Things that contribute to good work-life balance:
- total numbers of hours expected per week
- quality of educational experience for worked hours
- distribution of call days / weekends worked throughout residency
- total number of sick, personal, or other leave days
- ease / flexibility in requesting leave / having it approved
- total salary
- health insurance
- geographic / regional opportunities to practice your preferred lifestyle (e.g. owning a home, hiking, skiing, sailing, climate, proximity to family). Does compensation make this feasible in that area?
- culture at the institution of being more scut-work, clinical work, shadowing, or more didactic heavy
- schedule availability (electives in PGY-4 only or earlier?)
- sole days dedicated to didactics or do you have one class every day for lunch?
- opportunities to moonlight
- moonlighting internal only, external only, or both
- competitive compensation for moonlighting
- moonlighting opportunities that are educationally/professionally meaningful experiences vs cash grabs
- is there 24 hour call, short call, night float, home call?
- is call all for one service or does the schedule rotate throughout the years among multiple settings, health systems, and schedules?
- does 4 residents mean Q4 24hr call, down to Q3 if a colleague is on extended leave?
- expectation for didactics on post-call days?
- does the program offer rotations in your preferred setting? Or will you need to work hard to get that PHP/IOP/ state hospital rotation?
- average length-of-stay for units
- cross-coverage requirements
- are clinical services using you to make megabucks for a system or do they focus more on teaching, supervision, and introspection?
- opportunities to rotate with residents from other programs or disciplines
- are residents unionized?
- how responsive is administration to resident concerns?
- work space for residents: dedicated, shared, take-what-you-can-get?
- availability of access to library time/space and librarians
- nursing ratios / shortages
- nursing administration culture
- working alongside mid-level, working under mid-levels, or not working with them at all
- medical students and whether the system makes them a burden, a benefit, or allows you to control your level of interactions with them
- emphasis on psychotherapy
- program motivation to assist you with access to psychoanalysis / will they work with you on a planned time limitation for rotations
- IM rotations for 4 months straight @80 hours a week?
- IM rotations include ICU?
- IM rotations include OP? UC?
- IM rotations include consult specialties?
- IM rotations at same site or different hospital system?
- Amount of dedicated exam leave
- realistic schedules for exam leave?
- university affiliated or not?
- mostly public or private?
- Medicaid? (Surprising number of residencies don't have Medicaid patients on their IP units or the OP clinics)
- mix of public and private, cash-pay, private insurance, and Medicaid?
- chief resident to PGY-4 ratio
- rates of fast-tracking to child or research
- dedicated research blocks? Or are you expected to publish but not given any time to work on actual research, thus increasing the number of hours per week?
- attrition / graduation rate
- reasons for the attrition rate
- length of parental leave, compensation during parental leave
- committee opportunities / requirements
- is there a fellowship in a specialty you are interested in? Are residents allowed to attend fellow didactics?
- does the hospital have a cafeteria (a surprising number do not)? If there is one, do you get a food stipend / funds? What's the food like at the cafeteria?
- will you be going through a metal detector every day / not allowed to bring in metal spoons?
- unit size, team size, censuses, division of labor
- training-level appropriate levels of supervision? Too much handholding? Not enough access to attendings when needed?
I'm sure there are plenty more. This was just off the top of my head and only a handful are related to wanting to work less.
Things that contribute to good work-life balance:
- total numbers of hours expected per week
- quality of educational experience for worked hours
- distribution of call days / weekends worked throughout residency
- total number of sick, personal, or other leave days
- ease / flexibility in requesting leave / having it approved
- total salary
- health insurance
- geographic / regional opportunities to practice your preferred lifestyle (e.g. owning a home, hiking, skiing, sailing, climate, proximity to family). Does compensation make this feasible in that area?
- culture at the institution of being more scut-work, clinical work, shadowing, or more didactic heavy
- schedule availability (electives in PGY-4 only or earlier?)
- sole days dedicated to didactics or do you have one class every day for lunch?
- opportunities to moonlight
- moonlighting internal only, external only, or both
- competitive compensation for moonlighting
- moonlighting opportunities that are educationally/professionally meaningful experiences vs cash grabs
- is there 24 hour call, short call, night float, home call?
- is call all for one service or does the schedule rotate throughout the years among multiple settings, health systems, and schedules?
- does 4 residents mean Q4 24hr call, down to Q3 if a colleague is on extended leave?
- expectation for didactics on post-call days?
- does the program offer rotations in your preferred setting? Or will you need to work hard to get that PHP/IOP/ state hospital rotation?
- average length-of-stay for units
- cross-coverage requirements
- are clinical services using you to make megabucks for a system or do they focus more on teaching, supervision, and introspection?
- opportunities to rotate with residents from other programs or disciplines
- are residents unionized?
- how responsive is administration to resident concerns?
- work space for residents: dedicated, shared, take-what-you-can-get?
- availability of access to library time/space and librarians
- nursing ratios / shortages
- nursing administration culture
- working alongside mid-level, working under mid-levels, or not working with them at all
- medical students and whether the system makes them a burden, a benefit, or allows you to control your level of interactions with them
- emphasis on psychotherapy
- program motivation to assist you with access to psychoanalysis / will they work with you on a planned time limitation for rotations
- IM rotations for 4 months straight @80 hours a week?
- IM rotations include ICU?
- IM rotations include OP? UC?
- IM rotations include consult specialties?
- IM rotations at same site or different hospital system?
- Amount of dedicated exam leave
- realistic schedules for exam leave?
- university affiliated or not?
- mostly public or private?
- Medicaid? (Surprising number of residencies don't have Medicaid patients on their IP units or the OP clinics)
- mix of public and private, cash-pay, private insurance, and Medicaid?
- chief resident to PGY-4 ratio
- rates of fast-tracking to child or research
- dedicated research blocks? Or are you expected to publish but not given any time to work on actual research, thus increasing the number of hours per week?
- attrition / graduation rate
- reasons for the attrition rate
- length of parental leave, compensation during parental leave
- committee opportunities / requirements
- is there a fellowship in a specialty you are interested in? Are residents allowed to attend fellow didactics?
- does the hospital have a cafeteria (a surprising number do not)? If there is one, do you get a food stipend / funds? What's the food like at the cafeteria?
- will you be going through a metal detector every day / not allowed to bring in metal spoons?
- unit size, team size, censuses, division of labor
- training-level appropriate levels of supervision? Too much handholding? Not enough access to attendings when needed?
I'm sure there are plenty more. This was just off the top of my head and only a handful are related to wanting to work less.