Residency = Hell??

[Satsuma]

lol thats a great starting pay... many other professions start with a much lower pay!

 

I argue that for the training, responsibility and hours worked that is a terrible pay. I made more as an SLP before starting med school: I worked 8-4 daily, with breaks and an hour lunch. If I worked over for some reason 1 day, I banked those hours and took off early another day. I had ALL my weekends off. I could not possibly kill any of my patients. I had a pension plan that the hospital I worked for contributed to. I was never required to stay at work for 28+ hours without sleep 2-3 times per week (yep, despite all the rules, you innevitably end up with a Mon, Fri, Sun call each month). I didn`t have 4 weeks of vacation but I did have 3 weeks, which isn`t terrible considering I was not nearly as exhausted as an SLP. I also did not have the huge debt I have now.

[ubcredfox]

Residency = Hell (true).

 

Firstly, let's discuss hours and how much they blow for an R1. For the third month in a row, I'm working 19 days without cessation and only have 4 days off during the entire month i.e. two weekends. I've worked 52 hours already and it's only Tuesday. An average week is about 85 hours for me. Days start at 0730 and end around 1800. Sometimes there's time for lunch i.e. 15 minutes to choke down a sandwich. In Nova Scotia, residency work hours are limited to 90 hours per week. I've worked very holiday so far this year and it's not looking any better in the future.

 

Secondly, the pay is disproportionately low for the work that we do. Furthermore, considering that senior residents often function as junior staff i.e. with almost no or minimum staff input/supervision, it is really amazing that they are paid about a fifth of what attending staff make. It makes you feel really good knowing that when you see 40 patients in the clinic on a given day, do all the grunt work, you've made your attending a grand or so, while you've taken home about two hundred bucks. Further, for the hours that are worked, our pay is laughable. My friends who went into engineering (five years of total schooling at much lower tuition fees) have started in the mid-60's straight out of the gate, working 9-5 with four weeks vacation. Friends who chose to do other jobs, such as the police, have an even sweeter deal. We actually save lives on a daily basis and bring people back from the brink. Without my fellow residents' intervention there'd be a lot less people prowling the streets of this city...and we get paid **** to do it.

 

Thirdly, the abuse that residents suffer is truly incorigable. I am a physician only so that I can sign orders and bear the brunt of all responsibility. Certain other residents refer to the R1's as just the R1. Some staff are similar. No collegiality here - no I'm just the ward ***** that's meant to do all the leg work. Some nurses act similarly. I really wonder why such malignant personalities go into medicine, and how in the hell they actually make it through? I don't know - but I've worked with some really a$$holes thus far. That makes the hours just fly by.

 

Fourthly, and most vexing, is the fact that our residency training programs are totally and completely arbitrary in terms of length. Just look at the US. They graduate specialists in fields like IM, Peds, ER, Path etc. in a much shorter time frame then we do in Canada. Are they trained to an inferior standard? I doubt it. Not much training happens in the hospital anyway - most of it is mindless rounding and worthless paperwork. On a good day there is an hour of decent teaching - however most of that is directed at the medical student level and is kinda lost on us who've been there and done that. Your a$$ is owned by your program. If you speak up or ***** and moan, you'll be thrown out with hundreds of thousands to pay back to the bank. So toe the line! That's the spirit of residency. Know your place and toe the line.

 

So ya, is residency fun? Not at all. If I didn't have loans to pay back, I'd be long gone.

 

Enjoy.

[tooty]

^^ that's a hell of a rant ubcfox

 

but won't it all be worth it after you finish residency?

[Yeasayer]

That doesn't seem that terrible. My older sister went into the health industry as a dietitian and her internship was also long hours and relatively low salary. I know it might not have been as grueling as a residency, but it seems kind of like a right of passage. There isn't really any getting around it, and I think if you've chosen the right career you'll enjoy it or at least be able to accept it as part of becoming an MD

[nosuperman]

Residency = Hell (true).

 

First off, thanks for info and sorry about how residency is turning out. What program are you in?

[bugette]

Residency = Hell (true).

 

 

I agree, although I think some people have a better experience (or handle it better, or just appear to?).

 

It is not just the long hours that make it hellish. A multitude of factors, and I'm so caught up in it that I cannot even think of realistic suggestions to make it better!

 

The 4+ weeks of vacation are nice though and make sure you use them all up.

[Lactic Folly]

Perhaps the lesson is to pick your program carefully, which I know is easier said than done. I have been on rotations where the lack of collegiality and the service >>> education ratio have left me with some of the disillusionment that ubcredfox expresses.

 

For my part, I'm enjoying residency. Sure, the hours can be long, but I'm doing things I'm interested in, and I'm learning lots. I like being busy, and it's satisfying to grow in confidence and competence and be able to make a difference in patient care. I don't have issues with the pay since I consider myself primarily a student and not an employee. Finally, I find the staff and residents congenial, and this can be a key determinant of how much one looks forward to coming to work each day.

