[quote]sloh wrote:
Hey Fawkes,
Could you elaborate more on what residency is like, in terms of stress and how much time you actually have to stay in the hospital?
I am a pre-med student right now. Although I am set on going through with this route, I question if i truly LOVE this field. [/quote]
It depends. Intern year (PGY1 , first year of residency, post graduate year 1) typically sucks.
PGY 1 for surgery - 100 hours week average. Law prohibits more than 80 hours week average but all programs violate it and get around it.
PGY1 for everthing else is usually about 60-85 hours per week average. Some are lighter and kinder - some are more malignant. During your 3rd and 4th year try and rotate at hospitals in areas you want to do residency in, and you can ask around and see what that hospital and program is like.
A bad week may be something like , in patient internal medicine :
monday - preround at 5 AM, see 8 patients, collect data, try to write notes but can’t finish. Meet with attending physician and rest of team for rounds at 7 AM - present the information on the patients you have been assigned to, depending on the attending get verbally reprimanded or a surly look for not finishing notes. Round with team until 9:30 - some attendings love to teach and will teach you alot at this time, others don’t like to teach and you won’t learn much. Then finish notes, order labs, consults with specialists. Noon - lecture with lunch. 1-6 clinic. (13 hours)
Tuesday - preround, round, clinic, then oncall in the hospital until noon the next day. From 7 PM until 7 AM get about 30-100 pages from nurses with questions - can this patient have Tylenol, does this patient need restraints etc etc etc. At 2 AM go to the residents room and lay down to sleep. 3:00 Am get woken up by emergency dept because they have someone with acute renal failure they want you to admit and take care of. 5:30 Am consider sleep but realize you have to go and pass patients off to the incoming team. Noon you leave. (30 hours)
Wednesday go in for clinic from noon until 5:30. (6 hours)
Thursday repeat Monday. Get pages from nurses at 1 AM who thought you were on call but you aren’t. (13 hours)
Friday repeat Tuesday - admit a very sick child. Keep checking on them in between all your work and tell them its going to be okay. See them as your first patient 5:30 Am no matter what, breathe a sigh of relief they are alright - the rest of the day seems so much better because they are alright. Supposed to get off at noon, but incoming team is slow and you don’t get out until 1. Sleep a few hours, go to the movies - get page from nurse in middle of movie because she thought you were the resident on call. (31 hours, but that last hour from 12 to 1 seemed like 6 hours)
Week total was 92 hours. The next week so that they are in compliance with the law you will only work about 70 hours - so that it averages 80 hours.
Some residencies like Physical medicine and rehab (PMR) or psyche - you will often go in at 7 and be done at 2 PM. Those residencies are notorious after the first year of only working like 35 hours per week - I have literally seen psyche residents peel out of the parking lot at 2 AM, knowing I am there until much much later. When oncall for internal medicine you will see them the next day coming in 7 AM the next day for their NEXT shift while you are still finishing yours from the day before.
So PGY2 etc can vary alot from residency to residency. Dermatology, radiology, psychiatry,pathology, PMR , anesthesiology are all pretty darn cake. Family medicine, internal medicine, etc are at the upper limits of what is legal to make you work usually - although maybe 30% of all family medicine residencies only have you work perhaps 60 hours per week even your intern year. you just have to look around and ask around. Surgery is always crazy - plan on literally doing surgery non-stop some days for 18 hours. Obstetrics sucks in terms of the hours - you will get called in ALOT at 2 AM to deliver a baby.
Stress? It depends on what you find stressful - someone is suited for all those specialties - those suited for surgery love it (like my brother, loves the OR), and working 30 hours per week in psychiatry talking about feelings would kill him. If you PM me or something I can point you towards some posts that might help you make a decision in some doctor websites.
The money’s not bad either, but my main goal is a challenging career with an endless learning curve. I’m pretty much stuck at the level of care I can provide and there are so many facets of medicine that interest me that I’m not allowed anywhere near.