Worried about the intensity of clinical rotations and residency.

[365649]

Hello everyone, not a med student but I wanted to get medical students input on this. I was pretty sure I wanted to go to medical school and become a doctor, but recently I've been reading a lot of stuff online and it sounds like clinical rotations during the last two years of med school and then residency are extremely grueling. Do you really have to work 12+ hours per day, for six days a week (no holidays either I'm assuming), for 8+ years straight? I'm getting the sense that's what you have to do and I'm wondering if it would be easier to become a Navy SEAL at this point...

I kind of value spending time with my family on weekends and of course on Christmas and would like to have time to go surfing once a week.

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[Frazier]

You can do all those things in med school and residency. Not guaranteed consistently daily, but it is about priorities.

While the training to be a physician is much longer than becoming a SEAL, to say it is more physically grueling day-to-day is just gross exaggeration.

What specialties are you interested in at this time?

 

[NotAProgDirector]

In many fields, it's not that intense all the time. Residency in Internal Medicine is 3 years long, usually broken up into 2-4 week rotations. Some rotations are time intense -- 6 days of work, 10-12 hours a day. But other rotations are electives with much shorter days and weekends off. You'll also be doing rotations of night shifts, or some rotations where you switch between different shifts. Surgical fields tend to be more intense, non-procedural fields tend to be less so. Long days when you enjoy what you do aren't as bad as they sound.

You will make sacrifices. You'll also make sacrifices in many other fields other than medicine.

 

[calivianya]

I‘ve never had a job where I didn’t have to work weekends or holidays, including multiple jobs outside of healthcare. My first year of medical school was the first time I’d had Christmas Day off of work in years. Weekend and holiday work definitely isn’t limited to becoming a doctor. Any industry that has businesses that are open on the weekends and holidays is going to require weekend and holiday work.

The nice thing about being a doctor as far as weekends go is that you can choose a job where you don’t have to work weekends once you’re done with residency, and if you do work weekends and holidays, you are certainly going to be well compensated for them. Not to mention that often you only work some weekends, as opposed to every weekend, as a physician either because you’re on an every other week schedule, or you’re on a rotating call schedule with other doctors in your group.

Being a doctor is honestly less weekends per year than many other jobs/industries when you really break it down.

 

[ciestar]

I just came off a 11-12 hour 6 day a week rotation, on vacation now, and start on an 8-5 rotation next week. Not all is bad. I’ve also not worked a single holiday, as an intern or med student.

 

[365649]

You can do all those things in med school and residency. Not guaranteed consistently daily, but it is about priorities.

While the training to be a physician is much longer than becoming a SEAL, to say it is more physically grueling day-to-day is just gross exaggeration.

What specialties are you interested in at this time?

Thanks for the reply, it is reassuring. I'm interested in a bunch of stuff actually, family medicine, emergency medicine, dermatology. Maybe orthopedic surgery or general surgery, but I would have to actually do the rotation for that one before I would really know if I could handle it. I find the bones interesting and I like being hands-on.

 

[365649]

I just came off a 11-12 hour 6 day a week rotation, on vacation now, and start on an 8-5 rotation next week. Not all is bad. I’ve also not worked a single holiday, as an intern or med student.

Thanks for the reply, it is reassuring to know that there are breaks between the intensity. Also nice to know that it's possible to not miss the holidays. Don't really care about new years but missing Christmas would be rough.

 

[ciestar]

Thanks for the reply, it is reassuring. I'm interested in a bunch of stuff actually, family medicine, emergency medicine, dermatology. Maybe orthopedic surgery or general surgery, but I would have to actually do the rotation for that one before I would really know if I could handle it. I find the bones interesting and I like being hands-on.

All of those but surgery definitely have a better lifestyle/work-life balance

 

[ciestar]

Thanks for the reply, it is reassuring to know that there are breaks between the intensity. Also nice to know that it's possible to not miss the holidays. Don't really care about new years but missing Christmas would be rough.

Im very grateful im in a good program where they do that for us.

 

[365649]

I‘ve never had a job where I didn’t have to work weekends or holidays, including multiple jobs outside of healthcare. My first year of medical school was the first time I’d had Christmas Day off of work in years. Weekend and holiday work definitely isn’t limited to becoming a doctor. Any industry that has businesses that are open on the weekends and holidays is going to require weekend and holiday work.

The nice thing about being a doctor as far as weekends go is that you can choose a job where you don’t have to work weekends once you’re done with residency, and if you do work weekends and holidays, you are certainly going to be well compensated for them. Not to mention that often you only work some weekends, as opposed to every weekend, as a physician either because you’re on an every other week schedule, or you’re on a rotating call schedule with other doctors in your group.

