Training during medical residency

hi,
I am relatively new to structured cycling training. I’ve always been on a bike, but never had the funds to get into racing. got my first real road bike about 2 years ago.

I’m an emergency medicine resident and love training. however, I work about 60-70 hrs/week. my schedule is constantly rotating from days to evenings to night shifts. I find it hard to maintain a schedule and progress. I’m currently on the mid volume plan with a goal of doing about 5 hrs of riding/week. I’m trying to increase that slowly over time.

just wondering what strategies other have had to help keep up motivation and energy when work gets in the way.
thanks.

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Do you have any particular goals or target events?

Baring specific stuff like that, with the time demands and shifting work schedule, I’d think simply using TrainNow is a better option than trying to use a training plan.

Check out podcast #181 where the TR crew spoke with an EM resident who qualified for Iron Man world champs. I believe he went over what he did to work in training.

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Do you have any particular goals or target events?

ya, there is a local weekly crit that i’m looking at and I have an A event coming up in mid july. the biggest thing is maintaining any sort of healthy sleep schedule or eating habits.

for example. yesterday, I was on call for 24h (got maybe 4h of sleep), came home, slept for another 5h and had to bail on my vo2 max workout for the day. felt like i hit a way halfway through, despite eating a gel, drinking gatorade/water mix.

other thing for me is building endurance base. like i said earlier, i’ve only been doing structured training since sept 2021. have definitely seen some improvement, and feel like I have a long way to go to see what my potential is.

I continued to train and race during my 3-year CRNA program using a mix of TR and outside rides (this was pre “outside version” workouts). For me it provided a necessary escape from school/clinicals. At first, I felt guilty for taking time to ride when my classmates seemed like they were always studying, but I found that when I took adequate personal time, my school/work time was more efficient and productive. So that helped my motivation. Energy wise, don’t sacrifice on sleep and nutrition. Understand that you might not be the best bike racer while in school, but one day when you are done, you will have spent years building a solid base upon which you can build when you have more free time. As far as specific rides, ride endurance when you can/as long as your schedule allows, but really try to nail 2 intensity focused sessions a week. For the most part, I was single/childless in school and went to bed whenever I wanted to (earplugs, sound machine, blackout curtains) and woke up before clinicals/class to train many days (I’m a morning person). If you work out before you go to the hospital, you have to eat carbs otherwise you may have some mental fog, which I’m sure in your line of work, as well as mine, is not really an option. Hope this helps.

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I’m a now retired general surgeon. One of the biggest traps to a tough schedule and lack of sufficient sleep is eating junk at odd hrs in hopes it will make you feel better. Hospitals are notorious for having all kinds of no-nos in the break rooms. After I figured this out, I never ate anything in the hospital that I didn’t bring from home. I managed to race into my mid 50’s with a combination of 5 AM trainer rides and weekend rides when I could. The stress and fatigue did finally catch up with me. I think the suggestion of Train Now is spot on. Do what you can, enjoy a level of fitness much higher than your peers, and accept your current lifestyle as one of your limiters.

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Go down to the low volume plan. You can get some good gains, especially as a newer cyclist. Prioritize the 3 workouts per the plan, then add easy Z2 miles when you can. Realize that regardless of the plan, it will change. As somebody else said, Train Now might be a good option as well. For post call days, I like easy Z2. You’ve got the “day off” but unlikely to have gotten good sleep, so I wouldn’t go crazy and try VO2 on those days. Save that for true days off or when you get a good night sleep.

It’s going to be tough, but it’s only 3 or 4 years until you finish and hopefully cut way back on your hours. It’s doable though. I’m finishing up my 2nd year as an anesthesia resident and work on average 70-75 hours a week. My last 6 weeks have been (in hours on bike): 4.5, 3, 6, 5, 8, 3.5. But I’m on a busier rotation right now. I usually can get 6-8 hours a week consistently. And TR has taken my 200 FTP at the start to 335 currently on the low volume plan. It’s really hard finding the time and energy, but can be done. I focus on nailing the 3 key workouts each week, then ride long on my days off. If you’re struggling with that, go down to 2 hard interval workouts and get more easy miles in.

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I appreciate hearing from a fellow indentured servant aka resident.
it is so hard to balance having a social life with wanting to get faster when you spend so much time either in the hospital, or asleep lol.

