I know I’m a long way off from needing this information anyways, but I’m curious so I figured I might as well ask. I’d love to do surgery, specifically orthopedic or cardiovascular surgery, if I get good enough grades in med school to get into that residency but I have a few questions for anyone who’s done a surgical clerkship, residency, etc. or is doing them. The first is what kind of hours do you do? I realize that with any hospital based specialty you’re on call a lot and all that but I’m wondering how many hours a work you week, what time you get off and when, etc. and is it possible to work nights exclusively if you’re a night owl and are there benefits to doing so? I’m also curious as to how much politics you have to deal with, whether surgery is as high speed and exciting as it seems to be and is it a good specialty to get into? I’m basically just looking for any good information on surgery, thanks. 
One great place to look is in the diaries. Our own resident surgeon, Dr. Natalie Belle, wrote updates througout her intern year and beyond. Also, she has some posts in the forum where she chronicles some of her surgery rotations, so a search of those may yield some helpful info too.
Hope this helps,
Tara
Given that Natalie’s the surgeon around here, I’ll let her handle most of the nitty-gritty questions but I will tackle your question about “night owl” work. Presumably you’re asking about the lifestyle of a surgeon AFTER residency (which is several years following medical school). The short answer is no, you won’t be able to organize it like that. Surgeons don’t just operate, they also see patients pre-operatively and post-operatively and for that they need to do office hours. Now, I bet there’d be folks who’d LOVE to have doctors who have office hours in the evening, say, or really early morning (my 4:30pm and 8:00am appointment slots are ALWAYS the first ones to fill because people come on their way to or from work). But the reality is that doctors’ office work hours are generally 8-5.
The other reality is that hospitals run operating rooms according to a schedule - while emergency surgery can be done at any time, scheduled surgeries are during the day.
I’ve seen trauma teams where someone might spend a month as “night float,” taking all the trauma calls each night and someone else in the practice is doing the office hours. But that’s pretty hard-core and not too many people want to do that ALL the time. A month is long enough!
Natalie will be able to flesh this out considerably but that’s my .02 from the perspective of a former surgery student and intern now grateful primary care resident.
If you REALLY get off on working at night, ER is the place for you!
Mary
Tara and Mary, thanks for the insight, I’ve looked at some of the diary entries that Natalie has on here and so far my interest in surgery is rising. 
Out of curiosity though, why did you switch from surgery to primary care?
I don’t mind working the day, I mean I’ve done it my entire life, but I’ve heard plenty of stories about hospital doctors such as surgeons being on call so they get called into work in the middle of the night, and my thinking was if that’s going to happen why not just work at night. I am a night owl though, so whatever I’m doing at night, I’m a lot more active which is why I figured if it was possible it’d make sense to do night shifts. Surgery seems more appealing to me then ER though, I have extremely good eyesight and hand-eye coordination so I figured surgery might be a good match for me.
whoops, didn’t mean to imply I switched out of surgery, I did surgery rotations both during medical school and as part of my family medicine training and that’s ALL. I liked surgery a lot but it is definitely not something I’d want to do all the time.
Pretty much every medical specialty is going to have on-call time. Depending on your practice set-up you may or may not actually have to go into the hospital in the middle of the night. As a family practice resident, I’m making the middle-of-the-night treks to do admissions for patients from my own practice and that of several “satellite” practices who participate with our residency program. My attendings consult with me via phone on these admissions, and do have to get out of bed and come in for the ICU admissions. A critical care specialist (not a resident) also comes in for the ICU admissions. Other specialists will see patients in the middle of the night depending on the circumstances - a cardiologist will be called in if someone looks like their transient chest pain is turning into an actual heart attack, a gastroenterologist will be called in if someone is vomiting blood and can’t be stabilized and needs an emergency endoscopy to find the ulcer that’s bleeding, a neurologist might be called in if someone’s having a stroke with symptoms that are progressing, or seizures that aren’t responding to ED treatment, an orthopedist will be called in the middle of the night for a compound fracture, pediatricians will meet families in the ER when a baby looks like she might have meningitis, etc. etc. etc. And I haven’t even mentioned obstetricians 
Pretty much everybody puts in some weird hours in medicine. Exactly how one individual’s practice will be structured is highly variable. In many hospitals, “hospitalists” are becoming much more utilized - these are physicians often trained as primary care docs (internists or family medicine) who take care of the hospitalized patients of primary care docs in the community who don’t want to include hospital rounds in their routines. (Seeing patients in the hospital takes a big chunk out of office hours.) Other physicians simply work out some sort of agreement with a physician who is happy to manage the care of hospitalized patients, so that they don’t need to go into the hospital. And of course in big teaching hospitals, residents will be doing a lot of the in-hospital work but the attending physician of record MUST come see the patient daily or they can’t bill for the patient’s care. (Yes, it’s all about the money when you get down to it.) In those cases, the attending doesn’t actually have to come to the hospital in the middle of the night, but they WILL need to be coherent on the phone when we call! 
