What hours do attendings work?

[BaylorDDS]

I am wondering what hours attendings (specifically ortho surgeons & internists) work per week? I am aware it is 60ish, but does that include call? and when are the hours they are working, is it mainly 6am-8pm, or is it weekends, nights, everything?

I am trying to get a sense of what type of life these specialties lead. Mainly when do they work the hours they work? and what is up with the call schedule.

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[Dirt]

I am wondering what hours attendings (specifically ortho surgeons & internists) work per week? I am aware it is 60ish, but does that include call? and when are the hours they are working, is it mainly 6am-8pm, or is it weekends, nights, everything?

I am trying to get a sense of what type of life these specialties lead. Mainly when do they work the hours they work? and what is up with the call schedule.

simple answer...it varies.

 

[WDeagle]

Yea there is alot of variance. However, both residencies are known to be pretty brutal. As for ortho attendings its probably hard to avoid being on call even in big group practices. Alot of orthopedic problems are emergencies. Internists have alot of variance among different sub-specialties. Hard to avoid call as a cardiologist, GI, or pulmonologist/CC.

 

[SouthernSurgeon]

I am wondering what hours attendings (specifically ortho surgeons & internists) work per week? I am aware it is 60ish, but does that include call? and when are the hours they are working, is it mainly 6am-8pm, or is it weekends, nights, everything?

I am trying to get a sense of what type of life these specialties lead. Mainly when do they work the hours they work? and what is up with the call schedule.

Agree with above that it varies; but I would point out that in a number of fields, life as a junior attending is worse than life as a resident - with the advent of the 80 hr work week, a lot of work extra work falls to the junior attendings (esp in surgery). I know one young attending who said she routinely put in 100 hr weeks her first year out of fellowship, and she didn't exactly get the most glorious of cases either (since it takes time to build a decent practice and she had to take what she could get)

 

[Habeed]

This comes over and over again. What I don't get is this :

So you're right out of fellowship/residency. You are now (finally!) the Big Cheese. Your skills are suddenly worth hundreds and hundreds of thousands of dollars per year. Doing just one operation can pay several grand.

So, I can't see why you don't have the leverage to say "no".

Say "Until I recover from residency, I'm doing no more than 100 hours per month. Pay me accordingly, take it or leave it."

If there's really a shortage of doctors, especially specialists, why could you not negotiate something like this?

I'd rather make $100k per year and be able to enjoy some of that money than $350k at 100 hours/week.

The only thing that I can think of is maybe malpractice insurance costs the same no matter if you work 4000 hours per year or 1200.

 

[thechad]

So, I can't see why you don't have the leverage to say "no".

Say "Until I recover from residency, I'm doing no more than 100 hours per month. Pay me accordingly, take it or leave it."

If there's really a shortage of doctors, especially specialists, why could you not negotiate something like this?

I think a lot of primary care docs would argue that this is part of the problem with our health care system.

 

[Habeed]

I think a lot of primary care docs would argue that this is part of the problem with our health care system.

I guess you're saying that the system should be set up to make everyone work 80+ hours a week from day 1 of intern year til the day you retire or die. Even if there weren't a shortage of doctors, someone should be able to work fewer hours and get paid more or less proportionally.

 

[BigRedBeta]

You're forgetting the massive amount of debt that the majority of us will be carrying. Most people defer their loans throughout residency too, just allowing them to accumulate interest...even if you don't, if you're in a surgical specialty or go through fellowship, you're left with only a few years of earning a high salary to make a dent in those or to refinance. Throw in the fact that most people in their late 20's and early 30's are making a lot of big purchases for the first time (eg, engagement rings/weddings, first homes, etc), and the financial pressures are immense.

Further, I think your biggest logical flaw is the idea that any established practices are looking for people who are going to slack off. That's not how the contracts are offered, and if you aren't going to take the deal, there's someone behind you who will - especially in the large metro areas. If the practices are prepared to offer you a significant base salary with a portion of billable hours (the group practices I'm aware of usually combine the gross collected income generated by the practice then pay out overhead costs and salary, and the remainder is then payed out to the physicians based on their overall % of billable fees), then they feel they have the patient volume to support someone who is going to work long hours...if you're just going to work 40 hours a week, you're not going to be making a significant impact on their volume.

