Residency lifestyle in ENT (vs. other surgery specialties)

[Brathmore]

I am trying to get a better sense of the lifestyle of urology vs. ENT vs. ortho DURING residency and afterwards.

Basically, I love surgery and hope to do it, but I'm trying to figure out if the residency lifestyle in all of the surgical specialties is so terrible that I simply ought to try one of the ROAD specialties. When I say "terrible" lifestyle, I'm referring to sleep deprivation.

--Who deals with the most middle-of-the-night emergencies, and is the difference between these 3 specialties significant? For instance, if ortho>ENT>urology in terms of sleep deprivation, how big of a difference is it? Are ortho's up all the time with emergencies compared to urology or ENT residents getting decent sleep? Or visa versa?

--What's a typical night's sleep for these specialties? I ask because I'm personally not the all-nighter type of guy. In a typical week, what's a person's sleep schedule like in ENT or one of these other specialties? (e.g., no sleep 1 day a week, but normal nights on 5 days, etc.)

--I know that ENTs and urologists are supposed to have pretty good lifestyles after residency is over, at least as far as surgeons go. But during residency, is one much harder than the other in terms of sleep deprivation?

--How do these specialties compare in lifestyle 1-10 years out after residency?

Informed comments only, please! Also, no need to re-hash the old "if you want to know about this, don't be a doctor." I'm just looking for information to help me choose.

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[ThePursuit]

All surgical residencies are hard unless you go to a crappy program. A typical night sleep can vary from 0-7hrs (day off). Lifestyle can vary drastically. I would recommend you read through some of the older threads on here, I've learned a lot from them over the last couple years.

 

[ZagDoc]

I am trying to get a better sense of the lifestyle of urology vs. ENT vs. ortho DURING residency and afterwards.

Basically, I love surgery and hope to do it, but I'm trying to figure out if the residency lifestyle in all of the surgical specialties is so terrible that I simply ought to try one of the ROAD specialties. When I say "terrible" lifestyle, I'm referring to sleep deprivation.

--Who deals with the most middle-of-the-night emergencies, and is the difference between these 3 specialties significant? For instance, if ortho>ENT>urology in terms of sleep deprivation, how big of a difference is it? Are ortho's up all the time with emergencies compared to urology or ENT residents getting decent sleep? Or visa versa?

--What's a typical night's sleep for these specialties? I ask because I'm personally not the all-nighter type of guy. In a typical week, what's a person's sleep schedule like in ENT or one of these other specialties? (e.g., no sleep 1 day a week, but normal nights on 5 days, etc.)

--I know that ENTs and urologists are supposed to have pretty good lifestyles after residency is over, at least as far as surgeons go. But during residency, is one much harder than the other in terms of sleep deprivation?

--How do these specialties compare in lifestyle 1-10 years out after residency?

Informed comments only, please! Also, no need to re-hash the old "if you want to know about this, don't be a doctor." I'm just looking for information to help me choose.

First of all, let me say don't let a few years of sacrificing sleep keep you from doing what you love. I think a lot of student's spend so much time thinking about lifestyle now, they spend less time thinking about what they actually love to do. Residency is a temporary state, your end career not as much so, so do what's going to keep your challenged and engaged for the next 30 years, instead of what's going to be more tolerable for 3-5 but less stimulating for the next 30.

Oto is a surgical residency, there's no way around it. I'm at a pretty busy program, but on our heavier months (head & neck, peds) we're working just as long of hours as our GS colleagues. Busy days on the head & neck service when you're scrubbing a big flap case can run from 5 am to 10 pm or later. A more 'typical' day runs around 6 am to around 7 pm in the hospital. But throw in didactics, conferences, tumor boards, prepping for cases, home-study, catching up on dictations, research, and just general reading and I'm doing some form of work most nights until 9 or 10ish. That isn't an every night affair, I exercise/socialize/make time for my SO a fair bit, but in general I spend more nights working on things than kicking back. I'm generally in bed by 11 or 12 and up at 5. My counterparts with children generally will wait for the kiddos to go to sleep and will be up a bit later. For weekends I have off, I generally spend about a half a day or so doing work, plus the obligate email time. Surgical residencies are different from residency in IM, peds, etc. You have a lot less time built in during the day for teaching/learning (e.g. things like morning report, noon conference, radiology rounds, etc), and are expected to accomplish more on your own time.

Every specialty has its things which bring the pain from the ED. ENT does too (epistaxis, pus in it's various locations, face trauma, airway, et cetera). Our call nights can be pretty quiet where you can get a couple hours of sleep, or really do their best to destroy you. Anecdotally, I know my buddies in ortho tend to get abused a bit more on call than we do (they tend to average 4 or 5 more consults per 'call' then we do where I'm at). I have no idea what constitutes a urological emergency or what uro's calls are like.

You have to factor in that if you do a urology residency, your first 3 years really as spent as a "general surgery resident". Those also tend to be the more painful years of a general surgery residency. For what its worth. Other than that, I feel the fields, and the residencies, are pretty comparable. There's likely to be institutional differences, but I think if you averaged it all out they'd be about the same. Also anecdotally at my hospital, I think the ENT and urology residents do tend to have more outside interests and hobbies than some of the other surgical residents. Whether its because we "have" more time (schedule driven) or "make" more time (personalty driven), I'm not sure.

