Internship/Residency time commitment

Hi again everyone!

I have a question for all of you who have knowledge about residency completion. I have two young children, and if all goes to plan (ha!), they will be 7 and 9 when I start my residency. I understand that residency, especially the first intern year, is long hours, little pay, hard work, and personal sacrifice. I’m wondering exactly what the time commitment looks like. For instance, new standards say that residents are capped at 80 hours in a hospital per week. If commute, shower, and sleep are added, that leaves about 1-2 hours a day for personal time. I can do anything for a period of time and I understand that this is a necessary sacrifice; however, I’m looking at pediatric neurology which is a 5 year residency. If these numbers are really accurate, I basically wouldn’t see my children for 5 years. As much as I want to be a doctor, I don’t know if I can sacrifice something like that. I would miss their childhoods, would miss them growing up. I can’t do that.

If, however, my numbers are wrong, or in actual reality it’s not like that, I would love to know. I’m no stranger to hard work and personal sacrifice to get the job done, that’s not a problem. I just want to know that my kids aren’t going to grow into their teenage years basically without a mother because of the way this timing worked out. What is the personal life of a resident actually like, in real life?

Thanks so much. Y’all have been an invaluable help!

new residency hours are capped at 65. I also think that you are way ahead of yourself already.

Focus on the here and the now, not the what could be or what may be. If there are very few spots in that specialty, chances are that you may not match there.

Take your time. focus on your studies now and then the next is the MCAT. Do not worry beyond that.

I understand what you’re saying about not worrying about it, but I’m kind of a planner. “Count the cost,” you know? I don’t want to go through tens of thousands of dollars of tuition and years and years of education to find out this isn’t something I can handle. I want to know exactly what I’m getting into before I get started. I’m not really sure that’s an immature way of looking at things. I know how to concentrate on the “here and now” and right now all I’m really worried about is just getting accepted to an undergrad program. But wouldn’t it be silly of me to just assume that “everything will work out eventually” instead of having some sort of idea of what’s coming? Some sort of plan? Be honest, is that a bad way to approach this very big decision?

Your concerns are valid but possibly premature. One of the reasons I waited until mine was “grown and gone” was because I didn’t want to compromise family time. I’m not sure that was the right decision, after seeing how some of my classmates and people on this forum have handled family responsibilities with such grace and fortitude! Back then, there were no limitations on residency work hours. By the time I started residency, the 80 hour rule was in effect, and starting this July the limitations will be even more strict. All of that aside, medical school was a huge time committment too, so if you have doubts about how this is going to affect your family, you’re right in addressing it now. Should you decide to go forward, rest assured you won’t be alone. Many medical students either already have small children or start their families in medical school. It’s difficult, but probably not any more so than any other career. The fact that you reach for your goals and do something you love sets a great example for your kids. The med school and residency “community” is also a really positive experience for kids, one that they will remember always. I’ve known several students who have fond memories of their parent’s days in med school/residency. Who knows…maybe one of your little ones will follow you into the profession.

This is an exampled from the University of Texas, Southwester:

Monday, February 28 2011

University of Texas Southwestern Medical School Program

Identifier: 185-48-21-043

Specialty: Child Neurology (N)

Basic information

Last updated: 02/16/2011

Survey received: 06/16/2010

Program Director:

Rana R Said, MD

Univ of Texas Southwestern Med Ctr

Pediatric Neurology Pgm

5323 Harry Hines Blvd

Dallas, TX 75390 Tel: (214) 456-8242

Fax: (214) 456-8990


Person to contact for more information about the program:

Kellie M Shaw

Univ of Texas Southwestern Med Ctr

Pediatric Neurology Pgm

5323 Harry Hines Blvd

Dallas, TX 75390-9063 Tel: (214) 456-8242

Fax: (214) 456-8990


Web Address:…

Accredited length 3

Required length 3

Accepting applications for 2011-2012 No

Will be accepting applications for 2012-2013 No

Program start dates July

Participates in ERAS No

Affiliated with U.S. government No

Institution list

Sponsor: University of Texas Southwestern Medical School - Dallas, TX

Participant: University Hospitals St Paul - Dallas, TX

Participant: University Hospitals Zale Lipshy - Dallas, TX

Participant: Children’s Medical Center of Dallas - Dallas, TX

Participant: Dallas VA Medical Center - Dallas, TX

Participant: Dallas County Hospital District-Parkland Memorial Hospital - Dallas, TX

Participant: Texas Scottish Rite Hospital for Children - Dallas, TX

General Information

Comments: We offer an integrated 5-yr child neurology residency through SF Match. This consists of 2-yr pediatric and 3-yr child neurology residencies at UTSW. Those interested will have coordinated interviews with both programs. Indicate interest on application.

