stamina required of a practicing physician

[superfob]

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Hi,

I am in the process of deciding whether or not I should take the MCAT and apply for medical school (next year). I know this is the residents' forum, but I am looking for input from currently practicing physicians. My two current choices I am deciding between is medical school and graduate school for bioengineering.

Out of all careers/subject, I find medicine to be the most interesting. I have volunteered at hospitals, shadowed physicians, and researched on SDN - in terms of my knowledge and exposure to medicine (but I think this exposure is not enough for me to make a decision).

My biggest concern with going down the medical path is the stamina and energy that is required on the job. Growing up, I noticed that I generally have lower stamina/energy than my peers. I require more sleep and tired more easily, and have trouble staying up at night whereas most of my friends didn't seem to so sensitive to lack of rest. I feel like between engineering and medicine, medicine is more physically and mentally demanding. Doctors are required to work long hours, attend to patients in the middle of the night, walk or stand frequently, and are exposed to more immediate problems.

I am primarily worried about my own health since I've had experiences in which excessive stress/insufficient rest cause noticeable problems with my health. In other words, I seem to be quite sensitive to stress. While engineering can be stressful and require long hours, medicine seems to be even more demanding and restrictive on one's schedule. In terms of interest, I'd place medicine over bioengineering. In terms of stress and rest levels, I think I would prefer bioengineering.

I understand that there is a place in medicine for research, or for specialties that require fewer hours and less urgent situations. However, it seems like these specialties are difficult to enter and increasing demands are placed on physicians due to a lack of physicians relative to the population.

Thanks for any input.

 

[Phyozo]

I can speak from the perspective of a matched MS4. As you go through medical school, everyone finds that it's much harder than whatever it was they expected (unless you knew someone close who went through it). Everyone develops self-care and coping skills. The reality is that no one who is not in the field is really mentally and physically prepared for the grueling hours of studying / working. I'm sure I will discover this to be true in residency also, but to the next level. At every point, you learn how to adapt to the new expectations and you learn how to take better care of your own health both physically and mentally. I wouldn't let the fear of being unable to physically handle the job keep you from applying to the field, but I would say that no matter what you do, you will need to learn how to take care of yourself. Burnout, fatigue, depression, anxiety, and physical illness appear in every job no matter what you do so it's really about adaptation and investing in your own self-care so that you can always show up to work ready to give it your all.

 

[PMPMD]

Hi,

I am in the process of deciding whether or not I should take the MCAT and apply for medical school (next year). I know this is the residents' forum, but I am looking for input from currently practicing physicians. My two current choices I am deciding between is medical school and graduate school for bioengineering.

Out of all careers/subject, I find medicine to be the most interesting. I have volunteered at hospitals, shadowed physicians, and researched on SDN - in terms of my knowledge and exposure to medicine (but I think this exposure is not enough for me to make a decision).

My biggest concern with going down the medical path is the stamina and energy that is required on the job. Growing up, I noticed that I generally have lower stamina/energy than my peers. I require more sleep and tired more easily, and have trouble staying up at night whereas most of my friends didn't seem to so sensitive to lack of rest. I feel like between engineering and medicine, medicine is more physically and mentally demanding. Doctors are required to work long hours, attend to patients in the middle of the night, walk or stand frequently, and are exposed to more immediate problems.

I am primarily worried about my own health since I've had experiences in which excessive stress/insufficient rest cause noticeable problems with my health. In other words, I seem to be quite sensitive to stress. While engineering can be stressful and require long hours, medicine seems to be even more demanding and restrictive on one's schedule. In terms of interest, I'd place medicine over bioengineering. In terms of stress and rest levels, I think I would prefer bioengineering.

I understand that there is a place in medicine for research, or for specialties that require fewer hours and less urgent situations. However, it seems like these specialties are difficult to enter and increasing demands are placed on physicians due to a lack of physicians relative to the population.

Thanks for any input.

