Life during clerkship and residency

[Hanmari]

I realize this is too early on in the game for me ("Go study for your next exam!"), but as I hear more things about clerkship and residency I can't help but feel scared about how much time and effort it is going to take.

 

Current clerks and residents: How do you maintain that work-life balance, if at all? Are "extracurriculars" (read: hobbies) even feasible during either of the two periods?

 

I realize that workload may vary hugely between programs and hospitals, so I'd just like to hear your own personal story, and the stories of your colleagues as you know them. Thanks in advance!

[rmorelan]

I realize this is too early on in the game for me ("Go study for your next exam!"), but as I hear more things about clerkship and residency I can't help but feel scared about how much time and effort it is going to take.

 

Current clerks and residents: How do you maintain that work-life balance, if at all? Are "extracurriculars" (read: hobbies) even feasible during either of the two periods?

 

I realize that workload may vary hugely between programs and hospitals, so I'd just like to hear your own personal story, and the stories of your colleagues as you know them. Thanks in advance!

 

It really depends a lot of one part of clerkship or residency you are at. There are some really busy parts and some not so busy parts - although there is no doubt there is a lot of time being spent on medicine. For instance I just did neuro surg and vascular for a month each which was 6am to about 6pm daily and 7 call shifts in 4 weeks for each (your stereotypical 90 hour work week), so not a lot of time there for much else when you factor in studying on top of that. Other blocks where 8-5 and more "humane".

 

Clerkship was similar - there were some blocks like family medicine - no call, 8 or 9 to 4 or 5 that was easy. Others again were tough. Away electives are busy as you try to impress but the second half of fourth year post carms is relatively light.

 

You become much more efficient with time - you have to be. You just become so much more aware of any time being wasted. If there is something valuable to you then you have to carve out protected time for it and hold on. You still can do things outside of medicine but it takes planning and effort.

[future_doc]

In clerkship, 12 hour shifts leave no time for ECs, but 8 hours shifts allow for a more normal life. And then are weekends that are free to do whatever you wish.

[rogerroger]

Early clerkship is the worst time. Everything is new. You are learning how wards and clinics work and how to translate that meager pre-clerkship book knowledge into practical clinical decision making. Another skill you learn rapidly is how to manage your time in a meticulous manner, you have no choice if you are going to pass your rotations. For me acquiring this skill and coming to terms with the new demands on my life was the biggest learning curve of medical school.

 

A big part of being happy as a med student and later doctor is finding that balance. There is a steep learning curve but it is certainly possible. Some heaver rotations make your "free time" very limited but it is still there if you are efficient.

 

As a resident I find things get easier because you have some real experience to fall back on. You have the foundational time management skills in place as well.

 

I have multiple non-medical related hobbies and relationships, they keep me sane. The time exists. It is important to utilize those precious free moments in order to be a well adjusted med student/resident.

[JohnDakota]

If we get enough students in clerkship and residents to contribute to this thread, their speciality/work-life benefit and how they go about balancing their lives, I think it could be a real help to us pre-meds.

 

I've always found it very helpful when people speak very candidly about career paths I'm considering.

[rogerroger]

If we get enough students in clerkship and residents to contribute to this thread, their speciality/work-life benefit and how they go about balancing their lives, I think it could be a real help to us pre-meds.

 

I've always found it very helpful when people speak very candidly about career paths I'm considering.

 

 

Pretty much nothing from clerkship translates to pre-med, they are different worlds entirely. I would not waste a second as a pre-med worrying about clerkship. You will gravitate toward a path which is meant for you once you get into medical school. Medical school is set up in a way to facilitate this process.

 

Below are my tips for pre-clerks/clerks.

 

(1) Schedule free time and give this time as much importance as any clinical work you have.

 

(2) Keep your non-medical passions, force yourself to do these things.

 

(3) Kiss the 6hr long study sessions goodbye. Those days are gone come clerkship. Study and read during the 30min or hour long chunks of time you can find.

