Surgery with a decent lifestyle

charlest said:

I found similar threads from a few years ago, but nothing recent, so I figure its time for an update.

I am looking for a field that will allow me to operate, but also work reasonable hours (is 40 hours/wk as an attending even a realistic goal anymore?). How do the various specialties line up (with regards to residency and beyond)?

Everyone seems to agree that general surgeons work the longest hours. How does that compare with ortho, ent, derm, ophtho?

Your feedback is appreciated.

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Despite some dermatologists referring to themselves as "Dermatological Surgeons" or the ever-popular "MOHS Surgeon," they're not surgeons.

The only surgeons out there are those eligible for fellowship with the American College of Surgeons. Everyone else is a wannabe.

There is NO surgical specialty that will offer you a 40 hours per week work schedule in training. It's just not possible. And even in practice, you'll never survive with that kind of work ethic. You may make a buck or two, but your partners will be incredibly disenchanted with you and you'll really just make $1 or $2 a year.

Oh and I forgot the obligatory smiley...

castro is right - in 2008 and the foreseeable future, it just isn't possible to be any type of surgeon working 40 hours per week. until this country see a true shortage of qualified med students willing to go into surgery, that isn't going to change. but my med school has, in my opinion, a reputedly malignant general surgery residency, and they have no problem filling their categorical spots each year, along with most of their prelim spots, via the Match. so if the system ain't broken there's no impetus to change. and in the eyes of the people making the "rules" the system works great (if great means missing your wedding anniversary, which supposedly happened to one of the surgical attendings here one year - what's most shocking to me is that these guys find women willing to marry and stay with them in the first place when they're working 60 hours per week).

all that said, at the VA here the gen surgical attendings probably work no more than 50 hours most weeks. what i observe is that they come in around 7:30, operate until late afternoon, and then go home. they take call of course, but the early morning and late afternoon/early evening work is done by the residents, giving the attendings a pretty comfy lifestyle by surgical standards.

Tired said:

General Surgeons are just failed Orthopods. It's a scientifically proven fact.

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Just what the hell does an Orthopod know about science?

Heck, I"m in a lifestyle friendly general surgery subspecialty and even I work more than 40 hrs per week, and I'm not even up to speed (having just started my practice).

40 hrs per week is considered "part time" in the surgical world in most cases. Your partners would not be very happy with you since your malpractice insurance and overhead would be the same but you're bringing in less money to the practice.

There are some environments in which you can work less:

- academic practice (ie, having residents to take calls for 2 am Tylenol)
- no trauma call
- mostly outpatient surgeries
- operate on children or the well
- large group (less call)

aProgDirector said:

Ophthalmology, maybe? I expect people will say "it's not surgery", and it isn't, but it does give you time in the OR. Is it 40hrs/week? Maybe.

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if its not surgery then what is it?

I'll move this over to the Surgery Forum (where we can continue to laugh about Derms being Surgeons).

I Surgeon said:

if its not surgery then what is it?

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Surgery lite.

J/K...its Surgery,we just don't trust anyone who sits all day in the dark, doesn't shed much blood, cut much tissue and makes more money in a week than we do in a month!

proctology/ano-rectal surgery has a pretty relaxed lifestyle compared to other specialties if you:

1. like seeing people's anuses all day every day and
2. are able to find a spot in such a program since they are certainly a disappearing breed
3. are cool with not doing much in the way of big cases and enjoy disimpacting jars and bottles from auto-erotic mishaps

procto patients however are often very thankful for you services, since very few of them enjoy having a bleeding or painful anus

urology is also a choice for pretty decent hours and has a varied caseload between office surgeries and major opens every now and again....there is also the option of doing robotic procedures in uro.....but

1. uro is quite competitive
2. starting my 5th consult at 9:30 on a friday night disabused me of any notion that comparatively good lifestyle in a surgical field means having normal work hours
3. every urologist i have met works way more than 40 hours a week and deals with irritating consults like a hematuria work up after the nursing student inflated the foley balloon somewhere in the prostatic urethra

if you're truly motivated by a 40 hour week, you will likely find yourself pretty miserable in any surgical field i can think of

mlw03 said:

but my med school has, in my opinion, a reputedly malignant general surgery residency, and they have no problem filling their categorical spots each year, along with most of their prelim spots, via the Match.

