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How does one survive neurosurgery residency?

Discussion in 'Allopathic' started by CassieBagley, May 5, 2012.

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  1. CassieBagley

    CassieBagley

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    nothing
    Last edited: Jan 18, 2014
  2. JP2740

    JP2740

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    :laugh:
  3. CassieBagley

    CassieBagley

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    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?
  4. CaptainSSO

    CaptainSSO

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    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.
  5. jumpmanv15

    jumpmanv15

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    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.
  6. Chakrabs

    Chakrabs

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    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.
  7. CaptainSSO

    CaptainSSO

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    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.
    Last edited: May 5, 2012
  8. Wheatley

    Wheatley

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

    Morsetlis SGU MS-4

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    Want to buy...
  10. DrSnips

    DrSnips IM PGY-1

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  11. LazyElemental

    LazyElemental

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    I made one exactly like this but couldn't figure out where to link it from. So Bravo :thumbup:
  12. KinasePro

    KinasePro Das it mane

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    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."
  13. Chakrabs

    Chakrabs

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    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.
  14. copes

    copes

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    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.
  15. Oxer45

    Oxer45

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    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.
  16. copes

    copes

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    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.
  17. 45408

    45408 aw buddy

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    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.
  18. neusu

    neusu Chief Resident

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    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 would be like having the free time of someone who works 40 hours/week.
    Last edited: May 6, 2012
  19. Alvarez13

    Alvarez13 PGEEE2 mediates FEEEVER

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    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.
  20. sportsperson

    sportsperson

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    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.
  21. JackShephard MD

    JackShephard MD

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    Owned.
    :)
  22. LossForWords

    LossForWords PGY-1

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

    CassieBagley

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    nothing
    Last edited: Jan 18, 2014
  24. DrSnips

    DrSnips IM PGY-1

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    Think of it this way. A typical full-time job is 40 hrs/week. 120 hrs/wk is only 3 full-time jobs. There are a lot of people out there who work 2 full-time jobs. Working 3 is only 50% harder. That's not too bad.
  25. sportsperson

    sportsperson

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    This is probably key.
  26. Mortal_Lessons

    Mortal_Lessons H.Perowne

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    I think you're viewing the situation with the wrong set of frames. Continuity of care does not mean the same thing for each specialty. The idea of work-hour restrictions were not made with neurosurgery in mind. Do you understand that signing out a pneumonia is not the same as signing out a post-op craniotomy or a ruptured aneurysm? You stay with your patient until they are better. You don't complain. You can leave when the situation is under control and it's safe to hand over the care to another capable provider. The nature of the work dictates the reality. You're some outside observer with theoretical notions that have no meaning in the actual trenches of the work. Why don't you spend a few days on the neurosurgery service? As someone who just matched in neurosurgery, I can say I would not want you there as a co-resident. Please consider something else like radiology or dermatology. You can sit around and talk about continuity of care for a seborrheic keratosis. Also, please consider that not each week is the same. You can be assured each week will be busy but there will be days when you might have more time for yourself than others. I have attached an editorial on work hour restrictions by senior neurosurgery leadership for you to better understand their viewpoint on the situation.

    Attached Files:

    Last edited: May 6, 2012
  27. CaptainSSO

    CaptainSSO

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    Hey Cassie bagley I have a very innovative solution to your problem. It took me a while to figure out but eventually did cause I'm really smart.

    Ok, so this might be a bit a much for you to grasp, but, here it is:

    Don't do neurosurgery.
  28. Shnurek

    Shnurek

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    :laugh:
  29. CassieBagley

    CassieBagley

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    Nobody is doubting the importance of staying with a patient throughout diagnosis, operation and post-op for something like a ruptured aneurysm. This of course can as long as it takes to ensure proper care of the patient. What I would like to understand, preferably from neursurg residents, is if and how one finds a balance between neurosurg and lifestyle: hence the question, how does one survive neurosurg residency? How do you find peace throughout the day? Do you feel burned out? What do you do to alleviate feeling burned out? This all stemmed from hearing that neursurg have some of the longest hours and worst career satisfaction ratings (pubmed that ****).

    And Mortal_Lesson, of course this is purely "theoretical" as the subject of this thread is to hear everyone's opinions and experiences of the "actual trenches".
  30. neusu

    neusu Chief Resident

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    I beg to differ. Until you have done it and had the feeling it still was not enough, you should not comment on the sensibility.


    16 hour days are the days when you are not on call. When you are on call, the day often stretches to 28 hours, or previously 30-36 hours. Worth it is relative. I love what I do and would not want to do anything else. The only way to get to do it is through a neurosurgery residency program. Would I like to go out running more, or travel more, or drinking with friends? Sure, I would. Would it be worth doing something less demanding so I could do those things? Not at all.

    Agreed

    A little harsh, but probably true.

    Finding peace and avoiding burn out is different for each resident, everyone copes in a different way. Regardless of the method, it requires a lot of adjustment both of personal priorities and an ability to adapt. Likewise, for most neurosurgery residents I know, the work load is more of a badge of honor than something to be afraid of.

    Your questions are valid if you are considering neurosurgery as a career, and if you think you can adapt to the long hours and work load then maybe it is for you. Convincing yourself you love it because of neuroscience, the work load is not as bad as it sounds, and the work hours restrictions will save you will likely result in you washing out during your second or third year when you face the reality on a daily basis.

