<p>I have been doing some pretty deep soul searching and now I have questions concernings different specialties in medicine. My primary concern is my ability to treat patients properly when I am not at my prime (at night)</p>
<p>I don't mind waking up nice and early in the morning. In fact, I wake up everyday at around 7am and find myself very productive in the morning. However, after about 8pm, I start crashing and can't concentrate on important things. </p>
<p>After reading about the hours that most residencies have, I don't really know if I am fit to become a doctor. I would be able to wake up at 6am to help my patients. However, I don't want to be assigning to wrong drugs late at night. </p>
<p>So I guess my questions is: Are there any specialties in medicine where I wouldn't need to work overnight and risk my patients?</p>
<p>During residency you will definitely have to work nights. No way of getting around that. Once you get past that, your on-call duties should be significantly easier. Many pediatricians are on-call from the comfort of their own homes (however, if needed, they will have to go to the hospital in the middle of the night). The usual cushy specialities (radiology, derm, etc.) should have more regular hours.</p>
<p>I promise you most general pediatricians in private practice get phone calls from worried parents at all hours of the night. If you get in a large enough practice then there is shared called, so one doctor takes call for the whole office for a day, a week, a month, whatever. But you've got to take your turn. While true that the pediatrician may just tell the parents to go to the emergency room, the call will still most likely get the initial call.</p>
<p>In a small town, it's even more likely that a pediatrician is going to be called in the middle of the night. That's just the nature of small town life (which I found out last summer). In a small town, you can be at the grocery store, the HS football game, or getting coffee and people will come up and ask you to check out things they have wrong with them.</p>
<p>Seriously, look in the back of JAMA in the ads and see how many ads mention reasonable call schedules.</p>
<p>To the OP...I think you'd be surprised what you're capable of, but if you seriously cannot extend yourself after long periods of time, you'll really need to find something else to do. I wish I could tell you differently, but at the same time I really want to tell you to "sack up" and get over it, if becoming a physician is what you really want to do.</p>
<p>I think med school fits the description of sleep-deprived a majority of the time...</p>
<p>In Ithaca there are no hospital-affiliated pediatricians and two private pediatric practices. I had the pleasure of shadowing a pediatrician from one of those practices. They take turns being on call on the weekends (they physically go to the office and sit there waiting for calls from parents). Ironically, because Ithaca is so small, they've teamed up with the pediatricians from the other practice (their competition) to have one person handle on-call duties for both practices each weekend (this way, they're on-call half as often).</p>
<p>Sleep interruption in residency is a fact of life, but residency conditions have theoretically improved with the implementation of duty hour limits. Sleep interruption in private practice in a function of the specialty and the intensity of practice. Some specialties, for instance, dermatology and radiation oncology have few emergencies requiring immediate intervention; other specialties such as radiology, pathology and emergency medicine permit shift oriented work schedules.</p>
<p>Call duties do not always improve after residency since residents are relatively isolated from the economic realities of production pressure.</p>
<p>As noted, most doctors participate in call pools to reduce the frequency of overnight call at the expense of increased intensity.</p>
<p>I guess I will just have to suck it up and live with it. It seems to me like it is only really bad during residency and gets a bit better after that. Thanks!</p>