 

[BaylorDDS]

I still would like to know what hours attendings in an surgical specialty work. Please don't give me vague "it varies" answers. I am aware, I just want an idea of what hours attendings work. So any specific or general examples are great.

For attendings in surgical specialties, what hours do they work? (like 6am-7pm M-F, weekends??) that sort of info. Don't tell me well if your in plastics or in some groups... I would like to know about the attendings you know or know of, or if you can generalize thats great too.

Thanks a lot, I'm really struggling trying to find this information as it could impact my career choice.

 

[Habeed]

Sigh. So there really is no 'promised land'? After 4-7 years of working your butt of 80+ hours a week for about $10 an hour, you finally make it. No more scut, no more tests, you're finally The Man (or woman).

And you're telling me that in practice, you can't enjoy a year or two of light duties before you really try to make the big bucks.

 

[WDeagle]

I still would like to know what hours attendings in an surgical specialty work. Please don't give me vague "it varies" answers. I am aware, I just want an idea of what hours attendings work. So any specific or general examples are great.

For attendings in surgical specialties, what hours do they work? (like 6am-7pm M-F, weekends??) that sort of info. Don't tell me well if your in plastics or in some groups... I would like to know about the attendings you know or know of, or if you can generalize thats great too.

Thanks a lot, I'm really struggling trying to find this information as it could impact my career choice.

Dude shadow a surgeon. But since you need a general answer, surgeons work their A** off. If your concerned with lifestyle, go with the DDS. If you cant see yourself doing anything else in life besides surgery regardless of lifestyle, go to med school. Example of an attendings day: 1st surgery of the day starts at 5am and the day ends with rounding around 5 or 6.

 

[SouthernSurgeon]

1st surgery of the day starts at 5am

Where is this happening? OR ancillary staff are still nicely tucked in at 5am (as are the anesthesiologists). First starts are usually more like 7:30-8am; 5 am would be pretty crazy.

 

[mercaptovizadeh]

Dude shadow a surgeon. But since you need a general answer, surgeons work their A** off. If your concerned with lifestyle, go with the DDS. If you cant see yourself doing anything else in life besides surgery regardless of lifestyle, go to med school. Example of an attendings day: 1st surgery of the day starts at 5am and the day ends with rounding around 5 or 6.

This kind of bizzarre schedule seems to be confined to the US. I spoke to an anesthesiologist from China and she said that the first surgery of the day was at 8:30 or 9:00, and she worked at a major hospital in Beijing.

 

[Dr. McDreamy]

If you want a good lifestyle in surgery, you have to do something like Plastics which is hella competitive to get into. You basically have to be superman/woman to match into it.

The General surgeons I worked with in med school often were there from about 7 am till 6 or 7 pm every week day. If any of their patients had a complication on the weekend, guess who was there to fix it? The general surgeon. There is no light at the end of the tunnel, and that's why I decided not to do surgery.

Of course if you do a surgical subspecialty you can have a little more control over your life. But "a little" is the operative word. To have maximum control, you must be in a specialty which allows you to comprise your practicce of mainly simple surgeries which do not have high complication rates, and are preferably elective so you actually get paid.

 

[Instatewaiter]

Dude shadow a surgeon. But since you need a general answer, surgeons work their A** off. If your concerned with lifestyle, go with the DDS. If you cant see yourself doing anything else in life besides surgery regardless of lifestyle, go to med school. Example of an attendings day: 1st surgery of the day starts at 5am and the day ends with rounding around 5 or 6.

Like southern IM said, first start isnt usually that early. Where I am it is 730. That means that you round on the current in-patients at 630a so you have to get there somewhere between 5 and 6am.

If you want a good lifestyle in surgery, you have to do something like Plastics which is hella competitive to get into. You basically have to be superman/woman to match into it.

