Third year student here, wondering if anyone has advice on where I can find average working hours for each specialty once in practice. I've checked CIM and FREIDA, and most of what they mention is work hours DURING residency. Don't care about that. I'll put the work in. I want to know what the hours are AFTER residency. I know the simple answer: it varies between institutions/practice. That's great, but short of emailing every institution to find out, where can I figure this out?
Work hours AFTER residency
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This is the best source I've been able to find, but it's from 2003, and their salary numbers are pretty inaccurate even for that time.
http://www.medfriends.org/specialty_hours_worked.htm
The best answer is that you can work as much or as little as you want in most fields. However, it is easier to have a flexible schedule in the less "hard-core" fields (i.e. not surgery), or if you own your own practice.
I would say the following fields work best for those that want a good balance of lifestyle, hours, and money (feel free to add or disagree, just my opinions):
FM - although pay averages are lower, hours are pretty much daytime, and it's pretty easy to either work for yourself or a group, and dictate your schedule. Weekends usually off, occasional call (not too bad, mostly home call if you use hospitalists in your area like most do these days).
IM - Outpatient, see FM. Inpatient, hospitalist schedules are fairly flexible if you don't mind looking around a little for a place that needs someone part-time, or just days, or just nights, or whatever you want. Most full-time hospitalist gigs will require a good number of nights and weekends/holidays per year.
EM - See inpatient IM/hospitalists. Nights and weekends usually required, but probably the lowest # of hours worked for the best money, as long as you like the ED.
Psych - Very flexible, especially private practice. Probably easiest field to setup a private practice in, as there is very little overhead compared to other fields.
Radiology/Derm - Usually fairly cush hours, but competitive to get into and you have to like rads/derm.
Other thoughts: I find anesthesia to be fairly good hours, but have the usual OR hours (i.e. early start) and fairly random call, i.e. lots of nights, weekends, etc. Surgery is pretty brutal all around, and I've never heard of a part-time surgeon, although I'm sure they exist. If you want to do surgery, you should just make it your life. OB can be somewhat controllable if you work in a group, but it's still kinda crazy hours. Obviously some of the more "obscure" specialties like ophthomology, allergy, etc can have pretty good hours.
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Just need to call out the anti-surgery bias here. True "part-time surgeons" are rarer than some specialties, but I have heard of it (esp female surgeons with young children). The "hospitalist general surgeon" model is also gaining a lot of popularity. This frees the rest of the practice/department up for their elective cases, and removes the burden of call and the vortex of the ED. I've heard of general surgeons who are doing 2+2 (2 days clinic, 2 days OR) plus 3-4 days of call a month (and when you're on call, you don't have clinic or OR scheduled). That's pretty nice, and in the community you generally do more outpatient procedures and only have a few patients in house - it's a very different bird from the academic programs we all rotate through. A lot of it also has to do with where you choose to practice. True if you're in a rural setting, there's less (if noone) to share the work so you can get slammed, but in most places of the country, there's enough general surgeons out there that you can tailor your practice quite well.
And that's ignoring many of the surgical subspecialties. ENT, urology, colorectal, plastics, surg onc, and endocrine surgery all have quite reasonable lifestyles due to the relative absence of emergencies/disasters.
I think a lot of med students get biased by the slavery-model general surgery services they rotate through at their academic institutions and build up this very negative assumption of the specialty that you'll be working 90 hours the rest of your life. Less than 15% of graduating general surgery residents stay in academics - there's a big, wide world out there that is very different and much more reasonable. Many of my classmates settled on anesthesia or ER because they like procedures and wrote off surgery because of some negative connotations they had formed - I think they would have been surprised if they dug a little deeper.
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I believe AAMC: Careers In Medicine might have something on that. I know they have projected salaries and work characterisitics. Check it out.
Thanks for your advice.
I definitely enjoy procedure-based work, but the residency of general surgery is simply not a viable option for me. Hence, things have really been narrowed down to IM sub-specialties vs. anesthesiology vs. EM. And as I imagined, it's probably going to be highly variable.