Total program size

Year Positions

1 3

2 3

3 3

Primary teaching site Children’s Medical Center of Dallas

Primary teaching site uses electronic medical records Yes

Program best described as University-based

Requires previous GME Yes, 2 years

Offers preliminary positions No

Applicants must have passed USMLE Step 2-CS before starting a first-year position in 2011 Yes

Participates in National Resident Matching Program (NRMP) in 2011 for 2011 positions No Code(s):

Participates in National Resident Matching Program (NRMP) in 2011 for 2012 positions (Advanced/Fellowship match) No Code(s):

Participant in San Francisco match Yes

Participant in another matching program No

Interviews conducted last year for first year positions 7

Required letters of recommendation 3

Latest date for applications for 2011-2012

Interview period –

Earliest date for applications for 2012-2013

Latest date for applications for 2012-2013

Interview period –

Expectations for IMG applicants include, among other qualifications, the following. Contact the program for additional information.

Current ECFMG certification Yes

US citizenship Yes

US permanent resident Yes

J-1 visa Yes

H1-B visa No

F-1 visa No

Unrestricted state medical license for this state No Answer

Program Faculty

Faculty type Physician Non-physic ian

Full-time paid 57 4

Part-time paid 0 0

Total 57 4

Percentage of full-time paid female physician faculty


Ratio of full-time equivalent paid faculty to positions 6.3 to 1

Work schedule

Avg. hrs/wk on duty during first year (excluding beeper call)


Maximum consecutive hours on duty during first year (excluding beeper call) 29

Average number of 24-hour off duty periods per week during first year 1.0

Program allows moonlighting No

Night float system (Residents participate during first year) Yes

Offers awareness and management of fatigue in residents/fellows Yes

Call schedule

Year Most taxing schedule and frequency per year Beeper or home call (weeks/year)

1 Every fourth night for 4 month(s) 26

2 Every fourth night for 3 month(s) 30

3 NA 42

NA=Not Applicable

NGO = Negotiable

OTH = Other

Educational Environment

Educational setting Year 1

Avg. hours/week of regularly scheduled lectures/conferences 6

Training at hospital outpatient clinics 15.0%

Training in ambulatory non-hospital community-based settings, e.g., physician offices, community clinics NA

Educational benefits

Physician impairment prevention curriculum Yes

Program to assess/enhance medical professionalism Yes

Debt management/financial counseling Yes

Formal program to develop teaching skills Yes

Formal mentoring program Yes

Formal program to foster interdisciplinary teamwork No

Continuous quality improvement training Yes

International experience No

Resident/fellow retreats Yes

Off-campus electives Yes

Hospice/home care experience No

Cultural competence awareness Yes

Instruction in medical Spanish or other non-English language No

Alternative/complementary medicine curriculum No

Training in identifying and reporting of domestic violence/abuse No

MPH/MBA or PhD training No

Research rotation Required

(4 wks)

Educational features

Offers additional training or educational experience beyond accredited length No

Offers a primary care track No

Offers a rural track No

Offers a women’s health track No

Offers a hospitalist track No

Offers a research track/nonaccredited fellowship Yes

Offers another track No

Resident evaluation

Yearly specialty in-service examination required Yes

Patient surveys Yes

Portfolio system Yes

360 degree evaluations Yes

Objective structured clinical examinations (OSCE) Yes

Program evaluation

Program graduation rates Yes

Board certification rates Yes

In-training examination scores Yes

Performance-based assessment scores (eg, OSCE) Yes

Employment Policies and Benefits

Part-time/shared positions


On-site child care Yes

Subsidized child care No

Allowance/stipend for professional expenses Yes

Leave for educational meetings/conferences Yes

Moving allowance No

Housing stipend No

On-call meal allowance Yes

Free parking Yes


Placement assistance upon completion of program Yes

Cross coverage in case of illness/disability No

Compensation and leave

Grad year Salary compensation Vacation weeks Sick days

3 $53,698 3 10

4 $55,869 3 10

5 $58,022 3 10

6 $60,485 3 10

NGO = Negotiable

Maximum number of paid days for family/medical leave 10

Maximum number of unpaid days for family/medical leave NGO

Major medical benefits

Major medical insurance for residents Fully paid by institution

Major medical insurance for dependents Fully paid by institution

Outpatient mental health insurance Fully paid by institution

Inpatient mental health insurance Fully paid by institution

Group life insurance Available not paid

Dental insurance Fully paid by institution

Disability insurance Available not paid

Disability insurance for occupationally-acquired HIV Not available

Medical insurance coverage begins When resident/fellow starts program

Copyright 1995-2009 American Medical Association. All rights reserved.

