Hi there -

I'm at Gundersen Lutheran in La Crosse Wisconsin for categorical medicine. I love it and am home by 5 almost every night except call nights. AND on call days, we get to go home between noon and 4 or whenever we get our first patient (which sometimes isn't until 7 or 8 PM). AND the residency comes with housing that is across the street in this nice, sheltered community where the kids play together every afternoon and everyone is there for each other. I was initially averse to the idea because I like my space and privacy. However, our homes are private and well built (duplexes with 2 bedrooms and a convertible office to bedroom) and include everything - all utilities, TV, phone, high speed wireless internet. EVERYTHING - and the rent is so unbelievably low that many pay down on the student debt and most live an upgraded lifestyle compared to most residents. This enables those with kids to afford their spouses to stay at home if they wish.

Its a community program with a 100% board pass rate for 6 or 7 years, located in a safe, affordable and great town. Its "community" but also considered a teaching facility and serves as a site for medicine, elective and surgical rotations for med students at University of Wisconsin. I guess I never expected NOT to work hard. And I'm learning a ton. I have always planned to pursuit fellowship after residency and have no doubts I will do so. The residents here who want fellowship seem to have no problem matching (this year there are two residents matched to cardiology and heme/onc programs next year).

I think what makes this residency program so nice is the balance that you can have between learning/work and family. I'm 100X more satisfied than I anticipated I would be. This facility also has general surgery and transitional year programs as well.

I'm just starting my 8th week of call Q4 and there are days when I'm tired. However, I'm not overwhelmed by fatigue and am still excited to walk the 5 minutes it takes me to get to work every morning.

I'm also an IM intern at a community program, and overall very happy. We have 3 months of Q3 in the ICU, but a night float system for wards so we all do a month of nights and then have overnight only 2 nights during each ward month. I'd trade a month of nights for Q3 or Q4 during 5 ward months any day of the week.

The learning is great, dedicated teaching time and morning report and noon conferences that I actually look forward to.

Wherever you end up, you'll do just fine. Sure, it's a balance. It's a long run balance, not an everyday balance. One day at a time really is all it takes. Of course, it helps to have a wonderful husband and 3 little smiling faces who still love you no matter what

I keep trying to remind myself that this year will go so fast and soon I'll be attending (!) and probably missing some of this...

i was a new mom intern and it was tough. its still tough. i'm glad we have a daughter but it is so difficult. thing is i think as mothers we need to not be hard on ourselves and learn to not let other peoples opinions bother us. problem is i am not the kind of resident i wanted to be, i'm not the kind of mom i wanted to be. my husband is supportive so that helps. but i'm really struggling to re-define my expectations and feel comfortable with me doing "my best" some days work better than others days. today wasn't too good!

What specialty are you going into?

Can somebody explain me exactly how that the 80 hours/week work? I have 2 kids and I am going to start residency in July so I am trying to figure out how to schedule many things at home, seeking for daycare/aupair nanny. I would like to know hwo it is supposed to work the 80 hours /week?
I already was a member in the forum but forgot my password and i have to get a new account so I am a new member again.

I am currently an intern in pediatrics and I have a 14 month old and am expecting baby #2 in September. My program is very family friendly - there are a lot women with children at my program, it is one of the reasons why I chose it. I have never gotten to the 80 hour work week, on the floors the most is about 70-72 at the worst. I usually get to see my son in the morning for about an hour and then again for about 2-3 hours at night.

Thank you dr.leahs. Do the 80 hours/week include the on call hours?. It might be a silly questions but I am not sure how we get those 80 hours /week, I came form another medical reality and I used to work about 75/week but they include the nigth calls, so most days we worked from 7am-5/6 pm and shifts from 7 pm -7am q4.

I saw that you are in NY, I will be moving in that area too, I am not sure how family friendly is my program yet althouhg many residents have family but it is a very busy program although they look happy. Can you tell me what would be better option to kid's'care in NYC? a day care center or a nanny/au pair, I mean it is just very expensive compare with the actual place where I live in the US and we have no family support there.

Congratulations on your second baby, I am happy I am done with kids before starting residency because it was hard my second pregnancy to work and study for the steps.

The hours include call, mostly because the average call night = lots of work. Not always, but more often than not.

Now, where I trained, the ortho guys took "home call" once they were PGY 3-5, and those hours apparently didn't count. Rumor had it that was the only way they could stay under the 80 hour work limit.

Every program is different, and every month is different so it's hard to generalize. Being on call q4 generally means that you spend each 4th day working a 30 hour shift and go home around noon the next day. That racks up the hours really quickly. On call q3? Then you've got 2 of those 30 hour shifts in a week.

The 80 hour limit is averaged over 4 weeks, so it would be theoretically possible to be q2 for a week or two and have less call the rest of the month to make up for it. Q2 is exquisitely painful and I did it for a week on the trauma service as an intern. It's roughly 30 on, 18 off, 30 on, 18 off, etc., and miserable. Thankfully, it's pretty rare and only happens when there are extenuating circumstances. (Emergency trades for family emergencies, etc - most Chiefs who make the schedules know how it sucks and try to avoid it)

HTH,
Danielle (who doesn't take call now and doesn't even have a pager)

Call was one of those things what was deepest mystery to me when I was pre-med, so I'll venture in here. I'm an intern in internal medicine. Here's my schedule this week:

Sunday, yesterday: I worked 7AM to 1 PM. Very unusual, but awesome.

Monday, today: OFF. Gorgeous. Sitting in my backyard, enjoying a glass of wine and the daylight savings time sunshine, watching my boy dig in the dirt. Heaven.

Tuesday: call, which means my team, which consists of two interns and one resident, is admitting patients from the emergency department today. We also take direct admissions and transfers from other services and from the ICU.

I'll arrive at the hospital around 7 and check in on my patients. I'll discuss the patients with my resident around 8. At 9, we'll meet up with our (new) attending and start to round. Likely a break from 10-11 for morning report (resident teaching), then more rounding until noon. Lunch conference (food and more teaching) at noon. I'll probably spend the early afternoon getting some work done: writing notes, discharging patients, that kind of thing. Generally we start admitting mid-afternoon. I can admit up to 6 patients on a call and most calls, I'm quite busy until around 2 AM, admitting the full 6. On a typical call, I sleep from ~2 AM to about 6 AM, with 5-10 pages/interruptions sprinkled in there.

Wednesday: I'm up at 6 AM if not before, seeing patients, writing notes, and generally scrambling to get my work done by noon so I can go home. I nap until about 3, then pick up my one-year-old at daycare.

Thursday: I'll get to the hospital at 7. We're "short call", which means I can admit up to 2 overnight patients. I have clinic at the VA in the afternoon, so the day in general will be a bit of a flail because I have to make time to bike from my university hospital to the VA around noon.

Friday: pre-call, which is generally quiet, except that this Friday, my resident has the day off and my co-intern has clinic in the afternoon, so I expect the afternoon to be quite busy since I'll be doing the work of three. I think I'll be lucky to leave the hospital before 6 or 7.

Saturday: on call again. Repeat of Tuesday.

I think that's around ~75 hours for the week. Could be worse, I guess.

I'd love to see more examples of weekly schedules (and what field you are in!)...helpful to those of us still in medical school and deciding our futures!