What does the schedule of an Emergency Medicine Physician look like?

As an Emergency Medicine Physician, my schedule is anything but predictable. One of the hardest things I remember from my first year in residency, was teaching my body NOT to have a schedule. It took about a year for me to get used to switching back and forth. That’s part of Emergency Medicine. We work mornings, days, nights, weekends, holidays, you name it we work it. The hard part, is that our schedule is never the same. Often times we will work a couple of morning shifts, then transition into a couple of night shifts, and then back to mornings. The hardest transition being nights back to days within a short period of time. Of course, our schedules are dependent on the group we work for and what their requirements are, but every week is different for most EM docs.

How many shifts per month?

The hours in an EM doc’s shifts and number of shifts worked per month is largely dependent on the group requirements also. “Full time” for one group may be 12 shifts per month while for others it may be 15 or more. Some groups hire part time physicians, so the option to work less than 12 is also out there. My experience may not be the same as others, but I typically work 12-13 shifts per month. The number of shifts per month was a choice for me, thankfully.

That’s one of the things I love about Emergency Medicine. The shifts may be tough and at light speed, but the positive trade off is that we generally have more days off than any other physician in medicine. I used to work more shifts each month, but I noticed a little bit of burn out and blogging became my second job. Finding more of a balance is something I am grateful for, because I love medicine but I also love free time to be creative.

Emergency Medicine offers up a widely flexible schedule, on top of everything else I just mentioned. Have a dentist appointment you’ve been waiting to schedule? No problem. Just plan it for a morning when you don’t work until the afternoon. Easy peasy, with no time-off requests needed. You want to take a vacation with your family? We EM docs can typically stack a chunk of shifts together, allowing for multiple days off in a row. There are of course, the trade offs of night shifts and holidays, but at least there are many positives to sweeten the deal.

How long are the shifts?

The length of each shift will depend largely on the department’s flow and census. Physician coverage is also dependent on these numbers. Some locations may be very slow with a low census (think small rural town), so they will likely have single doctor coverage (only one doctor in the department seeing patients). These shifts could be up to 24 hours, but this is rare for any busier department. The majority of departments have shifts that are 8-12 hours (8-10 being most common), and staff multiple physicians during each shift, tailoring up or down for the busiest/slowest times of the day. I personally see patients for 8 hours on average, but my shift isn’t necessarily done at 8 hours. Many groups will sign out patients to the next oncoming doctor while others do not. In the latter case, the physician stays until their patients all have a disposition (admitted or discharged).

What does a typical shift look like?

A shift in the Emergency Department is typically busy. Unlike a doctor who is “on call” overnight, we don’t lay down or nap during shifts. There is rarely down time, for me, but again this is dependent on the population you serve and the areas surrounding the department. The best part about being busy for 8 straight hours, is that the time seems to pass quickly!

What about night shifts? Do you have to work nights forever?

Some Emergency Medicine group structures include a “buy in” period, where the newer physicians work more nights than those with more seniority. This has been my experience. When I started (almost 4 years ago!) I worked half of my shifts at night. Back then it was about 7 night shifts per month, single coverage, and it was brutal at times. Circadian rhythms do not like to be disrupted my friends. Chris had a night shift alter ego name for me, we won’t get into that part! You can check out this blog filled with tips for those night shift workers out there.

So there you have it! My full time job as an Emergency Medicine Physician allows me the time and flexibility to also be here, in this space, writing blogs and creating content. And now you know why!

Feel free to leave any additional questions about scheduling below in the comments!



Leave a Note

8 thoughts on “What does the schedule of an Emergency Medicine Physician look like?

  1. When it comes to Ems, how do you and C work your schedules so that you have enough time for her? Do you hire a sitter to come check on her when your shifts overlap or work it out so that you both have shifts at different times? My boyfriend and I have a similar situation and just got a dog (:

    1. Hi there! EMS is 3 now, so she’s able to be in her crate while we are at work. When we got her, Chris was actually off work on injury so it was perfect timing, he was home all the time. We don’t have a sitter or doggy daycare. She was crate trained very young and loves being in there. With the way our schedules overlap it’s actually perfect for her. She’s rarely in there more than 8 hours. When Chris was working 2 days on, 4 days off, it would sometimes be more than that if I was working those 2 days he was gone, but now he has a more normal schedule. Doggy daycares and walkers are a great option for people who work longer hours. Residency would’ve been a tough schedule to keep with a puppy, but I know many friends who do it!

  2. This was such a good read! I’m also considering EM because of the life-work balance. I was wondering if you could tell me more about your day in a life as an EM physician. What time do you wake up, get to work, go home, how many patients do you see in a daily, etc etc. Also, since you are working in shifts, does that mean you’re never on call? Looking forward to your response! 🙂

    1. Hi there! It’s hard to say what time I wake up or get to work or go home because every shift is different! I either work very early, mid day, or late evening. Overnight shifts are less common for me now. Typically my shifts last 10 hours because we see our patients through to the end of their care. On average I see 2-3 patients per hour, which is definitely busy and fast paced in comparison to other ED’s I’ve worked in. Just depends on the site and coverage. Correct, I am never on call. Shift work only. We do have a backup schedule when needed but most docs prefer to be busy so it’s not typical that it is activated.

      1. Hi Dr. Majestic!

        Thank you so much for all the information! It was so helpful, as I’m considering EM as well! Can you talk more about what made you chose EM? I’m not sure if I’m interested in EM for the right reasons. Also, what kind of patients do you typically see in EM? I would really appreciate your reply 🙂

        Thank you so much 🙂

  3. Mam there is a period where you are at home… Say for 15 days and again you have to jump into medicine…… Doesn’t it affect your continuity or active way of practising medicine?

    1. Not at all. The length of school and training including experience clinically helps you never forget. Even if you have days off!

Dr. Majestic

I invite you to take a glimpse into my crazy, beautiful life in medicine and allow me to teach you my health, wellness, and lifestyle tips along the way. 

Learn More