Is 7 on, 7 off the best lifestyle schedule for attendings?

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I've been thinking about this and I think it's the schedule I will want as an attending. You only work half the year and your weeks off give you plenty of time to spend with kids, pursue hobbies or other money making endeavors, travel often, etc. But is there another type of schedule out there that would be even better for lifestyle?

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It varies from person to person.

Working 7/7 means you work every other weekend and every other holiday. Having a week off is great when kids are younger, when they start school the week off doesn't get you that much extra time with them.

I love my 8-5 M/F. No nights, weekends, or holidays. With some warning, I can take time off to do kids stuff like school programs and what not.
 
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It varies from person to person.

Working 7/7 means you work every other weekend and every other holiday. Having a week off is great when kids are younger, when they start school the week off doesn't get you that much extra time with them.

I love my 8-5 M/F. No nights, weekends, or holidays. With some warning, I can take time off to do kids stuff like school programs and what not.
Yeah, the schedule where you don't think about work at all during your week off. Seems like it'd also be the best for hobbies and for travelling a lot. I wouldn't mind working every other weekend if it means more time to go places.
 
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It varies from person to person.

Working 7/7 means you work every other weekend and every other holiday. Having a week off is great when kids are younger, when they start school the week off doesn't get you that much extra time with them.

I love my 8-5 M/F. No nights, weekends, or holidays. With some warning, I can take time off to do kids stuff like school programs and what not.
This. I love being 8-5 M-F. I enjoy a few extra hours per evening every day, having all the weekends, and that my schedule aligns with my spouses.
Others prefer 7 on/7 off for the long off stretches.
There’s no perfect schedule. You do you.
 
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There is no one size fits all. All schedules have pros and cons. The best part of the Monday-Friday is the predictability and having time off when your friends/family also have time off (ie nights weekends and holidays).

7/7 has some perks, but realistically you can only travel so much before you’re too tired or too broke. If kids are in school you can’t travel while school is in session. The worst part is the 7 on is essentially a week of your life that you’re never getting back. You probably won’t see the kids at all during that week. Also, being off Monday-Friday while all your friends are working leaves you with little to do on your days off, and you’ll miss half the weekend activities.

As a shift worker, I’m still trying to find the sweet spot. I’d never give up the flexibility in my schedule, as I love having half the year off. I can easily take 4 weeks off and make time up here and there. But the above grievances sometimes are rough.

More recently, I’ve tried to mostly do 3-4 days on and 3-4 days off. Sometimes I’ll do a stretch if 6-8 days in a row to take 10 days off without loosing pay. Again, still trying to find the ideal balance but I definitely feel like I spend a lot more time with my kids than the average full time working dad, and especially true compared to the average surgeon.
 
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I think if I had kids I'd rather take the 8-5 M-F with decent vacation time and consistently be home in the evenings with the weekends off rather than 7 on 7 off. Working 1/2 of all weekends and holidays sounds pretty bad even if you only work half the year. The hard part I feel like is finding a specialty and job that allow you to do the former.
 
I think if I had kids I'd rather take the 8-5 M-F with decent vacation time and consistently be home in the evenings with the weekends off rather than 7 on 7 off. Working 1/2 of all weekends and holidays sounds pretty bad even if you only work half the year. The hard part I feel like is finding a specialty and job that allow you to do the former.
Depends how you define “decent vacation time”. I imagine 3-4 weeks a year is standard initially. Physicians who get paid based on productivity I’m sure can take more time off but would end up loosing pay. Seniority probably helps.
 
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Depends how you define “decent vacation time”. I imagine 3-4 weeks a year is standard initially. Physicians who get paid based on productivity I’m sure can take more time off but would end up loosing pay. Seniority probably helps.
Myself and 5 of my 6 partners take at least 30 days off per year. I've taken 3 full weeks, a half dozen long weekends, 5 days over July 4th, and a 6 day weekend over Christmas.
 
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Myself and 5 of my 6 partners take at least 30 days off per year. I've taken 3 full weeks, a half dozen long weekends, 5 days over July 4th, and a 6 day weekend over Christmas.
Dam yall hiring! The more and more I look at things private seems worth the headache
 
Some like it and others hate it. I happen to be part of the former. I think it works well if your job is not too demanding. There are a few places you can just round and leave and people are home by 4-5pm during the week days and 1-2pm on weekends
 
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You have to consider personality as well. Speaking partially tongue in cheek as a non-psychiatrist, I swear some of these people who signed up for week on/week off schedules have some form of iatrogenic cyclical depression. Constantly moving from looking forward to being off and then dreading going back to work OVER AND OVER. It starts to really affect some people.

