How does one survive neurosurgery residency?

So I'm really excited about pursuing a neurosurgery residency, but I can't possibly fathom the number of hours they put in each week. I read one survey that totaled their hours to 110 per week. That's barely enough time to eat and sleep without feeling rushed. It seems like 14-16 hour days with only 1 day off per week are the norm in neurosurgery. How do you mantain a normal life and do everything else: workout, raise kids, buy house, cook food, see movies, etc?

Or if you go into neurosurgery do you just have to accept the fact that your life will only be about neurosurgery any nothing else? Insight needed!

Originally Posted by CassieBagley

So I'm really excited about pursuing a neurosurgery residency, but I can't possibly fathom the number of hours they put in each week. I read one survey that totaled their hours to 110 per week. That's barely enough time to eat and sleep without feeling rushed. It seems like 14-16 hour days with only 1 day off per week are the norm in neurosurgery. How do you mantain a normal life and do everything else: workout, raise kids, buy house, cook food, see movies, etc?

Or if you go into neurosurgery do you just have to accept the fact that your life will only be about neurosurgery any nothing else? Insight needed!

Originally Posted by JP2740

I know, I know- silly to expect to be normal when you're doing neursurg. But, realistically, isn't neurosurg breeding its residents to be soulless drones who are just really good at one aspect of life (ie. cutting skulls open)? Is it wrong to expect to experience everything else in life, such as committed relationships, nature, and heaven forbid, your hobbies? I understand the "sacrifice" argument, but is there ever a median in between lifestyle and work? Any anecdotal input?

Originally Posted by CassieBagley

I know, I know- silly to expect to be normal when you're doing neursurg. But, realistically, isn't neurosurg breeding its residents to be soulless drones who are just really good at one aspect of life (ie. cutting skulls open)? Is it wrong to expect to experience everything else in life, such as committed relationships, nature, and heaven forbid, your hobbies? I understand the "sacrifice" argument, but is there ever a median in between lifestyle and work? Any anecdotal input?

You're not going to have a lot of time for those things. Not on any regular basis at least.

They say don't do neurosurgery if you have another specialty you would like equally.

You said it yourself, 110 hours a week. Unless you have a machine that's going to add hours to the day, what are confused about.

Originally Posted by CaptainSSO

Unless you have a machine that's going to add hours to the day, what are confused about.

Want to buy...

Nuerosurg.jpg

Originally Posted by CassieBagley

I know, I know- silly to expect to be normal when you're doing neursurg. But, realistically, isn't neurosurg breeding its residents to be soulless drones who are just really good at one aspect of life (ie. cutting skulls open)? Is it wrong to expect to experience everything else in life, such as committed relationships, nature, and heaven forbid, your hobbies? I understand the "sacrifice" argument, but is there ever a median in between lifestyle and work? Any anecdotal input?

During residency? Not really.

Something will definitely have to give, and it's usually going to be your sleep, hobbies, and spare time with your SO/spouse. It's a good thing I can function on 6 hours of good sleep a night.

Originally Posted by CassieBagley

So I'm really excited about pursuing a neurosurgery residency, but I can't possibly fathom the number of hours they put in each week. I read one survey that totaled their hours to 110 per week. That's barely enough time to eat and sleep without feeling rushed. It seems like 14-16 hour days with only 1 day off per week are the norm in neurosurgery. How do you mantain a normal life and do everything else: workout, raise kids, buy house, cook food, see movies, etc?

Or if you go into neurosurgery do you just have to accept the fact that your life will only be about neurosurgery any nothing else? Insight needed!

Have you been accepted to a Neurosurg residency yet? I would say first get in/shadow neurosurgeons/rotate through their hospitals, and then worry about that stuff later, if its what you really wanna do.

But I am only a 2nd year so I prob don't know jack.

