Lifestyle post-residency?

Kopa said:

I'm yet another MSIII trying to figure out what to do with myself. I've been drawn to surgery since day 1 of the clerkship, but lifestyle issues are making me hesitate. Can anyone shed a little light on what life is like for a general surgeon (or surgeons in various subspecialties--vascular, trauma, colorectal, etc) after residency is over? Is it really possible to work in a community hospital, join a private practice, and still play a significant role as a father/mother/husband/wife? I understand that attendings in academic institutions work their tails off till retirement, but I'm hoping to hear that it doesn't have to be that way.

A big part of me wants to take the plunge, but a few surgical residents told me "if you can see yourself doing anything besides general surgery, do that instead," because it's so all-consuming. As a result, I'm thinking about ophthalmology and some procedural IM things like cards and GI.

Any feedback would be greatly appreciated. Thanks!

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I've heard this many times myself, and considering the posts from some residents in this forum, I think it can be considered a truism for those considering Gen Surg. "If you like any other field of medicine other than General Surgery, go into that field." After all of my rotations, required clerkships and electives, I can honestly say the ONLY field of medicine that gave me a rush was surgery. Thats not bravado or any kind of macho BS. Only surgery really pulled me. Now anyone can tell you that lifestyle in General surgery especially during residency, is going to sour at some point even the most gung ho resident (but of course there are obvious exceptions).

If optho, interventional cards, or GI interest you, proceed posthaste to pursue them. They are radically different tracks than Gsurg, with totally different scientific/clinical focuses and a much more relaxed personal life.

Lifestyle for the various surgical subspecialties like Vascular, Trauma, ICU, Colorectal, Peds, Onc, are all difficult when compared to Optho or GI (Especially Trauma and Peds - average 74 hours a week as attendings).
Of course Plastics can be much easier, But thats after completing a 5-7 year residency in Gen Surg.

As for familial committments, the answer is of course. You won't be home to play catch every day, or go swimming, hiking, etc... But you will definitely be around... just you will not be around a lot as well. My father is a urologist, works on average 65 hours a week (also the average for a gen surg attending). Did I know him growing up - Sure...But I got to know him much more when I got older and now we're really close. The point is, you can always make it work; you won't be the Cleavers or the Reed's but you can be a family.


Check out the "Whats your price" thread in this forum. If you want a 40 hour work week and crazee pay...Gen Surg is not your thing. If you think that you love surgery and don't like everything else, and are willing to commit to it for 20+ years and make a good salary then check it out.

BTW - did you think to ask your attendings about their lifestyle? I mean ask the question in a politic manner but they would know wouldn't they?

I've met plenty of community general surgeons who work 4 days a week, take call 1 night a week, 1 weekend a month and make a nice living. They do mostly small to medium (breast, hernia, LC, colectomies, etc.), elective cases and have a reasonable schedule.

Surgery RESIDENCY is at best hard, at worst brutal and you have no control over it. Life as an attending is anything you want it to be. You can have a great location, great pay, or a great schedule - pick two.

not to play into stereotypes, but sometimes i think we all over-estimate the amount of time that our own parents spent with us, and even the amount that we will spend with our own children.

when i was younger, my parents were gone by the time i woke up every morning. they usually left at 4-6am, and came home at around 6pm, monday through saturday. most of that time i was either asleep or at school. by the time i was in elementary school i was able to hang out with friends or watch tv, do anything i wanted. i never thought, gee, i wish i could see my dad as soon as i got home from school and spend all day with him.

kids have their own lives. when they grow up they will want independence, not mommy and daddy trying to hang out with them all the time. i mean if you can come home in time for dinner, or at least to see your kids a few hrs on most nights, and have one day off a week when you have the option of spending the whole day with quality time, what more do you really need? you don't need 128 hrs a week free in order to spend time with your family. maybe my case is unusual, but i doubt it. my parents worked hard, and that was okay. i don't remember feeling particularly neglected. remember, as surgeons you will have 4 weeks off a year; that's a luxury my parents never had.

my parents went through some hard times, with financial uncertainty. that is a burden you will likely never face as a surgeon. even with the well running dry, a surgeon begins at 200,000+ out of residency and only goes higher. there are no worries about going out of business or getting fired. there is such security in medicine that you don't see with many other jobs worth a damn.

surgery requires some sacrifices but i don't think it's the huge lifestyle sacrifice that people make it out to be. it's not much different than any other job that requires some amount of dedication. maybe it's not derm, but it isn't the gulag either. hint: there are not many real-world jobs like derm out there, so it shouldn't be your only comparison. surgery is an awesome thing, and it's gotten to the point now that if affords plenty of flexibility in lifestyle. 60 hrs a week, come on, that's not that bad when you really think about it. not many people only work 40 hrs a week, that's such a misconception...

automaton said:

60 hrs a week, come on, that's not that bad when you really think about it. not many people only work 40 hrs a week, that's such a misconception...

