What Are EM Hours\Shifts Like?

[muffeoniv]

I would greatly appreciate any help you can give me with this question. I volunteer in the ER and want to become an emergency room doctor.

What would the typical month be like for an emergency room doctor? (shift length, days between shifts, number of night shifts ect.) I would greatly appreciate it if someone could give me an example of the typical month of an EM doctor. Thank you so much.

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[DrMom]

I'd recommend you look at the EM FAQ thread at the top of this forum.

 

[Daiphon]

Agree w/ Dr. Mom.

I'd also consider changing your vocabulary from "emergency room doctor" to "emergency physician" (or the dreaded "emergentologist" - I never did care for this one).

We EPs have made great strides over the last several decades in defining our specialty by our work and scope of practice, instead of the physical space in which we work.

One would never call a cardiologist a "cath lab doctor," or a radiologist a "dark room doctor," so why must "emergency room doctor" persist.

Sorry, just one of my bugaboos... to get to your original question, EM is a great field, and wouldn't change my choice for anything. Shift flexibility in terms of timing and scheduling are a huge bonus, but shouldn't be the major reason for going into EM.

Cheers!

 

[Apollyon]

One would never call a cardiologist a "cath lab doctor," or a radiologist a "dark room doctor," so why must "emergency room doctor" persist?

What about the "OR doc"? (A colleague back on the mainland called himself that, because he only took night and weekend call, and only came in to admit/operate. No clinic and no office during the week.)

 

[DrVanNostran]

I would greatly appreciate any help you can give me with this question. I volunteer in the ER and want to become an emergency room doctor.

What would the typical month be like for an emergency room doctor? (shift length, days between shifts, number of night shifts ect.) I would greatly appreciate it if someone could give me an example of the typical month of an EM doctor. Thank you so much.

Could we get some examples of a month of an attending. Yes I know this is variable, and yes I did go through the faqs.

 

[pratik7]

Could we get some examples of a month of an attending. Yes I know this is variable, and yes I did go through the faqs.

it is very variable...between 130-150 hours a month would be average. Depending on the volume and setup of the ED you may do 12 hours shifts around 3 times a week or 8-10 hours 4-5 times a week. There are a fair number of people that are independent contractors that may work out of a few different hospitals. You can be full time at a place and work a few extra shift at another hospital. It is want you want to make of it. Just remember the more you wanna make the more you gotta work

 

[med2UCC]

Could we get some examples of a month of an attending. Yes I know this is variable, and yes I did go through the faqs.

Well, in my shop the full time attendings work 16 eight hour shifts over the month. In theory these are grouped together as 3 or 4 days on (and at least 2 days in a row off) but sometimes this doesn't happen. In theory it also goes day (9-17:00), noon (12-20:00), evening (17-1:00) then night (20:00-06:00 - yes, I know that's not 8 hours, that's just how it works). However, due to the way the part timers are scheduled, most of whom are also holding down an office practice as family docs (this is Canada) it often works out to 2 nights in a row and no day shift. We also have one lad who's 70 and almost exclusively works days (9-17:00 at that).
Since I am new and do office practice, my schedule is too variable to comment on except to say that in general I do 8-12 shifts a month emerg (some 8 hour, some 10-14 hour; one site has an odd 10 hour day 14 hour night shift arrangement that in my opinion is crazy), 2 days a week in the office (I'm splitting practice with a doc who would like to retire if I would just commit to being there all the time) and 1/2 day a week in the OR assisting an orthopaedic surgeon that I really like. I also do occasional call for the OR (I was in last night until 1:30 assisting on a small bowel obstruction and a lap chole on a super necrotic gall bladder). Once the mortgage is paid off I will be working considerably less, and I am planning to take off more time in the summer to garden.
At one of the periferal sites the schedule is 12 twelve hour shifts a month, but some of them come to the regional hospital to work as well, so they work a bit of a mix. There are no full time ERP's at the other two periferal sites.
Have I muddied the waters enough? I could go on. Cheers,
M

 

[deleted109597]

120 hours per month is what is on my contract. Another one had 144.
You can always work more if you want.

You can only schedule request more than 5 days in a row off with director approval. It usually isn't hard to get that.

 

[spiderpete]