The General surgeons I worked with in med school often were there from about 7 am till 6 or 7 pm every week day. If any of their patients had a complication on the weekend, guess who was there to fix it? The general surgeon. There is no light at the end of the tunnel, and that's why I decided not to do surgery.

Of course if you do a surgical subspecialty you can have a little more control over your life. But "a little" is the operative word. To have maximum control, you must be in a specialty which allows you to comprise your practicce of mainly simple surgeries which do not have high complication rates, and are preferably elective so you actually get paid.

Even some of the subspecialties have bad hours. Plastics is a good example. If you are in a major academic setting where the plastics team does all the flaps, reconstructions etc they may be there until quite late. While I was on surgery, I would guess they were there until at least 6 every night and there were a few times when they would have marathon cases that lasted until midnight. Out in the community it is a bit different than the academic centers where more cases are elective, cosmetic cases. McDreamy is right, to have good hours you need to be in a subspecialty in the community where you have more control of your hours.

From what I saw, the hours worked by the attendings were not drastically different from the residents in surgery. They were still working about 80 hours a week. While I think Surg would be interesting, that is a lifestyle that I just dont want to deal with.

 

[WDeagle]

Like southern IM said, first start isnt usually that early. Where I am it is 730. That means that you round on the current in-patients at 630a so you have to get there somewhere between 5 and 6am. quote]

Yea this is more accurate. Sorry, it was late and i was distracted when i wrote that post. Surgeons are more likely to get to the hospital around 5 or 6 depending on how much rounding they have to do. Although, i know a few surgeons that that will do outpatient surgeries at 5 or so. I guess they can do this because they control their ancillary staff. Either way surgery=hard.

 

[Law2Doc]

Sigh. So there really is no 'promised land'? After 4-7 years of working your butt of 80+ hours a week for about $10 an hour, you finally make it. No more scut, no more tests, you're finally The Man (or woman).

And you're telling me that in practice, you can't enjoy a year or two of light duties before you really try to make the big bucks.

No promised land. In fact, once the 80 hour work week requirement was implemented, most fellows and younger attendings in surgical fields saw their hours jump, because somebody has to make up those lost hours. So you often see young surgeons leave the 80 hour work week and start as a new attending working 100 hours/week. The light at the end of this tunnel is often a train. You don't want to get your hopes up for cushy hours anytime soon on this path. You only get them in certain fields, or if you work in certain practices.

And yes, medicine in the US is an early morning profession. Most specialties working in hospitals start 7ish, which means anyone who has to round/pre-round will be starting an hour earlier. And surgeons are notorious for starting their day at 4:30-5:30ish.

 

[meister]

And surgeons are notorious for starting their day at 4:30-5:30ish.

An attending at my school told our class she gets up every day at 4am, swims 2-3 km in the pool at her gym, and gets to the hospital by 530am-6am. She was BY FAR the most type A anal retentive person I've ever met in my life.

 

[Dirt]

You guys are scaring everyone.

While I don't know tons about surgery since it's not where I am headed, it sounds like you are talking about academics almost exclusively. Don't know if non-academic surgeons work so hard.

As for everything else, I know many docs in multiple fields (int. med, neuro, heme/onc, GI etc) that are in private practice and work mon-fri 8-5 with a half day once a week or something.

So I stand by my first answer, it varies.

 

[niranjan162]

You guys are scaring everyone.

While I don't know tons about surgery since it's not where I am headed, it sounds like you are talking about academics almost exclusively. Don't know if non-academic surgeons work so hard.

As for everything else, I know many docs in multiple fields (int. med, neuro, heme/onc, GI etc) that are in private practice and work mon-fri 8-5 with a half day once a week or something.

So I stand by my first answer, it varies.

theyre not scaring people. My dad's a surgeon he works a ton of hours. 70+ per week, at his old job he used to work more ( as an attending non academic).

To the OP if lifestyle is a factor surgery is probably not best for you.

According to him the light is indeed a train.