The schedule can be nice but as others said, medical students often make professional decisions without considering their place in the world. Of course being off for a week at a time sounds awesome when the only thing you do is travel and drink with friends who also don't have families or responsibilities outside of work. Once everyone grows up and has a real job suddenly no one can take the boat out with you on a Tuesday afternoon, get drunk on Monday etc. Then if you have kids, you don't see your kids. Speaking completely frankly, I would rather spend less time with them regularly than bolus time with kids. It's better for them and when they aren't a couple years old they will have a lot to do so they aren't going to drop everything just to see you on Thursday because it's your week off.

The schedule is absolutely great for some people. Med students are just notoriously bad at making decisions like this.
 
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Speaking completely frankly, I would rather spend less time with them regularly than bolus time with kids.
As a parent and someone who has had to bolus time with my kids due to the military, I 100% agree. It is much easier on them even if I only see them for a couple hours before bed almost every night than for me to be essentially gone for a week and then home for a week.
 
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You have to consider personality as well. Speaking partially tongue in cheek as a non-psychiatrist, I swear some of these people who signed up for week on/week off schedules have some form of iatrogenic cyclical depression. Constantly moving from looking forward to being off and then dreading going back to work OVER AND OVER. It starts to really affect some people.

The schedule can be nice but as others said, medical students often make professional decisions without considering their place in the world. Of course being off for a week at a time sounds awesome when the only thing you do is travel and drink with friends who also don't have families or responsibilities outside of work. Once everyone grows up and has a real job suddenly no one can take the boat out with you on a Tuesday afternoon, get drunk on Monday etc. Then if you have kids, you don't see your kids. Speaking completely frankly, I would rather spend less time with them regularly than bolus time with kids. It's better for them and when they aren't a couple years old they will have a lot to do so they aren't going to drop everything just to see you on Thursday because it's your week off.

The schedule is absolutely great for some people. Med students are just notoriously bad at making decisions like this.
Beat me to it. I always say 7 on 7 off sounds like iatrogenic bipolar depression. I know I’d personally need a day or two just to feel like a person again after 7 on and then I’d spend the rest of the week off trying to distract myself from the dread of doing it again.

There’s lots of people in FM doing outpatient 4.5 days/week with no nights/call/weekends/holidays for basically the same pay as a hospitalist.

It’s hilarious that people pick 7 on 7 off for “the lifestyle” when derm is the notorious lifestyle specialty that everyone fawns over despite basically having the same hours as outpatient primary care.
 
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I know a lot of docs who do schedules like this. For the hospitalists I know, they seem to really like that kind of schedule even if they do look pretty ragged by day 7.

As a surgeon, I did that schedule with a partner for a year. It was brutal. The "off" week was usually clean up from the previous week. And when someone took vacation, you could end up doing two weeks of call in a row. Sometimes we'd get lucky and have a light call week. But that was the exception. It also made me a basketcase and was not conducive to a good home life.

I'm in a group of three now and we alternate every third day/weekend, which is much nicer now. We also have 5 weeks vacation per year, plus unofficial time off for meetings or other administrative activities.
 
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As a parent and someone who has had to bolus time with my kids due to the military, I 100% agree. It is much easier on them even if I only see them for a couple hours before bed almost every night than for me to be essentially gone for a week and then home for a week.
Same. I am a better parent seeing them regularly for less time each day. Personally, I also believe it provides a better representation as to what being an adult means in our society. We can argue about the merits of our relationship with work as Americans but the reality is that being an average adult means going to work most days of the week unfortunately. As a parent, I worry about setting unusual expectations about lifestyle/work during an already challenging transition to adulthood. I think everyone has some moment when they realize that most of their life will be spent working. Better have that younger than 18, IMO.
 
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Same. I am a better parent seeing them regularly for less time each day. Personally, I also believe it provides a better representation as to what being an adult means in our society. We can argue about the merits of our relationship with work as Americans but the reality is that being an average adult means going to work most days of the week unfortunately. As a parent, I worry about setting unusual expectations about lifestyle/work during an already challenging transition to adulthood. I think everyone has some moment when they realize that most of their life will be spent working. Better have that younger than 18, IMO.
Working for pay is for suckers. I’m hoping I can find a way for my kids to make money without having to work.
 
