Residency Advisor
The fantasy that you can “catch up on life later” after residency is a lie.
If you do not deliberately protect time for your real life during training, the system will absorb every leftover minute and hand you burnout, regrets, and a shaky sense of self. So let’s answer the question you’re actually asking:
How many hours a week should residents realistically protect for life?
The blunt answer: protect 20–30 waking hours per week as non‑negotiable “life time”
Not theoretical. Not “if the week is light.” Realistically.
You should be protecting:
- At least 20 hours/week of waking off‑duty time that is not for medicine, commuting, charting at home, or mandatory admin
- Ideally closer to 25–30 hours on most weeks
This is not your total time off. This is the slice of time that is truly yours: for sleep‑adjacent routines, relationships, exercise, groceries, spiritual life, hobbies, staring at a wall, whatever.
Under that 20‑hour floor, I see the same pattern: cognitive decline, resentment, poor empathy with patients, and a very high odds of “I hate this” by PGY‑3.
Let me show you the math so this stops feeling like a vague wellness poster.
| Category | Value |
|---|---|
| Minimum | 20 |
| Ideal Target | 28 |
Why 20–30 hours and not “as much as possible”?
Because you’re a resident, not a lifestyle influencer.
Here’s your reality on a heavy month:
- 70–80 work hours/week (sometimes more in practice, even if logged as 80)
- 6 days/week in the hospital on some rotations
- Post‑call days that are technically off but feel like a hangover
You do not have 60 beautiful free hours to optimize. You probably have:
- 88 total hours off duty (168 total hours in a week – 80 work = 88)
- ~49–56 hours of sleep if you average 7–8 hours/night (you should; more on that later)
That leaves you something like 32–39 waking, off‑duty hours. That’s your real pie. Out of that, you must carve out 20–30 for life and let the rest be “slippage” for charting, commuting, random crises, and just existing.
If you’re below 20 protected hours, medicine is eating you whole.
What does “protected” actually mean?
Protected life time is not just “time I’m not physically in the hospital.”
Protected means:
- You’re not available for routine work calls/texts
- You’re not charting, “just finishing a couple notes,” or checking labs
- You’re not doing mandatory program stuff (lectures, studying for tomorrow’s case because you’ll be unsafe otherwise is a gray area, but still)
Protected time is the mental stance: “This block belongs to me and the people I care about. Medicine doesn’t get it.”
If you’re on a q4 call schedule, that might look like:
- Post‑call day: 4–6 real waking hours after you’ve slept
- Golden weekend days: 8–10 hours each
- A couple of evenings: 2–3 hours each
Added up, that’s where you squeeze your 20–30 protected hours.
| Step | Description |
|---|---|
| Step 1 | 168 hours per week |
| Step 2 | Work 70-80 h |
| Step 3 | Sleep 49-56 h |
| Step 4 | Remaining 32-39 h waking off duty |
| Step 5 | Protected life time 20-30 h |
| Step 6 | Unprotected spillover 5-15 h |
Notice something: I’m not counting “scrolling your phone in bed exhausted” as protected time. If you’re too depleted to choose how you use it, it does not count.
How this fits with duty hours, ethics, and self‑respect
You’re in a phase labeled “Personal Development and Medical Ethics.” That’s not fluffy branding. There are real ethical stakes here.
Ethically, you have obligations to:
- Patients – to be competent, present, and not dangerously impaired
- Yourself – to preserve your health and future capacity to practice
- Your family/friends – to not abandon them for 3–7 years because “training”
When residents run at 90–100 hours/week or sacrifice all non‑sleep off‑duty time, they start violating all three.
You’ve seen this: the short‑tempered senior in the ICU snapping at nurses, the intern crying in the med room because of a minor mistake, the resident who hasn’t seen their partner awake in days. That’s not just “toughing it out.” It’s an ethical failure of the system and of individuals who refuse to set limits.
Reasonable protected time is part of professional ethics, not a luxury.
A realistic weekly template: surgery, medicine, and lighter rotations
Let me walk through how this actually plays out across different styles of rotations.
Heavy rotation (surgery, ICU, busy inpatient medicine)
Assume:
- 70–80 work hours
- One day off per week
- Call or long days mixed in
Aim for:
- 1 day off: 8–10 protected hours (yes, the whole day minus basic errands)
- 2 weekday evenings: 2–3 protected hours each (home by 7 pm → 10 pm that’s yours)
- Post‑call: 4–6 protected hours once you’ve slept a bit
That gets you:
- Day off: 9 hours
- Evenings: 5 hours
- Post‑call: 5 hours
= 19 hours
You’re near the minimum. You need to squeeze at least one more small block: a short walk, coffee with a friend, 90 minutes for the gym. This is where most residents give up and say “I’ll survive.” That’s the mistake.
Moderate rotation (clinic, consults, some electives)
Assume:
- 55–65 work hours
- One full day off reliably, maybe two some weeks
You should be able to hit 25–30 protected hours if you’re not bleeding time doing charting at home every night.
Template:
- 1–2 days off: 8–16 protected hours
- 3 evenings: 2–3 hours each = 6–9 hours
- Occasional half‑day/early day: 3–4 hours
That’s where you build your actual life: consistent workouts, date night, seeing your kids, religious services, language class, whatever matters to you.
Light rotation (research, electives, “golden” consults)
Here’s where people either heal or over‑function.
You’ll be tempted to give these rotations back to medicine: more research, more moonlighting, more studying. Some of that is fine. But you should be hitting at least 30 protected hours here and actually recovering your baseline.
Use these months to:
- Sleep like a human
- Rebuild friendships
- See a therapist if you’ve been meaning to
- Start one small habit that can survive busy months (10‑minute run, weekly dinner, etc.)