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This bears repeating. I can't think of ANYONE who works 40 hours a week, excluding those with menial, dead-end jobs. I think real careers demand more time and energy than that.

funkless said:

This bears repeating. I can't think of ANYONE who works 40 hours a week, excluding those with menial, dead-end jobs. I think real careers demand more time and energy than that.

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I agree, but being the ones that are MADE to work these long hours, us drs. do love to complain about how much we work. Most successful people work very hard and as much as many drs., they just make more money is all.

In regards to kids, lifestyle, its a strange thing in medicine and surgery in particular. Your never really off, and are always a page away. For kids its much more important to actually be there when your there. Just b/c your in the same house doesnt mean your spending q time.
Sometimes i think maybe its b/c its an easy target as a profession when someone is emotionally/physically unavailable, not all drs are going to be great parents no matter how much time they have off.
We probably spend more time with our kids as a whole nowadays then ever before. What were the 50's like? Dads were just a disciplinarian and werent necessarilary involved as much with raising kids (gross over generalization).
I do think you have to make a consistent effort to keep connected with your kids, and spouse for that matter, its so very easy to fall into a lull.

I hope to find a happy medium myself, enough money to get by and time to enjoy my life with friends and family.

LMAO @ medicine, thats what you get when trying to select out the most "well-rounded" students, a bunch of bright slackers who want it all. Who wants cake if your not going to eat it anyway?

Consider that the typical 3rd year medical student is 24 or 25. This person has been a student for their whole life practically. It strikes me as odd that a 25 year old person who has never had a real job, is worried about working too much!

Remember that it's not just investment bankers, and CEOs who work 60+ hours a week. These days almost everyone with a real career works 60+ hours a weeks. And the trend isn't to work less, it's to work more.

And how many people that work only 40 hours a week come home, plop down in front of the TV and fall asleep instead of spending time with their kids?

There is some flexibility in surgery which is dependent on the types of cases you primarily do. Time off and call are dictated largely by how many other surgeons are in your group. If you are the only surgeon in a small community, you are basically on call 24/7. If you are in a group of, say 6 surgeons in private practice, you could be on call once in every 6 days. In academia, you have the advantage of having residents to do much of the daily scutwork for you.

I think that many other specialties work more than 40 hours a week. For example, internal medicine. Their office hours may be from 8-5 in the office, but they will still have pts in the hostipial that must be seen either before or after office hours, and office hours frequently run late. Add just 1 hour before office to round in the hospital, add 1 hour for running late...now you are up to 50 hours. Plus rounds on weekends and endless calls from their pts..they aren't doing a cushy 40 hours a week.

As a previous poster pointed out, average work week for attending surgeons is in the range of 60 (according to a few published studies)..not much different from the corporate word. Plus the leaders in surgery know that they are loosing ground and that the specialty has to be structured to be more lifestlyle friendly, and that will evolve as we enter practice.

I think that part of a good lifestyle is having a job that you truly enjoy, rather than one that you settled on. So if you enjoy surgery, don't let these issues deter you. It is possible to have a good lifestyle as a surgeon.

Sorry

Celiac Plexus said:

Consider that the typical 3rd year medical student is 24 or 25. This person has been a student for their whole life practically. It strikes me as odd that a 25 year old person who has never had a real job, is worried about working too much!

Remember that it's not just investment bankers, and CEOs who work 60+ hours a week. These days almost everyone with a real career works 60+ hours a weeks. And the trend isn't to work less, it's to work more.

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I think you're right and that you get right to the heart of the matter. No one has any sympathy for physicians "working so hard for little money." Its really laughable. You correctly point out that many fields work long hours now (although I would stay away from CEO - their compensation is generous at worst) even if their long hours don't contain the same circumstances as physicians do.

Who wants to hear another physician whining about "we don't get no respect!" Or "we only make minimum wage!" The government is against us! etc...

Sure everyone, no matter their profession, wishes they made more money. Its just that the average surgeon's compensation, puts them in the top 5% of income earners in this country. Pity? I think not.

And as for q time with your kids - great point. If you make the most of it your family life will be great.

I agree completely with these posts.

Also, take into account that a 40-hour week job isn't always good. I've had that in biotech when I was a researcher. HATED IT. I had the best hours you can imagine. But, the work was so freaking boring I couldn't wait to get into med school.

Even now, doing one of my rotations in a clinic, it's constant patient in, patient out, no real excitement. It's totally 9-5. Wouldn't want to do this for the rest of my life.

I guess, if you're working hard, but, doing something that your enjoy (not necessary love), then, it's worth all the sacrifices. I see the light...

bigtimesmally said:

I agree completely with these posts.

Also, take into account that a 40-hour week job isn't always good. I've had that in biotech when I was a researcher. HATED IT. I had the best hours you can imagine. But, the work was so freaking boring I couldn't wait to get into med school.