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4 days/week, 9-5 is best for lifestyle. That way you can have a day off in the middle of the week, have evenings to you and weekends too.
 
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4 days/week, 9-5 is best for lifestyle. That way you can have a day off in the middle of the week, have evenings to you and weekends too.
That's only 32 hrs per week so you're essentially working part time. Would likely have to take a big paycut and you would pro probably be making at the very bottom percentiles of your specialty. More difficult to do right out of training, especially if you have high med school loans and kids to pay for.
 
That's only 32 hrs per week so you're essentially working part time. Would likely have to take a big paycut and you would pro probably be making at the very bottom percentiles of your specialty. More difficult to do right out of training, especially if you have high med school loans and kids to pay for.
Why big cut? Fulltime is 40/week, 32/week is 80% of that so I'd imagine you get 80% of the salary. 21% of physicians are working part time so I don't think 32/week would be "very bottom" percentile (at least in something like FM, PM&R or Psyc which are what I'm going for).

But yeah, this is more of a schedule after loans are paid off or close to.
 
I've been thinking about this and I think it's the schedule I will want as an attending. You only work half the year and your weeks off give you plenty of time to spend with kids, pursue hobbies or other money making endeavors, travel often, etc. But is there another type of schedule out there that would be even better for lifestyle?
This is probably still the most common schedule for shift-based IM/FM hospitalists. But has its pros and cons.

Works well for people who want to block larger chunks of time off if they have other things to do outside medicine, such as a part-time non-clinical job or travelling. Buti it's basically cramming 2 weeks of work into 1 week. For hospitalists, the typical schedule technically involves 12 hrs shfits during those 7 days, but in many places you can finish and leave a bit early (and take call from home) if the workload is reasonable so it may only come out to a 9-11 hr shift on those weeks, and you're not responsive for taking call overnight.

The main downsides are working half the weekends each year, which is less than ideal for those with families. And some people get tired by day 6- or 7, especially if it the days are very busy and you end up staying for a full 12 hr shift. If that's the case some places will allow different variations like 5-on-5-off to avoid working 7 days in a row. If you also have to take call from home at night on those 7 days (more common in surgical specialties or ICUs/Critical Care facilities that don't have overnight in house attending), or are in high-intensity environments like ED, working 7 days in a row can quickly lead to burnout.
 
Why big cut? Fulltime is 40/week, 32/week is 80% of that so I'd imagine you get 80% of the salary. 21% of physicians are working part time so I don't think 32/week would be "very bottom" percentile (at least in something like FM, PM&R or Psyc which are what I'm going for).

But yeah, this is more of a schedule after loans are paid off or close to.
I work ~36 hours/week (8-4 M-F 8-12 W), 90 minute lunch, discussed time off previously. My partners do similar. We're all above 90th percentile when it comes to pay. The trick is worked hard when you are at work.
 
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7 days on/off is the best schedule there is. That's why many FM docs are getting into the hospital medicine bandwagon.

Hospital medicine jobs are also VERY flexible. I can't count the # of times I sat in the physician lounge watching a whole soccer or a college football game (i have been a hospitalist for only 4 months)

If I show up to work at 7:30am (instead of 7am, which many where I work do), I won''t have to apologize to an angry patient who got upset because he/she was waiting.

Another perk is the amount of time you can take off. For instance, I have a colleague who is taking a "3-week on" in a row off (close to 2 months off total) so he can spend the entire summer of 2022 in his vacation home with his kids in another state.

It's not ONLY the 7 on/off. It's ALSO the flexibility.
 
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I worked 7-7 (both varieties) in a different aspect of healthcare before med school.

I think whether this is good or not depends on if you get cranky with no free time. I have discovered that I do need a little bit of time to decompress every day. By the time I hit my middle shift of the week working consecutive 12s, I would be very irritable that I just had to eat dinner, shower, and go right to sleep. I wanted to watch some TV, or a movie, or hang out with my SO.

I usually ended up staying up late to just have the free time and started a cycle of getting less than six hours of sleep, so I went to work sleep deprived, which made me even more irritable. And then I got home and wanted more free time, so I stayed up again, etc. I’d get resentful about sleep - it was just something that took away all my free time, so the later I stayed up, the more time I felt like I had to myself. Sometimes I did this my entire week, and I was really running on fumes and feeling incredibly worn down by the end of my stretch of days.

