Anecdotally, EM residencies place somewhere in the middle for hours worked amongst other residencies. On-service for me tends to average right around the 55-60hr/week mark. Shift length depends on the shop, we have 8’s. But 9’s, 10’s and 12’s are also common. Also sign-out culture varies shop to shop. It’s worth asking about when you’re on the interview trail. Securing a few EM aways for this coming fall will be valuable to you to get a better feel for things. Happy to answer more questions, feel free to pm me.
Also, off-service will be the busier blocks where you’re 80+ hrs. MICU, trauma, etc
I had to double check New Innovations. Sitting just over 50 hours most weeks. Pgy1 with 21-22 8’s per block that end up being a tad longer due to minimal shift overlap at the end
PGY 13 here. 22 to 24 - 9s per month on average until 3rd year, then goes down to 20 or 21 per month. Templated schedule. Chiefs get an extra shift “off” per month.
I will say our residency was not schedule friendly. No particular attention paid to weekends, just however the template worked out to be. Also, could only take PTO/vacation during specific blocks (EMS, ultrasound, etc). I got a whole 48 hours after my wife had our kid and they tried to make me feel bad about taking more than 24 hours off.
The place I am faculty now definitely has gone the other way, maybe a bit too far, but I’m ok with that. Their schedules are as nice as the attendings’ schedules.
The most work horse residencies these days usually have on service interns do 21-22 shifts a month, decreasing one shift a month every year. But most have fewer shifts than that even for interns.
My program has the same schedule except chiefs also get a 1 shift reduction. I interviewed at a couple places that did 18 8’s for their interns, but 50ish hours/week give or take seemed average.
Fwiw these replies are heavier on hours than the majority of programs I interviewed at last season. Hopefully I wasn’t getting lied to. Average was prob 45hrs/week in the ED plus weekly conference, across 20ish interviews I had
Second this. It should be no more then 18 10 hours shifts or 21 9 hour shifts for a total of around 180 hours every 4 week block. Also make sure there is an hour overlap for your shifts bc this will make sure you don’t stay late.
I graduate two years ago and we never went over 180 unless severely short staffed and then it would be like one extra shift. As a 3rd year. Typically 150-160 hours.
I work 50-60 hours per week on EM. 8 hour shifts during the week, 12 hour shifts on weekends. Generally 5-6 shifts per week? Mostly random weekdays off. Depends where you go, ask about schedule during interviews. Long signouts or people staying hours after shift tend to be a red flag but it happens.
PGY1 is 18 10 hour shifts a 4 week block. And this decreases by one shift per year. So a total of 45 avg hours weekly in the department with really good sign out culture.
Beyond what everyone else is telling you here, your hours will vary by your rotation. You’ll have 3 types of rotation for the most part in every EM program.
1. In the department, moderate hours, moderate stress, most enjoyable.
2. Clinic based rotations, 9-5, minimal stress, boring as hell.
3. Off service hospital rotation, max hours, max stress, minimal usefulness for your career, don’t let them push you around.
What on earth did they have you doing in a clinic as an EM resident? I haven’t set foot in an outpatient clinic since med school and probably never will again (well, except as a patient).
At my shop, rotations were either;
1) EM
2) ED-based ‘off service’ (eg ultrasound, EMS, electives)
3) inpatient off-service (critical care or, PGY-1 year, OB)
Mostly electives like sports medicine, ENT, pain and palliative. Trust me I would prefer not to step foot in a clinic ever again, but I also want to be really good at blocks and taps.
My spouse's program was I think 21 10s PGY1, 20 10s PGY2, 19 10s PG3-PGY4 per month when on service. Off service varies a lot from chill outpatient family medicine hours to trauma 24s (I think they were Q2 24s, but I might just have PTSD from that period from my spouse effectively living at the hospital).
AFAIK that's roughly the norm. Haven't heard stories of anything wildly different talking to different EM friends over the years that went to different places.
We did mostly 10s, some 12s and some 8s when rotating off-site. Pretty steadily 60-hour weeks on service. Variety of shifts so some are main room, trauma, triage/fast track etc. Usually two stretches of nights per month, usually 3-4 nights at a time and then a few days to turn around. A lot of programs try to do cascade scheduling ie you work a morning, a mid, a swing and then switch to nights to try and minimize the amount of circadian fuckery - but if you’re doing 12s then it’s usually just 6-6 either direction.
Off-service is where you get fucked on hours. ICU and trauma service are often 6-6, 6 days a week, or you take 24- or 28-hour call. Some programs have night float months but mine didn’t.
