Compare with where I did fellowship, they were pulling q4 call and worked at least one day each weekend - just how they handled rounds and weekends. Their program would be considered much more intense, but I arguably logged far more good cases and came out with better training while also enjoying my life.
Based on my limited experience, QoL and good training, even in surgical fields, are not mutually exclusive. Even more importantly, hours worked does NOT translate to good training. I worked long hours on my last sub-I (base hours 5a - 6:30p, 12 on, 2 off PLUS additional time for late consults, emergent cases, interns late for signout, etc...) despite being on a very low volume service (3-4 patients on service at most times including consults, 2-4 cases/week). I spent a lot of time sitting around the workroom reading, but it wasn't really efficient. I can read 3x more efficiently at home or in the library compared to the workroom, where you're being interrupted every 5 minutes or having to read while someone else is gossiping in the background. I tried to scrub for as many cases with other services as possible when there was down time, but even that didn't make up for it.
Overall, it was one of my worst learning experiences. Inefficient reading time. Long hours. Poor sleep. Low case volume. Poor prep for additional cases, which were scattered. It showed me that I want a residency program that is busy in terms of patient volumes and cases, but lighter on hours so I can actually sit down at my desk and re-organize, absorb, and supplement the conditions I managed that week. If I'm not
studying my patients and their conditions, I am no different from a mid-level who practices based on experience alone rarely cracks a book.
As for the specialties, I agree it's definitely program dependent, but I love arbitrary lists so IMHO
1) Neurosurgery
2) Gen surg, ortho
3) ENT, urology, plastics, OB/Gyn
4) Neuro, IM, peds, rads, anesthesiology, ophtho
5) FM, EM, pathology, PM&R
6) Psych, derm
