Neurosurgery vs Orthopaedic surgery vs anesthesiology

[Doc_92]

Hi everybody,
I was always interested in the "surgery field" of medicine and neurosurgery was my top choiche. However, I cannot deny that the lifestyle of a neurosurgeon is something that would not give me the possibility to spend time for my family and for myself(I have other interests outside medicine).
So I came up with the idea tha ortho and anesthesiology could be two good compromises.
I'd like you to share your personal experience(no sugar coating please, I'd rather a brutal reality than a good illusion) about these three fields. I think there are many myths about the topic (i.g. neurosurgeons work 16 hours daily and have time only to sleep) and I'd like you to talk about FACTS:
1) Lifestyle (of course every residency is tough and demanding more or less, so the focus is about the post-residency lifestyle)
2) salaries
3) future developements
4) competition (usmle scores, people trying to apply for that residency, so on...)
5) issues (insurances, anything that comes into play..)

Thanks to everyone responding in advance

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[gonogo]

Hi everybody,
I was always interested in the "surgery field" of medicine and neurosurgery was my top choiche. However, I cannot deny that the lifestyle of a neurosurgeon is something that would not give me the possibility to spend time for my family and for myself(I have other interests outside medicine).
So I came up with the idea tha ortho and anesthesiology could be two good compromises.
I'd like you to share your personal experience(no sugar coating please, I'd rather a brutal reality than a good illusion) about these three fields. I think there are many myths about the topic (i.g. neurosurgeons work 16 hours daily and have time only to sleep) and I'd like you to talk about FACTS:
1) Lifestyle (of course every residency is tough and demanding more or less, so the focus is about the post-residency lifestyle)
2) salaries
3) future developements
4) competition (usmle scores, people trying to apply for that residency, so on...)
5) issues (insurances, anything that comes into play..)

Thanks to everyone responding in advance

1) Lifestyle (of course every residency is tough and demanding more or less, so the focus is about the post-residency lifestyle).
Anesthesia >>> neurosurg/ortho. Between neurosurg and ortho, it'll depend on the setting (pp vs academic, etc...)

2) salaries
This will depend on the setting. Lot of variability here: pp vs academic; If it's pp it'll vary a lot depending on location, setting, etc...

3) future developements
Not sure what you mean

4) competition (usmle scores, people trying to apply for that residency, so on...)
Probably Neurosurg/Ortho >>> anesthesia

5) issues (insurances, anything that comes into play..)
Not sure what you mean

 

[PMMA]

Hi everybody,
I was always interested in the "surgery field" of medicine and neurosurgery was my top choiche. However, I cannot deny that the lifestyle of a neurosurgeon is something that would not give me the possibility to spend time for my family and for myself(I have other interests outside medicine).
So I came up with the idea tha ortho and anesthesiology could be two good compromises.
I'd like you to share your personal experience(no sugar coating please, I'd rather a brutal reality than a good illusion) about these three fields. I think there are many myths about the topic (i.g. neurosurgeons work 16 hours daily and have time only to sleep) and I'd like you to talk about FACTS:
1) Lifestyle (of course every residency is tough and demanding more or less, so the focus is about the post-residency lifestyle)
2) salaries
3) future developements
4) competition (usmle scores, people trying to apply for that residency, so on...)
5) issues (insurances, anything that comes into play..)

Thanks to everyone responding in advance

I don't know enough about NSGY but between ortho and Anesthesia:

1) Post-residency lifestyle will vary based on the setting and subspecialty. In general, Anesthesia>Ortho will be better but if you're a Sports Orthopaedist, you're gonna be 9-5, 5 days a week.

2) Salaries: In general, Ortho>>>>>>>>Anesthesia

3) Anesthesia is in trouble. CRNA have in creased independence and I foresee huge issues for the field of anesthesia. Ortho is likely to get hit with significant reimbursement cuts. Not sure about NSGY.

4) Ortho and Anesthesia aren't even on the same planet in terms of competition. ortho has a match rate in the 70s% while anesthesia is in the high 90s. Ortho/Derm/NSGY/ENT are the most competitive fields....by far.

5) I know you focused on post-residency but residency is 5-7 years of your life and in that time, Ortho residency is absolutely brutal. NSGY is even worse. Extremely stressful, huge volume to learn and no sleep. A very unpleasant experience.
In the end, depends on what you care about. I always thought of the surgical specialties as a constant challenge, and I think they are the most satisfying. They also happen to pay the best (ortho, nsgy, ent, uro).
Like I mentioned, with changes in healthcare, the financial component is likely to change significantly, and that's certainly a concern given the length of training.
If you care for prestige, NSGY and Ortho are far more prestigious than Anesthesia. Sadly the field has taken a massive dive in the last 15 years, and is a perfect example of how the "ROAD" of competitive specialties has remodeled.

 

[addy]

I don't know enough about NSGY but between ortho and Anesthesia:

1) Post-residency lifestyle will vary based on the setting and subspecialty. In general, Anesthesia>Ortho will be better but if you're a Sports Orthopaedist, you're gonna be 9-5, 5 days a week.

2) Salaries: In general, Ortho>>>>>>>>Anesthesia

3) Anesthesia is in trouble. CRNA have in creased independence and I foresee huge issues for the field of anesthesia. Ortho is likely to get hit with significant reimbursement cuts. Not sure about NSGY.

4) Ortho and Anesthesia aren't even on the same planet in terms of competition. ortho has a match rate in the 70s% while anesthesia is in the high 90s. Ortho/Derm/NSGY/ENT are the most competitive fields....by far.

5) I know you focused on post-residency but residency is 5-7 years of your life and in that time, Ortho residency is absolutely brutal. NSGY is even worse. Extremely stressful, huge volume to learn and no sleep. A very unpleasant experience.
In the end, depends on what you care about. I always thought of the surgical specialties as a constant challenge, and I think they are the most satisfying. They also happen to pay the best (ortho, nsgy, ent, uro).
Like I mentioned, with changes in healthcare, the financial component is likely to change significantly, and that's certainly a concern given the length of training.
If you care for prestige, NSGY and Ortho are far more prestigious than Anesthesia. Sadly the field has taken a massive dive in the last 15 years, and is a perfect example of how the "ROAD" of competitive specialties has remodeled.

I'd be interested on people's thought on NSG and ENT compensation. From what I've heard, certain spine surgeries are going to get a huge cut due to lack of good data that they 'actually help'.

 

[Bombrainiac]

Compensation varies considerably, depending on your business acumen and practice environment. In general, though, neurosurgeons are the highest paid specialists, but that being said, I know a pediatrician who makes more than many neurosurgeons (she is the exception, obviously, and not the rule.

Neurosurgeons are all licensed to do spine surgery, and so are orthopedic surgeons who have completed a spine fellowship; the major difference is that neurosurgeons are licensed and trained to go intramural (for tumors, vascular malformations, syringosubarachnoid shunts, etc.). Spine brings in a lot of money for two reasons: there are a LOT of patients who need spine surgery, and implanting hardware is a very lucrative billing opportunity. We fuse 28 times more patients in the U.S. than in Europe, so that should give you an indication as to how hot an issue spine instrumentation is, especially with CMS focusing on cutting healthcare expenditures. The spine pot of gold is more like a pot of silver or bronze, but it is still lucrative.

Additionally, neurosurgeons are in short supply and the demand is only increasing.