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USF? In Tampa? Malignant? I suppose you should know better than me, but on my interview there I was told not only do Chief Residents and Seniors take home call, but interns take home call too.

I Surgeon said:

if its not surgery then what is it?

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It's Ophthalmology. By my definition they're surgeons since they're eligible for fellowship with the ACS, but no one in the surgical world really considers them surgeons. I don't even think they really consider themselves surgeons.

Castro Viejo said:

It's Ophthalmology. By my definition they're surgeons since they're eligible for fellowship with the ACS, but no one in the surgical world really considers them surgeons. I don't even think they really consider themselves surgeons.

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You simply don't know what you're talking about. Have you seen ophthalmic surgery? Probably not? Did you know that cataract surgery is the country's most commonly performed surgical procedure? Which (IMHO) means you as a general surgeon are less of a surgeon than the ophthalmologist since they actually operate more. Do you know what a vitrectomy is? Have you ever seen a strab? Or a DCR? Obviously not. I'm not sure what your beef is with ophthalmology, but to not consider us surgeons is simply ignorance on your part ...... oh of course until you have a macular hole and find out we'll put you under general for a 4-6 hour operation, maybe then you'll consider us surgeons.

Jake the Snake said:

You simply don't know what you're talking about.

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Castro really wasn't knocking optho....Reading as the unexperienced idiot, I still got the impression that it wasn't knocking optho. Some people may consider it a "procedure" more than surgery. It just depends on your connotation of what a surgery is. Everyone can quote the denotation, but it doesn't hold as much as to what one views as surgery. Optho is really really cool stuff, but go out on the street and ask the laymen what they think surgery is. It most likely won't be cataracts, STAB, or whatever else.

Also, I'm sure castro has seen the surgeries and knows what they are. You can treat me like an idiot for all I care, but he was just stating his viewpoint from a surgeon's perspective. (And many other doctors) Think of how many stents are put in every day in cardiology and rads. It isn't considered "easy", but they don't consider themselves surgery. They are working through a pretty small area too.

Jake the Snake said:

You simply don't know what you're talking about. Have you seen ophthalmic surgery? Probably not? Did you know that cataract surgery is the country's most commonly performed surgical procedure? Which (IMHO) means you as a general surgeon are less of a surgeon than the ophthalmologist since they actually operate more. Do you know what a vitrectomy is? Have you ever seen a strab? Or a DCR? Obviously not. I'm not sure what your beef is with ophthalmology, but to not consider us surgeons is simply ignorance on your part ...... oh of course until you have a macular hole and find out we'll put you under general for a 4-6 hour operation, maybe then you'll consider us surgeons.

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Are you trying to convince us or yourself?

MossPoh said:

Castro really wasn't knocking optho....Reading as the unexperienced idiot, I still got the impression that it wasn't knocking optho. Some people may consider it a "procedure" more than surgery. It just depends on your connotation of what a surgery is. Everyone can quote the denotation, but it doesn't hold as much as to what one views as surgery. Optho is really really cool stuff, but go out on the street and ask the laymen what they think surgery is. It most likely won't be cataracts, STAB, or whatever else.

Also, I'm sure castro has seen the surgeries and knows what they are. You can treat me like an idiot for all I care, but he was just stating his viewpoint from a surgeon's perspective. (And many other doctors) Think of how many stents are put in every day in cardiology and rads. It isn't considered "easy", but they don't consider themselves surgery. They are working through a pretty small area too.

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First of all, it's ophtho, not optho.

Second, it's too bad that so many doctors have this misconception regarding ophtho. I know Castro isn't the only one, and I myself though LASIK when I heard ophtho several years ago.

I think you are misinformed regarding the lay public. They know ophthos are surgeons. Have you seen the commercials asking you to tell your eye surgeon if you are taking ____?