Well, in my shop the full time attendings work 16 eight hour shifts over the month. In theory these are grouped together as 3 or 4 days on (and at least 2 days in a row off) but sometimes this doesn't happen. In theory it also goes day (9-17:00), noon (12-20:00), evening (17-1:00) then night (20:00-06:00 - yes, I know that's not 8 hours, that's just how it works). However, due to the way the part timers are scheduled, most of whom are also holding down an office practice as family docs (this is Canada) it often works out to 2 nights in a row and no day shift. We also have one lad who's 70 and almost exclusively works days (9-17:00 at that).
Since I am new and do office practice, my schedule is too variable to comment on except to say that in general I do 8-12 shifts a month emerg (some 8 hour, some 10-14 hour; one site has an odd 10 hour day 14 hour night shift arrangement that in my opinion is crazy), 2 days a week in the office (I'm splitting practice with a doc who would like to retire if I would just commit to being there all the time) and 1/2 day a week in the OR assisting an orthopaedic surgeon that I really like. I also do occasional call for the OR (I was in last night until 1:30 assisting on a small bowel obstruction and a lap chole on a super necrotic gall bladder). Once the mortgage is paid off I will be working considerably less, and I am planning to take off more time in the summer to garden.
At one of the periferal sites the schedule is 12 twelve hour shifts a month, but some of them come to the regional hospital to work as well, so they work a bit of a mix. There are no full time ERP's at the other two periferal sites.
Have I muddied the waters enough? I could go on. Cheers,
M

This is very helpful. Those of us who ask these silly questions beg for the mundane. How is it, really?

Many thanks

 

[docB]

I work between 140 and 160 a month.

How is it really?

It's hard. I think the whole "EM is a lifestyle specialty" thing is a myth. We have some things better than other docs and some things worse. Our work is very intense and unpredictable. That is why most of us were attracted to it but I frequently wish I could turn it off. For example we can't schedule a meeting or lunch during a shift. Most other docs can make time for such during their day.

 

[med2UCC]

You also spend a certain amount of your down time checking up on people to make sure you didn't kill them or maim them or reduce their fracture so their hand is now on backwards (fortunately fairly impossible)(although reducing the ankle fracture where the foot was on backwards was fun, in a bone crunchingly icky kind of way). I have a certain confidence level in what I do but every now and then I have a bad week and spend a few hours making sure everyone I'm still worrying about is OK, whether that means checking with the orthopod I sent them to or scanning the chart or, very occasionally, calling them at home to make sure they are still alive (they think this is really awesome and a sign that I really care)(which I do, but which is sometimes an issue).
And very occasionally you spend your down time having really gruesome nightmares about something you saw that day/week/month, or shopping for cheap clothes to replace the ones you had to throw out (that's mostly a skin glue issue, really, for those of you who had more exciting things on your mind - it doesn't come out of cloth at all). Then again, when I worked in child care I had these issues as well, and at least EM pays well enough that I can afford to replace the clothes, and go talk to someone about the nightmares if I need to.
It's not all sunshine and roses.
Cheers,
M
Oh dear, I do babble on when I am so very tired.

 

[Birdstrike]

.

 

[taylormade2006]

A place I shadowed at had these shifts: 6a-2p, 8a-4p, 2p-10p, 4p-12a, 7p-3a, 12a-8a

I think that is all of them, but I may have missed a few. I'm not sure how many shifts/week or month they did.

 

[pinipig523]

It's busy and stressful. It's a tough job but someone's gotta do it.

 

[spiderpete]

I couldn't agree more. There's a reason that most EM physicians avoid working more than 140-150 hours per month and try to get out of full-time EM by age 50.

I am an in-coming M1 this August and have a very strong interest in EM...and I am 48. My plan, which I expect will change with time and experience, is to work in an urban/academic environment for several years, say until I am 60. Then I would probably move to a rural area. I have a couple things working in my favor in that I am physically fit and I am free of the financial burdens of most students and new docs. The physical demands of shift work is what concerns me most. But I wonder, will I even have the chance to try?

Is it realistic to start in EM at 53? Other things being equal (grades, scores, lor, interviews), will even be able to get a residency?

 

[Birdstrike]

.

 

[spiderpete]

Will you be able to get a residency spot? I don't see why not. I can assure you of this, however: if you become an EM doc at the age of 53, you'll have one great advantage over all the other 53 year old EM docs: you'll be bright eyed, bushy-tailed and ready to go from not having been an ER doctor for the past 25 years.

Thats me! BEBT

 

[2662]

The "Big Lie" of EM , by Birdstrike

Nice write up there, Birdstrike.

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I'm 53 now, and three years-ago I reduced my schedule from ~160 hours per month in the ED to ~130. Two years from now I will quit the ED and live off my savings (and those over 55 discounts ). I've always worked in large, busy, big city EDs-- it was a great ride, but it was more rewarding "back then".

 

[deleted65604]

We EPs have made great strides over the last several decades in defining our specialty by our work and scope of practice, instead of the physical space in which we work.

The other abreviations have been taken...

EP's=Electrophysiologists
ED=Erectile Dysfunction

ER doctor= commonly known entity in the public and in medicine defining a doctor who in fact, works in the ER.

ER Doctor= 4 syllables
Emergency Physician= 7 syllables

There is a well known show called "ER" that has been watched by millions of people.

"We are not a room, we are a department." This statement is my pet peeve. It is asinine. Have you ever heard a surgeon say, "I'm taking this patient to the operating department!" No, they gladly admit to taking patients to the "OR". Throwing a fit over what somebody calls you smacks of insecurity and is more than a little juvenile.