And even physicians who don’t do hospital admissions get calls at night - there’s pretty much no escaping that.
During my residency I’ve learned that physicians in ALL specialties who want to have admitting privileges at the local hospitals must agree to be the “on-call doc” for their specialty a specified number of times per month. No on-call time, no privileges - simple as that. So you could pick something that seems “call-proof,” like dermatology, but then you find that you sometimes need the hospital’s surgical facilities for your patients… if you want to work under their roof, you must agree to take derm call for their ER every so often. Now, you may never get called, but if a dermatology emergency comes into the ER, you’d better be available.
Hope that makes sense - it’s way more detailed than you need right now but it’s important to know that no matter what you go into, you’re going to have to be awfully available an awful lot of the time.
You will hear this a lot but I’ll start: no matter what you THINK you’re attracted to in medical practice, keep an open mind because when you’re in medical school and exposed to the various specialties, you may very well find something ideal for you that you hadn’t even thought of. I never dreamed of family practice - but I love it. Natalie wanted to be a pediatrician when she went to med school - and she’s on her way to being a vascular surgeon. So this question of “which specialty has what hours” is not really a very helpful one to nail down when you’re in this exploratory phase anyway.
Good luck!
Mary
Mary, thanks again for the insight as it’s greatly appreciated. I actually am not that concerned with being on call, that was just mainly a curiosity since like I’ve said before I’m a night owl, and because of being in infantry basic I’ve acquired the ability of waking up at the slightest noise and being 100% coherent/alert (and no, learning this skill wasn’t voluntary ), so being on call doesn’t bother me at all.
As far as knowing what I want, yeah my stepdad’s been able to give me a lot of information I normally wouldn’t have had before I even did any research on my own since he has a lot of doctor friends since he’s a dentist himself, and one thing he’s consistently reminded me of is that I won’t know what residency I’ll want until I do my clinicals. The only thing I’m probably going to rule out immediately is OB/GYN (no offense to people who are OB/GYN, I just have no attraction to that 
).
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I know I’m a long way off from needing this information anyways, but I’m curious so I figured I might as well ask. I’d love to do surgery, specifically orthopedic or cardiovascular surgery, if I get good enough grades in med school to get into that residency but I have a few questions for anyone who’s done a surgical clerkship, residency, etc. or is doing them. The first is what kind of hours do you do? I realize that with any hospital based specialty you’re on call a lot and all that but I’m wondering how many hours a work you week, what time you get off and when, etc. and is it possible to work nights exclusively if you’re a night owl and are there benefits to doing so? I’m also curious as to how much politics you have to deal with, whether surgery is as high speed and exciting as it seems to be and is it a good specialty to get into? I’m basically just looking for any good information on surgery, thanks.
Hi there,
I am a PGY-4 General Surgery resident with plans to do a fellowship in Vascular Surgery. Currently, I work about 80-hours per week give or take a couple of hours. My hours are generally 5:54AM to 5:00PM most days with my hours extending to 6:00PM on conference days (T,W,R). Every other Friday, I work a 24-hour shift (on call) and every other Saturday I work a 24-hour shift (on call). I get one day a week (24-hours) totally free of all patient care responsibities.
Most of the surgical attendings that I know, operate in the morning and see patients in office in the afternoons. Rounds on hospitilized patients are done in the morning and in the evening if necessary. I know of few surgeons that would be content to operate all night and sleep during the day.
Natalie
Oh wow, that’s a pretty long schedule. 
Do you work those many hours by choice or is that just how the surgeon schedule works? I don’t mind long hours but working at six in the morning would just, lol. Well, I’m not a early morning person.
residency hours for the most part are capped at 80hrs/week so yes, in most residencies folks start pretty early…
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Oh wow, that’s a pretty long schedule.
Get used to the idea. As a third-year medical student and again as an intern, I was usually rounding on patients at 6am. Sometimes earlier. I had lots of classmates who considered themselves “not morning people,” but they generally adapted. It gets a lot easier to go to bed early if you’re up early every day!
As for # of hours a week, it’s my impression that your average physician in the community expects to put in about 60 hours a week - that’s an average full-time workload.
Mary
Shoot, I do that already! Actually 70-80 hours is pretty normal. I just don’t have call.
Oh ok, if that’s for residencies then that’s fine, that’s only until the end of it anyways. 60 hours a week is fine, that’s not that bad, 80 hours a week would be vicious. 
You’re right though, at the start of my current job I had to be in there at 7:00 every morning for training and I stopped caring about being up early after the first week.