/wk. Recent increase in hours mainly due to push for more ICU months.

 

[usnavdoc]

I am an anesthesia resident and i can tell you most anesthesia residencies fall btwn 65-75 hrs/wk. Recent increase in hours mainly due to push for more ICU months.

I think a distinction between lifestyle while in residency and after graduating needs to be made. In anesthesia for instance I would not say it has a great lifestyle while in residency. Dont get me wrong its not malignant as surgery can be, but calls can be brutal. As a Ca1 I worked an avg of 65 hours a week. As a Ca2 75 or so. Regular work days are great but Call is fairly tough with cases going all night, trauma, OB and airway emergencies. I rarely sleep when oncall.

 

[TRAMD]

While it is not one of the major specialties, Occupational Medicine has to be one of the cushest residencies. After your first year in whatever (which can be tough) it gets really easy. The second year is all classroom getting your MPH and is usually less than 20 hrs per week in class. The third year is clinics and on-site work observations with zero call of any kind, zero nights and zero weekends. Not to mention it is maybe the least competitive residency out there. Once out, median salary is about $170 and can go as high as $300+ with the same no call, no nights and no weekends. I have heard stories (true? I don't know) of Occ med docs making 7 figures by being the medical director for a large corporation. Anyways, just felt like advertising this sweet specialty.

 

[ndmd80]

can I speak to someone personally with regards to occupational medicine residency....and their lifestyle. Preferably the person who wrote the post.

 

[Winged Scapula]

can I speak to someone personally with regards to occupational medicine residency....and their lifestyle. Preferably the person who wrote the post.

Probably want to post your specific question here or send them a PM.

 

[Ligament]

Yeah Occ Med has to bee the cushiest residency. PM&R was not bad at all I must say; home call. NICE!

Rads call is HARD. Anesthesia residency is HARD.

 

[JackBauERfan]

I have to mention EM here. EM has a more restrictive work hours limit (60 clinical hours per week). When on an ED month, there really isn't "call." However, you work a heck of a lot of nights and overnights and there is rarely time to eat (or visit the bathroom). Working a week of 12 hour shifts can be brutal. I found that I had lots of days where I could sleep in (we worked 10 hour shifts), but I was rarely home for dinner and was often completely off schedule from my spouse.

I did feel like I got an extra day or two off a week, compared to my medicine collegues.

I dont know...I think EM looks great on paper, but if you're working a busy 12 hour shift (really more like 13), you get more days off during the month, but then again you are doing some nights and some days intermixed. In general they try to schedule blocks, but sometimes just not possible.

I did a year of medicine as my preliminary and was about 80 hours a week, in EM i'm doing about 60-65.

I feel more chronically tired this year than last, and the actual time I'm in the hospital i'm working so i'm a lot more tired when I get home.

I think maybe if the EM shifts were 8 hours and I did more of them in the month it may be better than IM/surgery any of those, but with the 12 hour I'm just too tired at home to do anything besides sleep and then mix it up with nights and days and conference and presentations...its just tiring. but thats residency, every one of them gets you tired, right?

 

[JackBauERfan]

yeah i dont know why peopel think anesthesiology and rads is easy.. It seems like to me that they work pretty hard.

 

[Llenroc]

I dont know...I think EM looks great on paper, but if you're working a busy 12 hour shift (really more like 13), you get more days off during the month, but then again you are doing some nights and some days intermixed. In general they try to schedule blocks, but sometimes just not possible.

I did a year of medicine as my preliminary and was about 80 hours a week, in EM i'm doing about 60-65.

I feel more chronically tired this year than last, and the actual time I'm in the hospital i'm working so i'm a lot more tired when I get home.

I think maybe if the EM shifts were 8 hours and I did more of them in the month it may be better than IM/surgery any of those, but with the 12 hour I'm just too tired at home to do anything besides sleep and then mix it up with nights and days and conference and presentations...its just tiring. but thats residency, every one of them gets you tired, right?

From what I saw on my ER month:

Add 2 hours minimum for finishing paperwork/patient care to any shift, although most in the field seem to enthusiastically forget to count these hours.

Prepare to get royally screwed with lots of tedious class/presentations/cases/grand rounds etc. which all happen when you're not on duty.

Although there's no call, get ready to work a shift one night and then have to come in 8 hours after your shift officially ends (and more like 6 hours in reality) the next morning.