I just matched into neurosurgery. I think the OP has legit concerns, but they're a little overblown. Certainly some programs blow past the hours limits but those programs are becoming fewer and fewer as the ACGME is cracking down. My program is in New York, which has the most stringent regulations in terms of resident hours so I'm not really concerned about being overworked. I will say though, I completely understand why we work the hours that we do. We deal with very sick patients and continuity of care is really important. So I wouldnt really mind working longer hours to make sure I'm on the same page regarding all the patients on the service that I'd have to take care of. Also remember that neurosurgery programs are very small, typically with 2 residents per year. We work longer and harder simply because of numbers as well.

Originally Posted by Chakrabs

I just matched into neurosurgery. I think the OP has legit concerns, but they're a little overblown. Certainly some programs blow past the hours limits but those programs are becoming fewer and fewer as the ACGME is cracking down. My program is in New York, which has the most stringent regulations in terms of resident hours so I'm not really concerned about being overworked. I will say though, I completely understand why we work the hours that we do. We deal with very sick patients and continuity of care is really important. So I wouldnt really mind working longer hours to make sure I'm on the same page regarding all the patients on the service that I'd have to take care of. Also remember that neurosurgery programs are very small, typically with 2 residents per year. We work longer and harder simply because of numbers as well.

Yea, I read a neurosurgeon's account of how the length/commitment of the residency itself selects for the type of personality they want. And it makes sense, though, because after all you're going to be operating on the freaking brain.

Are you in medical school? If so maybe you should try asking some actual neurosurgeons.

Originally Posted by Chakrabs

I just matched into neurosurgery. I think the OP has legit concerns, but they're a little overblown. Certainly some programs blow past the hours limits but those programs are becoming fewer and fewer as the ACGME is cracking down.

Hmm, I've heard pretty much the exact opposite. Granted, I'm nowhere close to the match, but from talking to other residents in busy surgical specialties (ortho, uro, gen surg) it's my impression the work hour restrictions are almost never enforced. Residents routinely pull 110+ hr weeks at many programs across the country, and reporting (or even complaining about) these programs to the ACGME is considered "poor form."

Obviously it does happen. I interviewed at 16 neurosurgery programs and I'd say half of them regularly go over the hours. But most programs really did seem to be making an effort to reduce the hours. And aside from a few programs none of the residents seemed overworked or resented working the hours. Its neurosurgery you gotta put in the time if you want to learn how to operate and properly take care of patients. At first I had trepidations about it, but after doing a bunch of rotations I can see why they need to work the hours they do and am looking forward to starting my residency.

Originally Posted by KinasePro

Hmm, I've heard pretty much the exact opposite. Granted, I'm nowhere close to the match, but from talking to other residents in busy surgical specialties (ortho, uro, gen surg) it's my impression the work hour restrictions are almost never enforced. Residents routinely pull 110+ hr weeks at many programs across the country, and reporting (or even complaining about) these programs to the ACGME is considered "poor form."

Yeah from what I've seen on general surgery, even if you sign out at the 12 hour mark, which would be considered a good day, there's always loose ends to tie up that could take an hour or two. You also have to take a look at the culture of the specialty. Neurosurgeons tend to take a lot of pride in being the strongest and hardest working people in the hospital, so not only are you dealing with long hours, you're working with people who don't necessarily want to go home early even if they could.

Originally Posted by KinasePro

Hmm, I've heard pretty much the exact opposite. Granted, I'm nowhere close to the match, but from talking to other residents in busy surgical specialties (ortho, uro, gen surg) it's my impression the work hour restrictions are almost never enforced. Residents routinely pull 110+ hr weeks at many programs across the country, and reporting (or even complaining about) these programs to the ACGME is considered "poor form."

I interviewed at a gen surg residency where they said they were very strict about following work hour rules. How do they enforce the rule? At the end of the month, all residents have to write down on a sheet of paper how many hours they worked/week. Hahah.

Originally Posted by Oxer45

I interviewed at a gen surg residency where they said they were very strict about following work hour rules. How do they enforce the rule? At the end of the month, all residents have to write down on a sheet of paper how many hours they worked/week. Hahah.

Pediatrics resident - "I came in late today because otherwise I would violate work hours regulations and that would be very hard on our program".

Somehow I don't think that'll fly for any surgery specialty.

Originally Posted by CassieBagley

I read one survey that totaled their hours to 110 per week.