If you do that, it’s going to take you at least the first couple days of the week off to recuperate. It’s not really a whole seven days off if you’re playing catch up from being sleep deprived for half of it because you couldn’t make yourself go to bed at a decent hour during the week you were working.

I do better with more free time each individual day. I was really happy on rotations where I worked from 8-5, personally.
 
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In my specialty (radiology) weekends and evenings demand a premium so 7/7 is generally considered not great since you’re giving up 52 weekend days and half your holidays. The premium is generally worth 2-3 “regular” weekdays so a more common scheme in radiology is 7 on/14 off and sometimes 7 on/21 off, particularly if you’re doing nights on-site in an undesirable location.
 
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As others mentioned, I think it just depends on your lifestyle. One of my friends does 7 on 7 off as a hospitalist. He has young kids and they travel a lot so it's easier for him to just schedule travel time on the weeks he has off than having to schedule a week off of a weekly 8 to 5 schedule and use vacation time.
 
I've only ever worked a 6 days on, 1 day off 80-90 hours a week thanks to a surgical residency.

The job i took is 4 days a week, "10 hrs a day", and the days are usually significantly shorter if you're quick in the O.R. Only 4 weekends of call a year. I get paid right at the MGMA median for my speciality in a desirable city to live and work significantly less hours than anyone in academia or private practice. It still seems like a dream and is my ideal schedule especially with kids at home.

Having a week day off is huge to do all the deferred maintenance stuff like haircuts, bank trips, mechanic appointments etc.
 
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I've only ever worked a 6 days on, 1 day off 80-90 hours a week thanks to a surgical residency.

The job i took is 4 days a week, "10 hrs a day", and the days are usually significantly shorter if you're quick in the O.R. Only 4 weekends of call a year. I get paid right at the MGMA median for my speciality in a desirable city to live and work significantly less hours than anyone in academia or private practice. It still seems like a dream and is my ideal schedule especially with kids at home.

Having a week day off is huge to do all the deferred maintenance stuff like haircuts, bank trips, mechanic appointments etc.
How do you only have 4 weekends of call a year in ortho? Tons of partners?
 
Depends how you define “decent vacation time”. I imagine 3-4 weeks a year is standard initially. Physicians who get paid based on productivity I’m sure can take more time off but would end up loosing pay. Seniority probably helps.

As a new faculty member at my institution, I get I think 28 days of vacation per year, though I have to take 'vacation' if I'm not working a holiday, and the hospital recognizes 6 holidays per year, so it works out to 22 weekdays other than holidays off per year, and we arrange the call schedule so that we're not on weekends leading up to or coming off our vacation. So a little more than 4 weeks if you take it in large chunks. Or you can do several 3-4 day weekends.

That's only 32 hrs per week so you're essentially working part time. Would likely have to take a big paycut and you would pro probably be making at the very bottom percentiles of your specialty. More difficult to do right out of training, especially if you have high med school loans and kids to pay for.
Depends on how your time is defined. I am in clinic 6 half days per week (broken up into 2 full days and 2 half days, so I'm physically in clinic 4 days per week), but am full time. The other 4 half days (M-F) I'm expected to be doing office work (following up on lab results, calling patients, doing other administrative activities, and some educational stuff cause I'm in academics). Many general pediatric practices have 4 days per week of clinic and 1 day of admin time to catch up on charting, patient calls, etc.
 
Why big cut? Fulltime is 40/week, 32/week is 80% of that so I'd imagine you get 80% of the salary. 21% of physicians are working part time so I don't think 32/week would be "very bottom" percentile (at least in something like FM, PM&R or Psyc which are what I'm going for).

But yeah, this is more of a schedule after loans are paid off or close to.
in psych there are a lot of 4 day a week jobs, schedule is typically 8-6 though and you see a large number of pts.
 
That's only 32 hrs per week so you're essentially working part time. Would likely have to take a big paycut and you would pro probably be making at the very bottom percentiles of your specialty. More difficult to do right out of training, especially if you have high med school loans and kids to pay for.
Tangential, but 32hrs/week is .8 FTEs which is considered full time in many jobs. That aside, the extent to which working this many hours per week will impact income as a physician is highly dependent on how reimbursement is structured (e.g., salary v. productivity v. salary + productivity), doesn’t relegate someone to the very bottom of their earning potential within their field, and definitely is doable right out of residency even with a family - just depends on priorities and numerous other factors.
 