Finally, not all that lies in the realm of the "surgeon" is considered surgery. Examples: central venous access, endovascular "procedures" (nsgy and vascular try to write these "procedures off as surgery), floor and ICU work. I could go on. Basically, IMHO, if you consider laparoscopic procedures to be surgery, then you must also consider all intraocular procedures to be surgical.

dynx said:

Are you trying to convince us or yourself?

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I'm already sold, my friend!

smq123 said:

This is kind of a silly argument. It seems like every specialty uses it to prove that THEY are REALLY surgeons.

A lot of people (predominantly med students and interns, it seems like) who are in OB/gyn always say, "Hey! C-sections and hysterectomies are the MOST COMMONLY performed operations in the US! We really ARE surgeons, no matter what those general surgeons say!" So do you think that ob/gyns are really surgeons? Do you think that a general surgeon is "less of a surgeon" than an ob/gyn, because he does less frequently performed operations?

And yes, as opthalmologists you may (or may not) do the most frequently performed surgery in the US. But you still operate less, over all, than general surgeons do. Compare your 3 years of ophtho training vs. the general surgeon's 5 years of surgical training. It doesn't really compare.

So you do eye surgery. That's great. But do you think that cardiologists are "artery surgeons" because they do more cardiac caths than vascular surgeons? Or that gastroenterologists are "intestinal surgeons" because they do so many scopes?

And why the big rush to declare that you're a surgeon? It sounds cool, I guess, but what's wrong with just saying that you're an ophthalmologist? Why is it such a big deal that the whole medical world recognizes you as a surgeon as well?

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I prefer the term ophthalmologist because it implies that we are more than just surgeons. We manage a lot of issues non-surgically. One big reason why our residency is due to the nature of the field. The procedures are shorter and carry less complication rates. In one given day, we can operate on 10 patients as a resident and do so 2-4 times a week. So one theory is that we can concentrate our learning experience much more than others involved in training that involves longer procedures. When was the last time you met a general surgery resident who operated on >20 patients in one week? Imagine the kind of learning experience that kind of volume could have on your training.

I consider OBGYNs to be surgeons. Cardiologist, I dont consider surgeons. But on the other hand, would you consider a vascular or cerebrovascular trained surgeon to be a "surgeon" when all they do is endovascular? ..... or basically the same thing the cardiologist does? I hope not.

And for the record, to the OP, ophthalmology happens to be a field where one can operate and work approximately 45-55 hours/week. 40 or less is pushing it. It also happens to be a field where one can work 100 hours per week. In part, it is up to you.

mlw03 said:

castro is right - in 2008 and the foreseeable future, it just isn't possible to be any type of surgeon working 40 hours per week. until this country see a true shortage of qualified med students willing to go into surgery, that isn't going to change. but my med school has, in my opinion, a reputedly malignant general surgery residency, and they have no problem filling their categorical spots each year, along with most of their prelim spots, via the Match. so if the system ain't broken there's no impetus to change. and in the eyes of the people making the "rules" the system works great (if great means missing your wedding anniversary, which supposedly happened to one of the surgical attendings here one year - what's most shocking to me is that these guys find women willing to marry and stay with them in the first place when they're working 60 hours per week).

all that said, at the VA here the gen surgical attendings probably work no more than 50 hours most weeks. what i observe is that they come in around 7:30, operate until late afternoon, and then go home. they take call of course, but the early morning and late afternoon/early evening work is done by the residents, giving the attendings a pretty comfy lifestyle by surgical standards.

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Now, how often are these surgeons on call, though? And in addition, how often does being on call turn into having to come into the hospital to do a decent sized amount of work?

Which specialties generally avoid call again? ENT, Uro, Vascular?

First, I consider SDN the foremost authority on all things medical <snicker>, and since ophtho is not found in the "Surgery and Surgical Subspecialties" forum, but rather in its own forum, it automatically becomes obvious that ophtho isn't surgery.