Depends on the week. I've had weeks >120.

Originally Posted by CassieBagley

Or if you go into neurosurgery do you just have to accept the fact that your life will only be about neurosurgery any nothing else? Insight needed!

You adapt. I sleep less and get more efficient with things I need to get done. I plan ahead and maximize utility in free time. Likewise, the people in your life have to realize it is a major commitment and adapt too, or else you'll have to make a choice between them and residency. More often than not, residency wins.

Originally Posted by Chakrabs

I just matched into neurosurgery.

Congratulations

Originally Posted by Chakrabs

I think the OP has legit concerns, but they're a little overblown. Certainly some programs blow past the hours limits but those programs are becoming fewer and fewer as the ACGME is cracking down. My program is in New York, which has the most stringent regulations in terms of resident hours so I'm not really concerned about being overworked.

I see you drank the interview cool-aid. Check in with us in a couple of years and let us know how stringent the duty hours are followed.

Originally Posted by TheProwler

Something will definitely have to give, and it's usually going to be your sleep, hobbies, and spare time with your SO/spouse. It's a good thing I can function on 6 hours of good sleep a night.

This is very true. Hobbies and sleep adjust to the residency. Things get better, but I couldn't imagine what it would be like having the free time of someone who works 40 hours/week.

Originally Posted by neusu

Depends on the week. I've had weeks >120.


You adapt. I sleep less and get more efficient with things I need to get done. I plan ahead and maximize utility in free time. Likewise, the people in your life have to realize it is a major commitment and adapt too, or else you'll have to make a choice between them and residency. More often than not, residency wins.


Congratulations


I see you drank the interview cool-aid. Check in with us in a couple of years and let us know how stringent the duty hours are followed.


This is very true. Hobbies and sleep adjust to the residency. Things get better, but I couldn't imagine what it be like having the free time of someone who works 40 hours/week.

You get to drink craft beer with friends, play basketball with your kids, and do things to your wife that I can't post about on this forum.

Originally Posted by neusu

Depends on the week. I've had weeks >120.

How do you function working >120 a week? That would leaves 6.x hours a day of "free time" which (after showering/eating) leaves an average of 4.5 hours for sleep. And this is a best case scenario.

Originally Posted by sportsperson

How do you function working >120 a week? That would leaves 6.x hours a day of "free time" which (after showering/eating) leaves an average of 4.5 hours for sleep. And this is a best case scenario.

Eat at work, shower less often, sleep less, and keep loaded guns away from yourself.

Originally Posted by sportsperson

How do you function working >120 a week? That would leaves 6.x hours a day of "free time" which (after showering/eating) leaves an average of 4.5 hours for sleep. And this is a best case scenario.

1. Eat most/all of your meals at work. I never eat breakfast or lunch at home, and if I'm on call (every 3rd or 4th night), then I'm eating dinner there too.

2. Don't shower *every* day.

3. Have a very, very short commute.


That said, I've never worked 120 hours in a week. The most that I ever remember logging in a week was 100. I'm only in general surgery though.

Originally Posted by neusu

I see you drank the interview cool-aid. Check in with us in a couple of years and let us know how stringent the duty hours are followed.

Owned.

Originally Posted by neusu

I see you drank the interview cool-aid. Check in with us in a couple of years and let us know how stringent the duty hours are followed.

I rotated at the program, saw them send home post-call residents on multiple occasions. Do they go over the numbers sometimes? Of course, but i feel comfortable that it won't be on a regular basis. And even if it is, it doesnt really matter - the works gotta get done and residency eventually comes to an end.

Which school are you? what was your MCAT/cGPM / I need to know this for some body trying get admission in USA?

Originally Posted by JackShephard MD

+1



Wow, posts like these make me grateful I have zero interest in neurosurgery. That life sounds terrible.

The following is the oath taken on the first day of neurosurg residency:

lmao! Game of Thrones FTW!

