I have seen old threads on this but everyone just beats around talking about regulations instead of answering the real question being asked. So how many hours do people work during residency? What is a typical week like (eg 7-5 Mon-Fri and every other weekend, on call every 4th day,etc)? What does the average weekly schedule of a resident look like?
What is residency really like?
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I'm sure that everyone would agree that it's highly variable based on specialty, program, and PGY year.
Which is why I am hoping to get individual examples to see what kind of variability is out there.
Any specialty, should've specified that. Just looking for some examples of a week by week as a google search hasn't helped much and the similar threads haven't really addressed this question. I have been interested in starting with internal medicine but it is wide open at this point. I have just heard people say it sucks life away and I am looking for some people's concrete examples to make my own judgements
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Every specialty will give you different answers. In IM, you're looking at 12 to 30 hour shifts, for instance, with highly variable structures. There is no way to generalize that- it differs program to program and specialty to specialty.
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There are more than 20 specialties that you can do residency in. In addition to varying by specialty, your call schedule / hours / etc will depend on your year of training, specific program, and rotation within that program.
Best this to do is observe what goes on at your institution. When you narrow you speciality list down a bit, then you can look for more details.
Best this to do is observe what goes on at your institution. When you narrow you speciality list down a bit, then you can look for more details.
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At my program (Internal Medicine), the day starts at 7 (or 645 if you're on call), you get sign-out from the night team, then go round on your patients. Depending on your attending, they may round with you, or you staff with them later. You put in orders and answer pages as the day goes on. Usually there is noon conference during the week every weekday that is required. After noon conference the day is spent finishing up notes, putting in new orders if need be, and preparing to sign out to the night team at 4. Realistically I'm usually there til 5 since sign out takes some time and usually I got some notes to finish. We have q5 call, meaning every 5 days is a long call day where I am there from 7 til 9 and admitting new ones from 2:30 to 8, and my senior resident stays overnight and is gone early the next day. There are also short call days interspersed where you pick up new patients from 7 to 4. Usually on those days I'm not done til 6-ish since I'm admitting new patients while also taking care of my existing ones. The expectation is that I can carry 8-10 patients at a time but i'm not supposed to go over 10 carried at once. Half day of clinic once a week from 1 to 5. I get 1 day off a week. This is for IM wards only (yet to experience ICU or other months). I think most IM programs have a similar system to this. We also have night float where at specified nights throughout the year you show up on wards to cover patients (usually they try and schedule these during your lighter months like electives or ambulatory). Looking at my log I worked just under 70 hours last week. I've only been an intern about 2 weeks, and so far it has been a lot of hours but not as intense/malignant as some people warned me would be. So far it's much better than being a student in that I have actual responsibility and there's less of a "bottom of the totem pole" type feeling compared to my medical school experience. Of course I've only just started. Hope that helps.
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Shouldn't this be in pre-allo?
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As a CT surgery resident, can confirm that I work 79.99 hours every week. No more. No less.
Seriously though my days are pretty variable.
If not on call, I get there around 5am to see patients and take care of floor issues, then I go to the OR. The length of my day is dictated by the OR schedule. If it's a light day, I can be done by 3-4pm, in which case I'll stay until 6 or so working on research, following up patient care issues, getting them tucked away, etc. If it's a heavy day, I can be there as late as midnight (and no I don't get to sleep in the next day). Most days are somewhere in between, so I typically leave around 7-8ish on non call days.
Call days are the same as non-call days except I'm in house overnight and my official call duties begin at 7pm when the CVICU attending and NPs leave for the day. I sign out the call pager to the next person around 7am. If it was a relatively easy call and I got a couple hours of sleep, I'll usually stay for a case in the morning and leave around 12-1p. If call was busy and I'm exhausted, I'll just finish seeing my patients that morning and leave earlier - around 9-10.
I work every other weekend (i.e.: work 12 days straight, get 2 days off). I much prefer this to a random day off during the week or just one weekend day as it lets me do real human activities on my weekends off...
Seriously though my days are pretty variable.
