Which specialty allows you to have a more balanced life?

[NickNaylor]

One month of actual experience as an M4 is plenty for me to make a judgement on the field's lifestyle. I wasn't in some sleepy small town ER, it was a major urban level 1. Still not seeing why everyone is so soggy about the lifestyle. 35-40 hours a week in discrete shifts is pretty sweet for any job in medicine, regardless of the shift timing.

I'd agree about the appeal of shift work, but I think for some people (e.g., me) the constant flipping of the timing of shifts is a bit of a deal-breaker. In terms of overall lifestyle, though, I'd agree that EM has it pretty good apart from the potentially odd working hours.

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[Mass Effect]

One month of actual experience as an M4 is plenty for me to make a judgement on the field's lifestyle. I wasn't in some sleepy small town ER, it was a major urban level 1. Still not seeing why everyone is so soggy about the lifestyle. 35-40 hours a week in discrete shifts is pretty sweet for any job in medicine, regardless of the shift timing.

One month is really nothing, compared to a career. Anything can be enjoyable for one month. It's when you're constantly flipping your days and nights for years on-end that it becomes physically and mentally draining. By the way, keep in mind, no one said that ED is a horrible specialty for everyone. Obviously, some ED docs like what they do. But the facts are that (a) it has a huge burn-out rate and (b) most people will not adapt to the sleep cycle changes as well as others.

 

[VisionaryTics]

Lots of med students think trauma surgery is amazing after their one month rotation...

Not many general surgery residents think trauma surgery is amazing after 4-5 years...

Every otolaryngologist enters residency a head and neck surgeon and leaves a plastic surgeon.

 

[AnonymousD.O.]

delete

 

[oldanddone]

 

[razor]

"Cush" isn't the word I'd use to describe EM docs. Yes, it is cool to only work a few shifts a week. On the other hand, when you're constantly changing your sleep cycle to work overnight for three days, followed by a day shift for two days, then another two days of overnights, it's not exactly "cush" in my book. Also, weekends and holidays don't exist, so unless you marry someone with similar schedule constraints, you could weeks without the same day off as your spouse.

Just my opinion and I'm sure people will disagree, but I think being a hospitalist in IM is more cush than being an ED doc.

Do EDs typically schedule physicians all over the place like this, or do they ever get a consistent day or night shift routine? Same with hospitalists? Are they at risk of being bounced back and forth between days and nights?

 

[KinasePro]

One month is really nothing, compared to a career. Anything can be enjoyable for one month. It's when you're constantly flipping your days and nights for years on-end that it becomes physically and mentally draining. By the way, keep in mind, no one said that ED is a horrible specialty for everyone. Obviously, some ED docs like what they do. But the facts are that (a) it has a huge burn-out rate and (b) most people will not adapt to the sleep cycle changes as well as others.

Lots of med students think trauma surgery is amazing after their one month rotation...

Not many general surgery residents think trauma surgery is amazing after 4-5 years...

Obviously more time in any field allows you to develop better insight into whether a field is a good fit for you.

But in 1 month, especially on EM, you have access to dozens of attendings and dozens of residents. If that is not enough "data" for you to determine whether or not you'll be happy with that lifestyle, then I don't know what to say to you. Maybe the students your talking about are hesitant to shed their rosy red glasses and aren't vigilant about becoming fully immersed in the field during that month. But that's more attributable to thier lack of insight, not to thier lack of exposure to the field.

 

[KinasePro]

I think any field with high levels of burnout or attrition, my own included, you have to at least consider whether students have had adequate exposure to make an informed decision about their careers.

But what else would you learn about lifestyle in an extra 3 months on a busy trauma service that you wouldn't have learned in a single month? While there are seasonal variations in trauma volume, if you're at a truly busy hospital the misery will be mostly constant. In 1 month you can talk to multiple attendings/residents, take copious call, stay up all night doing ex laps and struggle through clinic the next day, arrive early/stay late to ensure your patients are cared for, and anything else becoming totally immersed entails.

As someone who did 4 months on very busy orthopaedic surgery services, I'll opine that theres a diminishing marginal benefit in learning what the "day to day" lifestyle is like after a few weeks. My impressions about the lifestyle of the field didn't change from week 2 to month 4.