One would never call a cardiologist a "cath lab doctor," or a radiologist a "dark room doctor," so why must "emergency room doctor" persist.

Yet, hospitalists gladly label themselves as such and don't go around demanding that we refer to them as "Internal Medicine Physicians who Specialize in Treating Inpatients" Can you imagine a hospitalist correcting you and insisting on you referring to them as IMPSITIs?

I for one, am more than glad to refer to myself as an ER Doctor. The more I demand stupid labels, in an attempt to get more respect, the less respect I will get.

 

[Slechts1Leven]

For private groups and public hospital, is it possie to work 4 hrs 7 days a week. I would not like 8-12 shifts, is it mandated that you have to work a certain number a day? I just prefer shorter shifts

 

[RustedFox]

For private groups and public hospital, is it possie to work 4 hrs 7 days a week. I would not like 8-12 shifts, is it mandated that you have to work a certain number a day? I just prefer shorter shifts

No.

 

[gman33]

For private groups and public hospital, is it possie to work 4 hrs 7 days a week. I would not like 8-12 shifts, is it mandated that you have to work a certain number a day? I just prefer shorter shifts

It is very rare to have a shift less than 8 hours.
I have heard of some overnight shifts of 6 hours.
As in midnight to 6 AM or something similar.
Again, this is very rare.

Besides the obvious scheduling issues, it is difficult to fully workup and dispo a lot of patients with shorter shifts. This means more signouts on both ends.
Not a good thing.

 

[TooMuchResearch]

For private groups and public hospital, is it possie to work 4 hrs 7 days a week. I would not like 8-12 shifts, is it mandated that you have to work a certain number a day? I just prefer shorter shifts

No.

 

[RustedFox]

No.

Yeah. No.

 

[SleepyMeerkat]

So...no?

 

[catalysts]

Nah.

 

[Apollyon]

For private groups and public hospital, is it possie to work 4 hrs 7 days a week. I would not like 8-12 shifts, is it mandated that you have to work a certain number a day? I just prefer shorter shifts

By your NOT use of the word "possible", but "possie", I suspect you to be young. Would I be correct?

By extension, this topic is probably not relevant to you, nor will be for many years to come.

 

[MSUSpartan642]

For private groups and public hospital, is it possie to work 4 hrs 7 days a week. I would not like 8-12 shifts, is it mandated that you have to work a certain number a day? I just prefer shorter shifts

I don't want to say you won't ever find this type of set up. But I highly doubt you will.

 

[TooMuchResearch]

Yeah. No.

Heh, I was replying on my phone and didn't see your response. I think you answered the question beyond sufficiently.

 

[The White Coat Investor]

For private groups and public hospital, is it possie to work 4 hrs 7 days a week. I would not like 8-12 shifts, is it mandated that you have to work a certain number a day? I just prefer shorter shifts

I worked at a place once that had a 4 hour princess shift M-F 8-12. The other shifts were 12 hour shifts. I certainly wouldn't count on ever having shifts shorter than 8 hours. Most are 8-12.

The shift number is far easier to adjust however, and you could easily be a prn or part-time emergency doc, especially as an independent contractor moonlighter. Don't count on great pay, benefits, a great location, or job security however if you want to start your career like that. And keep in mind that 8-12 is on the low side for most docs out of residency. While I have a pretty lifestyle oriented group, and many partners who are only working 6-12 shifts, all of the guys/gals within 10 years of residency are in the 13-17 range. Student loans, mortgages, retirement savings etc don't just magically appear when you're only working 50 hours a month.

 

[The White Coat Investor]

I work between 140 and 160 a month.



I think the whole "EM is a lifestyle specialty" thing is a myth.

Maybe it seems a myth to you because you're not doing it right. You can't see the disconnect between your two sentences?

Think of it this way. The average worker does 40 hours a week, for four weeks a month. Perhaps add 8 more hours for a 30-31 day month. So, 168 hours a month, right? Okay, but he also gets a bunch of holidays, let's say 12 days a year or so. And he gets 4 weeks vacation, so another 20 days. Plus, he gets to use workdays to go to an educational conference or two a year. Let's call that 6 more days. Subtract those 38 days out,, and that works out to be about 26 hours a month, so he's down to 142 hours. Okay, now you lose a couple of days a month to flip flopping back and forth from nights to days and days to nights. I mean, if you go to work from 10p-6a, which of those two days did you really have off? I'd argue neither. So that's good for another 16 hours a month. Now our average worker is down to 126 hours. But wait, he gets lunch and coffee breaks and chatting at the cooler. Let's call that another hour per work day. Now we're down to 105 hours. Yet you're working 35-55 MORE hours per month than the average worker and wondering why your lifestyle sucks? That's because full-time for EM is about 120 hours a month. You're working an extra week+ every month. Try working twelve 8s and it'll feel a lot more like a lifestyle specialty I assure you. Seriously. 160 hours on shift in an ED is a ton.