Jake the Snake said:

We manage a lot of issues non-surgically. One big reason why our residency is due to the nature of the field. The procedures are shorter and carry less complication rates. In one given day, we can operate on 10 patients as a resident and do so 2-4 times a week. So one theory is that we can concentrate our learning experience much more than others involved in training that involves longer procedures.

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Either you need to update your status, or you need to refer to ophthalmologists as "them" rather than "we." I find it funny that you, a medical student, keep talking about "us" and "our" program when you are not yet an ophthalmologist, and then you have the audacity take pot-shots at general and vascular surgeons (and I know some of it must be tongue-in-cheek) who I would consider surgeons much more than ophthalmologists simply because of the training involved.

Jake the Snake said:

When was the last time you met a general surgery resident who operated on >20 patients in one week? Imagine the kind of learning experience that kind of volume could have on your training.

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I know at many community hospitals, general surgery residents can log 100 (bread and butter) cases in a month, which works out to more than 20 per week.

Jake the Snake said:

...would you consider a vascular or cerebrovascular trained surgeon to be a "surgeon" when all they do is endovascular? ..... or basically the same thing the cardiologist does? I hope not.

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I think they are trained as surgeons, so I would consider them as such. I don't think any vascular surgeon's practice is entirely endoluminal; they still do CEAs, AVFs, amputations and extra-anatomic bypasses even if they aren't doing many open AAAs, and they are still the people you are going to call with a ruptured AAA or an acute limb ischemia because they are most likely going to have to be addressed with an operation.

Jake the Snake said:

Did you know that cataract surgery is the country's most commonly performed surgical procedure? Which (IMHO) means you as a general surgeon are less of a surgeon than the ophthalmologist since they actually operate more.

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And to keep playing, this is faulty logic. It could just mean ophthalmologists are one-trick ponies. Simply because they do one procedure more doesn't mean they do more total procedures.

Jake the Snake said:

I think you are misinformed regarding the lay public. They know ophthos are surgeons. Have you seen the commercials asking you to tell your eye surgeon if you are taking ____?

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Perhaps they lay public thinks they are surgeons because these "eye surgeons" tell them that is what they are to be called...?

Jake the Snake said:

Basically, IMHO, if you consider laparoscopic procedures to be surgery, then you must also consider all intraocular procedures to be surgical.

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I agree that not everything, or even most, of what the general surgeon does is considered surgery. That is why we are physicians, too. However, I think there is a subtle difference between sticking a camera into a patient's belly and slicing open an eye. Then again, I think there is a subtle difference between sticking a camera into a patient's belly and sticking a camera into a patient's urethra for a TURP or into a patient's rectum for a TEM, but I would consider all of the above mentioned procedures "surgery."

Look, I don't care if the ophthos consider themselves surgeons or not. They suture under loupes or microscopes, so that is good enough for me. Eyes gross me out and I couldn't do it, so I'm glad someone can. You can also compare ophthalmologists to optometrists to show there is definitely a procedural difference in the two practices. However, one thing I would like ophthos to do if they are going to consider themselves surgeons is respond to the trauma consults like all of the rest of the surgical services instead of deferring the "r/o entrapment" consult to the morning shift person because they don't want to come in, even if it is more of a CYA consult than an actual concern for entrapment because we all get those stupid consults yet we all come to see the patient in a timely manner (not really all that angry about it, but it is frustrating when the patient is sitting in the ED for four hours and ophtho still hasn't come in or even returned the page).

mlw03 said:

all that said, at the VA here the gen surgical attendings probably work no more than 50 hours most weeks. what i observe is that they come in around 7:30, operate until late afternoon, and then go home. they take call of course, but the early morning and late afternoon/early evening work is done by the residents, giving the attendings a pretty comfy lifestyle by surgical standards.

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I agree, but how much true operating is done by the attendings at the VA? Our attendings are in the room, but in most instances that is the extent of their involvement. Why not get a desk job with pharma if that is what you want? Probably pays much more and you don't have the occasional night call.

charlest said:

I found similar threads from a few years ago, but nothing recent, so I figure its time for an update.