 

[Renaissance Man]

I know it is just a Medscape survey from last month, but look how closely grouped almost all of the specialties are in burn out rates. I think that burnout is a huge problem for all specialties and isn't really a failing specific to EP's. I personally always hear the "burned out" warning when I tell others about my desire to practice EM. The reality is that the absolute risk reduction of burnout from pursuing another specialty is probably minimal/not significant.

 

[Mad Jack]

Do EDs typically schedule physicians all over the place like this, or do they ever get a consistent day or night shift routine? Same with hospitalists? Are they at risk of being bounced back and forth between days and nights?

You will generally rotate until you die. A day-only ED job is an extremely rare thing indeed.

Hospitalists generally work days, but some are nocturnists (nights). You will have a set schedule, one or the other.

 

[Brigade4Radiant]

Lol ER doesn't really have that much worse of a burnout factor compared to other fields. A higher % of docs may feel symptoms of burnout but as for severity of burnout ER is dead middle. IM and FM also have similar burnout rates. EM sucks in some aspects and rules in some other. Same with hospitalist in which you WILL work nights. Reality check if the ER doctor is working at night other doctors have to work to. Yes you work night shifts but no call as in no getting waked up in the middle of the night to take care of your patients and have a full day of clinic in the morning. You can work 6 shifts a month and make as much as a pediatrician. You will never work the same amount of true night shifts as you will evening or day because after 3:00 AM there will not be that many patients to see. Your night shifts are generally scheduled all toghether so that is about 3/4 nights a month. Gen surgery has a 20% attrition rate way more stressful. Pathology may be considered a lifestyle specialty but the residency is long as hell and the chances of getting a job in a place you want to live is really low. In medicine you pick your poison.

Even for surgical subspecialties you are going to be working 60+ hours building your practice and patient base after residency

 

[colbgw02]

Huh? Pathology is either 3 or 4 years. Same as EM.

 

[Mass Effect]

But what else would you learn about lifestyle in an extra 3 months on a busy trauma service that you wouldn't have learned in a single month? While there are seasonal variations in trauma volume, if you're at a truly busy hospital the misery will be mostly constant. In 1 month you can talk to multiple attendings/residents, take copious call, stay up all night doing ex laps and struggle through clinic the next day, arrive early/stay late to ensure your patients are cared for, and anything else becoming totally immersed entails.

As someone who did 4 months on very busy orthopaedic surgery services, I'll opine that theres a diminishing marginal benefit in learning what the "day to day" lifestyle is like after a few weeks. My impressions about the lifestyle of the field didn't change from week 2 to month 4.

Right, just like day 2 of nightfloat feels exactly like week 2.

 

[charmiedermie]

you start early, but often get to leave early if there aren't too many cases. Besides, if you've ever been in the OR during a case, anesthesia is usually chilling out, texting and Facebooking during the case.....of course, if there are issues during the case, you deal with those, but most of the time, it's pretty laid back...you're not scrubbed/sterile so you can watch movies on your iPad and just chill

ok some of us would sacrifice some of that pay in return for getting to wake up later....not all docs wake up at 0500 am and that's also not when most "tax paying" adults wake up for work. some do, but many folks wake up at 8 and are at work by 9. also, i would rather start later and be done later (ie 9-5). but other people are "morning ppl" and they would prefer 6-2.

on my OBGYN rotation, my attending started her outpt clinic at 1000 everyday. pretty sweet

Thanks Kristy! I got a lot of sarcasm, personal jabs, and unnecessary insults but none whom would just directly answer like u did of why Anesthesia is a lifestyle specialty. And lol at the person who said that most taxpaying adults wake up at 530/600 to start at 630. I agree on your sacrifice of pay comment.

 

[FreakofMeds]

Plenty of cush fellowships within Internal medicine like endo, allergy, rheum, GI. Personally, I would rather spend 80 hours in the cath lab than do a 12 hour shift in the ED. Call me crazy, but even within cardiology you can have pretty good lifestyle. It just depends on what practice you end up getting into. Non invasive / imaging will have good life style. Pure EP too. Interventional not as much, but even it depends on how large of a group you are in and how often you have to take STEMI call.