There are many specialties in medicine; not all of them require long hours, night call, or even standing. And not all of the "lifestyle" fields are ultra-competitive. There are more important differences between medicine and engineering than just hours and stress - which one would really make you happy over 30 years?

 

[O2Doc]

Residents are required to work long hours, attend to patients in the middle of the night, walk or stand frequently, and are exposed to more immediate problems. On some rotations.

Doctors can have a 9-5 job composed largely of sitting on their ass if they want to, depending on their specialty and practice setting.

 

[Law2Doc]

While I agree with Phyozo that most people do find med school and training harder than they expected going in, I don't share his/her conclusion that everybody adapts relatively well. OP, if you are, in fact, more sensitive to need of sleep and your health actually suffers from excessive stress, maybe this path isn't for you. I think a lot of people underestimate what they are capable of, but if you say your health deteriorates, that's going to be a real problem. You will be sleep deprived on this path. You will have overnight calls. You will potentially exceed 80 hours of work on a given week. You will have schedules where you are coming into work before the daylight several weeks in a row including weekends, and going home each night after the sun sets. And you will be under constant stress, because you will be making decisions that impact people's lives. Yes, there are fields which are more lifestyle friendly than others, but they aren't stress free, you still have to get through med school, and generally most of these fields require you to get through an intern year or residency complete with call first. if you aren't prepared to work hard, put in long hours, and find ways to manage stress without detrimental effect to your health this might not be the best profession for you.

 

[Law2Doc]

Residents are required to work long hours, attend to patients in the middle of the night, walk or stand frequently, and are exposed to more immediate problems. On some rotations.

Doctors can have a 9-5 job composed largely of sitting on their ass if they want to, depending on their specialty and practice setting.

First, you have to get through residency to become a doctor. If the OP is so sensitive to sleep deprivation and stress that he has "noticeable problems with his health", I'm not sure that residency, however brief, is a great idea. Second, the hours of doctors in most fields has gone steadily up with declines in reimbursements, and will be sure to increase further if we move to a universal coverage regime. In most fields, you are going to have to work your way up within a medical practice a lot if years before you are allowed to work 9-5 and sit on your ass as a senior partner. The younger guys in every practice take the lions share of the call. Plus there are no duty hour restrictions to protect attending level physicians, so most see their hours go up, not down, post residency.

 

[Dejavu]

I was an older Med Student since I had an earlier career as a Nurse/CRNA.

I was unprepared for the amount of work that med school and internship and residency demanded. I was in the Marine Corps for 4 years and I would rather spend four more years in the Corps than redo one year as an intern. To this day I like to sit and listen to it rain because I never heard it rain for a whole year that year.

If you are asking the questions you are asking, one has to wonder whether you have the deep interest and inner drive to push through all the long days and long sleepless nights to become a physician.

It is true, there are jobs that allow decent hours after becoming a physician, but you still have to get through the wilderness first. You would hate to arrive sick and beaten down, realizing it was a mistake for you to have done it all.

 

[O2Doc]

First, you have to get through residency to become a doctor. If the OP is so sensitive to sleep deprivation and stress that he has "noticeable problems with his health", I'm not sure that residency, however brief, is a great idea. Second, the hours of doctors in most fields has gone steadily up with declines in reimbursements, and will be sure to increase further if we move to a universal coverage regime. In most fields, you are going to have to work your way up within a medical practice a lot if years before you are allowed to work 9-5 and sit on your ass as a senior partner. The younger guys in every practice take the lions share of the call. Plus there are no duty hour restrictions to protect attending level physicians, so most see their hours go up, not down, post residency.

Of course, but since OP said:

I understand that there is a place in medicine for research, or for specialties that require fewer hours and less urgent situations. However, it seems like these specialties are difficult to enter and increasing demands are placed on physicians due to a lack of physicians relative to the population

It seemed they were talking beyond the rigors of residency and more about the stamina required for actual practice. After all, you also don't get those academic or other specialty positions without going through residency.