Oh yeah, there's no downtime on the job.

IMO, overrated as a lifestyle specialty in residency and as an attending.

 

[mdjobexchange]

Anesthesiology and Radiology residents work hard. No doubt about it. Not as hard as surgery, but nobody works as hard as they do.

Derm has the best hours as a resident and a great lifestyle afterwards. They do not make quite as much as radiology, but they don't have to take call either. How many dermatologic emergencies are there? None, except for maybe prom night when your rich client's daughter has a big zit.

I know a recruiter at one of the big health systems and he said there are 7 jobs for every graduating dermatology resident. They have done a good job of managing their numbers.

One misadventure to steer clear of is some of the primary care specialties. If you like primary care, then by all means, do it. But, if you are doing it because you think they work less hours, that can be a bad decision. Some primary care residencies do have decent hours, but many primary care docs work more hours after residency than they did during. It is really hard to make a living in primary care these days without putting in some serious hours.

Radiology, surgery, and anesthesia may have worse hours during residency, but can be much better afterwards, because you can work fewer hours and make decent money. Still, it is a hard decision. If you are going to have kids during residency, you don't want to miss out on the kids when they are small because they grow up fast.

 

[nitemagi]

Radiologists make twice as much as Dermatologists and ENT Surgeons.

Go for LIFESTYLE and $$$$.

Assuming the bubble doesn't break there.

 

[RockfordWF]

The reason Im asking is because Im doing the gen surgery rotation now and these people work 100+ hours(80 in their records) and are always tired and just overworked. The time they do spend at home is probably asleep. I really dont want to live my life like that.


So I was curious of what everyone thinks to be the specialties with the better lifestyles in residency. By that I mean Hrs/wk, workload, call ,ect. I know every residency program is different(even within certain specialties) but still theres got to be some generally easier residencies.

EM is max 60 hours a week. No-call on the EM months.

 

[nitemagi]

EM is max 60 hours a week. No-call on the EM months.

The difficulty and benefit of EM is that it's shiftwork. That's great if you don't mind having your circadian rhythm completely flipped every month (common at least). On the other hand, I remember an attending who loved it bcause she worked nights but then could be home in the morning to see her kids off to school and when they got home, and slept inbetween. She said it gave her the flexibility to be an available parent.

Hey Rockford-- you at UofI-R? I was born in that town.

 

[abefromann]

There is no residency like the derm residency. It's definitely not EASY (learning Andrews and dermpath takes at least three years), but the hours are sweet.

 

[Blade28]

There is no residency like the derm residency. It's definitely not EASY (learning Andrews and dermpath takes at least three years), but the hours are sweet.

Hardest part is getting in, right?

 

[secretwave101]

Saying the best lifestyle residency is Derm is like saying the car you should get is a Lamborgini. Sure, it's a great lifestyle...for most it isn't an option.

I have to put in a shout for family medicine. We only have a few rotations that really demand the full 80. Otherwise it's around 65 and sometimes less. Trumping ER is that those 65 are in daylight hours. With a night-float system, I'm only on call every other weekend...that's q14 call. Some months aren't even call months.

Not saying it's cushy, but it isn't bad, either. And I agree with the surgery stuff - they claim 80hpw but it isn't true. It's at least 90-100.

 

[MissAmanda]

how do ophtho and psych compare?

 

[cowme]

optho can have pretty long days and lots of call, depending on the program. Psych is far more cush.

 

[Law2Doc]

how do ophtho and psych compare?

When you revive a thread from 4 years ago please say you are doing so so people don't get confused.

Some of the hours/schedules probably have changed since this post started. I would suggest folks be careful about simply looking at hours because not all 24 hour shifts are equal. A 24 hour shift in radiology where you are reading a neverending flow of studies the whole time is going to be harder than a 24 hour psych shift where you are mostly minding the store and only have a couple of admissions.

Also the paths with prelim years probably got a lot less hour intense in terms of call now that interns can only do 16 hours in a row.

 

[DrJosephKim]

Don't forget to add that primary care physicians who are now working in a "concierge model" practice have some of the best work/life/reimbursement models compared to many specialists. The ethical debate regarding concierge medicine is another topic, but if you're mainly thinking about lifestyle and reimbursement, you may want to look into this. Most residency programs will not teach you about the world of concierge medicine.