Interesting. I'll admit that I don't have much experience other than one year going through rotations in specialties, so I might have more of the naive viewpoints

I'm assuming most signoffs occur when a patient is stable and the physician is comfortable having the night team cover until the next day? I can see a doctor staying over to see the patient from admission to discharge, but if the patient is there for 5 days, at some point they need to take a breather...right?

Originally Posted by KnuxNole

It'll probably go like this:

http://www.youtube.com/watch?v=Zq5bw3BhOCI

Haha

Originally Posted by JP2740

Why are people so insecure by the fact that some people go into medicine because they don't just see it as their job? Listen, no one will knock you for doing it for the cash and lifestyle. Some people think of it more than their job. Does that mean working 100 hours a week? Maybe not, but it's really lame to come out and say "it's just a job." To many of us, it isn't just a job, and some people just will never understand that.

Pretty sure last time I checked it was still a job.

Originally Posted by auburnO5

Pretty sure last time I checked it was still a job.

no, to some people it's something more--- an entitlement bestowed upon them by the gracious public to boost their self-esteem and give them power over the fragile lives of others


... at least that's what i wrote in my personal statement

I knew I'd get bashed. I of course don't mean it's "just" a job. Like I said, it's a very important job. The gist of my post though is that you should not choose your entire professional life off of purely whether you "like" or "dislike" the job itself. In the overall scheme of things, you are in fact choosing a JOB, but what I am saying is that you need to think about whether you are the type of person that wants your entire LIFE defined by your job. If you are, and it is ok to be one of those people - there are plenty in medicine, then green light on N.surg if that interests you. But if you are not one of those people, you probably are not a good fit and will be unhappy and conflicted the rest of your life if you choose a career that demands more than you want to give to it later on. Just sayin.

Originally Posted by napoleondynamite

I knew I'd get bashed. I of course don't mean it's "just" a job. Like I said, it's a very important job. The gist of my post though is that you should not choose your entire professional life off of purely whether you "like" or "dislike" the job itself. In the overall scheme of things, you are in fact choosing a JOB, but what I am saying is that you need to think about whether you are the type of person that wants your entire LIFE defined by your job. If you are, and it is ok to be one of those people - there are plenty in medicine, then green light on N.surg if that interests you. But if you are not one of those people, you probably are not a good fit and will be unhappy and conflicted the rest of your life if you choose a career that demands more than you want to give to it later on. Just sayin.

Originally Posted by napoleondynamite

I knew I'd get bashed. I of course don't mean it's "just" a job. Like I said, it's a very important job. The gist of my post though is that you should not choose your entire professional life off of purely whether you "like" or "dislike" the job itself. In the overall scheme of things, you are in fact choosing a JOB, but what I am saying is that you need to think about whether you are the type of person that wants your entire LIFE defined by your job. If you are, and it is ok to be one of those people - there are plenty in medicine, then green light on N.surg if that interests you. But if you are not one of those people, you probably are not a good fit and will be unhappy and conflicted the rest of your life if you choose a career that demands more than you want to give to it later on. Just sayin.

I for one really appreciate your insight and thoughts on the matter. It's pretty great to have someone who has seen the whole picture and is on the tail end of their training to provide some input and perspective. Additionally, the advice on finding someone 10yrs deep to their field and finding what sort of life they are leading is a sage suggestion.

Originally Posted by napoleondynamite

I knew I'd get bashed. I of course don't mean it's "just" a job. Like I said, it's a very important job. The gist of my post though is that you should not choose your entire professional life off of purely whether you "like" or "dislike" the job itself. In the overall scheme of things, you are in fact choosing a JOB, but what I am saying is that you need to think about whether you are the type of person that wants your entire LIFE defined by your job. If you are, and it is ok to be one of those people - there are plenty in medicine, then green light on N.surg if that interests you. But if you are not one of those people, you probably are not a good fit and will be unhappy and conflicted the rest of your life if you choose a career that demands more than you want to give to it later on. Just sayin.