Concrete breakdown: how to spend those 20–30 hours so they actually help
You don’t need a perfect pie chart of your life, but you do need to avoid one trap: using all protected time for mindless decompression.
A rough, realistic allocation of your protected hours:
| Category | Value |
|---|---|
| Relationships | 8 |
| Physical health | 4 |
| Errands & life admin | 3 |
| Joy/hobbies | 3 |
| Quiet/mental reset | 4 |
For a 22‑hour “life budget,” that might look like:
- 8 hours – Relationships
Dinner with partner, playing with your kids, calling your parents, hanging with friends, a weekly game night. Actual human contact. - 4 hours – Physical health
Three 45–60 minute workouts, or long walks, or yoga + stretching. - 3 hours – Errands and life admin
Groceries, laundry, bills, renewing your license. Necessary but not your whole life. - 3 hours – Joy/hobbies
Reading non‑medical books, music, gaming, art, gardening. Something that reminds you you’re more than “the resident.” - 4 hours – Quiet/mental reset
Sitting with coffee, journaling, therapy, religious services, meditation, or just lying on the couch actually resting.
You’ll flex week to week, obviously. But if you notice “relationships” and “joy” keep getting erased in favor of random chores and doom‑scrolling, you’re not actually protecting life. You’re just not at work.
Where residents usually lose those hours (and how to plug the holes)
If you’re thinking, “I don’t even know where I’d find 20 hours,” here’s the ugly truth: you’re probably already spending close to that, it’s just fragmented and low‑quality.
Common leaks:
- “Just finishing notes” at home every night – 30–90 minutes gone
- Group chats endlessly complaining about the program – emotionally draining, does not restore you
- Social media/internet spirals – 1 hour becomes 3
- Saying yes to every extra shift or research ask
- Long commutes with nothing that refuels you
You don’t need to become a productivity robot. You do need to be honest about where your time actually goes.
| Time Trap | Better Use During Protected Time |
|---|---|
| Charting at home nightly | Batch notes at work, hard cutoff |
| Endless doom-scrolling | 30-min intentional show or reading |
| Complaining group chats | One short vent call + boundaries |
| Extra shifts for no reason | Protect day off, plan something |
| Mindless commuting | Audiobooks, music, language, quiet |
How to enforce protected time without being “that resident”
Here’s where ethics comes back in. You’re balancing personal protection with being a decent colleague.
Step 1: Define your non‑negotiables
Pick 2–3 anchors that you protect almost every week:
- “Friday night is for my partner and I. I do not pick up extra call then.”
- “I go to religious services Sunday morning unless I’m on call.”
- “I work out 3 times a week for 30 minutes.”
These become structural. Everything else flexes.
Step 2: Use simple, honest language with co‑residents and attendings
You do not have to overshare. Try:
- “I already have a commitment that day off.”
- “I can help this time, but I’m not able to pick up extra weekends regularly.”
- “I need to leave by 7 tonight; what are the must‑dos vs nice‑to‑dos?”
Most reasonable attendings respect clear boundaries framed around patient care and your ability to function.
Step 3: Stop apologizing for being human
You’re not “weak” because you protect time. You’re the one who’s going to make it through a 30‑year career without imploding.
The resident who proudly works 100 hours, never sees their kids, and tells you to “suck it up”? I’ve watched a lot of those people burn out hard or quit clinical medicine entirely. That’s not the model.
Special cases: parents, couples, and those on the edge of burnout
This is where “20–30 hours” stops being a suggestion and becomes survival strategy.
Residents with kids
You need:
- Predictable anchor time with your children every week (e.g., Saturday morning, bedtime routines 3 nights/week, Sunday afternoon)
- A hard commitment not to dump every day off into extra shifts
Real talk: you will feel guilt from both sides. If you try to erase your needs completely “for the kids,” you’ll end up resentful and emotionally unavailable anyway. Build your 20–30 hours so that at least half of it is truly with them and still leave a sliver just for you.
Resident couples / two‑physician households
Minimum goal: 8–10 hours per week of shared, present time where you’re not both charting or talking shop the entire time.
That can be:
- One real date night
- One long weekend morning together
- A recurring walk after work twice a week
If you do not protect this, your relationship will default into “co‑managers of a shared inbox and pantry.”
| Category | Value |
|---|---|
| Current | 4 |
| Minimum Target | 8 |
| Ideal | 12 |
If you’re already burned out
If you’re:
- Dreading every shift
- Snapping at patients or nurses
- Fantasizing daily about quitting medicine
- Emotionally numb or crying easily
You don’t need a fine‑tuned schedule right now. You need to claw back any consistent protected time and probably get help.
Start with:
- 10–15 protected hours/week, non‑negotiable
- One honest conversation with a trusted attending, mentor, or therapist in the next 2 weeks
This is not you being dramatic. This is you trying not to become a patient safety issue.
The ethics test: would you recommend your current life to a med student?
Here’s the simple diagnostic:
If a third‑year med student you like asked, “Should I live the way you’re living now when I’m a resident?” would you say yes?
If you’d warn them “Don’t do what I did,” you have your answer. You’re under‑protecting your life.
You don’t control macro‑level exploitation. You do control:
- How available you make yourself on your days off
- How often you volunteer away your personal time
- Whether you treat your own life as expendable
Stop waiting for permission. You won’t get it.
Do one thing today: look at the coming week and block off two specific chunks of time—at least 2–3 hours each—as absolutely protected for your life. Put them in your calendar, tell the person involved if it’s relational, and then defend those blocks like a consult you actually care about.