 

[randomedstudent]

The reason Im asking is because Im doing the gen surgery rotation now and these people work 100+ hours(80 in their records) and are always tired and just overworked. The time they do spend at home is probably asleep. I really dont want to live my life like that.


So I was curious of what everyone thinks to be the specialties with the better lifestyles in residency. By that I mean Hrs/wk, workload, call ,ect. I know every residency program is different(even within certain specialties) but still theres got to be some generally easier residencies.

Personally I wouldn't base the decision on what to do for the rest of your life on the lifestyle during residency. This is a short period of time in the grand scheme of things. That said, sometimes residency can be indicative of lifestyle post-residency as well, but not always. There are some surgical subspecialties with good lifestyles so if this is something you like, you shouldn't rule it out. Also remember that the "80 hr" work week only applies to residents and not once you are out, there is also no such thing as "post-call" in the real world. So even if you have a cush residency, you may find yourself working harder in private practice.

 

[Law2Doc]

Personally I wouldn't base the decision on what to do for the rest of your life on the lifestyle during residency. This is a short period of time in the grand scheme of things. That said, sometimes residency can be indicative of lifestyle post-residency as well, but not always. There are some surgical subspecialties with good lifestyles so if this is something you like, you shouldn't rule it out. Also remember that the "80 hr" work week only applies to residents and not once you are out, there is also no such thing as "post-call" in the real world. So even if you have a cush residency, you may find yourself working harder in private practice.

As I suggested would happen when someone bumped this, you are responding to someone's 4 year old post. The dude you are quoting is probably close to the end of his training by now.

 

[voidlogin]

Why do people place so much emphasis on 3-5 yr residency rather than how you'll work for the next 30-40 yrs? Sure, in some fields like surg, you'll be working hard forever. But the derm I go to, who's a partner at the practice, works 60hr's/wk.
I'm doing an outpt FP clinic rotation now and the docs who own the clinic work 9-7 Mon-Sat (60hrs/wk). I think its safe to say, if you open up your own practice, you'll be working a lot.

 

[Sneezing]

When you revive a thread from 4 years ago please say you are doing so so people don't get confused.

Some of the hours/schedules probably have changed since this post started. I would suggest folks be careful about simply looking at hours because not all 24 hour shifts are equal. A 24 hour shift in radiology where you are reading a neverending flow of studies the whole time is going to be harder than a 24 hour psych shift where you are mostly minding the store and only have a couple of admissions.

Also the paths with prelim years probably got a lot less hour intense in terms of call now that interns can only do 16 hours in a row.

Whoa there! Psych shifts are not cake walk. People do not sleep at my institution and do admits and consults all night long. We've all stopped hoping to get sleep and just assume we'll be working all night. The same pressures that make radiologists read all night long are also forcing psychiatrists to admit/consult all night long, too.

 

[MagicalTrevor]

Holy Thread Resurrection, Batman!

 

[heyjack70]

psychiatry is probably the hardest specialty.

 

[Groove]

I think EM should be removed from that list as the raw hours are very misleading. I love what I do, but it's draining to say the least. You may work X hours a week on paper, as said earlier, but it's shift work, so you have a combination of nights and days and constant switching back and forth. If I'm on 5 nights and have 2 days off then 3 more days. That first day is spent sleeping, because it's not a true day off, it's my "night", then the next day is spent trying to adjust your body back to days, so you feel like a zombie. I don't consider them days off at all in cases like that, merely time to adjust to upcoming day shifts. 3 days off to me is really only 1-1.5 days off as far as leisure time. Also, yes we may not wear pagers, but I think EM work is the most stressful and difficult in the hospital. I'm much more drained after 12 hours in the ED compared to any of the 34 hour calls I had as an intern on any service. All that being said, we have lots of perks but "cushy" residency would not be one of them in my opinion, so be warned.

There probably is a lot of residency specific variability though. I interviewed at one program who I think only made their EM residents work 40/hr weeks because they wanted them reading and studying more. Personally, I wouldn't even want to be trained at a program like that. You learn by doing. The more time you are in the hospital or your specific clinical setting, the more you see and learn. Nobody said residency was supposed to be easy. You want to be well trained when you're finished.

 

[aequanimitas11]

As an ortho resident working 110 hours a week, this post makes me sick.

