Specialties without rotating shift work

[drhesitant]

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What specialties have the most stable work schedules?

I have worked in acute care with rotating shifts, and I'd like to get a sense of specialties where physicians work mostly fixed day shifts. So, neurology, psychiatry, physiatry, would that be about right?

 

[mlw03]

many pathology positions are day shift type work, with little or no overnight call depending on the position. my specific subspecialty, forensic path, is virtually always regular daytime hours. of course pathology is quite different from other areas of medicine, and many folks find it interesting but don't want to practice medicine without seeing patients (a very respectable and understandable choice). that said, the position I'll be in after fellowship is literally an 8-5 type position, no nights, weekends, or call (however many offices do work one or two days of the weekend to prevent too many cases from building up).

 

[smq123]

Moving to allopathic.

 

[J ROD]

family med as long as you have someone that does hospital coverage.

 

[DrBowtie]

Anything that is primarily outpatient clinic will be 8-5 weekdays.

 

[drhesitant]

Moving to allopathic.

Thanks for moving the post. I didn't know in which forum to place my question.

 

[Law2Doc]

Anything that is primarily outpatient clinic will be 8-5 weekdays.

With a huge caveat -- for example the typical pediatrician may work 9-5 and then spend the evenings until 10pm returning calls to parents. Many of the family medicine guys have to go see various patients who have been admitted to the hospital before or after they finish their outpatient hours.

OP, Patients don't get sick only during business hours. So unless you are talking about something purely schedule-able (rad onc is a good example) or shift work like EM or hospitalists, plan on frequently open ended hours in medicine in most fields.

FWIW, My experience is that folks already focused on hours as premeds tend not to want to go into medicine in the end.

 

[nitemagi]

With a huge caveat -- for example the typical pediatrician may work 9-5 and then spend the evenings until 10pm returning calls to parents. Many of the family medicine guys have to go see various patients who have been admitted to the hospital before or after they finish their outpatient hours.

OP, Patients don't get sick only during business hours. So unless you are talking about something purely schedule-able (rad onc is a good example) or shift work like EM or hospitalists, plan on frequently open ended hours in medicine in most fields.

FWIW, My experience is that folks already focused on hours as premeds tend not to want to go into medicine in the end.

And no matter, you have to be willing to sacrifice your night schedule for 7+ years, regardless. You won't be able to limit your hours during some of med school or most of residency.

 

[drhesitant]

OP, Patients don't get sick only during business hours. So unless you are talking about something purely schedule-able (rad onc is a good example) or shift work like EM or hospitalists, plan on frequently open ended hours in medicine in most fields.

FWIW, My experience is that folks already focused on hours as premeds tend not to want to go into medicine in the end.

Thanks Law2Doc. I can see how this could be a problem. My issue, though, isn't so much the total number of hours or open-ended hours, it is the rotating shifts. I've done rotating shift work at a hospital for a considerable length of time, and I know how my body deals with it. How this factors into my career choices going forward only time will tell.

We were told at work that some people deal well with rotational shiftwork, and with others it doesn't agree as well. Some people just tolerate it better. It is not a matter of willpower.

I actually like shift work. It makes work more interesting. It helps to be smart about this, though. I can work rotating shifts when I need to, but I also know that some colleagues recover better than me, which is something to consider. Yes, there are the clinical years in med school, there's residency and then there's call of course, but there probably are a few specialties where day shifts dominate. Do correct me if I'm wrong.

Thanks for your thoughts.

 

[drhesitant]

And no matter, you have to be willing to sacrifice your night schedule for 7+ years, regardless. You won't be able to limit your hours during some of med school or most of residency.

Thanks. 7+ years would be okay, I think, just based on having done a few. It's 27 years that I'm wondering about. 🙂

 

[Law2Doc]

...

We were told at work that some people deal well with rotational shiftwork, and with others it doesn't agree as well. Some people just tolerate it better. It is not a matter of willpower.
....

Ah, but it is. Even if we accept your premise that some handle it better than others, (which seems reasonable, but I doubt anyone has done the study), you can still, within this framework, will yourself to your personal best. So someone who works best 9-5 can will themselves to accomplish as much working off shift even if that's not their ideal in terms of biorhythms.

 

[drhesitant]

Ah, but it is. Even if we accept your premise that some handle it better than others, (which seems reasonable, but I doubt anyone has done the study), you can still, within this framework, will yourself to your personal best. So someone who works best 9-5 can will themselves to accomplish as much working off shift even if that's not their ideal in terms of biorhythms.

Interesting points for discussion, debate, you name it! There is a sleep specialist on this forum somewhere, isn't there? If only we could get her/him to add his/her two cents! 🙂 Now I can't help but start googling shift work tolerance.

 

[MossPoh]

If willing to sacrifice money or live in certain areas, most specialties can be catered to your schedule, even surgery. My attending usually started around 7:45 a.m. on OR days and 9 on clinic days and was done by 4 or 5 p.m. He did have to go round on some patients 1 weekend every 6 weeks, but it was usually very limited. He never took ER call, which helped too. He made less money, but was able to do things he enjoyed more often.

Regardless of specialty you choose, there will be crappy nights and odd hours until you reach that goal.

 

[drhesitant]

Law2Doc, I actually went ahead and googled a little, and I found something to support both our points of view. There seems to be a considerable personality component and some genetic dispositions.

"Individual differences in tolerance to shift work--a systematic review" from Sleep Medicine Review, published last year. http://www.ncbi.nlm.nih.gov/pubmed/20851006

"Personality factors related to shift work tolerance in two- and three-shift workers"
Some of the same researchers here in Applied Ergonomics, also published 2011. http://www.sciencedirect.com/science/article/pii/S0003687010001936

Quoting the first paper, "Overall, the studies indicate that young age, male gender, low scores on morningness, high scores on flexibility and low scores on languidity, low scores on neuroticism, high scores on extraversion and internal locus of control and some genetic dispositions are related to higher shift work tolerance." Some of this made me laugh out loud, to be honest! But seriously, thanks, Law2Doc, for pushing me to think about this from a different perspective.

Importantly, it appears there's at least one variable in there that probably contributes to your being able to 'will yourself', as you put it, and one that I would think a person can work on, which is hardiness. (The Appl Erg paper defines this as "resilience to stressful life events.") I did another quick search for this too -- I love research, can anyone tell? -- and it brings up a number of interesting articles.

Mindfulness Meditation Will Make You Tougher Too
http://www.psychologytoday.com/blog...dfulness-meditation-will-make-you-tougher-too

Prayer, meditation, exercise, and special diets: behaviors of the hardy person with HIV/AIDS. http://www.ncbi.nlm.nih.gov/pubmed/8400157
(I wonder about causality here, though.)

So in conclusion, shift work tolerance has been researched, it is a complex issue, and tolerance is largely down to personality, with some genetic dispositions.

 

[IlDestriero]

You could find employment in anesthesia with no call and no weekends. Ambulatory surgery centers, office based practices, etc. We refer to them as mommy track jobs. They're usually employed positions, but you might be able to find an eat what you kill situation.