As for your second point: meh. It also depends on how much money you want to make. I have a friend in family practice (there's no night call in said practice) who chooses to work 3.5 days a week. She obviously makes significantly less than her full-time colleagues, but she likes her lifestyle and makes enough for her needs. As a military doc (Canuck) I also make significantly less than my civvie colleagues (seriously, significantly less, and we're not talking highly paid specialties. It's office-based family medicine), and hell, I don't even bother to up my income via civvie moonlighting. Again, enough for my needs.

 

[smq123]

Moving to pre-allo. The general residency forum is for issues of direct concern to current (and past) residents.

 

[hmockingbird]

Have you ever talked about how fatigue affects your health with your doctor? If so, he/she might be the best person to ask because they know you personally, and have also been through residency and obviously are practising medicine. Also, if you haven't, it might be a good idea just in case there's something else going on, like a sleep issue.

I had a research internship one summer in which about half was shadowing. Standing and walking all day was kind-of an adjustment (compared to college where I sit in class or at work all day haha) but I got used to it and felt more in shape from doing so much walking. I think on one level you will adjust to the level of physical activity. On another, if it's too much for you, it just might be. I don't mean this in a demeaning or offensive way at all (as exercise has been shown to help with fatigue) but maybe you could try getting more exercise daily and see how that affects your health. Obviously it's not going to match up and what I experienced was nowhere near intern year but it might give you an idea of how your body will be able to handle increased physical activity.

 

[superfob]

Thanks for all the replies, and sorry for posting this in the wrong forum.

Maybe the best course of action for me is to pursue bioengineering for now, and put medicine on the backburner until I'm sure I want to do it.

Personally, I have this idea that I'd be happier as a doctor 30 years from now, since by then I would be well established and earning a steady income without debt (hopefully). But until I live through those thirty years, both as a doctor and as an engineer, I don't really know.

It seems like MS3, residency, and the years following residency will be the most challenging in terms of workload and stress. After residency, I would not want to work fewer hours since that is the time when I'd want to pay back my med school loans. But later on, I would choose to work fewer hours and make less pay, if that option is available.

My current doctor says I am hypothyroid which is causing lower energy levels. Problem is, the medication I tried didn't seem to help that much, but we are going to try another type.

And exercise definitely helps with energy, but only for a couple hours after I exercise. I actually end up needing more sleep the days after I exercise 😴

 

[Joe the Plumber]

I was an older Med Student since I had an earlier career as a Nurse/CRNA.

I was unprepared for the amount of work that med school and internship and residency demanded. I was in the Marine Corps for 4 years and I would rather spend four more years in the Corps than redo one year as an intern. To this day I like to sit and listen to it rain because I never heard it rain for a whole year that year.

If you are asking the questions you are asking, one has to wonder whether you have the deep interest and inner drive to push through all the long days and long sleepless nights to become a physician.

It is true, there are jobs that allow decent hours after becoming a physician, but you still have to get through the wilderness first. You would hate to arrive sick and beaten down, realizing it was a mistake for you to have done it all.

I'd just like to mention that this is incredibly depressing.

 

[littlealex]

I came into medical school expecting it to be pretty tough and in hindsight I really don't think it was that bad. Sure, surgery was a tough 2 months but otherwise medical school wasn't so bad.
If you're willing to work hard and keep a positive attitude, you'll learn tons and you won't feel tired. It's not like you're building homes or shoveling dirt. It's a lot of standing around, doing fine manual labor stuff in surgery or writing notes in medicine.

You're probably not going to get to take afternoon naps, but I never had trouble. With the new work hour rules, there's maybe 20 days a year that I can't get 7 hours of sleep at night.

 

[Law2Doc]

I'd just like to mention that this is incredibly depressing.

But pretty darn true. Most of the time I have no clue whether it's warm or cold, or wet or dry out, except by the volume of patients being admitted.

