Anesthesiologist schedule

[econdr]

Hey everyone, anesthesiology is at the top of my list of specialties. I'm just wondering what a typical week is for you guys, attendings and residents (but especially attendings). I have read about CCU docs or hospitalists doing 7 days off , 7 days on, and of cardiologists doing two days of call each week and then two half days later in the week.

I'm sure there are dozens of different schedules possible, especially in academic vs private practice, but what is yours like?


Thanks guys!

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[PMPMD]

Hey everyone, anesthesiology is at the top of my list of specialties. I'm just wondering what a typical week is for you guys, attendings and residents (but especially attendings). I have read about CCU docs or hospitalists doing 7 days off , 7 days on, and of cardiologists doing two days of call each week and then two half days later in the week.

I'm sure there are dozens of different schedules possible, especially in academic vs private practice, but what is yours like?


Thanks guys!

We tend to start early since the ORs usually start around 0700. We have to be in the hospital before that to set up the room and preop the patient. The day ends when the cases end. This will be highly variable depending on the practice. Call schedules will also vary, as will the requirement for in-house or home call. I would say the average hours/week is in the 50-60 range, but again this varies.

At my academic gig, staff get there around 0645-0700 prior to the 0715 OR starts (except the one guy who always calls at 0715 from the parking lot). If not on-call or late, we usually get out by 1630.

 

[jwk]

Our group provides in-house anesthesiologist coverage (along with the anesthetists) 24/7/365. Although our anesthesiologists are not on a timed-shift per se, they generally work either a day time 8 or 12 hr shift, an afternoon/evening shift, or a night shift. These shifts overlap in a way that there is never a gap in coverage.

For example - our night doc comes in at 8pm on a weeknight. He will be relieved the following morning by another doc at 6am that covers OB for the day. That particular doc is obligated to stay as late as needed, but since they were the earliest doc in, they're gone first as well, usually by 1pm. Also at 6am, one of the 12hr docs comes in for the OR's. He is obligated to 6pm (or later if needed) but on most days is gone by 4 because other docs are coming in at 2pm and 5pm. One of those 2pm docs will be staying until he swaps off with that 8pm night doc.

For our main hospital, we have one doc at night plus another available on call. In the morning, we'll have about 21 docs, tapering down through the afternoon and evening until we get back to the one doc at night. Until you see the schedule laid out on paper, it doesn't make much sense, but it actually flows quite well and everything is covered with the appropriate manpower at the appropriate times.

We have a very large group, with more than 50 docs and 100 anesthetists covering three hospitals and multiple ASC's. We use a computerized scheduling program to keep track of everyone, and everyone has access to real-time schedules 24/7 via the internet. Even with that, it takes an office staffer whose primary job responsibility is scheduling.

 

[DreamMachine]

Reminds me of one of my all time favorites. From Narcotized...

An Anesthesiologist's typical Day through the Eyes of a Surgeon:

7:10- Roll out of bed, splash water on my face, head to work.

7:29- Arrive in time at the OR for my 7:30 cases. Determine each patient needs further lab work. I tell the surgeons we are delayed because patients were late arriving to hospital.

7:37- I'm hungry. Breakfast time.

8:42- I cut my breakfast short after 1 hour to make sure my 2 cases are now going. Stick my head in each room, patients asleep. From the door I hear beeping so I assume they both are alive, flash the thumbs up sign and leave.

8:44- Time to make rounds. I need to check on the RN.I.L.F.'s on 3W, 4E, 5C, and ICU.

10:06- "BEEP, BEEP, BEEP." FUQQ!! Rounds cut short due to pager going off, AGAIN! "Dammit, that's the third time this thing has gone off this month! What am I, the friggin hospitalist?"

10:11- Man, I'm hungry. It's been over an hour and a half since my last food break. I head to the doctor's lounge to grab a coke, some donuts, watch CNBC, and check emails.

11:03- Cut my donut break short to check on my cases. Both rooms are empty. I find out my next case is already in progress in a different room. Pulse Ox is beeping. Patient is alive. I flash the thumbs up from the door and leave.