 

[astrocreep96]

The cardiac electrophysiologist (for an IM perspective) I shadowed some time ago started his days at 7 and his case load varied quite a bit in the cath lab. Some days he'd be done at 2 or 3PM and have the rest of the day off if each case just fell together, but other days, when the cases were more difficult, he might be there until 10PM. I'm not sure how his non cath lab days worked out, each time I came wasn't purely cath lab or clinic.

On the other hand, I researched with an ortho surgeon last Summer (senior attending with big time academic responsibilities), and it seemed he had a relatively decent schedule. I got the impression he was working his ass off when he was in the office, though. He was private practice, plus at the hospital, and he showed up at 7am everday. I'm not sure exactly when he left, but he seemed to not stay after 6pm or so. But he really hit the ground running when he got to work, it was a sprint to keep up with him (literally, sometimes). He also had call everyone third weekend, I think.

 

[brentb23]

d

 

[ZagDoc]

This comes over and over again. What I don't get is this :

So you're right out of fellowship/residency. You are now (finally!) the Big Cheese. Your skills are suddenly worth hundreds and hundreds of thousands of dollars per year. Doing just one operation can pay several grand.

So, I can't see why you don't have the leverage to say "no".

Say "Until I recover from residency, I'm doing no more than 100 hours per month. Pay me accordingly, take it or leave it."

If there's really a shortage of doctors, especially specialists, why could you not negotiate something like this?

I'd rather make $100k per year and be able to enjoy some of that money than $350k at 100 hours/week.

The only thing that I can think of is maybe malpractice insurance costs the same no matter if you work 4000 hours per year or 1200.

The problem is that as a young attending, you have no patient base. You establish your patient base by playing nice with other physicians and getting referrals. I can tell you that the quick route to not getting ANY referrals is to take the attitude you stated. You have to play nice, especially early on in your career, which, as sad as it sounds, means more of being a "yes man." You need to make your reputation as a hard worker, you need to gain a reputation of having good relationships with patients, you have to make the reputation of being willing to take on the cr*p cases. Without your reputation, you are nothing once you are on your own, and a quick way to get a poor reputation is by saying "no." It's part of the tradition of medicine, every other physician had to go through it, so so do you. Even if you don't end up working 100+ hours (there's those that do but I've encountered plenty who don't), by stating "I won't go over 100 'cause I do wanna. *stamps feet*" will be seen as an unwillingness to do what is necessary.

There ARE places you can begin to put your foot down as an attending. You have more of an ability to barter when it comes to call schedule, there is some picking and choosing you can do with your cases/patients, you choose how aggressively you want to pursue reimbursement from the insurance companies, etc. But your ability to stand up for yourself and have others honor your wishes is once again due to your... reputation.

Could you find a job SOMEWHERE with the stipulations you stated? Probably, but I guarantee you it wouldn't be in a city or at a hospital you would enjoy living at. And the time you spent "recovering" from residency would be vital time lost growing your practice into the size necessary to maintain sustainability.

 

[SouthernSurgeon]

While I don't know tons about surgery since it's not where I am headed, it sounds like you are talking about academics almost exclusively. Don't know if non-academic surgeons work so hard.

That's definitely true, as most of us are just not very familiar with the private practice world.

But the service I just finished had both a junior attending who was leaving for private practice at the end of the year, and a senior resident who was applying for private practice jobs - the hours/responsibilities they were talking about weren't any better than academics (though the pay sounded better!)

 

[Narmerguy]

I would too if I were in a communist country making as much as the local baker.

Wow you're stupid.

 

[NonTradMed]

I would too if I were in a communist country making as much as the local baker.

China? Communist? Where have you been living in the last 30 years? Chinese surgeons in China, especially in top hospitals makes a TON of money.

China hasn't had socialized medicine for decades. In fact, they barely fund their public hospitals as it is. My parents had to pay in cash for my grandfather's heart surgery because there were no government health care for retirees whose pensions and healthcare money were siphoned off by corrupt officials.

Private hospitals are the new thing in China. My mom's friend's daughter works in one as a pediatrician. Not bad, 9-4pm.