[Madz25]

First, here's a link to resident salaries nationwide. Doesn't matter what program you are in - only matters what year of training.

 

http://carms.ca/eng/r1_program_salaries_e.shtml

 

Yeah the pay isnt horrible but what really gets me every time is seeing my pay stub saying i worked 75hrs for the 2-week pay period when in fact, I worked double that.

 

It isn't ALL that bad. As a current R1, yeah it sucks being the scut monkey but it's a right of passage. There are call shifts when you dont even see your call room let alone get a moment to rest. Sometimes you dont get the chance to eat, unless you prepare and bring granola bars or something (which I rarely remember to do) that you can stuff your face with as you're running from one place to another. As someone already mentioned, it really depends on the specialty. Lesson: think carefully about what you want to do!

 

Things used to be much worse and attendings often laugh at how 'easy' we have it nowadays. Suck it up buttercup! It's what you sign up for in medicine!

[Leon]

Sometimes you dont get the chance to eat, unless you prepare and bring granola bars or something (which I rarely remember to do) that you can stuff your face with as you're running from one place to another. As someone already mentioned, it really depends on the specialty. Lesson: think carefully about what you want to do!

 

How continuous is each, let's say, "shift?" Apart from the 4 week vacation, do you gets days off or anything? Or even a few hours off? Or is it continuous work for months on end?

/Thanks

[guitarded27]

What is it with the general delusion that everything is smooth sailing and money will rain down upon you after acceptance into/graduation from medical school?

 

Does anyone REALLY think that medicine is easy money? It's pretty much, on average, a ten year journey of abuse, stress and hell.

 

Yes, only the second day of classes, and I'm already a cynic.

[Lactic Folly]

How continuous is each, let's say, "shift?" Apart from the 4 week vacation, do you gets days off or anything? Or even a few hours off? Or is it continuous work for months on end?

/Thanks

 

This gives you an idea of what residency is like in Ontario:

http://www.pairo.org/Content/Default.aspx?pg=1287

 

And yes, weight loss is an unintended benefit of call. If I stay at home, I tend to snack too much.

[kylamonkey]

This gives you an idea of what residency is like in Ontario:

http://www.pairo.org/Content/Default.aspx?pg=1287

 

 

"Home after Handover"

I read this and thought it said "home after hangover"

[rmorelan]

I should mention that residency is not always easy for those specializations that have a good live style. Radiology has very busy call for instance thanks in part to the electronic transmission of images for review. Any emergency that is any way serious will involve some sort of scan to look at. The residents I have worked with are basically always up all night on call.

[moo]

I'd add my specialty, Community Medicine to the list. Residency is slack. I work from home a lot and a lot of my superiors do as well. Able to moonlight as a family doc to quadruple my current residency income.

 

Aside from BC, a Community Medicine doc can make 220-350K a year. However, this is salaried, meaning you get lots of intangibles that you do not get as a private practice physician, including dental, medical benefits, paid vacations, a fat pension, etc. If you love to travel, do global health and travel every few months. Loving residency and life now!

[Madz25]

How continuous is each, let's say, "shift?" Apart from the 4 week vacation, do you gets days off or anything? Or even a few hours off? Or is it continuous work for months on end?

/Thanks

 

You have a regular work day...which depending on the service can be 9-5 or 6am-6pm. It is not unusual to stay past the "regular work hours" because there is still work that needs to be done. You dont get paid overtime or anything.

 

In the evening starting at 5pm or 6pm "call" begins. Which means that 1+ residents (depending on the service) will be "on call" for anything until the rest of the team returns the following morning. Call can be in-house (must stay in hospital) or be home-call (must be able to arrive at the hospital within 15-20mins if called). Generally, if you are in-house call OR required to stay past midnight in home-call, then you get a "post-call day" where you are allowed to go home the following morning after handover. Now, depending on the service, you go home right after handover, OR right after handover then rounding on new patients, OR after handover then rounding on your patients etc etc. Needless to say, you get to go home some time during the morning. This is a huge change as it used to be that you had to say until noon the next day, which means you've been in the hospital for 30 hours straight. This doesnt mean that you are necessarily up and working for the whole night. It is "call" you are "called" if something comes up (consults, something happening with the ward patients etc). I have stayed up 30hours straight in the past but you can usually squeeze in a few hours of sleep. Then you get your post-call day where you can go home and crash - or as I do, use it to do banking and what not because usually nothing is open once im off work lol.

 

So its a regular work week + call (and a post-call day following call). For us, we're expected to work 2 weekends per month - which means call on either saturday or sunday. That usually means you show up saturday or sunday morning and do a 24hr call and leave the following morning after handover. The sucky part is working Saturday, your post-call day is sunday and back to the regular work week Monday...so it's like you havent had a day off at all. As well, call on Friday means your Saturday is ruined and only have Sunday to enjoy. I dont think Friday counts as a weekend call though but I would argue that at midnight Saturday morning I'm still in the hospital!!!!