I thought about doing this

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Yea, it is. You have to decide what gets priority and what gets pushed out. I’m kind of lucky(?) I guess in that I’m training in a place I’m not staying. And as bad as it sounds, what this means is that I don’t really care about a social life. I study/train/learn for work, and I train on the bike. I don’t plan on staying here, so I’ve prioritized riding/racing over my social life. I see my fellow residents enough at work (probably different for you doing shift work), so I don’t really feel the need to see them that much after work. I’d rather train. Which sounds kind of bad, but I don’t mind being a bit of a loner right now knowing that I’m just going to move to a new city in 2 years. But I can’t speak for you. Everybody has to decide what is important for them.

I’d generally agree that you will have more time once done with residency but all the fresh out of training ‘em docs I’ve known have continued to work 20-22 shifts a month. I agree with t_fields above: bring your own food to work and don’t eat anything else. Wish I had received that advice when I was a resident 20ish years ago. You’re off to a good start with trying to stay physically active but the garbage food that’s often readily available can easily counteract a lot of the training, especially if it becomes a habit (which is hard to avoid once you start down the slippery slope).

Another piece of advice I’d recommend: maintain your current resident lifestyle as long as you can after you are done to pay off educational debt as fast as you can. I finished with a tiny amount of debt compared to what is typical now, still wish I would have listened better to this.

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Yea, I didn’t want to claim any knowledge of new EM attendings and the hours. For me it’s a little different in that 90% of the new attendings I’ve spoken to have just about cut their hours in half going from residency to attending. So for me, I’m just trying to maintain until I have way more time.

Yeah, that part was directed to the original poster. Consistent with what you’ve heard, My hours also dropped about in half when I finished training (IM critical care). Since then I’ve been working 12-15 shifts a month. mostly 12 hours, sometimes 8 hour shifts at my current job.

Intern year I probably rode my bike 20 times. Actually had the hardest time riding during my EM months, since you guys work such bizzaro hours! 3 days on, day off, 4 nights on, day off, 1 day, 2 nights… Just know it gets better! If it helps to see the light, my buddy thats a EM attending at one of my hospitals did a few IM distance races last year. As a resident, it aint gonna happen, but your “real work” lifestyle seems to be great for hobbies outside of work.

Given your hours, Id say if you got in 2 good rides a week youre going above and beyond.

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I appreciate this thread. I’m about to start as a med-peds resident in a very demanding program with lots of q4 28 hour call (but no more 80 hours/wk, right? :wink:). I haven’t quite figured out what my training is going to look like. For the past few months, I’ve been hammering 20-25+ hour weeks. I think the biggest thing is I need to be nice to myself and forgiving with my training. I’m debating between doing a low volume plan + additional work prn and Train Now + outdoor rides prn. For my first month, I’ll definitely do Train Now as I get my legs under me. I’ll use my days off from work to hit big volume days for sure (at least while it’s nice out; I’m based in New England). I know that I beat myself up when I miss things on my calendar, even for very good reasons, so I’ll be happier if I don’t have a calendar to start out.

Maintaining fitness is a lot easier than rebuilding fitness. I’m concerned about the kg side of the W/kg equation with the hospital diet. I’m also concerned about drastically cutting my volume–I just love being on the bike that it’s hard to lose so much of it (and I’m necessarily going to be doing a lot more trainer work than outdoor riding). I’m also reticent to sacrifice sleep to ride knowing that could adversely affect my ability to care for patients.

Luckily for me, my girlfriend is a triathlete, so we can spend time together riding (indoor and out!).

I’m an emergency physician. What’s worked for me is:

  1. Accepting that weeks where you work a lot, or do some nights, the training volume/intensity your body can handle will drop. At my age, an overnight in a week means I need to drop my weekly TSS by like>20%. If the week is too busy, then I’ll drop out all intensity and just ride z2 as much as I feel I can.
  2. Do your highest intensity sessions on the days you are most rested. Will require some flexibility and moving things around on short notice.
  3. Do lots of z2 and less high intensity work. For me that means like 10 hours a week of z2 and then 1-2h of VO2 work or something.

Also things to consider to increase training volume are commuting; and doing your work/studying while on the trainer.

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so does that mean no s-works sl7 until I pay off loans? lol

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haha thats cute, you think youll ever pay them off! haha jk!

Surprisingly, the KG portion of w/kg didnt kill me in residency. Walked all day long, took the stairs when I could. We had breakfast and lunch taken care of for us in the doctors lounges so I was cheap and did that. Probably not the healthiest but a great perk on a residents salary

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EM Attending here. Focus on your patients/job first. Everything else comes second. you want to graduate being an exemplary resident so you can get a great job with a democratic group afterwards. Working for a SDG makes a huge difference in the rest of your life, allowing for way more training etc once you graduate (compared to a CMG). Be the best resident NOW, so the next 20+ years you can have a killer job…and then have the time for training (and your SL7).

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What is an SDG?

small democratic group

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