 

(4) Make sure your partner and friends know about the new demands. When you are with these people try not to talk only about medicine.

 

(5) While doing clinical work jot down your questions or things you don't understand. Go home and read around these questions.

 

(6) Study a tiny bit everyday. Cramming for the final exam basically does not work anymore as a clerk, you don't have any chunk of time big enough. Study consistently but in short bursts.

 

(7) Be honest with yourself. Lots of things in medicine are cool. But the life-style really does suck in a special way within many specialties. Not all specialties are equal, not even close. If you are going to sacrifice parts of your life for medicine, and you will, it is inevitable, you better do it for something you truly love and not just "like". If you just "like" it at 9AM you will come to curse it at 3AM. Never choose a specialty because it is "prestigious" etc. Only choose a specialty because you love it enough to justify the specialty specific sacrifices it will demand.

 

How is that for frank comments?

 

PS: this is an okay book if you want more tips on this topic: http://www.amazon.ca/Staying-Human-During-Residency-Training/dp/1442613645/ref=pd_sim_b_2 It is written for residents but lots of stuff in this book can apply to clerks too.

[JohnDakota]

PYou will gravitate toward a path which is meant for you once you get into medical school. Medical school is set up in a way to facilitate this process.

 

That's good to hear... pretty much the complete opposite of graduate education where they try to cram everyone in to academia... regardless of it's inability to accommodate even a fraction of the graduates.

 

(1) Schedule free time and give this time as much importance as any clinical work you have.

 

(2) Keep your non-medical passions, force yourself to do these things.

 

(3) Kiss the 6hr long study sessions goodbye. Those days are gone come clerkship. Study and read during the 30min or hour long chunks of time you can find.

 

(5) While doing clinical work jot down your questions or things you don't understand. Go home and read around these questions.

 

(6) Study a tiny bit everyday. Cramming for the final exam basically does not work anymore as a clerk, you don't have any chunk of time big enough. Study consistently but in short bursts.

 

 

Thankfully these are lessons I learned during grad school.. there's no way to accomplish such training and maintain your sanity without them.

 

(4) Make sure your partner and friends know about the new demands. When you are with these people try not to talk only about medicine.

 

I wouldn't be 32 and still looking forward to med without the most understanding partner ever. I'm fortunate this this area.

 

 

 

(7) From my own personal experience surgical specialties make life outside of medicine very difficult. There seems to me a certain culture which exists in these fields which makes work-life balance very difficult. (cue the surgical ppl saying otherwise)

 

(8) Be honest with yourself. Lots of things in medicine are cool. But the life-style really does suck in a special way within many specialties. Not all specialties are equal, not even close. If you are going to sacrifice parts of your life for medicine, and you will, it is inevitable, you better do it for something you truly love and not just "like". If you just "like" it at 9AM you will come to curse it at 3AM.

 

I wont lie.. the allure of surgery is there but I realize that fam-med is probably where I will fit best given how I really cherish personal connections with others. I was thinking fam-med with the one year specialty in sports medicine that's offered at some schools (eg. mcmaster). Do you happen to know of the demand for people with that training, or are schools training people for a saturated industry?

 

 

 

PS: this is an okay book if you want more tips on this topic: http://www.amazon.ca/Staying-Human-During-Residency-Training/dp/1442613645/ref=pd_sim_b_2 It is written for residents but lots of stuff in this book can apply to clerks too.

 

Thanks.. i'll pick up this book. I've read a few like this on Drug Discovery and the Biotec industry ... it really helped to understand the honest life experience of people who work in specific jobs within the industries.

[thebouque]

I realize this is too early on in the game for me ("Go study for your next exam!"), but as I hear more things about clerkship and residency I can't help but feel scared about how much time and effort it is going to take.

 

Current clerks and residents: How do you maintain that work-life balance, if at all? Are "extracurriculars" (read: hobbies) even feasible during either of the two periods?

 

I realize that workload may vary hugely between programs and hospitals, so I'd just like to hear your own personal story, and the stories of your colleagues as you know them. Thanks in advance!