To do more searches, go to the following website: a…

@Gabe: Wow! I’ve been Googling for hours and I couldn’t find info that detailed! Didn’t know what I was looking for. Thanks.

@JMD: Thank you! That’s very encouraging.

  • gabelerman Said:
new residency hours are capped at 65.

Clarification on residency work hours:

Starting in July, 2011 the ACGME will have new work hour rules in place. The new rules will have a direct impact on all years, but most importantly limit intern time. Not too sure where Gabe is getting the cap at 65, perhaps he can explain more. Here are the rules directly from the ACGME site [ h_index.asp]:

1. Interns are capped at a total of 16 hours per shift and should have a minimum of 10 hours (but must have 8 hours) between any two shifts (currently interns operate like any other year residents).

2. All residents are capped at 80 hrs per week (however, a program can go up to 88 hrs per week in special cases) inclusive of all duty time including resident didactic time averaged over a 4 week period of time. (Currently the same cap applies.)

3. Shifts for PGY-2's and above will be capped at 24 hrs per shift plus 4 hrs for patient care transfer or didactics (currently the total is 30 hours). There is a clause which states, in an extreme circumstance, the resident can stay for longer and participate in the care of a single patient.

4. PGY-2's and above should have a minimum of 10 hours between shifts and must have a minimum of 8 hours. In addition, these residents must have a period of at least 14 hours off after any 24 hour shift.

5. All residents must receive at least one day off in seven averaged over a period of 4 weeks (i.e. must have 4 days off in a 4 week period). (Same as now).

6. Residents may not be scheduled for more than 6 consecutive nights when on night float.

7. PGY-2's and above can be scheduled for in-house call no more frequently than every third night averaged over 4 weeks.

There has been much discussion in our residency programs that the new intern restrictions will mean that residents in PGY-2+ years will have longer hours than they have had in the past (as the hospital will still need to be covered). We will see if this holds true once the new schedules start.

There is no doubt that residency is grueling. That being said, even when I am hitting 80 hours a week, it has not been as bad as I thought it would be coming into it. I'm sure others have differing thoughts. The reality is that many parents have done this before you and have been successful. While certainly not the most ideal, it can be done.

I agree with Gabe that your focus now should be on things that are closer in time to where you are now. These hours may change by the time you hit residency as well.

Best wishes in all of the preparation!

So - I’m an intern. I don’t blame you for thinking about the future and how it will impact your family. I’m currently 2/3 of the way through intern year and while the hours are tough at times, they’ve been doable. In residency, first year is typically the worst in terms of total hours at most programs. We have yet to see if this will remain the case with the new duty hour limitations, but I think it will continue to be that way. With the elimination of 24 hour call for interns, most places are changing over to a “night float” system instead of the traditional 24 hour call. Essentially, it becomes more like shift work where you work either days or nights.

I have two small children (4 and 10 months) and some months suck. I’ve had 3 months so far where my average workweek was >70 hours. That being said, you make time where you can. Even if it’s nothing more than eating dinner with the kids, getting them ready for bed and reading stories and then crashing as soon as they’re in bed. You try and set aside special time for the kids as often as you can. The key isn’t so much how much time you spend with your children as much as the quality of time you spend with your children. There are plenty of parents who work 40ish hour weeks but still spend little quality time with their kiddos because they are busy doing housework, surfing the net, watching tv, etc.

Anyways - enough rambling - I’m post night float and not very coherent at the moment. The point I’m trying to make is that although your concern is valid, there are ways to make it work.

@MB2B - yeah, I was wondering about that 65 hour cap thing myself. That’s a good point, though, that in eight million years when I actually get done with school everything will probably have changed again. And it’ll be doable then, too.

@Emergency - lol, your post almost made me cry!! That’s exactly what I was wondering - you’ve 100% answered my question. Thanks so much.

Hi AmberB,

I really appreciate this thread that you started since I am in a very similar situation. I’ll be starting med school this August, but I would easily give that up if it meant not being there for my children (3 yr old and 1 yr old). My kids are the most important part of my life and I want to make sure they have some “daddy time” every day.

The physicians I work with who were non-traditional with kids during med school made it very clear that it will be a challenge. However, they were also very encouraging in saying that family time does not have to suffer as long as it is kept as a high priority. The fact that you are concerned about it now indicates that you will find time to make it work, even during residency and intern years. This is what the docs told me where I work.

So, I believe it’s a good sign that you’re thinking about this issue now before committing to a huge undertaking. From what I’ve heard, it can be done, but only if you make it a priority.

I also like how Emergency described it. Quality time with the kids doesn’t have to be sacrificed to be a good intern or resident.