If not on call, I get there around 5am to see patients and take care of floor issues, then I go to the OR. The length of my day is dictated by the OR schedule. If it's a light day, I can be done by 3-4pm, in which case I'll stay until 6 or so working on research, following up patient care issues, getting them tucked away, etc. If it's a heavy day, I can be there as late as midnight (and no I don't get to sleep in the next day). Most days are somewhere in between, so I typically leave around 7-8ish on non call days.
Call days are the same as non-call days except I'm in house overnight and my official call duties begin at 7pm when the CVICU attending and NPs leave for the day. I sign out the call pager to the next person around 7am. If it was a relatively easy call and I got a couple hours of sleep, I'll usually stay for a case in the morning and leave around 12-1p. If call was busy and I'm exhausted, I'll just finish seeing my patients that morning and leave earlier - around 9-10.
I work every other weekend (i.e.: work 12 days straight, get 2 days off). I much prefer this to a random day off during the week or just one weekend day as it lets me do real human activities on my weekends off...
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I know others have said it, but this question is so variable. Even at one institution you are always doing different rotations that can vary highly. You might have a few weeks of outpatient that is cush, then an inpatient where you are going near 80 hours consistently. You might have night float rotations, ICU rotations, research months, etc. Plus call schedules, vacation schedules, holidays, all work different at different institutions.
It's just best to assume you'll work your ass off in residency, and let anything less than 80 hours a week feel like a blessing.
It's just best to assume you'll work your ass off in residency, and let anything less than 80 hours a week feel like a blessing.
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I'm a third year on peds, and the schedule varies IMMENSELY month to month (and way more if you look at different programs who do 30 hour calls). Clinic months, I may have 8-5 shifts with a couple random 12 hour ER shifts and/or 4-5 days of sick call and most weekend days off. On ICU months, I'd say I'm usually there 5 to 5 on a non late day and around 5 to 7-9 on a call day. Wards, usually 6 to 4 on non-late days and until 7-9 on late days. Wards and ER, I get 4 days off in a month usually (random days). ER months are 10-12 hour shifts (with usually 2 hours of notes to write after) 5-6 days a week. Night float is 12 hours with usually an hour or so after for note writing but 2-3 days off a week. It's usually not the hours themselves that are so exhausting; it's more the fact that you're switching schedules a lot, on your feet running around, tiring your brain out, and dealing with a lot of stressful and emotional issues. Much of the time, it's a cognitive or emotional fatigue rather than just being physically tired.
Also, night float vs 30-hour call has pros and cons. If you're there late after your shift, there's no post-call to make up some of that sleep. If you're still there at midnight doing paperwork or admitting patients or dealing with unstable patients (and it happens), you're still expected to be back at 5 am; so, it's easy to get really behind on sleep when it adds up. Also, despite long call being exhausting, I feel like the nurses are more likely to think through their calls when they know they're waking someone up for the issue. On our night float, we get lots and lots of calls to clean up day team orders, ask if they can space out vital signs, requests for "stat" formula changes and butt paste, and various ridiculous orders like "the iv we weren't using fell out. I need a discontinue IV order."
Also, night float vs 30-hour call has pros and cons. If you're there late after your shift, there's no post-call to make up some of that sleep. If you're still there at midnight doing paperwork or admitting patients or dealing with unstable patients (and it happens), you're still expected to be back at 5 am; so, it's easy to get really behind on sleep when it adds up. Also, despite long call being exhausting, I feel like the nurses are more likely to think through their calls when they know they're waking someone up for the issue. On our night float, we get lots and lots of calls to clean up day team orders, ask if they can space out vital signs, requests for "stat" formula changes and butt paste, and various ridiculous orders like "the iv we weren't using fell out. I need a discontinue IV order."
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I'm doing IM - the first two weeks i definitely worked more than 80 hours, but apparently that's par for the course at new york city hospitals.
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Holy crap this sounds awful.
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PM&R
Now as a pgy-4 I take no call. Get in at 8:00-9:00 depending on the day. Leave at 3:00-5:30 depending on day.