11:06- Family members ask how the surgery is going. I tell them he is fine. They tell me it's a she. "Whatever. She's doing fine. Gotta run."

11:11- Surgeon wants to know if he can add on an emergency appendectomy. All 3 anesthesiologists already have 1 case in progress each that are being supervised, but we can do it first thing in the morning. Surgeon gets pissed. I tell him to tell the hospital to not be so cheap and give anesthesia more money.

11:13- I head off to finish my "floor rounds." (wink, wink)

11:46- Need to grab a quick lunch before I starve to death!

12:49- I cut lunch short after only an hour so that me and my colleagues can have our daily battle over who gets the short straw and has to stay. Once again we all walk out on the new guy.

12:52- Walking to doctor's parking lot. Feeling stressed. This is now the THIRD day in a row I've had to stay past 11:30am. Will bring this up at the next group meeting.

12:56- Driving away in my Bentley. Surgeon waves to me on his way to clinic. I flash him the finger.

 

[likeaboss]

Hahaha hilarious! This is really helpful everybody. I wouldn't mind being off by 1130am...

So jwk, do you alternate months between ASCs and hospital ORs? Are you just given a salary or is it more of an eat what you kill or hourly arrangement? I'm curious about how the management side of it works...

 

[cincincyreds]

Hahaha hilarious! This is really helpful everybody. I wouldn't mind being off by 1130am...

So jwk, do you alternate months between ASCs and hospital ORs? Are you just given a salary or is it more of an eat what you kill or hourly arrangement? I'm curious about how the management side of it works...

First, you won't be off by 1130am.

There are different arrangements. When I started, I worked every other weekend, took overnight 24 hour call 8-10x per month. After 2 years, I got sick of this. The money was good though.

Now, I just get a fixed salary, work 7-3 Monday thru Friday at the new place. I make half as much, but still it is enough to live on. Just didn't like the stress of the AAA in the middle of the night anymore.

Never been involved in eat what you kill. If you are curious about hourly wage, figure around 140-175/ hour depending on where you are from what I've seen. Big cities it could be less. I've seen as low as 125/hour in LA.

 

[jwk]

Hahaha hilarious! This is really helpful everybody. I wouldn't mind being off by 1130am...

So jwk, do you alternate months between ASCs and hospital ORs? Are you just given a salary or is it more of an eat what you kill or hourly arrangement? I'm curious about how the management side of it works...

I'll PM you.

 

[darby11]

Typically Anesthesiologists come in between 630-7 and leave between 4-5 . Daily. If you supervise you will have between 2-4 rooms. preopping and streamlining the rooms. If you are doing your own cases like me you are in the room all day every day.

If you are on call you will stay on call for 24 hours inhouse.. and if its a home call you will go home when all the cases are done and come back if there is a case in the middle of the night. to do it.. Most people have the day off post call Some places dont give you post call days off..

SOmetimes the call guy comes in later in the afternoon.

In the above scenario there is no room for 7 day shifts etc.

Its a grind and not at all as cush as people make it out to be.

 

[B-Bone]

I'm in a supervisory practice where we sit our own rooms about 10% of the time.

Supervising:
6:15-7:30-Look up pts for the day. See first round of pts in preop. Do any preop blocks/lines. Usually running 3 rooms to start. 1 if i'm doing hearts. 4 if it's a really busy day.
7:30-7:45-start first round of rooms.
Rest of day: check on rooms, wake people up, post op blocks, trips to L&D for labor epidurals, run ass off, etc. repeat as needed. pick up a room here or there as people need to get freed up or my rooms finish. at some point, run to docs lounge and grab lunch to eat in the workroom.

Sitting my own cases:
6:15-7:30-look up pts for day. Set up room. See first pt. Blocks/lines/etc.
7:30-start first case
Repeat prn.