I am looking for a field that will allow me to operate, but also work reasonable hours (is 40 hours/wk as an attending even a realistic goal anymore?). How do the various specialties line up (with regards to residency and beyond)?

Everyone seems to agree that general surgeons work the longest hours. How does that compare with ortho, ent, derm, ophtho?

Your feedback is appreciated.

Click to expand...

You can work whatever hours you want if you are willing to start your own practice. Being the boss has its advantages.

If I were you I would look into Plastic and Reconstructive surgery. If you start your own practice you can set it up however you like. By 5 to 10 years out you can have an entirely elective practice if you want. Of the surgical specialties PRS probably offeres the most flexibility, because for the most part you aren't dealing with life and death issues and you aren't beholden to referrals for your paying patients. Just a thought. Good luck.

mlw03 is correct and I agree with his entire post.

Surgery Lite = the VA. Malignant does not always equal hour issues.

Castro Viejo said:

Despite some dermatologists referring to themselves as "Dermatological Surgeons" or the ever-popular "MOHS Surgeon," they're not surgeons.

The only surgeons out there are those eligible for fellowship with the American College of Surgeons. Everyone else is a wannabe.

There is NO surgical specialty that will offer you a 40 hours per week work schedule in training. It's just not possible. And even in practice, you'll never survive with that kind of work ethic. You may make a buck or two, but your partners will be incredibly disenchanted with you and you'll really just make $1 or $2 a year.

Oh and I forgot the obligatory smiley...

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You really need to turn down your all-things-not-surgery bashing, because SDNers are coming into this forum and thinking we all have our heads up our @sses, when in fact it's just one muffled voice coming from his butt.....

What will be ironic is when, 2 years from now, you're bashing on general surgery as the grunts that can't handle fine vascular anastomoses.

As for other surgical specialties, they're all surgeons. There are plenty of gynecologic surgeons whose technique is equal or superior to some general surgeons, believe it or not. Also, there are plenty of things that we've learned from them, e.g. laparoscopy.

A Gyn Onc surgeon who does 15 complex cancer surgeries per week is more of a surgeon by this thread's ******ed logic than a rural general surgeon who did 10 scopes, an appy, and four gallbladders in the same week.

To address the OP:

Move to Europe

Random other two cents:

Props to Socialist for the response to the Snake. Especially the whole, whoever does the most wins concept. I think we can all agree that the Norwood or Arterial Switch procedures are the least commonly performed cases in the U.S., but if anyone wants to go tell the paediatric cardiac surgeons that the ophtho guys are somehow "more surgical", you'd better call the trauma hall to let them know you're coming.
(although I certainly consider ophtho as "surgeons")

On a more philosophical note, I think there is a push-pull around the use of the terms "surgeon" and "surgery" is one of street-cred. Among the (perhaps shrinking, but still many) advantages of being a "surgeon" is still the dedicated-to-your-patients, last line of defense against death image that is pervasive within both medicine and pop culture. This has of course been diluted by TV, lawyers, unethical surgeons etc., but still holds true. Think even about the way the hospital runs- when someone inadvertently hits the bowel (IR,OB), you call general surgery. When someone in the ER is really sick, you call surgery (or admittedly medicine). When Cards loses a wire, or the stents don't work, you call CVTS.

The flip side of the coin however, is that to earn this street cred, you may have to be there on the weekend or late at night, when we'd all rather be doing something (or someone) else. Think about how other people in the hospital describe the "best" surgeons- "Dr. X always sees their patients every day", "Dr. Y doesn't ever yell when they have to come in". It has absolutely nothing to do with what they do technically (which 99% of hospital staff and patients really couldn't comment on).

The bottom line of this endless dribble goes back to the OP. Part of the "mystique" about surgery (who is a surgeon and who is not), be it general, ophtho, ortho or OB/GYN (who I think certainly qualify as "surgeons" - they operate on the parts I don't), is a dedication to your patients. If people want to only work 40 hours a week (personally I don't know anyone outside of medicine who make more than 40K a year and does that), and pass off patients to other people when their shift is up, I'm sure you'll enjoy it. But don't be surprised when you get treated like an ER guy with a knife.