Of course, much of Chinese doctors, especially surgeon's income still comes from bribes and gifts but that's because there's s such a shortage of surgeons and reputable doctors that people have to give cash in order to get a number.

A family friend in Beijing had to have prostate surgery and managed to get a reputable surgeon. When he suffered complications after surgery, he couldn't even get in for an appointment for post-surgery checkup with the surgeon b/c the surgeon had so many people clamoring for him (and possibly the gift money wasn't big enough). Oh yeah, malpractice is really rare in China. Chinese doctors don't make more than the average highly skilled professional, but surgeons can make a killing. And most it is because of good ol' capitalism.

 

[PeepshowJohnny]

The orthos are my place are INFAMOUS for their early starts. They have that whole "Wake up at 4:00, run for an hour, quick rounds, into the OR at 6:30" culture.

 

[Habeed]

The orthos are my place are INFAMOUS for their early starts. They have that whole "Wake up at 4:00, run for an hour, quick rounds, into the OR at 6:30" culture.

So when do they ever get to enjoy their $400,000 per year average salaries and their high social status? That kind of lifestyle is no different than a resident, except that they get more choice about cases...

I'm not saying they should sit around all day and count their money, but money is just a number on a computer screen if you don't spend it.

 

[Gibbles]

This comes over and over again. What I don't get is this :

So you're right out of fellowship/residency. You are now (finally!) the Big Cheese. Your skills are suddenly worth hundreds and hundreds of thousands of dollars per year. Doing just one operation can pay several grand.

So, I can't see why you don't have the leverage to say "no".

Say "Until I recover from residency, I'm doing no more than 100 hours per month. Pay me accordingly, take it or leave it."

If there's really a shortage of doctors, especially specialists, why could you not negotiate something like this?

I'd rather make $100k per year and be able to enjoy some of that money than $350k at 100 hours/week.

The only thing that I can think of is maybe malpractice insurance costs the same no matter if you work 4000 hours per year or 1200.

Thinking that as a physician that you will at any point in your career wield this much power is incredibly foolish.

It doesn't matter what your specialty is, to any given hospital you're an expendable commodity. They want your services and will do anything to get them, but you're never untouchable in medicine.

If you are not willing to do the work, take the call, and see your patients, hospitals will do something really funny. They'll just not hire you, refuse to hire anyone else in that specialty that doesn't agree with their terms, and ship your patients and their needs to the lowest bidder in a different city or different part of the city.

 

[Law2Doc]

So when do they ever get to enjoy their $400,000 per year average salaries and their high social status? That kind of lifestyle is no different than a resident, except that they get more choice about cases...

I'm not saying they should sit around all day and count their money, but money is just a number on a computer screen if you don't spend it.

Depends what you mean by "enjoy". The Benz drives just as well at 4:00 am.

Most people don't go into surgical fields for the money. If there was ever a path that is way way way too much work and too many hours for the amount you earn, this is it. When you are working twice as many hours as most folks, earning several hundred grand AFTER a decade or so of training, that really isn't very impressive. So you only do it if you get a thrill doing the job. If you like to cut, like to hammer, work with your hands, fix things, then you go this route. If it's about $400k and social status, sorry you just don't. The same is generally true about most medical specialties, but surgery is even more obviously a bonehead play if you do it for the money because the path is so much longer and because the hours are worse. So nobody does this, and anyone who says they do is lying or demented. In fact, if you talk to surgeons, they tend to be most vocal about there being so many better ways to earn more money; most don't recommend their path to others unless you really really can't picture yourself doing anything else, and are willing to devote a substantial part of the rest of your life doing it.

 

[PeepshowJohnny]

So when do they ever get to enjoy their $400,000 per year average salaries and their high social status? That kind of lifestyle is no different than a resident, except that they get more choice about cases...

I'm not saying they should sit around all day and count their money, but money is just a number on a computer screen if you don't spend it.