 

[Groove]

haha, I'll admit, ortho shouldn't even be in the same room as that list... I love our orthopod residents, they work like dogs and generally always have a good attitude (minus the oddball 1 or 2). Hey, when it's all over with, at least you'll be making 3x as much as the rest of us.

 

[toomuch]

I agree with the Occupational Medicine Residency comment. I do usually work between 35-40 hours a week sometimes less and may be more for 2 months of the whole residency. 80% of patients in practice are primary care orthopedics.

 

[DD214_DOC]

My last weekend psych call as an intern (24-hour call) I was able to watch 3 movies and take a nap. After about 4pm, I was in the ER doing evals until 2AM. It's really hit or miss. The good thing is that hesitation won't kill someone (unless your patient is trying to kill someone on the ward) and you have a lot of time to think about what you want to do. The only "stressful" thing about psych call is (a) tons of patients coming in all at the same time and the ER consulting for literally everything (b) an agitated and combative patient, which usually is just a matter of telling them to give him 5/2.

Rads call isn't easy. They have a near-constant flow of studies from the ER and occasional ASAP/STAT imaging from the wards to deal with. I've popped into their dark cave a few times while I was on call and it seems to just never end; I'm glad I don't do it.

FM/IM is terrible. You have your typical rotation duties with intermixed didactics and continuity clinic. Your term OB continuity patients could come in at any time, and guess who gets called in for first dibs on the delivery?

Surg is even more terrible. No explanation needed.

EM is terrible. The promises of, "no call" and "shift work" are very misleading. I was more exhausted on my EM rotation than I was on either med wards rotations. Nobody works a set shift for their entire career. Everyone does, "blocks" and rotates to shift from days to nights to days. You're constantly moving and there's no down time. I would literally fall asleep sitting in a chair while my wife was trying to talk to me.

Anesthesia: I don't know much about their residency.

 

[Doctor Bagel]

Pathology? They don't have to do general medicine rotations, and I can't see them doing a ton of call.

Derm -- internship can be hard because lots do prelim medicine years. I don't think they get consulted a ton at night, but we weren't that hesitant to call them from the ED.

Radiology -- call does seem pretty miserable for them. Most of the on-call radiologists I've talked to sound like they want to die. And most do a prelim medicine year.

Anesthesia -- I think most programs have a decent amount of call. And again, a prelim medicine year.

Psych -- really program and year dependent. At my program, there's practically no call 3rd and 4th year but lots of call 1st and 2nd year (well now 2nd year). Call is hit and miss, but it can be pretty stressful. At my last call, I had both a medically crashing pt on the ward, which is a hard thing to deal with because it makes our nurses uncomfortable and we can't get stuff done as quickly as they can on the medicine floors. Also, lots of mean, antisocial types come in late at night. I personally find it to be a fairly negative experience. At my medical school, call responsibilities were pretty minimal, and pts with any sort of medical stuff just weren't admitted to the psych ward.

EM -- if you like EM, this probably is a good bet. The program where I'm at has pretty minimal off-service rotations (they do less medicine than us in psych). They're also capped at 60 hours a week, and the program where I rotated at was pretty good at shifting schedules in a logical way to reduce sleep deprivation. Your hours at work are hard, though, because there seems to be no down time.

We all know surgery, FM, IM, peds and ob/gyn are hard.

So, hmm, path.

 

[Neuronix]

Most derm and rads residents do prelim med internships? That's odd, I'm in a cush TY and there's plenty of derm and rads people around. I don't know the hard numbers, but that TY vs. prelim med decision is really a personal choice.

 

[Doctor Bagel]

Most derm and rads residents do prelim med internships? That's odd, I'm in a cush TY and there's plenty of derm and rads people around. I don't know the hard numbers, but that TY vs. prelim med decision is really a personal choice.

I have no idea what the percentages are, but it seems like a lot who I know did prelim years. I'd opt for a transitional year, too, but those can be pretty competitive, right?

 

[cjw0918]

I'm a path attending and I would say path residency probably is the easiest residency in terms of absolute hours spent in the hospital. The no overnight in-house call is a big perk. Having said this, the amount and difficulty of the material you must learn is staggering. You need to spend a fair amount of time reading and studying. And as pointed out repeatedly in the path forums, the job market is very tight when training is done. Path boards are also hell. The field has its advantages, but it's definitely not for everyone.