 

Clerks and resident work less than a lot of people in the private sector, accounting and law

[future_doc]

So true, I know a young lawyer who routinely works 14-16 hour days Monday through Friday and at least 8 hour days on weekends.

[Hanmari]

Clerks and resident work less than a lot of people in the private sector, accounting and law

 

So true, I know a young lawyer who routinely works 14-16 hour days Monday through Friday and at least 8 hour days on weekends.

 

Good lord, that definitely would not be my cup of tea.

 

Thanks for the replies =) Sounds like I'll only really find out how tough it is once I get there. Hopefully I will learn to adjust my lifestyle fast enough.

[Mighty Molar]

I always thought doctors work a lot, until i met people in Investment Banking where the average working hour is 90-120 hr/week for the rest of their life (not just residency as doctors) and if the boss or client demand a board meeting or modification of the MF at 7pm Sat night, they must do it. Worse than on-call since no resident or med student to back u up

[future_doc]

Not for life til late forties, by which time they are fired from their top positions, so if they have not saved their millions, they are toast.

[NLengr]

So true, I know a young lawyer who routinely works 14-16 hour days Monday through Friday and at least 8 hour days on weekends.

 

One big difference between residency and lawyers/bankers just starting off is if the lawyer/banker doesn't like the job, he/she can always quit that job and find a more laid back one. Two of my lawyer buddies and one of my banker friends did this because they wanted to slow down. As a resident, you can't really quit, unless you never want to practice medicine. Even switching residencies is difficult and not garunteed. The loss of control in your life is a very frustrating part of residency.

 

As a rule right now, one lawyer buddy works about the same number of hours as me (but less studying after work and way less 1 am working). Two lawyer buddies work less because they chose to favour a work-life balance. Ditto my accountant/marketing/engineering friends, less hours, better balance. One investment banker I know works as much as me. One less (again, that guy chose a more laid back company).

 

As for balance in residency, pick three things you really like (say family, painting and soccer). That pretty much what you will have time to do with any degree of consistency.

[Mighty Molar]

Not for life til late forties, by which time they are fired from their top positions, so if they have not saved their millions, they are toast.

 

1 mil invested in shares of the big 5 CA banks can generate a minimum of 50K through dividend, while the principle shall fluctuate. So if the banker just saves 2 or 3 mil by then, he can enjoys his life without working forever Unless all the 5 banks crash, which mean the whole capital system crashes

[future_doc]

These guys live above their means in the sense that they spend cash flow. They spend more than a couple of hundred thousand to live, e.g., mortage in excess of 1M, property taxes in excess of 50k, nanny for kids, private schools, some have private airplanes, homes with 8 bathrooms, so it is almost impossible to cut back. They cannot live like wealthy physicians, few save enough, they live on the edge.

[JohnDakota]

These guys live above their means in the sense that they spend cash flow. They spend more than a couple of hundred thousand to live, e.g., mortage in excess of 1M, property taxes in excess of 50k, nanny for kids, private schools, some have private airplanes, homes with 8 bathrooms, so it is almost impossible to cut back. They cannot live like wealthy physicians, few save enough, they live on the edge.

 

I'll tell you one thing graduate studies is great for - teaching one to budget themselves so they can enjoy life with next to no income.

 

I'm clearing ~40k as a post-doc (less taxes of course) and I'm not worried about a thing.

[rmorelan]

I'll tell you one thing graduate studies is great for - teaching one to budget themselves so they can enjoy life with next to no income.

 

I'm clearing ~40k as a post-doc (less taxes of course) and I'm not worried about a thing.

 

One of the best things I ever learned I think is how to be happily "poor". Sounds corny but I really don't have much use for material possessions. Many of my friends are struggling with the transition to reaching the limits of their credit and locked into residency salary. I don't seem to have that problem - ha, although they probably think I am overly frugal. I have switched back into full save mode once I hit residency.

[future_doc]

I too am happily poor with frugal habits that shall always follow me.