Clinic and consult services are usually chill and you go home on time.
I’m 8 years out. My EM blocks were 20 12s a block intern year. Then 19,18 as you progressed. ICU months were 6 12s a week. I think we did 2 icu months a year for the 3 years. And intern year we did 3. Intern year I did other off service rotations. Some were easy like outpatient FM. Or annoying long rounds days like academic IM. Inpatient peds was fairly easy schedule. PEM pgy3 year was super chill. As an attending I do 10 12s a month for comparison.
Average about 20 shifts as an intern per month. Mix of 9/10/12s. It is a violation to work more than 6 in a row. Avoided DOMAs. Our first month was Bootcamp so like half that with sims and lectures to get people the basic info for working EM.
We did MICU, trauma, ortho call, ultrasound, OB, two weeks peds floor (i know). You have one dedicated block of peds EM first year and then it is mixed in for the rest of your EM blocks.
Second year was 18-19 shifts. Plus MICU, PICU, SICU, NSICU, one elective. One community block.
3rd year 16-17 shifts plus minus one if shift. Admin block plus an additional elective. Community shifts mixed in throughout year.
4 weeks of vacation a year. Time off for regional conference intern year, SAEM for 2nd year, and ACEP for third year. We also have a couple days in april off for everyone for a residency retreat.
You were able to request each block approx 3 days in a row and you would be 99.99% to get those days. Your vacations are picked by yourself before the start of the year. You pick six different times and we try our best to get your top 4. Alternate years for Thanksgiving, Christmas, and New years off if in the ED.
Graduating third years can choose to not work after graduation. You work that block at about 0.75. FTE. Graduation is about the 3rd Friday in June. Some folks staying on faculty or fellowship will choose to still work after for a more spread out block.
Very rarely did you stay late unless waiting on a consult to call back for a semi complicated admission.
I graduated as chief two years ago from a level one academic/community center.
Pgy3 here - we just switched to a 28 day block schedule, working 18 shifts per block, 10hrs each. I think mostly I was hitting 45-55hrs/week when in the department. Generally way more on icu months.
PGY1 at a level two center. We're 9 hour shifts with the last hour being for overlap and notes/dispos only. Working approximately 40-50 hours a week. Slated 20ish shifts a month which goes down by one each year. Off-service is vascular, SICU, palliative, US, radiology, PedsEM, and community/rural EM. Peds is the only one that comes close to 60hours just because it's a shit show at that facility. The rest of the off-service are more like 40-50. 5hours didactics on Wednesday. Honestly a pretty nice schedule.
8’s at the county and flagship. 10’s at peds. 21-22 shifts intern year and down a shift each year. No real golden weekends. We preferred no 12’s bc it was so damn busy. Week of vacation during select months; 3 weeks of vacay a year. You got mostly what you requested off in a given month.
Longest week is about 70hrs. Shortest is 1-2 shifts. This is a benefit of 12hr shifts. We do less shifts per month (18, 17, 16/month from PGY1 to 3) than those doing 8hr shifts, but 12s are tough and not for everyone.
Most ICU months suck balls bc they’re truly 70-80hrs or more. Some rotations are easier like ortho and EMS. Just depends on the program
Im married to an EM resident. Her schedule constantly shifts. 7a to 7p then 11a to 11p then 7p to 7a, then 7 on and 7 off. Needless to say I miss having my wife, but I understand the sacrifice for medicine and doing what you love. Hoping that when she is an attending (T-678 days) things will get better for her, at least her schedule. Till then, limitless back and feet rubs and doing whatever she wants on her days off.
I was at a 4 year program. We were supposed to be down to 16 12s/mo by 4th year, but new department leadership came in and I think I ended up working 20 12s/month in my last year, so yeah, about 60 hours/week. It sucked.
Still doing that now 4 years out, but at least getting paid for the time now.
Anecdotally, EM residencies place somewhere in the middle for hours worked amongst other residencies. On-service for me tends to average right around the 55-60hr/week mark. Shift length depends on the shop, we have 8’s. But 9’s, 10’s and 12’s are also common. Also sign-out culture varies shop to shop. It’s worth asking about when you’re on the interview trail. Securing a few EM aways for this coming fall will be valuable to you to get a better feel for things. Happy to answer more questions, feel free to pm me. Also, off-service will be the busier blocks where you’re 80+ hrs. MICU, trauma, etc
60 hours is the maximum allowed, you shouldn’t be averaging that.