This is the life they've chosen for themselves. I can't speak for them directly, but they're very Type A. They want to get as much done in the day and they ENJOY doing a lot of cases (Hence, they're Orthos). I know a lot of them are the age where they have kids in tee-ball, soccer, school plays, etc so starting earlier in the day = done earlier at night (assuming you're not on call or a patient gets sick, but this happens less than in general surgery for various reasons).

 

[DrJosephKim]

It really does vary on the setting. There are academic hospitals, and then community-based teaching hospitals. And then you have your private hospitals. So it really depends on the setting and the amount of house staff (i.e., residents, fellows, etc.)

 

[bobsagat]

Depends what you mean by "enjoy". The Benz drives just as well at 4:00 am.

Most people don't go into surgical fields for the money. If there was ever a path that is way way way too much work and too many hours for the amount you earn, this is it. When you are working twice as many hours as most folks, earning several hundred grand AFTER a decade or so of training, that really isn't very impressive. So you only do it if you get a thrill doing the job. If you like to cut, like to hammer, work with your hands, fix things, then you go this route. If it's about $400k and social status, sorry you just don't. The same is generally true about most medical specialties, but surgery is even more obviously a bonehead play if you do it for the money because the path is so much longer and because the hours are worse. So nobody does this, and anyone who says they do is lying or demented. In fact, if you talk to surgeons, they tend to be most vocal about there being so many better ways to earn more money; most don't recommend their path to others unless you really really can't picture yourself doing anything else, and are willing to devote a substantial part of the rest of your life doing it.

As surgical specialties go, are there some that are notorious for having crazy hours? Which ones have less?

I've heard Gen Surg is ridiculously busy, while ENT is a little lighter as surgical schedules go. Is that true?

 

[BigRedBeta]

In my experience:

Crazy
Neurosurg (I believe the only field in which every single residency program has applied/received the 10% extension in duty hours from the ACGME)

Ortho - at my school, morning report/conference was at 6am everyday - so you had to be done with rounds by then

Gen surg - just a lot of patients

Peds surg - as a soon to be pediatric resident, I've yet to hear of a children's hospital that didn't have a shortage of pediatric surgeons.

Less Crazy (but it's not like these are vacations)

ENT

Urology

Colorectal - but from my friends who were on this service it was highly variable from week to week

Gyn Oncology - as the one purely surgical option out of GYN, this counts - and the data shows they do deserve to be called surgeons since they provide better outcomes than general surgeons in all types of female pelvic cancers.



Again, this is just my experience and what I've seen/heard. I'm sure there are 100 different accounts of neurosurgeons who see the sun and ENT surgeons who start in the OR at 4am and put the patients under anesthesia themselves.

 

[disarticulate]

I am wondering what hours attendings (specifically ortho surgeons...)work per week? I am aware it is 60ish, but does that include call? and when are the hours they are working, is it mainly 6am-8pm, or is it weekends, nights, everything?

I am trying to get a sense of what type of life these specialties lead. Mainly when do they work the hours they work? and what is up with the call schedule.

You asked about ortho in your original post.

I've worked in the OR for 3 years, so I'm somewhat familiar with most services. I'm thinking about going into ortho so I pay attention to a lot of what they do. Ortho Attendings take about 5-8 24hr calls a month plus a lot of them have private patients that they bring in on top of call. Many of them hold offices such as Chief of Ortho and Director of Sports Medicine at private hospitals. They also have to go to clinic for their private work, but some of them have PAs for that.

I've noticed that a couple of them take call at 2 different facilities on the same day. i.e. "Dr. X isn't going to start until 5pm today because he's also on call at another hospital."(Also, pedi anesthesia as well as pedi surg have been known to be on call at both teaching hospitals during the same day.)

Back to ortho... even though the attendings take call for 24 hours, it does not mean they work 24 hours. For cases taken while on-call, the resident works it up and posts the case, and the attending does not come in until the patient is in the OR. Most of the time, they will schedule cases for a 730am start, however, it's not uncommon for the attending to re-schedule his first case for 7pm so that he can get 2 rooms. Very rarely will an attending get paged to come in other than his scheduled start time... maybe for a revision/amputation or a VIP patient who is in a lot of pain. And when they do come in, it's straight to the OR and the patient is already asleep and prepped (most of the time.)