Earliest I've ever left is like 9 am. Some days I get a call the night before telling me not to come in if the schedule is really light and I'm the first guy out (this adds about 2-3 extra weeks of vacation/year). Latest I've been there (not on call) is about 8:00 pm as the backup call guy. Most days I leave around 2:30, rarely earlier, sometimes later.

Weekday calls I come in at 1:00 or 2:00 (depending on hospital). Take over rooms, finish out the schedule, peel my colleagues off as rooms close. Usually sleep a few hours, rarely all night, sometimes not at all (stupid L&D...). Stay until 7 am or maybe 8 to start a few rooms if it's really busy. Off the rest of the day.

Weekend/holiday calls are 24 hours (7-7). Can run 3 rooms from 7-3 on saturdays, emergencies only from 3 pm saturday to monday morning. May not visit call room for 24 hrs. May never do a case or labor epidural (happened to me once). Usually grab a few hours rest.

38 calls a year, which is about once a week when vacation is figured in. 13 weekends (either friday and sunday or just saturday).

 

[nycitygas]

I'm in a supervisory practice where we sit our own rooms about 10% of the time.

Supervising:
6:15-7:30-Look up pts for the day. See first round of pts in preop. Do any preop blocks/lines. Usually running 3 rooms to start. 1 if i'm doing hearts. 4 if it's a really busy day.
7:30-7:45-start first round of rooms.
Rest of day: check on rooms, wake people up, post op blocks, trips to L&D for labor epidurals, run ass off, etc. repeat as needed. pick up a room here or there as people need to get freed up or my rooms finish. at some point, run to docs lounge and grab lunch to eat in the workroom.

Sitting my own cases:
6:15-7:30-look up pts for day. Set up room. See first pt. Blocks/lines/etc.
7:30-start first case
Repeat prn.

Earliest I've ever left is like 9 am. Some days I get a call the night before telling me not to come in if the schedule is really light and I'm the first guy out (this adds about 2-3 extra weeks of vacation/year). Latest I've been there (not on call) is about 8:00 pm as the backup call guy. Most days I leave around 2:30, rarely earlier, sometimes later.

Weekday calls I come in at 1:00 or 2:00 (depending on hospital). Take over rooms, finish out the schedule, peel my colleagues off as rooms close. Usually sleep a few hours, rarely all night, sometimes not at all (stupid L&D...). Stay until 7 am or maybe 8 to start a few rooms if it's really busy. Off the rest of the day.

Weekend/holiday calls are 24 hours (7-7). Can run 3 rooms from 7-3 on saturdays, emergencies only from 3 pm saturday to monday morning. May not visit call room for 24 hrs. May never do a case or labor epidural (happened to me once). Usually grab a few hours rest.

38 calls a year, which is about once a week when vacation is figured in. 13 weekends (either friday and sunday or just saturday).

Wow, that's a pretty sweet job. Minneapolis (cold weather aside) is a nice place to live too.

 

[darby11]

Wow, that's a pretty sweet job. Minneapolis (cold weather aside) is a nice place to live too.

how do you know he is in minneapolis?

 

[nycitygas]

how do you know he is in minneapolis?

Join Date: Jun 2004
Location: Minneapolis
Posts: 129

 

[drccw]

I'm in an all MD practice....
18 MDs

We cover OB (overnight) 1:18. Our OB shift starts at Noon-7 AM the next day during the week. 1:18 also means 3 Saturday calls, 3 Sunday calls, 3 friday calls a year. Weekend call is 24 hrs

OR days I'm typically here at 7 AM. We have an out list, wit your position based on how late you worked the previous day or if you're on call the next day. If you're on OB call the next day, figure out by 3 PM on a typical day. Most average days out by 5 PM. 1:18 OR call (which is call from home). Typically in at Noon, out by 9 PM. Callbacks rare. Next day first to leave, around 1:30 PM. 1:18 weekend call from home (cover entire weekend Friday-Sunday). Usually 1-2 cases over the weekend. so 3 weekends a year for OR call.

So it usually stacks out to be 48-55 hours a week. 40 free weekends a year. 1 Holiday a year.