    Regarding satisfaction, I would argue to the contrary. Neurosurgeons have some of the highest career satisfaction.
  31. mjl1717

    mjl1717 Senior Member

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    I like this one!!
    Plus more semi-sprinting and a few pressure deflecting techniques. ! :thumbup:
  32. JackShephard MD

    JackShephard MD

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    +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:

    [YOUTUBE]x8MrKpmYVLY[/YOUTUBE]
    Last edited: May 6, 2012
  33. Chakrabs

    Chakrabs

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    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.
  34. JP2740

    JP2740

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    lmao!!!!!!!!!!!!
  35. CaptainSSO

    CaptainSSO

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    The neurosurgeon's watch. You just made my week.

    Now I want to go read game of thrones instead of studying.
  36. Renaissance Man

    Renaissance Man Saving the World Bronze Donor

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    I lol'd.
  37. KnuxNole

    KnuxNole Sweets Addict

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    That's why I would never step ONE foot into any surgery residency :laugh:

    I would sign out on the post-op craniomoty if it is going much over my hours. After all, the person I would sign off to isn't some bumbling moron. The pneumonia patient could crash and go to the ICU but so can the post-op guy. If that's the case, residents shouldn't sign off on anyone then. But, I'm sure I'll get ripped for this. Then again, as med students, we don't have to stay for post-op surgeries if it was at the end of the day:p
    Last edited: May 6, 2012
  38. Law2Doc

    Law2Doc 5K+ Member Moderator Emeritus

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    Actually anyone you sign out to who is acting on limited information is going to very much be a bumbling moron, just as you will be when you are in that position. It's totally a do unto others mentality in surgery (and in many other residencies, actually) -- you stay on until all the major fires are out, not just run out of the flames and say " tag, you're it". Both because what comes around goes around, and because it's what's needed for adequate patient care. Residency is a team sport, not a series of independent shifts. You screw over your co-workers by leaving unfinished business, you are going to hear about it and ultimately pay for it.

    On paper, every program will meet duty hours. In practice it's sometimes an unrealistic target for some specialties, because you can't really walk out on the code or crashing patient that will put you over your hours for the month.

    And bear in mind that duty hours dont really change total hours you have to devote to your craft-- when you are not working you are expected to be reading a lot of the time -- you have inservice exams and specialty boards that you can't really prepare for by osmosis, and possibly a research project or two. It's simply not the same spectrum as the 9 to 5 employee.
  39. Chakrabs

    Chakrabs

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    I just finished my medicine SubI (that was fun at the end of 4th yr) and I honestly felt very uncomfortable after coming back from the weekend and seeing the new developments with my patients. Obviously that'll improve as I get more experience, but for me it really drove home the point why continuity of care is so important. By all accounts, the increase in handoffs have also resulted in more mistakes and incidents not less as resident hours have been curtailed.
  40. NeuroCT Geek

    NeuroCT Geek

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    lmao! Game of Thrones FTW!
  41. KnuxNole

    KnuxNole Sweets Addict

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    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 :oops:

    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?
  42. mTOR

    mTOR | veritas.vos.liberabit |

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    I really don't understand those who go into neurosurgery. But thank god these folks exist. Seems like one of those lifestyles that religion was created for so; i.e., you have some sort of rewarding afterlife to look forward to after you've sacrificed your life to endure suffering (to ostensibly alleviate suffering).


    Kinda like suicide bombing. But the good kind. So kudos to the neurosurgeons, you'll get those 72 virgins one day :thumbup:
  43. KnuxNole

    KnuxNole Sweets Addict

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  44. mTOR

    mTOR | veritas.vos.liberabit |

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  45. NeuroCT Geek

    NeuroCT Geek

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  46. 45408

    45408 aw buddy

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    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.
  47. Mortal_Lessons

    Mortal_Lessons H.Perowne

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    Yeah-your post really highlights your misunderstanding. See, you have this view that somehow your hard work is supposed to be paid off later with vacation or time for your hobbies, or some kind of religious promise, etc. Try to understand there are people who see the reward as the privilege of being in a position to carry out the hard work they're doing. They are proud of their work and do not see themselves as suffering. Certainly there are those who will burn out and realize that the sacrifice to have this privilege is not worth it any longer. But realize that you will never have the chance to go into a patient's room as their neurosurgeon and describe how you evacuated their loved one's subdural, effectively saving their life. Or the terrible news that their loved one will never recover. Or the chance alter someone's brain. In most specialties you will have the chance to share bad news, etc., but never at the depth and scale as in neurosurgery.
    Last edited: May 6, 2012
  48. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    :thumbdown:annoyed:
  49. JackShephard MD

    JackShephard MD

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    I respect your field and the dedication, but to think that neurosurgery provides a greater service to patients than other specialties is convenient when you're a neurosurgeon. There are dozens of specialties that make equivalent contributions to patients.

    You want to believe that because of the time invested and complexity of what you do, but a great diagnosis does just as much, so does a basic surgical procedure performed. We like to elevate our importance, but everyone's contribution is valuable and to begin to compare is the beginning of vanity and conceit.

    Reminds me of a video...
    [YOUTUBE]THNPmhBl-8I[/YOUTUBE]
  50. Mortal_Lessons

    Mortal_Lessons H.Perowne

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    Haha, nice video!

    Yeah, you're right, though. I went a little overboard with that post. Everyone's contribution is the same...

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