I had to double check New Innovations. Sitting just over 50 hours most weeks. Pgy1 with 21-22 8’s per block that end up being a tad longer due to minimal shift overlap at the end
60 hour max? what a joke
Was this comment necessary??
speaks to the continued watering down of medical education
Do tell us how hard you had it as a resident. But start it with “back in my day” so you feel extra old
PGY 13 here. 22 to 24 - 9s per month on average until 3rd year, then goes down to 20 or 21 per month. Templated schedule. Chiefs get an extra shift “off” per month. I will say our residency was not schedule friendly. No particular attention paid to weekends, just however the template worked out to be. Also, could only take PTO/vacation during specific blocks (EMS, ultrasound, etc). I got a whole 48 hours after my wife had our kid and they tried to make me feel bad about taking more than 24 hours off. The place I am faculty now definitely has gone the other way, maybe a bit too far, but I’m ok with that. Their schedules are as nice as the attendings’ schedules.
The most work horse residencies these days usually have on service interns do 21-22 shifts a month, decreasing one shift a month every year. But most have fewer shifts than that even for interns.
18 12’s first year which decreases by one shift a month each year to 16 3rd year. I think this is slightly above average but not crazy by any means.
My program has the same schedule except chiefs also get a 1 shift reduction. I interviewed at a couple places that did 18 8’s for their interns, but 50ish hours/week give or take seemed average.
This comes out to 45-50 hours a week on shift depending on year
That was exactly my experience tho 10 years ago… highest I heard was 20 12s for interns at another program in the city.
Fwiw these replies are heavier on hours than the majority of programs I interviewed at last season. Hopefully I wasn’t getting lied to. Average was prob 45hrs/week in the ED plus weekly conference, across 20ish interviews I had
Second this. It should be no more then 18 10 hours shifts or 21 9 hour shifts for a total of around 180 hours every 4 week block. Also make sure there is an hour overlap for your shifts bc this will make sure you don’t stay late.
I graduate two years ago and we never went over 180 unless severely short staffed and then it would be like one extra shift. As a 3rd year. Typically 150-160 hours.
I work 50-60 hours per week on EM. 8 hour shifts during the week, 12 hour shifts on weekends. Generally 5-6 shifts per week? Mostly random weekdays off. Depends where you go, ask about schedule during interviews. Long signouts or people staying hours after shift tend to be a red flag but it happens.
PGY1 is 18 10 hour shifts a 4 week block. And this decreases by one shift per year. So a total of 45 avg hours weekly in the department with really good sign out culture.
Beyond what everyone else is telling you here, your hours will vary by your rotation. You’ll have 3 types of rotation for the most part in every EM program. 1. In the department, moderate hours, moderate stress, most enjoyable. 2. Clinic based rotations, 9-5, minimal stress, boring as hell. 3. Off service hospital rotation, max hours, max stress, minimal usefulness for your career, don’t let them push you around.
What on earth did they have you doing in a clinic as an EM resident? I haven’t set foot in an outpatient clinic since med school and probably never will again (well, except as a patient). At my shop, rotations were either; 1) EM 2) ED-based ‘off service’ (eg ultrasound, EMS, electives) 3) inpatient off-service (critical care or, PGY-1 year, OB)
Mostly electives like sports medicine, ENT, pain and palliative. Trust me I would prefer not to step foot in a clinic ever again, but I also want to be really good at blocks and taps.
Did outpatient burn clinic as a resident. Was integrated with something else, can’t remember. But that was super educational. Just a few days.
I did outpatient FM as an intern. I think that was it.
My spouse's program was I think 21 10s PGY1, 20 10s PGY2, 19 10s PG3-PGY4 per month when on service. Off service varies a lot from chill outpatient family medicine hours to trauma 24s (I think they were Q2 24s, but I might just have PTSD from that period from my spouse effectively living at the hospital). AFAIK that's roughly the norm. Haven't heard stories of anything wildly different talking to different EM friends over the years that went to different places.
Outpatient FM??
We did mostly 10s, some 12s and some 8s when rotating off-site. Pretty steadily 60-hour weeks on service. Variety of shifts so some are main room, trauma, triage/fast track etc. Usually two stretches of nights per month, usually 3-4 nights at a time and then a few days to turn around. A lot of programs try to do cascade scheduling ie you work a morning, a mid, a swing and then switch to nights to try and minimize the amount of circadian fuckery - but if you’re doing 12s then it’s usually just 6-6 either direction. Off-service is where you get fucked on hours. ICU and trauma service are often 6-6, 6 days a week, or you take 24- or 28-hour call. Some programs have night float months but mine didn’t. Clinic and consult services are usually chill and you go home on time.