 

[charmiedermie]

That is what most tax paying employed adults do. Especially when they have kids. 530-600 is an entirely normal wake up time.

Maybe in your bubble, but it depends on the specific job, depends on how close they live to that job, but many "taxpaying" adults don't have the 530/600 arrive to work time. Pretty sure schoolteachers aren't waking up that early on a frequent, consistent basis.

 

[fancymylotus]

no way am i ever waking up at 530am for work. lol.
or even 6

only way ill be up that early is if the princesses are crying.

 

[charmiedermie]

no way am i ever waking up at 530am for work. lol.
or even 6

Then you obviously don't pay taxes.

 

[fancymylotus]

Then you obviously don't pay taxes.

i pay taxes. i pay SO MUCH MONIES in taxes it makes me sick. hrmph. i guess what im doing wrong is waking up so late. i should wake up earlier= less taxes!

 

[charmiedermie]

My mother was a schoolteacher and school administrator for 30+ years, and lived less than 5 miles from work. When she had kids, that's exactly how early she woke up.

Good for u and her situation. My aunt is a schoolteacher and doesn't. Different people have different lives, are at different stages of their lives, and not everyone has kids.

 

[touchpause13]

The point wasn't about my personal life, it was just ironic that that was the example you gave.

If you sampled professional adults across a wide swath of fields, waking up sometimes between 5:30-6:00 would be extremely common. You act like it is extremely rare and borderline criminal.

FWIW Mr. Tp (ChemE) wakes up a 5:30.

 

[charmiedermie]

The point wasn't about my personal life, it was just ironic that that was the example you gave.

If you sampled professional adults across a wide swath of fields, waking up sometimes between 5:30-6:00 would be extremely common. You act like it is extremely rare and borderline criminal.

Sigh. I didn't act like anything. I said it was early previously, which is my opinion, and I replied more to what DrKristy85 said - "not all docs wake up at 0500 am and that's also not when most "tax paying" adults wake up for work. some do, but many folks wake up at 8 and are at work by 9." Hope that clears it up.

 

[Southplains]

Maybe in your bubble, but it depends on the specific job, depends on how close they live to that job, but many "taxpaying" adults don't have the 530/600 arrive to work time. Pretty sure schoolteachers aren't waking up that early on a frequent, consistent basis.

My sister is an 8th grade teacher with two young children and she gets up by 6 at the latest. I realize some people sleep in more but I've always seen the norm being 5-7. People like to drink coffee, eat breakfast, shower then commute to work and school classes start at like 8. If you have kids to get ready and drop off as well, you've gotta get up early.

 

[charmiedermie]

My sister is an 8th grade teacher with two young children and she gets up by 6 at the latest. I realize some people sleep in more but I've always seen the norm being 5-7. People like to drink coffee, eat breakfast, shower then commute to work and school classes start at like 8. If you have kids to get ready and drop off as well, you've gotta get up early.

I agree, if you have children, then its very normal to have to get up that early in general, much less go straight in car ride to work.

 

[AnonymousD.O.]

Plenty of cush fellowships within Internal medicine like endo, allergy, rheum, GI. Personally, I would rather spend 80 hours in the cath lab than do a 12 hour shift in the ED. Call me crazy, but even within cardiology you can have pretty good lifestyle. It just depends on what practice you end up getting into. Non invasive / imaging will have good life style. Pure EP too. Interventional not as much, but even it depends on how large of a group you are in and how often you have to take STEMI call.

I heard cardio reimbursements for nuclear echo etc. have plummeted. Was the person I was talking to full of it or what. Because that would be a huge hit if I ever were to consideral general cardio. Anybody know if that's true or not

 

[Dave89]

"Hate yourself?" --> Neurosurgery

 

[Winged Scapula]

What is this mythical "9-5" job? That's 8 hrs without lunch or breaks. Most people I know, with office jobs are in by 0800 at the latest. Like others here, the adults I know even those without kids are up between 430 and 630 and this includes a wide range of professions.