 

[100YardDash]

Hi,

I am in the process of deciding whether or not I should take the MCAT and apply for medical school (next year). I know this is the residents' forum, but I am looking for input from currently practicing physicians. My two current choices I am deciding between is medical school and graduate school for bioengineering.

Out of all careers/subject, I find medicine to be the most interesting. I have volunteered at hospitals, shadowed physicians, and researched on SDN - in terms of my knowledge and exposure to medicine (but I think this exposure is not enough for me to make a decision).

My biggest concern with going down the medical path is the stamina and energy that is required on the job. Growing up, I noticed that I generally have lower stamina/energy than my peers. I require more sleep and tired more easily, and have trouble staying up at night whereas most of my friends didn't seem to so sensitive to lack of rest. I feel like between engineering and medicine, medicine is more physically and mentally demanding. Doctors are required to work long hours, attend to patients in the middle of the night, walk or stand frequently, and are exposed to more immediate problems.

I am primarily worried about my own health since I've had experiences in which excessive stress/insufficient rest cause noticeable problems with my health. In other words, I seem to be quite sensitive to stress. While engineering can be stressful and require long hours, medicine seems to be even more demanding and restrictive on one's schedule. In terms of interest, I'd place medicine over bioengineering. In terms of stress and rest levels, I think I would prefer bioengineering.

I understand that there is a place in medicine for research, or for specialties that require fewer hours and less urgent situations. However, it seems like these specialties are difficult to enter and increasing demands are placed on physicians due to a lack of physicians relative to the population.

Thanks for any input.

I am one month away from finishing med school so I can't speak of residency yet. this is just my opinion and everyone is different and I respect that. Yes, there were times when I was stressed.. thats normal man. I think that if you manage your time well, always keep up with your reading, and continue your hobbies outside of school (for me it was crossfit/running/surfing) you'll be fine throughout med school. Honestly, I thought medschool were some of my best most relaxing years. My only job was to wake up, go to school, get home and exercise, then read for 2-4 hours, rinse and repeat.. yes, the loans building up over the years do add stress but you'll be able to pay them back in time. This is just my 2 cents man. If you really want medicine, then i say go for it dude. Hope this helps

 

[ManBroDude]

OP: Are you fat? Do you take care of yourself or would you consider yourself more on the slob side?

Serious questions.

 

[ESzczesniak]

It's a wide spectrum. I'm an orthopaedic resident and in my field, you're concerns are quite valid. Spending 24 hours on call pulling on shoulders to reduce them, lifting legs to splint/cast, reductions, hours in the OR pounding in IM nails or screwing plates on...well it can actually be VERY physically demanding and mental fatigue certainly isn't non-exhistant.

On the other had, while I'm not a radiology, pathology, etc resident it would seem that a shift work day time oriented job where you can spend a long time sitting would be much different.

 

[maybemed2013]

Your situation seems similar to mines. I was considering engineering before... but I realize I don't have what it takes to succeed in engineering field.
But I decided to just buckle up and go MD but if that doesn't work CRNA is the plan.

 

[Joe the Plumber]

Question: Where do you guys get your shoes? Even shadowing for a day, my feet were KILLING me. The doc said he had to buy his first $100 pair of shoes while in residency (this was in the last '80s). Do you just go crazy and drop a few hundred to save your feet?

 

[superfob]

I am one month away from finishing med school so I can't speak of residency yet. this is just my opinion and everyone is different and I respect that. Yes, there were times when I was stressed.. thats normal man. I think that if you manage your time well, always keep up with your reading, and continue your hobbies outside of school (for me it was crossfit/running/surfing) you'll be fine throughout med school. Honestly, I thought medschool were some of my best most relaxing years. My only job was to wake up, go to school, get home and exercise, then read for 2-4 hours, rinse and repeat.. yes, the loans building up over the years do add stress but you'll be able to pay them back in time. This is just my 2 cents man. If you really want medicine, then i say go for it dude. Hope this helps

Hey, thanks for the couragement. Your schedule looks pretty good =) - like undergraduate but maybe less free time. I guess it is very important to manage my schedule correctly and choose a speciality that I can handle.