PS: Having said that, a GOOD ER person is worth their weight in gold for defense against bogus calls...

Jake the Snake said:

You simply don't know what you're talking about. Have you seen ophthalmic surgery? Probably not? Did you know that cataract surgery is the country's most commonly performed surgical procedure? Which (IMHO) means you as a general surgeon are less of a surgeon than the ophthalmologist since they actually operate more. Do you know what a vitrectomy is? Have you ever seen a strab? Or a DCR? Obviously not. I'm not sure what your beef is with ophthalmology, but to not consider us surgeons is simply ignorance on your part ...... oh of course until you have a macular hole and find out we'll put you under general for a 4-6 hour operation, maybe then you'll consider us surgeons.

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Relax medical student. I have no beef with Ophthalmologists. Just twisting your ta-tas that's all

Jeezaloo, you're a bit defensive there.

Jake the Snake said:

I think you are misinformed regarding the lay public. They know ophthos are surgeons. Have you seen the commercials asking you to tell your eye surgeon if you are taking ____?

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I think you're giving the lay public way too much credit. I doubt they have any idea what an ophthalmologist is compared to an optometrist, to be quite honest with you. Hell, they can't even get straight what a D.O. is, and you think they'll immediately know that an ophthalmologist is an eye surgeon?

VoiceofReason said:

Now, how often are these surgeons on call, though? And in addition, how often does being on call turn into having to come into the hospital to do a decent sized amount of work?

Which specialties generally avoid call again? ENT, Uro, Vascular?

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Avoid call? Vascular?

Jake the Snake said:

When was the last time you met a general surgery resident who operated on >20 patients in one week? Imagine the kind of learning experience that kind of volume could have on your training.

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I did. Last week. I did eight cases over a 48 hour period. And had at least 12 cases in the days leading up to that hellish 48 hour period. And they weren't small cases. All major laparotomies with stupid bowel issues. Not programming your LASIK machine and pushing the "Play" button and walking away.

If you're going to try to convince me that Ophthalmology residency is more grueling than a General Surgery residency, you might as well give up now, 'cause it ain't gonna happen.

Jake the Snake said:

I consider OBGYNs to be surgeons.

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Well, that's obviously the first part of the problem...

Jake the Snake said:

would you consider a vascular or cerebrovascular trained surgeon to be a "surgeon" when all they do is endovascular? ..... or basically the same thing the cardiologist does? I hope not.

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I don't consider endovascular stuff a real operation in the sense that a laparotomy is an operation, but none of the endovascular or "cerebrovascular" stenting surgeons (i.e., Vascular Surgeons, Neurosurgeons, etc.) offer just stent and wire work to all their patients. It's just a part of what they do. They still cut.

SLUser11 said:

You really need to turn down your all-things-not-surgery bashing, because SDNers are coming into this forum and thinking we all have our heads up our @sses, when in fact it's just one muffled voice coming from his butt.....

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YOU need to get laid.

This is about the dumbest thread I've read here in a long time.

Please keep the personal comments out of it.

charlest said:

I found similar threads from a few years ago, but nothing recent, so I figure its time for an update.

I am looking for a field that will allow me to operate, but also work reasonable hours (is 40 hours/wk as an attending even a realistic goal anymore?). How do the various specialties line up (with regards to residency and beyond)?

Everyone seems to agree that general surgeons work the longest hours. How does that compare with ortho, ent, derm, ophtho?

Your feedback is appreciated.

Click to expand...

From my limited experience, I don't think 40 hours a week is even close to reasonable. I'm only a med student, but I feel like the clock-punching mentality of my generation may get some people into trouble if they decide to enter a career in surgery. You need to be able to stay until the work is done, and done right, not until you've put your XX hours in.

I have a different question: How many full days off per week do the various "surgeons" have? 1? 2?