 

[Psai]

What is this mythical "9-5" job? That's 8 hrs without lunch or breaks. Most people I know, with office jobs are in by 0800 at the latest. Like others here, the adults I know even those without kids are up between 430 and 630 and this includes a wide range of professions.

it's where you wear an ugly tie, sit at a computer and putt about with some useless papers, make some silly small talk with your co-workers over coffee, steal a slice of roast beef from bob's sandwich at 11:30 and say things like "Ah, yeah...so if you could go ahead and try to remember to do that from now on, that'd be great..."

 

[alpinism]

That is what most tax paying employed adults do. Especially when they have kids. 530-600 is an entirely normal wake up time.

Sure, but the vast majority of tax paying adults aren't starting work at 630am or even 7am according to the US census.

http://blog.expertmarket.us/what-time-america-start-work

I also highly doubt most people are getting up at 545 to be at work at 8am.

If you have kids then yeah you'll have to be up earlier, but then again if they had to be at work at 630 they'd be getting up at 4am.

 

[ThoracicGuy]

it's where you wear an ugly tie, sit at a computer and putt about with some useless papers, make some silly small talk with your co-workers over coffee, steal a slice of roast beef from bob's sandwich at 11:30 and say things like "Ah, yeah...so if you could go ahead and try to remember to do that from now on, that'd be great..."

 

[Winged Scapula]

it's where you wear an ugly tie, sit at a computer and putt about with some useless papers, make some silly small talk with your co-workers over coffee, steal a slice of roast beef from bob's sandwich at 11:30 and say things like "Ah, yeah...so if you could go ahead and try to remember to do that from now on, that'd be great..."

LOL- but don't they still start at 800 or is the average work week only 35 hrs?

My FB friends (teachers, mechanics, doctors, marketing execs, IT etc) all seem to posting from work before 900.

 

[Winged Scapula]

I heard cardio reimbursements for nuclear echo etc. have plummeted. Was the person I was talking to full of it or what. Because that would be a huge hit if I ever were to consideral general cardio. Anybody know if that's true or not

Reimbursements for almost everything have dropped especially for image guided interventional procedures.

 

[Slack3r]

Sure, but the vast majority of tax paying adults aren't starting work at 630am or even 7am according to the US census.

http://blog.expertmarket.us/what-time-america-start-work

I also highly doubt most people are getting up at 545 to be at work at 8am.

If you have kids then yeah you'll have to be up earlier, but then again if they had to be at work at 630 they'd be getting up at 4am.

"Average american" includes a pretty wide range of professions.

How about professionals? All the engineers, accountants, office workers, teachers, etc. I know start between 7-8, with most of them starting between 7-730. Even dermatology residents often have required didactics in the am (630-7 start time).

 

[PL198]

Plenty of cush fellowships within Internal medicine like endo, allergy, rheum, GI. Personally, I would rather spend 80 hours in the cath lab than do a 12 hour shift in the ED. Call me crazy, but even within cardiology you can have pretty good lifestyle. It just depends on what practice you end up getting into. Non invasive / imaging will have good life style. Pure EP too. Interventional not as much, but even it depends on how large of a group you are in and how often you have to take STEMI call.

I'd rather gouge my eyes out than stare at metabolic panel results and talk about ion levels

 

[Mass Effect]

What is this mythical "9-5" job? That's 8 hrs without lunch or breaks

Psych, people. Psych, psych, psych, psych, psych.

 

[Baller MD]

Psych, people. Psych, psych, psych, psych, psych.

Plus PM&R.

 

[Winged Scapula]

Psych, people. Psych, psych, psych, psych, psych.

We were talking about non medical jobs working 9-5; in PP medicine you can make your own hours (I could work those hrs if I wanted).

 

[touchpause13]

What is this mythical "9-5" job? That's 8 hrs without lunch or breaks. Most people I know, with office jobs are in by 0800 at the latest. Like others here, the adults I know even those without kids are up between 430 and 630 and this includes a wide range of professions.

Thinking about all the people I know with jobs....
Engineer, psychologist, police officer, lawyer, nurse, PA, retail workers, CNA, HHA, machinist....
Honestly I can't think of 1 person in my life that works a job like that. Everyone I know either gets up at 5:30-6:30 or does shift work of some sort. I don't think 9-5s really exist anymore...