[future_doc]

Prestige is meaningless nonsense.

[Hyperalgesia]

Life during residency seems to depend a lot on what residency you choose, as you would expect! I am not a resident, but my boyfriend started R1 in Internal this year, and while there are some weeks we spend less time together (depends on the rotation.. when he was on Rheum he had no end of free time, but mtu is always busier!), in general I am finding that we spend the same amount of time together as when he was in med school. He's usually at the hospital from 8am til 6ish on non call days, leaving him plenty of free time for the things he likes to do. I don't know if his is an isolated case, as he is one of those 'read something once, know it forever' people, so seems to need less time for studying and whatnot, but that is what I have experienced with him so far.

 

On the other hand, a friend of mine started plastics this year, and I haven't seen her for maybe three months due to conflicting schedules. Much harder to go out with the girls for wine when you've got to be at the hospital at 6am the next day haha.

[NLengr]

One of the best things I ever learned I think is how to be happily "poor". Sounds corny but I really don't have much use for material possessions. Many of my friends are struggling with the transition to reaching the limits of their credit and locked into residency salary. I don't seem to have that problem - ha, although they probably think I am overly frugal. I have switched back into full save mode once I hit residency.

 

The problem with residency is that you get nickel and dime'd to death. CMPA, OMA, CPSO, tuition, LMCC, Surgical foundations, books, conferences/courses, Royal College stuff, electives so you can find a job.....the list goes on and on. It eats into your budget. Although if your a single guy who has a roommate and little Pre-existing debt it's not too bad. If you have young kids, then it's brutal.

 

By the way, don't throw around poor unless you are actually poor. If you have to struggle to find bus money and can only afford to feed yourself by buying whatever meat/food is on 50% off cause its about to expire, then you can say your poor. Otherwise, frugal is a better choice.

[NLengr]

Life during residency seems to depend a lot on what residency you choose, as you would expect! I am not a resident, but my boyfriend started R1 in Internal this year, and while there are some weeks we spend less time together (depends on the rotation.. when he was on Rheum he had no end of free time, but mtu is always busier!), in general I am finding that we spend the same amount of time together as when he was in med school. He's usually at the hospital from 8am til 6ish on non call days, leaving him plenty of free time for the things he likes to do. I don't know if his is an isolated case, as he is one of those 'read something once, know it forever' people, so seems to need less time for studying and whatnot, but that is what I have experienced with him so far.

 

That'll change. Once he gets closer to the exam he'll realize there is +++++ reading, even if he's an efficient learner.

 

R1 isn't bad because there is much less pressure to know things, hence most don't feel the study pressure.

[ploughboy]

The loss of control in your life is a very frustrating part of residency.

 

This. So much this. Easily one of the most annoying parts of residency.

[Renin]

I was just telling someone about this today: I have found that in R2, the excitement of having money had kind of worn off and I'm sunk back into my frugal ways again. One other thing to consider is everyone (including your family) expects you to be able to pay for certain things because you are "a doctor". Even my very frugal family sometimes makes fun of the car I drive because it's not a "doctor car". It has no payments. It runs awesome. Am not getting rid of car!!!

 

The loss of control in residency is most acute when you're off service - a lot of the time you feel like a glorified medical student who gets worked because you have signing privileges. Once you rotate back onto your service, life is a lot better.

 

I'd echo the others to say that making things a priority is a big part of your work-life balance. Sometimes post-call you'll not feel like doing anything, but rapidly realize that is the ONLY time you can do certain things, so you kind of have to rough it out. Bah. I hate daytime only appointments

[rogerroger]

 

The loss of control in residency is most acute when you're off service - a lot of the time you feel like a glorified medical student who gets worked because you have signing privileges. Once you rotate back onto your service, life is a lot better.

 

Yeah that's spot on. Being off service is a pain. Most of the time it's all about being cheap expendable labour and this fact is only very thinly veiled. There are exceptions but these are rare. Being on service is amazing, that is where everything happens during residency.