 

Calls are at worst 1 in 3 for in-house. Mine have thus far been 1 in 4. Which means, every 4th day I'm on call. So basically it goes: regular day, regular day, regular day, CALL, post-call day, regular day, regular day, CALL, post-call day...make sense? The best is a thursday call with a weekend off because its like you have a 3day weekend since friday is your post-call day! OHHH the small joys

[kylamonkey]

I'd add my specialty, Community Medicine to the list. Residency is slack. I work from home a lot and a lot of my superiors do as well. Able to moonlight as a family doc to quadruple my current residency income.

 

Aside from BC, a Community Medicine doc can make 220-350K a year. However, this is salaried, meaning you get lots of intangibles that you do not get as a private practice physician, including dental, medical benefits, paid vacations, a fat pension, etc. If you love to travel, do global health and travel every few months. Loving residency and life now!

 

Sorry for any ignorance, but is that rural? Or is rural like that? Locums etc.?

[JayP]

You cannot possibly speculate what residency will be like until you actually do it. We can sit here and tell you our stories, but until you actually have a pager and responsibility, it will mean nothing. If you are on the fence about medicine because of how hard you have 'heard' residency is.....well that is life.

 

Residency is good times for the most part if you enjoy what you do. I will tell you what every resident has ever told me:

 

'Do not pick your residency based on what you think is the amount of time you want to spend as a resident....pick it based on something you enjoy doing and you will never regret your decision'.

 

To put this into perspective, suppose you enjoy surgery but just can't see yourself doing 5 years and then a fellowship, so you do FM. Meanwhile you hate FM after 2 years and you realize you should have gone into surgery. Well guess what? Your 2 years of FM isn't even worth 6 months towards a surgical residency, so you are back to square one, only 2 years behind and far more tired than you need to be.

 

Residency is like a full time job.....a low-paying, highly stressful, often thankless job....but nonetheless a job. It is vastly different from medical school. In 10-15 years money becomes much less of a focus and hopefully you'll be doing something you enjoy

[Lactic Folly]

Agree with the above post. If you don't enjoy your job and the people you work with, cushy hours will not be enough to make you happy.

 

In residency, there comes the realization that there is a short and finite amount of time to sufficiently master one's field before independent practice.. so it is not uncommon to see residents want to stay post-call to get more experience if they have a chance to do an infrequently encountered procedure, for example.

 

Yes, radiology call is busy, but I would argue that makes it challenging, not necessarily inhumane.. at least the residents go home post call, instead of staying and operating like the surgical residents. However, I think that the radiology staff are busier that most people realize. When on weekend call, I see them in house from morning to night, as they are responsible for dictating all the inpatient and emergent studies performed in the hospital.

[hkmedic]

first couple of years are also tax free pretty much due to the tuition tax credits as well. That 50-60K is the equivalent of a standard persons 65,000 to 80,000 according to my tax calculator here

 

Is it really 50-60K tax-free? What about things like malpractice insurance and other deductions??

[nosuperman]

Is it really 50-60K tax-free? What about things like malpractice insurance and other deductions??

 

It isn't exactly tax-free, its just that you've accumulated so much credit via education expenses that you put it towards what you'd normally pay on your income and you end up not paying tax.

[Jochi1543]

A resident I shadowed told me residency is all fun and games compared to 3rd year.

[kylamonkey]

for all you people that think 50-60k is good, LOL!!

 

I would have tuition loans to pay off, family to support, forget about sending my kid to private school, morgages, car loans, and for general surgery residency is like 6 years.

 

Most doctors dont live love Dr Mc Dreamy and live in a trailer park.

 

p.s if i was into the money, i might switch to dental.

 

I'm concerned about this person's focus on the lack of $ and not the lack of time to support a growing family. A 60-hr work week doesn't leave you with a lot of time to take care of the kids.

[hkmedic]

for all you people that think 50-60k is good, LOL!!

 

I would have tuition loans to pay off, family to support, forget about sending my kid to private school, morgages, car loans, and for general surgery residency is like 6 years.

 

Most doctors dont live love Dr Mc Dreamy and live in a trailer park.

 

p.s if i was into the money, i might switch to dental.

 

...then maybe you should switch to dentistry. There's no residency and you start rolling in the 6-figures a lot faster than a physician.

[ubcredfox]

And to further that comment on the 60 hour work week - the 85 hour work week leaves you with even less time, or energy.

 

It's difficult to maintain a relationship when you're working so much. Moreover, if you're this invested in your work, residency turns into a huge sink of emotional energy as well as sheer time. Hard to pull anything else when I get home post call from working 1:2 for 5 days straight.

[rmorelan]

It isn't exactly tax-free, its just that you've accumulated so much credit via education expenses that you put it towards what you'd normally pay on your income and you end up not paying tax.

 

Yeah exactly - I mean you have the entire med school tax credit thing and then you have what ever you might still have from your other undergrad degree.