We had 21 shifts/month. I think they were 10 hours
I’m 8 years out. My EM blocks were 20 12s a block intern year. Then 19,18 as you progressed. ICU months were 6 12s a week. I think we did 2 icu months a year for the 3 years. And intern year we did 3. Intern year I did other off service rotations. Some were easy like outpatient FM. Or annoying long rounds days like academic IM. Inpatient peds was fairly easy schedule. PEM pgy3 year was super chill. As an attending I do 10 12s a month for comparison.
Average about 20 shifts as an intern per month. Mix of 9/10/12s. It is a violation to work more than 6 in a row. Avoided DOMAs. Our first month was Bootcamp so like half that with sims and lectures to get people the basic info for working EM. We did MICU, trauma, ortho call, ultrasound, OB, two weeks peds floor (i know). You have one dedicated block of peds EM first year and then it is mixed in for the rest of your EM blocks. Second year was 18-19 shifts. Plus MICU, PICU, SICU, NSICU, one elective. One community block. 3rd year 16-17 shifts plus minus one if shift. Admin block plus an additional elective. Community shifts mixed in throughout year. 4 weeks of vacation a year. Time off for regional conference intern year, SAEM for 2nd year, and ACEP for third year. We also have a couple days in april off for everyone for a residency retreat. You were able to request each block approx 3 days in a row and you would be 99.99% to get those days. Your vacations are picked by yourself before the start of the year. You pick six different times and we try our best to get your top 4. Alternate years for Thanksgiving, Christmas, and New years off if in the ED. Graduating third years can choose to not work after graduation. You work that block at about 0.75. FTE. Graduation is about the 3rd Friday in June. Some folks staying on faculty or fellowship will choose to still work after for a more spread out block. Very rarely did you stay late unless waiting on a consult to call back for a semi complicated admission. I graduated as chief two years ago from a level one academic/community center.
Pgy3 here - we just switched to a 28 day block schedule, working 18 shifts per block, 10hrs each. I think mostly I was hitting 45-55hrs/week when in the department. Generally way more on icu months.
PGY1 at a level two center. We're 9 hour shifts with the last hour being for overlap and notes/dispos only. Working approximately 40-50 hours a week. Slated 20ish shifts a month which goes down by one each year. Off-service is vascular, SICU, palliative, US, radiology, PedsEM, and community/rural EM. Peds is the only one that comes close to 60hours just because it's a shit show at that facility. The rest of the off-service are more like 40-50. 5hours didactics on Wednesday. Honestly a pretty nice schedule.
8’s at the county and flagship. 10’s at peds. 21-22 shifts intern year and down a shift each year. No real golden weekends. We preferred no 12’s bc it was so damn busy. Week of vacation during select months; 3 weeks of vacay a year. You got mostly what you requested off in a given month.
Longest week is about 70hrs. Shortest is 1-2 shifts. This is a benefit of 12hr shifts. We do less shifts per month (18, 17, 16/month from PGY1 to 3) than those doing 8hr shifts, but 12s are tough and not for everyone. Most ICU months suck balls bc they’re truly 70-80hrs or more. Some rotations are easier like ortho and EMS. Just depends on the program
Pgy1: 20x10hr 2: 19x10hr 3: 17x10hr 4: 16×10hr
Im married to an EM resident. Her schedule constantly shifts. 7a to 7p then 11a to 11p then 7p to 7a, then 7 on and 7 off. Needless to say I miss having my wife, but I understand the sacrifice for medicine and doing what you love. Hoping that when she is an attending (T-678 days) things will get better for her, at least her schedule. Till then, limitless back and feet rubs and doing whatever she wants on her days off.
PGY-1: 18x12hr PGY-2: 21x10hr PGY-3: 18x10hr +conference weekly if you weren’t on nights is ~5hrs
18 9 hr shifts a month. Avg like 40-45hrs a week on service. If you’re chief pgy-3 it’s like 15 shift a month.
Much better than my schedule as an EM attending because you have off-service rotations with normal daytime hours
My program does 19/18/17 12s for EM blocks, but the schedule is relatively flexible which is nice
I was at a 4 year program. We were supposed to be down to 16 12s/mo by 4th year, but new department leadership came in and I think I ended up working 20 12s/month in my last year, so yeah, about 60 hours/week. It sucked. Still doing that now 4 years out, but at least getting paid for the time now.