Even now, doing one of my rotations in a clinic, it's constant patient in, patient out, no real excitement. It's totally 9-5. Wouldn't want to do this for the rest of my life.

I guess, if you're working hard, but, doing something that your enjoy (not necessary love), then, it's worth all the sacrifices. I see the light...

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Amen

med students have massive entitlement attitudes. most think because they study and train for so long then they deserve to be entitled to this and that. sorry that's not how the real world works. they really should consider banishing the mention of "delayed gratification" anywhere near med schools as it gives people the wrong impression.

zambo said:

med students have massive entitlement attitudes. most think because they study and train for so long then they deserve to be entitled to this and that. sorry that's not how the real world works. they really should consider banishing the mention of "delayed gratification" anywhere near med schools as it gives people the wrong impression.

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well, nowhere is the term "delayed gratification" more pertinent than in medicine. Physicians give up a lot in US to become somebody in the long run. Some read too much into that, but, the reality is that the road is long and difficult. We sacrifice a lot to get there. So, there is a sense of entitlement. It's only fair.

Yes, there are people who work hard but don't get the same money as surgeons. For example, my own father was an immigrant, worked some ****ty jobs to get where he is now. We were talking about my future in residency the other day and he admitted that no way in hell would he be able tolerate staying up all night q3 or doing 80-90 hour shifts. Sleep is too important to him. Now, this is a guy who has worked very hard. So, putting things into perspective, physicians do deserve to get what they do, because, like I said before, they are willing to undertake something that most of public would not and could not undertake.

bigtimesmally said:

well, nowhere is the term "delayed gratification" more pertinent than in medicine. Physicians give up a lot in US to become somebody in the long run. Some read too much into that, but, the reality is that the road is long and difficult. We sacrifice a lot to get there. So, there is a sense of entitlement. It's only fair.

Yes, there are people who work hard but don't get the same money as surgeons. For example, my own father was an immigrant, worked some ****ty jobs to get where he is now. We were talking about my future in residency the other day and he admitted that no way in hell would he be able tolerate staying up all night q3 or doing 80-90 hour shifts. Sleep is too important to him. Now, this is a guy who has worked very hard. So, putting things into perspective, physicians do deserve to get what they do, because, like I said before, they are willing to undertake something that most of public would not and could not undertake.

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Agree

I'm glad there are a lot of future surgeons who are happy to work 60-70 or more hours per week as attendings, because I'm sure not going to do it. Good thing most of you will be willing to pick up my slack.

Celiac Plexus said:

Remember that it's not just investment bankers, and CEOs who work 60+ hours a week. These days almost everyone with a real career works 60+ hours a weeks. And the trend isn't to work less, it's to work more.

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Funny you mention that. Between my fulltime fire department (24 hours on 48 hours off), my part time fire department, and my position as a fire/EMS instructor, I avg about 100 hours a week , Surgery will be a break for me

So, what have you ended up deciding Kopa? I am a female MSIII struggling with the same decisions right now. I have just finished my surgery rotation and it was the first time I could remember getting out of bed with some energy in the morning. However, I place a great importance on all those things outside of medicine that others have mentioned and it seems that I should be especially careful in making this decision because I feel that if I screw this up and don't think it through enough, then I'll be the only person to blame. The only other thing I liked somewhat was internal medicine. My problem is that I'm not particularly drawn to those "lifestyle" specialties like GI. So, I'm just curious as to what you have ended up deciding. Thanks.

I think that it's also important to note that in most jobs people can easily choose their days off for important family events, most surgery residents have a very difficult time doing that. That can translate to missed birthdays, anniversary, kids sporting events, recitals, etc. Kids can have a hard time understanding why their parent can't be there. I think that's why many are nervous about the lifestyle of the residency.

"Also, take into account that a 40-hour week job isn't always good. I've had that in biotech when I was a researcher. HATED IT. I had the best hours you can imagine. But, the work was so freaking boring I couldn't wait to get into med school."

I couldn't agree more. I am a pathologists assistant and gross in specimens all day long. The job is cake and the pay is ok, but I start med school this Fall and I can't wait, because I am so sick and tired of the same old, monotonous work ALL DAY LONG!!! Great point.

I just wanted to put in a note on the relationship with the kids and whether people have time for it. I think it's not a matter of whether your kids are going to grow up just fine with not seeing as much of you as you'd like there (most of us turned out ok), i think it's more a matter of you being heartbroken at not being able to spend more time with them when they're still young and still willing to spend time with you ('cause face it, they'll turn into teenagers and you'll be the most uncool person ever).
I've also done my share of battling myself with the surgery decision, and ended up deciding for having the time to do things I enjoyed outside of work. Not that I chose something that didnt suit me, i'm very happy with my decision to do EM, but I think a large part of the decision was the quality of life outside of residency when push came to shove.
Just my two cents.