I guess it all comes down to your priorities. I tend to function pretty well on 5 hours of sleep a night, I like being busy, and I like multitasking so I love being an ENT resident. I have seen a few people who have chosen ENT because it's considered a "lifestyle surgery specialty" and they tend to be pretty miserable after they found out its less "lifestyle" and more "surgical". If being busy and 5 hours of sleep sounds miserable to you, an ENT residency probably isn't for you. But it's not like you're a slave. A couple of our residents are training for marathons right now, one just did an ironman, I'm in an intramural sports league, I still have time to eat out, go to concerts, hell, even post on this corner of the internet.

 

[Pir8DeacDoc]

My own experience and thoughts on this are very similar to zag.

The only thing to throw out to keep it factual is that almost all urology residencies do 1 year of general surgery. Very few anymore do two years. I don't know of any that do three. Otherwise I agree with his/her thoughts almost to the word. Reminds me of my "life"

 

[nordr]

Expect to be very busy. Intern year should be the same for all three specialties. 2nd year in my program is by far the worst. Q2-Q3 call without post-call days as it is "home call." That's in quotes for a reason...

As others have said, choosing a specialty based on amount of sleep during residency is a very poor metric. Don't pick ENT because you want to do surgery but want an easy lifestyle. You will be quickly disappointed and burnout. Pick the specialty that you are most passionate about. The time passes quickly if you are doing what you love. To put it another way: A 60-hour week at a job that is not stimulating will be far more miserable than an 80-90 hour week at a job you love.

Another thing to consider is that the hours during residency probably vary more by program than by specialty. You can get a sense of that by looking at case numbers the graduates have. Just don't be that kid in the interviews obsessing over getting down exactly what the call schedule is.

 

[Brathmore]

Expect to be very busy. Intern year should be the same for all three specialties. 2nd year in my program is by far the worst. Q2-Q3 call without post-call days as it is "home call." That's in quotes for a reason...

As others have said, choosing a specialty based on amount of sleep during residency is a very poor metric. Don't pick ENT because you want to do surgery but want an easy lifestyle. You will be quickly disappointed and burnout. Pick the specialty that you are most passionate about. The time passes quickly if you are doing what you love. To put it another way: A 60-hour week at a job that is not stimulating will be far more miserable than an 80-90 hour week at a job you love.

Another thing to consider is that the hours during residency probably vary more by program than by specialty. You can get a sense of that by looking at case numbers the graduates have. Just don't be that kid in the interviews obsessing over getting down exactly what the call schedule is.

Thanks to everybody for their thoughts and advice. I understand your points that you shouldn't choose residencies based on lifestyle over a only a few years. But I've met practicing doctors who quit their surgical residencies because they simply became too physically exhausted. I'm definitely NOT the "iron man" type, nor am I the "hey, what the hell, I'll stay up all night type." When I don't get 6-8 hours of sleep, I definitely feel it the next day.

I guess my worry is about the uncertainty about whether I can adapt successfully to a situation where I get lots less sleep than I ever have in my life. How do you adapt? Do most people do it successfully?

 

[OtoHNS]

I guess my worry is about the uncertainty about whether I can adapt successfully to a situation where I get lots less sleep than I ever have in my life. How do you adapt? Do most people do it successfully?

Wait until M3 year and see for yourself. It's not a bad idea to brainstorm about future residency plans while you're still in the preclinical years, but you will get a lot better grasp on what you actually like once you spend some time on an ENT or ortho or GU service.

Things you can do now (I'm assuming you are a M1-M2): 1. go spend a couple days shadowing any of the specialties you are interested in. 2. Think about getting involved in a research project, especially over the summer between M1 and M2 years.

 

[Butler]

Moving over to another forum.

 

[Osteoth]

Expect to be very busy. Intern year should be the same for all three specialties. 2nd year in my program is by far the worst. Q2-Q3 call without post-call days as it is "home call." That's in quotes for a reason...

As others have said, choosing a specialty based on amount of sleep during residency is a very poor metric. Don't pick ENT because you want to do surgery but want an easy lifestyle. You will be quickly disappointed and burnout. Pick the specialty that you are most passionate about. The time passes quickly if you are doing what you love. To put it another way: A 60-hour week at a job that is not stimulating will be far more miserable than an 80-90 hour week at a job you love.

Another thing to consider is that the hours during residency probably vary more by program than by specialty. You can get a sense of that by looking at case numbers the graduates have. Just don't be that kid in the interviews obsessing over getting down exactly what the call schedule is.

So when did you figure out you were passionate about urology?

As I go through my medical training I feel as though I get less and less passionate and more and more accepting of my circumstances.

I think I could put myself through a surgical residency, but I feel like it would be via brute force, secondary to any innate passion. Obviously this is antithetical to your line of thinking, but I just wonder if its worth it to run that gamut.