It's a good gig. Our pay is solid. The work atmosphere is great.

drccw

 

[ssmallz]

I'm in an all MD practice....
18 MDs

We cover OB (overnight) 1:18. Our OB shift starts at Noon-7 AM the next day during the week. 1:18 also means 3 Saturday calls, 3 Sunday calls, 3 friday calls a year. Weekend call is 24 hrs

OR days I'm typically here at 7 AM. We have an out list, wit your position based on how late you worked the previous day or if you're on call the next day. If you're on OB call the next day, figure out by 3 PM on a typical day. Most average days out by 5 PM. 1:18 OR call (which is call from home). Typically in at Noon, out by 9 PM. Callbacks rare. Next day first to leave, around 1:30 PM. 1:18 weekend call from home (cover entire weekend Friday-Sunday). Usually 1-2 cases over the weekend. so 3 weekends a year for OR call.

So it usually stacks out to be 48-55 hours a week. 40 free weekends a year. 1 Holiday a year.

It's a good gig. Our pay is solid. The work atmosphere is great.

drccw

Sounds like a real nice gig dude

 

[econdr]

is vacation just the usual 4 weeks for non-partner and 4+ weeks for partners?

 

[Jay K]

is vacation just the usual 4 weeks for non-partner and 4+ weeks for partners?

No. Checkout Gaswork just as an example to see how different job descriptions vary.

 

[B-Bone]

is vacation just the usual 4 weeks for non-partner and 4+ weeks for partners?

with my group it's like 8-10 weeks for non partners and 14-16 weeks for partners (depending on the year).

 

[tima]

How often do attendings go on call? I see stuff like every 8th night.

Also, what's the difference between 1st and 2nd call? I saw it on gaswork.

 

[PMPMD]

How often do attendings go on call? I see stuff like every 8th night.

Varies a lot by group.

Also, what's the difference between 1st and 2nd call? I saw it on gaswork.

1st call = the first to get called. so if there's one emergency case, 1st call gets it. also, the last to go home if cases run late.

2nd call = 2nd to get called in (if there are 2 simulataneous or concurrent emergencies that need to be run in parallel. also the penultimate to go home if cases run late.

 

[B-Bone]

Varies a lot by group.

1st call = the first to get called. so if there's one emergency case, 1st call gets it. also, the last to go home if cases run late.

2nd call = 2nd to get called in (if there are 2 simulataneous or concurrent emergencies that need to be run in parallel. also the penultimate to go home if cases run late.

Another version of 1st/2nd call is where 1st call is in house overnight and 2nd call is at home available for additional emergency cases. That's how my joint rolls.

 

[likeaboss]

Do any gas residencies have 5 day work weeks? Or is that too good to be true?

 

[Mman]

Do any gas residencies have 5 day work weeks? Or is that too good to be true?

I hope not. Gotta learn what it's like to work nights and weekends. I mean you will do it the rest of your life, why not learn how it's done? I'd never even consider hiring from a residency that didn't involve nights/weekends.

 

[nycitygas]

Do any gas residencies have 5 day work weeks? Or is that too good to be true?

Umdnj cooper

 

[Laryngophed]

Our group provides in-house anesthesiologist coverage (along with the anesthetists) 24/7/365. Although our anesthesiologists are not on a timed-shift per se, they generally work either a day time 8 or 12 hr shift, an afternoon/evening shift, or a night shift. These shifts overlap in a way that there is never a gap in coverage.

For example - our night doc comes in at 8pm on a weeknight. He will be relieved the following morning by another doc at 6am that covers OB for the day. That particular doc is obligated to stay as late as needed, but since they were the earliest doc in, they're gone first as well, usually by 1pm. Also at 6am, one of the 12hr docs comes in for the OR's. He is obligated to 6pm (or later if needed) but on most days is gone by 4 because other docs are coming in at 2pm and 5pm. One of those 2pm docs will be staying until he swaps off with that 8pm night doc.