ESzczesniak - ortho sounds like a very demanding field. I heard a lot of former athletes go into that. But ya, I think certain specialities could be a lot more relaxing, at least after residency. I read "Hot Lights, Cold Steel", and don't think I could ever handle that amount of work/lack of sleep.

ManBroDude - I'm not fat, though I have put on weight recently. I've always taken good care of myself in terms of exercise and diet.

 

[ESzczesniak]

ESzczesniak - ortho sounds like a very demanding field. I heard a lot of former athletes go into that. But ya, I think certain specialities could be a lot more relaxing, at least after residency. I read "Hot Lights, Cold Steel", and don't think I could ever handle that amount of work/lack of sleep.

It can be, but I wouldn't trade it for anything...well maybe the $640 million lottery jackpot. Bottom line is that when you find what you love, it doesn't matter.

 

[Law2Doc]

I am one month away from finishing med school so I can't speak of residency yet. this is just my opinion and everyone is different and I respect that. Yes, there were times when I was stressed.. thats normal man. I think that if you manage your time well, always keep up with your reading, and continue your hobbies outside of school (for me it was crossfit/running/surfing) you'll be fine throughout med school. Honestly, I thought medschool were some of my best most relaxing years. My only job was to wake up, go to school, get home and exercise, then read for 2-4 hours, rinse and repeat.. yes, the loans building up over the years do add stress but you'll be able to pay them back in time. This is just my 2 cents man. If you really want medicine, then i say go for it dude. Hope this helps

Write back again after intern year, when you won't be having the time to exercise, decompress, etc. It's easy to say something is no biggie before you have worn those shoes.

 

[Law2Doc]

It's a wide spectrum. I'm an orthopaedic resident and in my field, you're concerns are quite valid. Spending 24 hours on call pulling on shoulders to reduce them, lifting legs to splint/cast, reductions, hours in the OR pounding in IM nails or screwing plates on...well it can actually be VERY physically demanding and mental fatigue certainly isn't non-exhistant.

On the other had, while I'm not a radiology, pathology, etc resident it would seem that a shift work day time oriented job where you can spend a long time sitting would be much different.

EM is the only shift work residency. Radiology certainly takes call, and unlike surgical specialties, where there is downtime between cases/consults the workflow in some of these other specialties is pretty continuous, and volume is high. So if you are on for 12 hours and you are under the gun for 12 hours, that's probably more stressful than if you are on for 24 hours, but with changes of pace, time to walk around, maybe nap. I'm not sure a call where you do 5 ortho cases is "harder" than a "sitting" specialty where you deal with 100 studies in terms of mental fatigue. Also radiology has a prelim intern year.

 

[45408]

I am one month away from finishing med school so I can't speak of residency yet. this is just my opinion and everyone is different and I respect that. Yes, there were times when I was stressed.. thats normal man. I think that if you manage your time well, always keep up with your reading, and continue your hobbies outside of school (for me it was crossfit/running/surfing) you'll be fine throughout med school. Honestly, I thought medschool were some of my best most relaxing years. My only job was to wake up, go to school, get home and exercise, then read for 2-4 hours, rinse and repeat.. yes, the loans building up over the years do add stress but you'll be able to pay them back in time. This is just my 2 cents man. If you really want medicine, then i say go for it dude. Hope this helps

It gets worse. A lot worse. It's still feasible, but I really have come to appreciate how much more time off you have in med school, now that I'm wrapping up my second year of surgery. Plus, people start having kids at the end of med school or in residency, so that adds an additional time sink. I would certainly have a lot more time now if I didn't have children.

 

[neusu]

I'm a neurosurgery resident: seriously considered not renewing the lease on my apartment and just getting a PO box for mail..

There are specialties for everyone. Look at PMR, Path, and psychiatry. Nice hours, nice to no call.