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I'm a huge sports fan so 7/7 is not ideal for me. I couldn't imagine ever having to miss a major sporting event (whether its NFL, NBA, golf, college sports, etc). But I have friends who absolutely love it. Just different for everyone
 
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I think if I had kids I'd rather take the 8-5 M-F with decent vacation time and consistently be home in the evenings with the weekends off rather than 7 on 7 off. Working 1/2 of all weekends and holidays sounds pretty bad even if you only work half the year. The hard part I feel like is finding a specialty and job that allow you to do the former.

Psych is busting at the seams with 7 on/7 off schedules. And the good thing about psych is that even on your on weeks, you're still getting out at 4 or 5 pm (just like the 8-5ers). Then you get a week off. The only bad thing is every other weekend, you have to work. But again in psych, you can typically get out by 1 or 2 pm on the weekends you have to work. And if you already know all the patients, you can get out even earlier. You still have the pager so you could get called back in, but you can go home by 1 or 2 (or earlier).

In other specialties, I hear the on weeks are 12+ hr days. In that situation, I'd prefer the M-F.
 
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Psych is busting at the seams with 7 on/7 off schedules. And the good thing about psych is that even on your on weeks, you're still getting out at 4 or 5 pm (just like the 8-5ers). Then you get a week off. The only bad thing is every other weekend, you have to work. But again in psych, you can typically get out by 1 or 2 pm on the weekends you have to work. And if you already know all the patients, you can get out even earlier. You still have the pager so you could get called back in, but you can go home by 1 or 2 (or earlier).

In other specialties, I hear the on weeks are 12+ hr days. In that situation, I'd prefer the M-F.
When you get out can largely depends on patient volume, which can fluctuate from day to day. The problem with being too efficient and leaving early in a shift-based job where you are paid by the hour (besides getting called back in) is that if your employer catches on, they may just argue that the patient volume doesn't justify the hours, and then just try to reduce your hours and pay and try to squeeze the same amount of work into a shorter (and thus lower-paying) shift.
 
That's only 32 hrs per week so you're essentially working part time. Would likely have to take a big paycut and you would pro probably be making at the very bottom percentiles of your specialty. More difficult to do right out of training, especially if you have high med school loans and kids to pay for.
That schedule is considered full time for dermatology. Although it’s usually 8-4
 
When you get out can largely depends on patient volume, which can fluctuate from day to day. The problem with being too efficient and leaving early in a shift-based job where you are paid by the hour (besides getting called back in) is that if your employer catches on, they may just argue that the patient volume doesn't justify the hours, and then just try to reduce your hours and pay and try to squeeze the same amount of work into a shorter (and thus lower-paying) shift.

I don't know of any 7 on/7 off psychiatrists being paid hourly. And while yes, patient volume fluctuates, you're never working IM hours. There are only so many beds on the unit. Employers also don't need to "catch on". You're not sneaking out like you're a kid ditching school. You're literally there to do the job and you leave when it's done, provided you have your pager. You can even wave at your boss as you head out. That's the beauty of inpatient psych, unless you're doing consults.
 
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As others have noted, I think the key is planning to have some flexibility over the course of your career as things evolve. 7/7 may be great in the beginning but less so as you get older when you might want more traditional 8-5 kind of hours with all your weekends free. I've also known some docs near retirement who liked the 7/7 thing since their friends and family had more free time and they could take advantage of the off weeks. I've also seen it work well for people mid career who own a business or some other venture that needs their attention.

It's hard to convey the challenges that come with any schedule though. Look at something like EM with an even better on/off ratio than hospital medicine, yet pretty high burnout rates and people saying they wouldn't do it again. While much of this is probably driven by the work itself, I'm sure that many who thought it was more a lifestyle field found it less appealing as all those other life factors got added in. Much harder for them to transition to other practice models outside EM or UC. At least someone in FM or IM could start in hospital medicine but transition to outpatient clinic if they find 7/7 no longer works for them.

Whatever you decide, try to err on the side of flexibility if you can. Perhaps the most important thing is finding something you somewhat enjoy so that the work time is at least semi-rewarding for you. Having half the year "off" is less appealing if you're truly miserable the other half of the year.
 
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