For our main hospital, we have one doc at night plus another available on call. In the morning, we'll have about 21 docs, tapering down through the afternoon and evening until we get back to the one doc at night. Until you see the schedule laid out on paper, it doesn't make much sense, but it actually flows quite well and everything is covered with the appropriate manpower at the appropriate times.

We have a very large group, with more than 50 docs and 100 anesthetists covering three hospitals and multiple ASC's. We use a computerized scheduling program to keep track of everyone, and everyone has access to real-time schedules 24/7 via the internet. Even with that, it takes an office staffer whose primary job responsibility is scheduling.

Does your group use a shift differential to "encourage" docs to take the overnight shift or is it done by everyone on a rotating basis?

 

[likeaboss]

I hope not. Gotta learn what it's like to work nights and weekends. I mean you will do it the rest of your life, why not learn how it's done? I'd never even consider hiring from a residency that didn't involve nights/weekends.

How steep is the learning curve on working nights and weekends. I'd much rather "learn" to work nights and weekends as an attending when I'm fairly compensated for it.

I'm sure there are some residencies with tough call schedules and ones that are more "family friendly"... Is that not right?

 

[pgg]

How steep is the learning curve on working nights and weekends. I'd much rather "learn" to work nights and weekends as an attending when I'm fairly compensated for it.

I'm sure there are some residencies with tough call schedules and ones that are more "family friendly"... Is that not right?

It's not so much that working when it's dark out is hard if you didn't get to practice during residency ...

Residents working nights and weekends tend to have more autonomy and "freedom" to work independently.

 

[Lightwand]

How steep is the learning curve on working nights and weekends. I'd much rather "learn" to work nights and weekends as an attending when I'm fairly compensated for it.

I'm sure there are some residencies with tough call schedules and ones that are more "family friendly"... Is that not right?

In a busy academic hospital/Level 1 Trauma Center, nights/weekends often bring cases that you may otherwise very rarely get a chance to do. We do great cases during the day, but it's an entirely different animal.

Emergent cranis, ruptured AAA's, huge bleeding traumas, emergent airways, etc. I can say that 95% of my experience with these cases was during the nights/weekends. When these cases do roll in during the daytime, it's unlikely that you (as a resident) will have an open room. An elective open AAA repair is a totally different case than a rupture who rolls in on the brink of coding.

Sure, call stinks. But I'd be pretty weary of a residency that never had you working nights/weekends.

 

[HollywdAnesth]

Sure, call stinks. But I'd be pretty weary of a residency that never had you working nights/weekends.

If you can't put in an epidural in a pitch black room, your residency failed you.

 

[likeaboss]

In a busy academic hospital/Level 1 Trauma Center, nights/weekends often bring cases that you may otherwise very rarely get a chance to do. We do great cases during the day, but it's an entirely different animal.

Emergent cranis, ruptured AAA's, huge bleeding traumas, emergent airways, etc. I can say that 95% of my experience with these cases was during the nights/weekends. When these cases do roll in during the daytime, it's unlikely that you (as a resident) will have an open room. An elective open AAA repair is a totally different case than a rupture who rolls in on the brink of coding.

Sure, call stinks. But I'd be pretty weary of a residency that never had you working nights/weekends.

when you put it this way it sounds exciting and fun. I get what you guys are saying now. I do want the best training possible, so I can see its value...

thanks everyone for the wisdom

 

[Mman]

How steep is the learning curve on working nights and weekends. I'd much rather "learn" to work nights and weekends as an attending when I'm fairly compensated for it.

I'm sure there are some residencies with tough call schedules and ones that are more "family friendly"... Is that not right?

Learning how to work at off hours is a part of the job. You learn how to juggle case priorities and delegate responsibilities to others. Monday through Friday 7A to 5P is just doing scheduled cases in a predetermined order for the most part. Nights and weekends are like the wild west. Personally I love the work on nights and weekends, although I dislike being there at those hours. It's fun to just run the show and do things how you want in the order you want and get stuff done.