I appreciated your post. I have to say personally that my goals have changed from a few years ago. I used to think medicine was the end all and it was more important to me than anything else. Now, I don't really *want* to be spending all my life in something like surgery and 80-100+ hours a week. I am not on the wanting a kid train at the moment, and don't see that changing, but I definitely enjoy going out to nice places with a significant other. I also really really want to get a puppy (which will have to wait until at least residency if not later). I think you can be super awesome and happy with what you do without having to dedicate your entire life to medicine. Don't get me wrong, I still love the field, but there's definitely other things I like doing too, that I wouldn't be able to do with 100+ hours working.

Hence leaning towards ID/EM, though more towards ID, cause I'm not sure how I'd like dealing with a lot of drug seekers + night owl shifts.

Originally Posted by Lbgem

I appreciated your post. I have to say personally that my goals have changed from a few years ago. I used to think medicine was the end all and it was more important to me than anything else. Now, I don't really *want* to be spending all my life in something like surgery and 80-100+ hours a week. I am not on the wanting a kid train at the moment, and don't see that changing, but I definitely enjoy going out to nice places with a significant other. I also really really want to get a puppy (which will have to wait until at least residency if not later). I think you can be super awesome and happy with what you do without having to dedicate your entire life to medicine. Don't get me wrong, I still love the field, but there's definitely other things I like doing too, that I wouldn't be able to do with 100+ hours working.

Hence leaning towards ID/EM, though more towards ID, cause I'm not sure how I'd like dealing with a lot of drug seekers + night owl shifts.

Whats ID?

Originally Posted by Ronin786

Whats ID?

Pretty sure it stands for interpretive dance.... either that or infectious disease

Originally Posted by Ronin786

Whats ID?

Infectious Disease. Think House in an ideal world .

Originally Posted by napoleondynamite

I knew I'd get bashed. I of course don't mean it's "just" a job. Like I said, it's a very important job. The gist of my post though is that you should not choose your entire professional life off of purely whether you "like" or "dislike" the job itself. In the overall scheme of things, you are in fact choosing a JOB, but what I am saying is that you need to think about whether you are the type of person that wants your entire LIFE defined by your job. If you are, and it is ok to be one of those people - there are plenty in medicine, then green light on N.surg if that interests you. But if you are not one of those people, you probably are not a good fit and will be unhappy and conflicted the rest of your life if you choose a career that demands more than you want to give to it later on. Just sayin.

Well said.

Here's an nice post from uncleharvey by a then-resident/now-attending neurosurgeon at UVa:

"i have to say that a lot of the horror stories that you hear are only partially due to career choice. i know plenty of happily married neurosurgeons who enjoy a nice lifestyle. a lot of what happens comes from your personality. if you’re a “career above everything else” kind of person, your personal life may suffer. you can be a successful neurosurgeon and still make your personal life a priority. Neurosurgery is an amazing field and i think it’s one of the only fields in medicine, if not the only one, that is growing at an explosive rate. the brain is still a black box and we’re learning new things about it every day. stuff we couldn’t treat surgically 20 years ago is now being treated with surgery: epilepsy, parkinson’s disease, essential tremor, depression, and even tourette’s. imagine years down the line when epidemics like obesity and hypertension could be treated neurosurgically. fields change. things like brain tumors and aneurysms may be treated differently in years to come, but there is so much more to the brain. Manual dexterity and stamina play a very small role in neurosurgery. if you think it’s the coolest job in the world, then you should do it. all kinds of people become neurosurgeons. tremor or no tremor, we’re all neurosurgeons, and there’s always going to be something for us to do."

It's an interesting perspective, much different than the oft-cited motto "only go into nsurg if you can't stand anything else."

Originally Posted by KinasePro

Here's an nice post from uncleharvey by a then-resident/now-attending neurosurgeon at UVa:

" imagine years down the line when epidemics like obesity and hypertension could be treated neurosurgically. "

Originally Posted by Law2Doc

First, it's not an 80 hour ceiling, it's an 80 hour average. You will go over 80 hours at times. Second, on paper , programs are always in compliance. Schedules will set down hours that average out to 80 or less. Third, your time cards are self reported, so the program isn't going to get in trouble if its residents aren't reporting an abuse. Finally, there's a culture at many/most programs of getting into as many cases as possible, never turning down the once in a lifetime chance to scrub into something cool, and not leaving your co-residents in a bad situation if there are fires you have yet to put out, so some folks will do what they need to and the time cards will just reflect the paper schedule.