In previous years I worked about the same hours but had to take call. Worked about 50 overnight calls (1-24 hour holiday and about 15 sats with 5 sundays) in pgy-2 (usually 5-6 hours if sleep) and post call day off. Essentially went straight from regular hours to the overnight shift. Worked about 8 sundays and 1 holiday in pgy-3 year with no sat or friday call and about 25 shifts total.
I probably have a better lifestyle this year than I will as an attending.
Intern year schedule was very complicated. Basically had 4-5 days totally off per month. I'd say averaged 65-70 hours a week.
Now as a pgy-4 I take no call. Get in at 8:00-9:00 depending on the day. Leave at 3:00-5:30 depending on day.
In previous years I worked about the same hours but had to take call. Worked about 50 overnight calls (1-24 hour holiday and about 15 sats with 5 sundays) in pgy-2 (usually 5-6 hours if sleep) and post call day off. Essentially went straight from regular hours to the overnight shift. Worked about 8 sundays and 1 holiday in pgy-3 year with no sat or friday call and about 25 shifts total.
I probably have a better lifestyle this year than I will as an attending.
Intern year schedule was very complicated. Basically had 4-5 days totally off per month. I'd say averaged 65-70 hours a week.
3rd year radiology resident - most rotations are 8-5. All rotaitons are Mon-Fri. We take call 24hr with post call off, ends up being q7 on avg with 7 in my class so 4-5 call shifts per month
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It's really not that bad. I get 2 weekends off per month plus 5-6 post call days off. Yes there are some weeks that are absolute dog **** but there are as many if not more that are reasonably chill. I feel like I have plenty of time to have a life. If I'm done around 6, I'll usually make time to go out for dinner/beers with my SO and/or friends. I make a point to do something fun on my weekends off. I work my balls off when I'm at work, but I also have no problem having a pretty nice life outside of work. Yeah, I have to sleep a little less sometimes, but it's worth it so I can go out and decompress when I need to.
Also, having done night float as an intern and 30 hour call, full call is so much more humane. Doing night float in January when your "day off" is 6am Sunday to 6pm Monday is so soul crushing; you never see the sun and have no time to see any friends/bf/gf, do ADLs, etc. At least with full call, you get the rest of your post call day off - sleep for a couple hours then spend the rest of the day doing chores/errands you have to do during the day and it still allows for a life outside of work.
I honestly can't fathom how anybody could ever prefer night float to full call, and this is coming from someone who is up the entire night for the majority of my calls dealing with sick as **** patients.
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I've always thought night call was a terrible idea. Switching schedules sucks but sucks less than doing nights over and over again.
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I maintain that the only people that prefer night float are the ones that have never done it.
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Start at 5-6 am
Finish when the work is done: 6-8 pm (occasionally earlier occasionally later).
Call is highly variable: can be in house or from home. Home call sucks because you have to work the next day no matter how busy the call was. We take call 1-4 nights per week; usually 1-2.
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Sounds rough, what specialty is this?
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Surgery
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Peds here.
As an intern/second year on inpatient, we do 6a-6p most days, with a slightly shifted schedule on the weekends since the overnight person rounds. Our night team is made up of people on that rotation, who come in Sun-Fri nights to take care of the patients on that team. So, in total, e generally end up working 65-75 hours per week. On outpatient, we work 8-5, m-f, and then cover inpatient services on the weekends so the people on can actually have days off.
As a senior, I do most of the admissions and supervise all the interns and second years, so only work 5 days per week, but end up staying later and arriving earlier than most of my interns, so I still generally log 60+ hours per week.
Obviously, ICU has its own unique schedule.
As an intern/second year on inpatient, we do 6a-6p most days, with a slightly shifted schedule on the weekends since the overnight person rounds. Our night team is made up of people on that rotation, who come in Sun-Fri nights to take care of the patients on that team. So, in total, e generally end up working 65-75 hours per week. On outpatient, we work 8-5, m-f, and then cover inpatient services on the weekends so the people on can actually have days off.
As a senior, I do most of the admissions and supervise all the interns and second years, so only work 5 days per week, but end up staying later and arriving earlier than most of my interns, so I still generally log 60+ hours per week.
Obviously, ICU has its own unique schedule.
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Surgery always means gen surg unless you're at a ped hospital
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This sounds lovely
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