Being a doctor is honestly less weekends per year than many other jobs/industries when you really break it down.

That is a good point! I was thinking about other jobs such as engineering, and while they may have the holidays and weekends off, they are still working strict hours 9-5 at least everyday. And I don't think I would enjoy being an engineer nearly as much.

 

[365649]

Im very grateful im in a good program where they do that for us.

That is nice, just looked at the actual websites for some residencies in emergency medicine and family medicine and they do seem to sound not as bad as the internet makes it seem to be.

 

[365649]

In many fields, it's not that intense all the time. Residency in Internal Medicine is 3 years long, usually broken up into 2-4 week rotations. Some rotations are time intense -- 6 days of work, 10-12 hours a day. But other rotations are electives with much shorter days and weekends off. You'll also be doing rotations of night shifts, or some rotations where you switch between different shifts. Surgical fields tend to be more intense, non-procedural fields tend to be less so. Long days when you enjoy what you do aren't as bad as they sound.

You will make sacrifices. You'll also make sacrifices in many other fields other than medicine

Thanks for the reply, thanks for the info. That is true, I think I would enjoy the work of being a doctor more than anything else. Perhaps I will stay away from surgery then, emergency medicine was one of my top ones and looking at the actual residency info for UCSD it says they work 45-55 hours per week (Which almost seems too good to be true), and they get four weeks vacation.

 

[Matthew9Thirtyfive]

I’m rotating on general surgery right now. I work about 65-70 hours a week, but we aren’t required to round every weekend. My friend is on inpatient medicine and works 6 12-hour days a week. My other friend is on family medicine and works 8-4 M-F. So it depends on the rotation in med school.

 

[ciestar]

That is nice, just looked at the actual websites for some residencies in emergency medicine and family medicine and they do seem to sound not as bad as the internet makes it seem to be.

FM definitely has busier rotations but, no, not as bad as the internet makes it out to me

 

[Eye-eye]

Thanks for the reply, thanks for the info. That is true, I think I would enjoy the work of being a doctor more than anything else. Perhaps I will stay away from surgery then, emergency medicine was one of my top ones and looking at the actual residency info for UCSD it says they work 45-55 hours per week (Which almost seems too good to be true), and they get four weeks vacation.

I've been surprised by EM hours. The pgy1 residents here work 6 shifts a week, and including charting and sign out, that's about 9 h / shift, so really not bad at all for intern year. Intern year usually sucks, but in most things your hours get significantly better afterward.

 

[altblue]

In terms of medical school, it really depends on the block and school. I've had blocks where I would comfortably take a decent amount of time off and not feel behind, and others where I'd study nearly every day and still be concerned about the workload. Most blocks are in between the two extremes.

In general you'll want to be a hard worker, but if you can get into a US medical school, you've established that you can learn to put in the work and be successful

 

[Redpancreas]

Hello everyone, not a med student but I wanted to get medical students input on this. I was pretty sure I wanted to go to medical school and become a doctor, but recently I've been reading a lot of stuff online and it sounds like clinical rotations during the last two years of med school and then residency are extremely grueling. Do you really have to work 12+ hours per day, for six days a week (no holidays either I'm assuming), for 8+ years straight? I'm getting the sense that's what you have to do and I'm wondering if it would be easier to become a Navy SEAL at this point...

I kind of value spending time with my family on weekends and of course on Christmas and would like to have time to go surfing once a week.

Grueling is not the word I would use. There's a huge variation in fields of medicine. I would not be turned off to medicine as a career because you don't feel like you'll be able to do the work which is often not the case. I would suggest you ask yourself instead whether you would be willing/motivated to do it.

The bolded is not accurate and selectively emphasizes the rigor without the easy stuff. Yes, on a bad week as an IM resident I worked 6 days for 13+ hrs for maybe two weeks on general medicine and when I was on Cardiac ICU I would wake up at 300 to arrive at work at 430 to preround so we could start rounds at 6am (again total of 4 weeks in all of residency). That said, every field has it's way of giving residents a break. With Internal Medicine, we have clinic every 5 weeks which is like half days/weekends off (i.e. 50 hr week with weekends off). In addition, there are elective rotations and specialty clinic rotations which are nowhere near as demanding as primary service (general med) rotations. There is also 2-4 week weeks of straight vacation.

 

[Redpancreas]

I’m rotating on general surgery right now. I work about 65-70 hours a week, but we aren’t required to round every weekend. My friend is on inpatient medicine and works 6 12-hour days a week. My other friend is on family medicine and works 8-4 M-F. So it depends on the rotation in med school.