I don't have the link offhand but roughly half of all programs have an exception which allows for 88 hour work weeks as I recall, so that also adds to staying compliant.

Originally Posted by Mortal_Lessons

I agree that developing intimate relationships is not exclusive to neurosurgery and that the highs and lows in cancer care are shared by many, even the cancer care that neurosurgeons partake in. However, I would disagree on the acuity and frequency with which these relationships develop. After spending 4 months rotating on various neurosurgery services, often interacting with radiation oncologists in tumor board meetings, it is clear that the level of ownership for a patient is not the same between a neurosurgeon and a radiation oncologist. The odds that a patient remembers their neurosurgeon is going to be many times greater than a patient remembering who planned their radiation oncology treatment. So saying you get to 'experience all that for ~50 hours per week' is your interpretation of the situation. It's a situation where you don't know what you don't know (an unknown unknown) and are quite content with it. Never in one of my rotations other than that spent on neurosurgery have I had a patient pull out of her wallet a picture of her neurosurgeon and state that that's her hero. One of my friends recently matched in radiation oncology after spending most of medical school leaning towards neurosurgery. In a sense he feels he sold out and as the poster above mentions and won't ever know what is was like to trod down this different, more intense path.

I disagree whole heartedly with this post. In fact, I'd argue the opposite. Radiation oncologist form relationships with their patients that I think are unrivaled by nearly any other specialty, especially neurosurgery. I think rad onc may still be an unknown unknown for you...

A typical consult/CT sim for a patient who needs radiation can involve hours of time spent directly with the treating radiation oncologist. In other words, in the first appointment they've spent more time with the patient awake, talking, than the neurosurgeon will in many months.

Then, the patient generally has to come for radiation 5 days a week for four to six weeks. They won't see the physician every day, but they will at least once a week. Treatment is then followed by years of follow-up.

I don't intend to put down neurosurgery, they are amazing at what they do. My point is that while hardly anyone in the medical community knows much about radiation oncologists or what they do, their patients never forget the impact they've had on their lives.

So apparently, no, they can't get over themselves.

Originally Posted by Wheatley

I find it unfortunate people perceive neuro as attracting the biggest tools in medicine. Whether this is true or not I'm not sure but the perception is there. There are many talented hard working people out there that are chill, nice and completely turned off by tools that I see avoiding the field because of this rep.

I'm sure there are tools in every field imaginable, medical and non-medical.

Originally Posted by RandomHero117

I'm sure there are tools in every field imaginable, medical and non-medical.

Yes but a lot of people seem to have a "tool" rep for neurosurgeons at least on SDN. I'm not sure if this perception is even warranted or true. There are probably tools that are plumbers or pilots, but I don't think they have that reputation. Maybe SDN skews the perception of neuro surgeons too high on the tool spectrum or something.

Or it could have something to do with the fact that the neurosurgeon posting on this thread is acting like a tool? Yes, N=1, but not many of us have that many interactions with neurosurgeons.

Originally Posted by CassieBagley

So I'm really excited about pursuing a neurosurgery residency, but I can't possibly fathom the number of hours they put in each week. I read one survey that totaled their hours to 110 per week. That's barely enough time to eat and sleep without feeling rushed. It seems like 14-16 hour days with only 1 day off per week are the norm in neurosurgery. How do you mantain a normal life and do everything else: workout, raise kids, buy house, cook food, see movies, etc?

Or if you go into neurosurgery do you just have to accept the fact that your life will only be about neurosurgery any nothing else? Insight needed!

Unfortunately, if you want to be a neurosurgeon, or even a primary care physician a "normal" life is not possible? Residency training not only teaches you knowledge but it also helps you build endurance and stamina, if it were "easy" then there would be more people becoming neurosurgeons? Now a days, and its only going to get worse, working in medicine in any specialty requires at least 80+hrs a week, and that is primary care. Neurosurgeons as well as other specialties work even more hours, after figuring "call" Good luck.