These specialties have the least free time

Alistair Gardiner | November 29, 2021

For many doctors, working long hours is the norm. According to a 2021 physician compensation report, physicians currently work an average of 51 hours every week, which is much longer than the average US employee, who worked about 35 hours per week in 2020.

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Most doctors report working too many hours, but some specialties have less leisure time than others.

How do these long working hours affect physicians? For one thing, it throws off work-life balance and can lead to burnout. According to one study, burnout affects half of practicing physicians and results in more medical errors, lower quality of care, higher costs, and worse health outcomes. COVID-19 has only exacerbated physician burnout and compassion fatigue.

Some specialties are worse than others. Here's a look at the six medical specialties that tend to work the longest hours, how their schedules affect their work-life balance, and some ways physicians can better manage their time.

Which specialties work the longest hours?

Findings from Medscape’s National Physician Burnout & Suicide Report shed some light on how different specialists spend their time. According to the survey, which garnered over 15,000 responses, the following specialists are most likely to spend more than 51 hours per week working:

  • General surgery, 77% 

  • Urology, 76%

  • Cardiology, 72%

  • Pulmonary care, 68%

  • Nephology, 68%

  • Critical care, 65% 

On the other hand, just 13% of those who work in emergency medicine typically work more than 51 hours a week. Other specialties with relatively lighter work hours include dermatology (24% of whom work 51 hours per week or more), allergy and immunology (25%), and public health and preventive medicine (25%).

To fill out the picture, Medscape’s recent Physician Compensation Report 2021 found that doctors specializing in infectious diseases, public health and preventive medicine, and nephrology tend to spend the most hours on paperwork and administration tasks. Those specialties reported dedicating 24.2 hours, 20.7 hours, and 19.8 hours, respectively, to pencil-pushing every week.

Few studies have examined the comparative working hours of physicians across specialties. One older study published in JAMA Network included a cohort of 6,381 physicians across 41 specialties. Compared with primary care,  researchers found that surgery, internal medicine, and pediatric subspecialties tended to have the longest working hours. Specifically, those working in vascular surgery, critical care internal medicine, and neonatal and perinatal medicine had the longest workweeks. 

The takeaway here may be best summed up in an article published in July by Med School Insiders, in which Kevin Jubbal, MD, wrote, “If you want a challenging lifestyle, you should check out general surgery. The running joke among medical students is that you go into general surgery if you’re either a masochist or couldn’t get into any more desirable surgical specialty.”

“This is obviously not the case and general surgery is a fantastic field with lots to love, but the reason medical students joke about this is four-fold,” he added.

The impacts of long hours

Longer work hours tend to correlate with higher rates of burnout. Physician responses indicated that a 31-40 hour workweek tended to result in burnout rates of 36%; working more than 71 hours per week, on the other hand, was associated with a burnout rate of 57%. 

Medscape’s 2021 Physician Burnout & Suicide Report further elucidated the links between work-life balance and burnout. When asked about the top factors contributing to their burnout, 58% of respondents pointed to “too many bureaucratic tasks” and 37% said they were working too many hours. Similarly, when asked what would help reduce their risk of burnout, 42% replied “a more manageable work schedule.” The survey found that 42% of female doctors and almost half of male doctors cited work-life balance as their top workplace concern. Click here to read about burnout rates by specialty.

Another Medscape survey, the Physician Lifestyle & Happiness Report 2021, tallied responses from 12,339 physicians. Results showed that 47% would take a salary cut for a better work-life balance—and 31% would accept $20,000-50,000 less for more free time.

One-third of all doctors feel at least “somewhat conflicted” over how their work demands impact their roles as parents. About 15% of male doctors and 21% of female doctors feel conflicted and 1 in 5 female doctors feel “very conflicted” about the situation.

How to find your perfect balance

For those who like working in their chosen specialty, but are still finding it hard to find a work-life balance, there are several strategies you can use. An opinion article published in Frontiers in Pediatrics posits that by focusing on purpose, priorities, and assessments of the situation, you can manage your time successfully.

This means ensuring that you’re finding meaning in your work but also seeking ways to unwind, like engaging in physical and recreational activities and spending time with family and friends.

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