In the end, as everyone always says, it just comes down to what I like the most, which is an entirely different conversation.
Already checked out CIM... unfortunately, they don't give average work hours post-residency.
I definitely enjoy procedure-based work, but the residency of general surgery is simply not a viable option for me. Hence, things have really been narrowed down to IM sub-specialties vs. anesthesiology vs. EM. And as I imagined, it's probably going to be highly variable.
In the end, as everyone always says, it just comes down to what I like the most, which is an entirely different conversation.
Already checked out CIM... unfortunately, they don't give average work hours post-residency.
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Honestly, I don't think you should pick a career based on what the training is like. If you settle, you will be in said second choice career for the rest of your life. Residency is temporary.
However, I'm not trying to say you should do surgery if you're not interested.
I mean... if you look at my initial post or the thread title, that's EXACTLY what I'm trying to do -- I'm trying to pick my career based on what the career will be like. I want to know what things will be like AFTER residency, which was the point of this thread. I couldn't care less how much work I have to put in during residency... well... that's a lie. If two careers offer similar work characteristics, I'll probably choose the one that current residents say has the better residency.
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But in your earlier post you say "the residency is general surgery is not a viable option" for you. Therefore, it does appear that you are picking a career based on residency training.
The differences between IM, Anesthesia, General Surgery and EM are *vast* both in residency and practice. They do not have "similar work characteristics".
I'm also not saying you should do general surgery, but if you like procedural work, you will probably not care for IM unless you do Cards or GI fellowship. And make sure you understand what "procedures" are - if you are satisfied intubating patients, catheter based interventions, endoscopy, placing lines, etc. then you may be satisfied with a non-surgical field. If you are interested in surgery rather than procedures, you will not be.
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My mistake. I just meant that doing residency in general surgery is not a viable option because the lifestyle AFTER residency, at least from what I've heard from surgeons, is not what I'm looking for.
And I absolutely agree that the lifestyles of EM, IM, and gas are going to be a lot different. But I've talked to a lot of people in all three of those fields, and at least they get to see their kids (exaggerating, of course).
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I know this isn't what the OP was going for, but I just wanted to say that I disagree. I mean, I would have agreed three generations ago when most people only did an intern year and a 'residency' was a 2 year program, but I know plenty of surgeons that trained for 6 years in residency (a lot of programs require a research year, now) and then did a 2-3 year fellowship. I mean, you're right that residency is temporary, but so is life. A decade is a LONG time to be miserable, however bright the light at the end of the tunnel might be.
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Also, I'd like to point out that it also depends on your age, goals, etc. For example, I am 32 and have a family. I'll be 34 when I graduate. If I did a 7 year residency, I'd be well past 40 before I even started practice, much less got established. I'm not going to do that. Plus, I like seeing my family 😀
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I never said to sign on for neurosurgery. 🙄 I meant that 3 vs 4 vs 5 years is not a large difference if it means being happy in a field you actually like.
I'm also older and married so I'm definitely cognizant of what a decade in training means. I would however, rather train for 5 years in a hellish general surgery program than be an internist/pediatrician/ER doc for the rest of my life.
And BTW, how many internists actually practice general internal medicine? Most of the residents I worked with were thinking about fellowships. So that's an equivalent or greater amount of time as training in gen surg. I also don't think that straight up general surgeons are that uncommon.
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It's not just the length of training, though, it's the misery of training. As you yourself said, surgery residencies are friggin terrible. I'm not saying an Internal medicine residency/fellowship is anything great, but in any given year you're likely to have 6 months of wards at 80 hours a week and 6 months of other rotations at less, with things getting better as you get more senior. Psych, PM&R? Bankers hours. On the other hand how many Orthos, or even General Surgeons, do you know that even stay within the 80 hour rule? The Orthos I know pull 120 hours a week and often work 48 hour shifts, and all in an abusive, fast paced enviornment, and it never gets better until they graduate.