Clearly you can do 60+ hrs/wk only working 5 days/wk. Maybe some of you can just share examples from attendings that you know or have worked with.

beastmaster said:

I have a different question: How many full days off per week do the various "surgeons" have? 1? 2?

Clearly you can do 60+ hrs/wk only working 5 days/wk. Maybe some of you can just share examples from attendings that you know or have worked with.

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Going back to what I posted earlier, if you start your own practice you can take as many days a week off as you want. I know a lot of private practice general surgeons who take Friday afternoon off. In fact one I know very very well used to take Wednesday afternoons off as well as the whole day Friday. He started doing a lot of bariatrics so he works Fridays now but it is by choice.

I'm starting my own PRS practice in about 4 months but I'm hoping to be busy enough to work 6 days a week but it ain't gonna happen at least for a few years. Some of the private guys around here will open a Saturday cosmetic clinic a couple times a month to drum up more business.

One thing I think you'll find is that you won't mind working a lot of hours as long as you have control over it. If you know in the back of your mind that you can say 'I'm taking next Thursday and Friday off because I feel like it,' then it makes working hard a lot easier. Also if the money is rolling into your own pocket the hours go by much easier. Be your own boss.

to OP:

you should go into neurosurgery... they only work 40 hours a week and take no call... Unfortunately, we can all agree that it is not really a surgical field.









I kid.. I kid.

Castro Viejo said:

I did. Last week. I did eight cases over a 48 hour period. And had at least 12 cases in the days leading up to that hellish 48 hour period. And they weren't small cases. All major laparotomies with stupid bowel issues. Not programming your LASIK machine and pushing the "Play" button and walking away.

If you're going to try to convince me that Ophthalmology residency is more grueling than a General Surgery residency, you might as well give up now, 'cause it ain't gonna happen.



Well, that's obviously the first part of the problem...



I don't consider endovascular stuff a real operation in the sense that a laparotomy is an operation, but none of the endovascular or "cerebrovascular" stenting surgeons (i.e., Vascular Surgeons, Neurosurgeons, etc.) offer just stent and wire work to all their patients. It's just a part of what they do. They still cut.

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I don't know about vascular, but there are cv trained nsgy who no longer operate. here's one. http://www.mgh-interventional-neurorad.org/staff.html#Anchor-Johnny-49575

smq123 said:

(I engage in the "OB/gyn is surgery too!" debate, jokingly, with surgery residents on SDN and in real life, but it's mostly just for fun. Mostly. ) What ob/gyns do is unique and distinct from what general surgeons do.

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In fact what OB/GYNs do most often is very unique from what goes on in general surgery. OB/GYNS divide the left uretur so commonly that they had to invent a new CPT code. Now they can bill for it as a procedure while they are placing 911 pages to the general surgery chief resident to come help. Just kidding.

Tired said:

Unbelievable that you're still arguing this point with a General Surgery Chief Resident who is one foot out the door to a Vascular fellowship.

You know, there's a reason your possible future specialty is included on the ROADs list.

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What's that supposed to mean?? What do radiology, anesthesia, and derm have anything to do with the discussion? lol...i dont get it.

Jake the Snake said:

I don't know about vascular, but there are cv trained nsgy who no longer operate. here's one. http://www.mgh-interventional-neurorad.org/staff.html#Anchor-Johnny-49575

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Great. I can also name at least one Vascular Surgeon I know who doesn't cut routinely. But he was trained to do so.

What exactly is your point? Should this interventional neuroradiologist be called a surgeon? Yes. He completed a Neurosurgical Residency at Washington University, according to that blurb you posted.

Tired said:

When the Optometrists take over all the sugical procedures done by Ophtho, will we have to call them surgeons too?