To further this point, every school will show you things a bit differently. At my FM site, I worked 8-6pm M-F in clinic which was the second most I worked after Surgery. My IM rotation residents often dismissed me after rounds on pre-call days. Psychiatry usually dismissed me after rounds, Neuro was a whole lot of sitting around. My elective was the same.

 

[Eye-eye]

Agree with above posters. If you really enjoy grueling specialties and fill your schedule with them, you'll absolutely be busy. And then if you choose something surgical for residency it will likely only get worse. But it's easy not to go down those roads if they're a big deterrent, and to choose things which give you an interesting glimpse into a new specialty while also letting you get some meaningful time off.

 

[mvenus929]

Thanks for the reply, thanks for the info. That is true, I think I would enjoy the work of being a doctor more than anything else. Perhaps I will stay away from surgery then, emergency medicine was one of my top ones and looking at the actual residency info for UCSD it says they work 45-55 hours per week (Which almost seems too good to be true), and they get four weeks vacation.

The thing about EM is that you're not infrequently changing the shift you work. So you may work 8a-4p one day, 11a-7p the next, and then work 7p-3a and 11p-7a the next couple nights, with a day off til you switch back to 8a-4p. It all depends on the shifts that are available and how the program structures it. Some places might have you work 4-6 day stretches on the same shift before swapping, for instance.

Remember, the ED is open 24/7 and has variable times that it is busy.

 

[odyssey2]

I'd say in my four years of med school, there was may be a total of 1.5 years where I was truly working every day and I would call "grueling": the lead up to Step 1 (which is not so much an issue anymore now that it has switched to P/F) and third year. Fourth year can be an absolute breeze if you want it to be.

 

[Eye-eye]

The thing about EM is that you're not infrequently changing the shift you work. So you may work 8a-4p one day, 11a-7p the next, and then work 7p-3a and 11p-7a the next couple nights, with a day off til you switch back to 8a-4p. It all depends on the shifts that are available and how the program structures it. Some places might have you work 4-6 day stretches on the same shift before swapping, for instance.

Remember, the ED is open 24/7 and has variable times that it is busy.

Is this problem pretty standard across the shift-based specialties, or do you think others like anesthesia get more consistent hours on average?

 

[Redpancreas]

Is this problem pretty standard across the shift-based specialties, or do you think others like anesthesia get more consistent hours on average?

EM alone has this schedule where shifts jump and it remains the same as an attending. Other specialties have more consistent hours on average. In IM you may work nights about 2-8 weeks a year depending on how much you've done the previous year. The thorn of IM is the q4 call where every 4th day you're working a day/night (with the next day off)...but again, it's just residency. Anesthesia is pretty consistent. Surgical residencies work terrible hours but they too are pretty consistent.

 

[Lanhaines Elsetion]

The reality is that even on a 12+ hour shift as a medical student, we are not working non-stop. You will likely have time to eat, use the restroom, check your text messages, study on down time, etc. You will probably get a few months during 3rd year that have 70-80 hour weeks with 12+ hour days 6 days a week (Surgery, OBGYN). But you will also get rotations that are M-F 8-5 (FM, PSYCH, PEDS), and sometimes a more chill rotation that takes Fridays off and stuff like that. I'm not sure how universal this is but it also sounds like most residency programs give 3-4 weeks off per year that are usually taken a week at a time. You should still definitely consider the rigor of med school and eventually residency and make sure that you will be okay with this kind of workload for the next 7-10 years.

 

[mvenus929]

Is this problem pretty standard across the shift-based specialties, or do you think others like anesthesia get more consistent hours on average?

BacktotheBasics answered this pretty well, but... the OR is busiest during the week during the day (starting at like 6:30). I imagine most anesthesiologists work during this time and then split the emergency/after hours time as call. How exactly that works will depend on the group/residency.

The path to medicine is hard, and it's unlikely to get significantly easier in the next several years. We do hold people's lives in our hands. There is a very real risk of burnout.

Would I follow the same path knowing what I know now? Yes. I find great meaning in my work. Could you pay me to go back to residency again? Nope. Not in a million years.

 

[YCAGA]

BacktotheBasics answered this pretty well, but... the OR is busiest during the week during the day (starting at like 6:30). I imagine most anesthesiologists work during this time and then split the emergency/after hours time as call. How exactly that works will depend on the group/residency.

The path to medicine is hard, and it's unlikely to get significantly easier in the next several years. We do hold people's lives in our hands. There is a very real risk of burnout.

Would I follow the same path knowing what I know now? Yes. I find great meaning in my work. Could you pay me to go back to residency again? Nope. Not in a million years.

Some anesthesia residencies pay $75-100/hr for staying after 5-6pm and for internal moonlighting on the weekends. This is pretty amazing to me, since staying late in surgery is a given, and you definitely don't get paid more.