Kids and ortho residency

I don't want to sound harsh, but this field (and the training for it) doesn't lend itself to being extremely family friendly. Night float or not, you end up hanging around until 7-8 anyways. I did have 2 young ones during training and I was around, but not anywhere close as other fathers. And now speaking from the attending side, it doesn't get much better. Yes, you have more control over your schedule, but you also have a crapload of other stuff to get done. In fact, there are stretches now that I see my family less than when I was in residency/fellowship. If you are going to be bitter for missing soccer games, plays, etc.. then you might want to reconsider the field completely. Go ahead everyone and flame me now! Just trying to give you some honest input.

I had my first kid during my 4th year of medical school. My wife was the daughter of a physician so she understood the time committment. As a surgical intern I went 3-4 days at a time without seeing my child. Woke up wife some nights to say goodnight. You're leaving the house before 5 am and coming home after 6pm. Weekends are for rounding and call.

We had our second child during my PGY2 year. These years were bascially paying my dues in the ER and taking care of all the inpatients. Outpatient specialities were better for weekend time though. Call typically is busy still as your point man

Senior years in residency give you more time at home if you do back up call.....but I ditto the comment that you'll not get the time with your child like other fathers. You won't be throwing the ball or taking them to all the practices/games (like my father did). Significant other tends to get bitter if you pull the I'm tired but when you come home....since they deal with kids 24/7

But theres nothing more special than coming home to a loving family after the long hard training....typically your kids can't get enough of you

I think this is program and specialty dependent. You need to ask the residents on the interview trail. Personally, our program has a night foat system and I rarely hang around until 7 or 8, unless I'm on a busy service which is only 2-4 months out of the year. I take 1 call a month as a PGY 3. On the other hand, a friend of mine at a small community program takes 8 calls a month. I'm not a staff yet, so I can't comment on this, but I'm generally of the opinion that you will make time for things that are important to you. No one can hold a gun to your head and force you to miss soccer games, etc. You need to pick a specialty and a practice situation that are amenable to those things if they are important to you. You might just have to trade money for time.

Do you think that by asking residents about how family friendly their program is you'll give the impression you are looking for a cushy spot?

With all the talk of how committed you have to be, it seems like a wrongly worded question with good intentions might do more harm than good.

From my small experience on the trail, most residents are married and many have kids. Obviously, you're not going to be there all of the time, but you'll find that most folks are pretty honest about how they spend the >88 hours/wk they're outside of the hospitals. That said, I wouldn't walk into an interview asking about maternity/paternity leaves, but life IS possible outside of service. "Family friendly" may be a bad approach, however you'd have to assume that most PDs probably realize that family life (to some extent) is important and, at the very least, "significant others" have a similarly-significant impact on ranklists. Finally, many hospital systems have some type of social network for spouses which are often well-funded and which are well-regarded by residents and their families.

I would disagree that being in a program with night float would make you less likely to see your family/kids. I went to a school with night float and matched at a program without, and at this point think I would definitely prefer night float.

This is obviously program dependent, but when you're on night float, you're not assigned to a service during the day, so expectations for you end at 5-7 a.m. Your hours are usually Sunday to Thursday 5 p.m. to 7 a.m., giving you a 70 hour week. When you just have regular call, there is definitely a tendency for attendings and other residents to "forget" that you were on call last night, and you end up sticking around much later than you should. Most of the residents not on night float were out of the hospital at 5-6 at the latest, leaving you ample time to go home and eat/play with the family before reading for your next day's cases.

Regarding home call, I would definitely not fall for that. Home call is code word for no relief from the 80 hour work week. You could be answering pages from nurses all night and not close your eyes once, but because you were home, you're there all the next day (or at least expected to be). In my mind, the AAOS or RRC or whoever it is needs to take a very close look at programs with home call and how they really keep residents under the 80 hour rule. I knew full well going into residency that it was going to be tough and I have no problem working 80 hours a week. I just didn't think that I'd signed on for much more than that. Beware the tales you're told on the interview trail and do your own investigation and thinking before making your lists.

i think the most critical part of this equation is your significant other. i don't know any residents who stay at the hospital because it is fun. you do your cases, take care of your patients, and then you get home to your family. if you come home every night to someone complaining that you don't spend enough time with the kids, then the guilt of your job can eat you up. i say this as i am in my last year of residency and i have watched schedules change, seen night float vs. regular q 3-4, home call, etc. They all suck and none is as fun as playing with your kids. The one thing through all these changes that is evident to me is the guys who constantly are fighting at home seem to resent work the most and end up having the most problems and the guys with understanding family situations seem to be the most upbeat. That is where doing residency close to you or your wives family may be critical. A lot of people don't think about it, but if the grandparents/aunt/uncles can lend a hand it pays great dividends. on the other hand if you have a very understanding spouse or a lot of supplemental income for daycare then you can also justify the tough burden of long hours.

In regards to Maxpowers statment:

"I knew full well going into residency that it was going to be tough and I have no problem working 80 hours a week. I just didn't think that I'd signed on for much more than that."

By "much more than that" do you mean that you don't expect to read, prepare presentations, and do research on your own time? What about spending time with your fellow residents to build some friendships? The 80 hours is direct PATIENT care, NOT including all of the other stuff. If you want a punch in, punch out job, then go do ER or go work at Target.

No, d-bag. Your insinuations about my work ethic are unacceptable, as are your taunts of working in the ER or punching the clock at Target. Of course I knew that the 80 hour rule did not apply to reading for cases, doing research, etc. I knew all that was above and beyond and was (and still am) fully willing to do all that.

What I didn't sign on for was 95+ hours of DIRECT PATIENT CARE A WEEK BECAUSE OF THE SLIPPERY HOME CALL RULES. If you'd read the rest of my post (particularly the part where I said "Regarding home call, I would definitely not fall for that. Home call is code word for no relief from the 80 hour work week."), maybe you would have figured it out.

Too all those out there who think you can not have kids in an ortho res, YOU ARE WRONG. You will have to sacrifice some time with you kid, but you can usually get a week off around the birth. I had a baby boy in my R3 year and it has been great. A whole new perspective. Remember you are in residency to learn a trade, not put your life on hold. If you choose not to have a child in residency due to work load I feel sorry for you. Many of my co-residents have had children and they all are doing well. You must have a VERY supportive partner that understands your hours, etc, ......Then you will be fine.

I am going to side with the douche bag. 80 hours applies to direct patient care and home call doesn't count as direct patient care. I loved home call, because I didn't have to miss cases the next day regardless of how many times I was awakened by phone calls or had to go in to the ER. Of course, I lived through 120 hour weeks as a MS3 and MS4 before work hours went into place, so maby I have a different perspective.

That being said, my residency had one of the busiest level 1s in the country and we spent 6 months there as an R2 and R3 and 3 months as an R4 and R5. The rest was home call at community hospitals. During residency I had three children. One in my R1, R3, and R5 years respectively. Did I miss out on events in their lives, of course and I am still missing out on events as a fellow and will likely miss events as an attending. That is the career path I chose. There are no work hour restrictions as an attending, but it will be nice to have much more control over my schedule.

I love being a douchebag...it comes naturally.

Residency sucks bro and I am only a PGY1. Night float/ no night float I have been at the hospital finishing up stuff until 11pm when I had signed out to the night guy at 6pm. Then you have to be back at work at 5:30am the next day. I couldn't imagine having a family but residents in my program do and its works well for them. You know what would make work much more fun having a HOT co-resident. I met this hot blonde girl on the interview trail. Being able to look at her everyday I would GLADLY stay at work until 11pm or maybe even 12 and would even come in a little earlier in the morning!