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yeah, how about surgical assistants that do most of the case. should they be called surgeons? I mean, sometimes surgical assistants do most of the case anyway, do we have to call them surgeons, too? No one does our surgery for us. optometrists will take over our procedures when Surgical assistants, interventional cardiologists (no need for CT surgery in the future?)...take over yours. in many cases this has already happened. you need to defend your own turf instead of bickering with fellow MDs. if you guys would do your own damn surgery, you would not be losing turf to midlevels.


jake,

I believe the general public knows we do "surgery". But with little exposure in medical school, even some medical doctors (your future colleagues) may be not informed. many on this board a) do not understand the eye, b) are scared of dealing with (or operating around) the eye.(and they should be)

No, we are not surgeons...we are microsurgeons dealing with a surgical field less than 40 x 40 mm (intraorbital, of course). Hell, if we did the gross movements that "Surgeons" do we would cut the eyeball in two. ophthalmic procedures are very difficult surgical procedures with no room for error (here I could list a bunch of procedures, but it would be useless, of course). we do a lot more than just cataracts or Lasik. did you know there are 6 subspecialty fellowships. In addition, who would'nt love lasers, we do plenty of these in the clinic


No I don't want to be a General Surgeon. I don't enjoy doing rectals and rather sit down during surgery. also like spending time with my family.

PS. stop the hateration...if you wanted a lifestyle specialty, you could have worked hard in medical school to get one too. stop being bitter or get out of your specialty "Mr or Mrs. Surgeon".

Jake the Snake said:

I don't know about vascular, but there are cv trained nsgy who no longer operate. here's one. http://www.mgh-interventional-neurorad.org/staff.html#Anchor-Johnny-49575

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I'll bet Dr. Johnny at Mass Gen considers himself a surgeon.

As others have noted above, if you are trained as surgeon, whether or not you do the majority of your procedures endovascularly, percutaneously, etc. you are still a surgeon, as you still have the ability and the privileges to perform open procedures.

If Dr. Johnny no longer has OR privileges, then I'll say he's crossed the line into non-surgeon land.

But let's stop the intra-specialty bashing here and get back on topic.

I Surgeon said:

PS. stop the hateration...if you wanted a lifestyle specialty, you could have worked hard in medical school to get one too. stop being bitter or get out of your specialty "Mr or Mrs. Surgeon".

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No one is hating on you eye doctors. Don't get your panties in a bunch. We are simply debating the definition of "surgeon". If you were secure with your field then you'd simply laugh and move along, who cares what an anonymous snot sucker like me thinks?

The best part about SDN is that when there is some inter-specialty bashing going on in an area outside of that specialty's "home forum", somehow a bat signal is sent up and hordes of heretofore unknown users suddenly rush to its (the specialty being bashed) defense.

At least I have an excuse when I find it...I'm all over this place. Always seeing, rarely lurking.

Tired said:

Are your surgical assistants trying to get independent procedure practice rights (and succeeding) too? Wow dude, time to stop arguing with the surgeons and get to protecting your turf.

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you misunderstood. reread my post.

Winged Scapula said:

The best part about SDN is that when there is some inter-specialty bashing going on in an area outside of that specialty's "home forum", somehow a bat signal is sent up and hordes of heretofore unknown users suddenly rush to its (the specialty being bashed) defense.

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Word up! It's quite an amazingly efficient system, whatever the heck it is, that people are using to figure out who's bashing whom.

Like, I could say, I think all FP docs are *****s and practically useless.

And tomorrow? We'd have a swarm of FPs here defending their "specialty."

Oops.

Oh, come on! Don't get so pissy. Jeez-Louise.

Castro Viejo said:

Word up! It's quite an amazingly efficient system, whatever the heck it is, that people are using to figure out who's bashing whom.

Like, I could say, I think all FP docs are *****s and practically useless.

And tomorrow? We'd have a swarm of FPs here defending their "specialty."

Oops.

Oh, come on! Don't get so pissy. Jeez-Louise.

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*Taking the bait*

Down With Castro, the Anti-Primary Care!!! First, it's called Family MEDICINE not Practice! You know Family Medicine is the root of all medicine, if you go back to 1975 ...... *blah blah blah blah*

Or maybe it's because it's always in the Surgery forum? So they'll just scout it out every now and then just to see what idiocy comes from its loud-mouthed members (i.e., Tired and me).