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Misery is all relative. Personally, I'd rather have a hellish 120 hour week on transplant surgery rotation than spend a 40 hour week in IM/peds/FP/PMR/neuro clinic or wards. It's all about what your likes and dislikes are. I was much happier on my surgery rotations, even with far worse hours, than I ever was on my other rotations, where I dreaded going in every day. Many of my med school friends loved clinic and hated the hospital.
You should pick something that you like enough to do EVERY DAY for YEARS....because you will be doing it every day for years. There is huge variability in hours within each field depending on how one tailors their practice. Ask attendings to describe their average day/week/month to get a sense of how many hours they are working. Also ask how much work they do from home (dictations? chart checking? mountains of paperwork?). That should give you a sense of things for the fields you are interested in. Keep in mind that private practice is different from academics as well.
You should pick something that you like enough to do EVERY DAY for YEARS....because you will be doing it every day for years. There is huge variability in hours within each field depending on how one tailors their practice. Ask attendings to describe their average day/week/month to get a sense of how many hours they are working. Also ask how much work they do from home (dictations? chart checking? mountains of paperwork?). That should give you a sense of things for the fields you are interested in. Keep in mind that private practice is different from academics as well.
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I think the "misery" of a general surgery residency is largely more of an urban legend these days as well at most programs (malignant programs do still exist and tend to prey of borderline applicants/the scramble). With the 80 hour work week, most GS residents don't spend that much more time in the hospital than a lot of other specialities. A large number of programs avg closer to 70 hrs for their residents. Granted, those hours are often higher intensity, but some people love that. Plus, like all residencies, GS has its cushier rotations intermixed into the more time-intensive ones. Its not like you spend 5 years on trauma and vascular.
This coming from someone not going into general surgery.
This coming from someone not going into general surgery.
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This. Although, I would add that you should consider what you want to be doing at 35-40 when you have a spouse and kids, who you love way more than your job, and when you're 60 and you're not as young as you used to be. For me, that's NOT surgery.
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Those 9-5 days on FM were so slow and painful. Doing my rotations I am really starting to figure out that hours are not nearly as important as actual happiness/interest during those hours.
I used to think it was urban legend until I saw firsthand on my surg rotation. And the program is known as a "benign" one.
It seems brutal and only people who absolutely love it should go into it. I know people who are deciding between Surg and IM - should be IM all the way and at most something like optho.
If you love surgery but have lifestyle concerns work extremely hard during med school and do ENT or Uro
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This article might be worth checking out, although it's not as detailed as I'd hoped, and is based on a survey...
Anim M, Markert RJ, Wood VC, Schuster BL. Physician practice patterns resemble ACGME duty hours. Am J Med 2009;122(6):587-93.
Of most interest to this discussion is Table 3, which says:
Overall, I think this fits with my experience that most surgeons tend to work a ton of hours. Obviously, there will be exceptions to this, and in reality, you can probably set up practice however you want...but it's less likely to happen in surg.
That being said, 40 hours of being bored to tears isn't good either, so everyone just do what you like.
Anim M, Markert RJ, Wood VC, Schuster BL. Physician practice patterns resemble ACGME duty hours. Am J Med 2009;122(6):587-93.
Of most interest to this discussion is Table 3, which says:
Overall, I think this fits with my experience that most surgeons tend to work a ton of hours. Obviously, there will be exceptions to this, and in reality, you can probably set up practice however you want...but it's less likely to happen in surg.
That being said, 40 hours of being bored to tears isn't good either, so everyone just do what you like.
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Most days I work 8-5 or 9-6. All depends on how fast you are at getting your charts done and the end of the day. I learned to be fast so I can dictate about 15 charts in an hour. Some people are way slower and take longer. This is in clinic only. I don't take call, I don't do OB, I'm not doing hospital medicine right now. I work in family practice clinic only.