I definitely see a hierarchy in work load, though. One of the older attendings will come in and only do 2 cases and then re-post the rest for the next day. All in all, they pretty much dictate how hard they want to work, but they're all naturally hard working.

Residents.... wow. I don't think I can put into words how hard they work. PGY2s & PGY3s get hammered. They pull 12's during the week and 24's on the weekend... but a 24 very easily turns into 30. PGY4s do sub-specialty rotations (total joint, pedi ortho, hand, etc...) and PGY5s take "backup" call, and we rarely ever see them.

Ortho sub-specialty... hand gets called in late several times a week for revision/amp. Spine has pretty cush hours, but it's really hard work and competes with neurosurg.

Here's an ortho call schedule for reference.

I still would like to know what hours attendings in an surgical specialty work.

Since you have DDS in your name, I assume you might be interested in OMFS. Those guys have it pretty cush compared to ortho, but it's because they do mostly elective cases at an ASC.

Other specialties...

Plastics never works at night unless they want to. But they also have to come in on the weekend to take care of their flaps. Keep in mind, this is plastics at a trauma hospital, private plastics would be completely different.

Neurosurg gets hammered because of trauma/cva's.
Trauma surg/Pedi surg get worked the most out of all of them, I don't know how they do it.

ummm.... let's see here....
bariatric - cush hours
ophtho - cush hours but hard work
ENT - not sure
others...
Interventional Cardiology is pretty cush because if they don't want to work, they just say "this needs to be done surgically" and dump it on cv.

Interventional Radiology can have weird hours because of coilings/clippings. (We have a neurosurgeon who takes trauma call and also does interventional neuroradiology... he never sleeps... ever)

To sum it up, surgeons work very hard. So if you want a cush job and great pay, go into private anesthesia! A lot of anesthesiologists will admit they have it pretty good compared to the surgeons. One of the anes. attendings was trying to convince me into anesthesia and said "Do you see how hard those surgeons work? Look at me, with these new automatic charting machines, I just pre-op, put 'em to sleep and ::crosses his arms over his chest:: cha-ching cha-ching cha-ching. Wake 'em up, kick 'em out, and leave at 5."

Disclaimer: this is just my perspective from the facility where I work. It could very well be completely different at another facility.

 

[45408]

So the general/vascular surgery group I rotated with in the fall had this arrangement:

Q6 overnight call (Sunday through Thursday) - this was home call.
Q6 weekend call (you had Friday afternoon through Sunday midday) - you had to round on every patient your practice was watching two Saturday and Sunday. If there was nothing else to do after that, you were done. If not, you'd do cases.
Every sixth week was entirely off (but if your patient was re-admitted with complications, you'd probably take that)

2 half days in clinic
1-2 half days in the outpatient surgery (hemorrhoids, wound care, I&D under local, etc)
~3 days of surgery
and then various administrative meetings that they typically seemed to have a couple times a week at 5pm

First case was usually around 8:30am. Emergency add ons at 6 or 7 am (usually a lap appy or lap chole that came into the ER in the middle of the night) were periodic. Last scheduled case was usually around 4-5pm.

One of the younger attendings said he worked close to 80 hours a week during his on weeks, but you can take 1/6 of that off if you average it all together. I couldn't give you an estimate of their income by any means, but their practice had a very nice office. They had their own office nurse to do H&Ps for the chart, and there was one PA for every 3 surgeons to handle most of the floor work and discharges.

 

[IHeartNerds]

Both of my mentors (1 adult and 1 peds neurosurgeons) work about 90-100 hours a week in a large academic practice. Both are relatively new (about 5-7 years out of fellowship) attendings. They have less scheduled stuff during their 'academic' time, but get add-ons at weird hours. It's a lot of hours and a lot of nights and weekends. But they also net 600+ grand each per year, and absolutely love what they do, so life could be a lot worse.