 

[Brigade4Radiant]

Thinking about all the people I know with jobs....
Engineer, psychologist, police officer, lawyer, nurse, PA, retail workers, CNA, HHA, machinist....
Honestly I can't think of 1 person in my life that works a job like that. Everyone I know either gets up at 5:30-6:30 or does shift work of some sort. I don't think 9-5s really exist anymore...

It really doesn't also if you are an engineer or lawyer or a business man you can't just leave at 5 if you have a project that has to be done by a deadline. Also with some of these jobs you also work weekends. American's lives in general are involving more work for less pay it isn't exclusive to medicine.

 

[calvnandhobbs68]

9-5 jobs do exist but they seem to mostly be (from observation) secretarial and government jobs. Essentially no private sector professional jobs, unless you're working some cush government contractor office job.

 

[Lawgiver]

8 hour job = 12 hour daily commitment, on average.

 

[pd1112]

I've never understood the "I could never wake up that early" argument or similar. You do it because you have to and within a month or less, you're wired that way. It's no longer a burden and you eventually don't even need an alarm.

Dude. Every time I see you in a thread you are arguing with people. The majority of your time, your opinion is the minority (and usually just factually incorrect). You never seem to present a logical, thought-out argument and there is always a myriad of posters poking holes in your piles of posts. You also have > 400 posts in less than 2 months. Reconsider the value of your internet time. Right now it's biblically low.

Lol'd in bed and woke up significant other. Just wanted to say props.

 

[Follow the Cairns]

I think you can have a good work life balance/working hours regardless of specialty. Often, it depends more on your practice arrangement, work environment and efficiencies (or lack thereof) etc.

My husband is an Orthopaedic surgeon currently in Academic practice (not Trauma, though he does often do trauma on call) and he routinely works an average of 50 hours per week not counting commute. This is in a practice where he sees 40 patients per day on clinic days and does about 10 cases per week. When he was in private practice, he often worked less than 40 hours, again, with similar or even higher productivity.

Could he be busier? Probably. But he is very satisfied with the balance he has now in terms of workload and makes roughly MGMA median for his subspecialty.

 

[e30ftw]

And lol at the person who said that most taxpaying adults wake up at 530/600 to start at 630.

all this bickering about time people wake-up is pointless because charmiedermie misinterpreted my original post.

I never said that typically taxpaying adults wake up at 0530, although many of them do.

I said, in reference to anesthesia, most adults wouldn't mind waking up at 0545 if they were done by 2pm and made $400k/yr.

and dammit, I stand by that statement.

 

[charmiedermie]

Sure, but the vast majority of tax paying adults aren't starting work at 630am or even 7am according to the US census.

http://blog.expertmarket.us/what-time-america-start-work

I also highly doubt most people are getting up at 545 to be at work at 8am.

If you have kids then yeah you'll have to be up earlier, but then again if they had to be at work at 630 they'd be getting up at 4am.

Great find @alpinism! With charts, and the median arrival time to work in the U.S. is 7:55 am. Safe to say an actual job which starts at 9, which is pretty late, and ends at 5 probably does not really exist. Didn't think that was a question for most people.

You get an A in reading in what I actually said, and not reading only half of what I said. I was talking about most taxpaying Americans, not all professionals, waking up that early to go to work. They may wake up early for a variety other reasons, sure, which other people have said.

And lol at the person who said that most taxpaying adults wake up at 530/600 to start at 630.

 

[charmiedermie]

.

 

[charmiedermie]

I said, in reference to anesthesia, most adults wouldn't mind waking up at 0545 if they were done by 2pm and made $400k/yr.

Lol. How many of those type of jobs are realistically available in major cities?

 

[maxxor]

Thinking about all the people I know with jobs....
Engineer, psychologist, police officer, lawyer, nurse, PA, retail workers, CNA, HHA, machinist....
Honestly I can't think of 1 person in my life that works a job like that. Everyone I know either gets up at 5:30-6:30 or does shift work of some sort. I don't think 9-5s really exist anymore...

Commercial Banking and Insurance

 

[e30ftw]

543 last time I counted.

 

[Psai]

LOL- but don't they still start at 800 or is the average work week only 35 hrs?

My FB friends (teachers, mechanics, doctors, marketing execs, IT etc) all seem to posting from work before 900.

If they're posting on Facebook, they probably aren't busy enough to have to be there before 9