A Question for Kimberli (or other surgery residents)

Discussion in 'Clinical Rotations' started by Toadkiller Dog, Dec 13, 2001.

  1. Toadkiller Dog

    Toadkiller Dog Senior Member
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    Howdy--

    I was chatting with a few of my classmates in our Surgery Interest Group here at my school, and we came up with some questions that we could use an unbiased answer on. Perhaps you can help me (us).

    Here goes. . .

    1. Are orthopedic surgery residencies "easier" (i.e less grueling, on average) than general surg? My colleagues think so, but I'm not so sure.

    2. I was originally considering General Surg, but tossed the idea out because I have a family (wife + 2 kids). If I were to go into surgery, I would want to focus on rural stuff, so my question is this: are there any programs, especially community-based ones, where I could get decent training and still have a family life? I was looking, at one time, at Geisinger over there in Pennsylvania, mainly because it appears to be a rural hospital. Anyway, let me know what you think (and don't be afraid to be honest).

    3. I'd be curious to know what your typical week on the surgery service looks like. When do you go to work/get home? How much useful stuff do you do vs. scut? How many days off and when? And how does this change after PGY1?

    Thanks for your time. I know you are busy.
    :)

    TKD
     
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  3. tussy

    tussy Senior Member
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    I'm not Kimberli, but i am a surgery PGY1, so i'll try to answer your questions as best i can:

    1. Are orthopedic surgery residencies "easier" (i.e less grueling, on average) than general surg? My colleagues think so, but I'm not so sure.

    I would say that it varies from program to program, but both are quite grueling.

    2. I was originally considering General Surg, but tossed the idea out because I have a family (wife + 2 kids). If I were to go into surgery, I would want to focus on rural stuff, so my question is this: are there any programs, especially community-based ones, where I could get decent training and still have a family life? I was looking, at one time, at Geisinger over there in Pennsylvania, mainly because it appears to be a rural hospital. Anyway, let me know what you think (and don't be afraid to be honest).

    I don't know much about specific programs, but in my opinion, in order to adequately trained as a general surgeon you need to put in a certain number of hours. - no matter what type of program you get into you still have to put in the hours.

    3. I'd be curious to know what your typical week on the surgery service looks like. When do you go to work/get home? How much useful stuff do you do vs. scut? How many days off and when? And how does this change after PGY1?

    my typical week:

    Start each day at 6 - round on ward until 7:30 or so, then either go to the OR (if i'm lucky), or stay on the ward taking care of the scut, or go to clinic. The day ends when the scut is all done (it's the intern's job whether you're in the OR all day or not), usually around 6 or 7, sometimes as late as 8 or 9. Then call every 4th night (work all night taking care of whatever happens on the ward, and seeing consults). Also, no going home early post call. We usually have to round on the weekend (we take turns though), but get to go home once everything is taken care of - usually noonish. I don't think it really gets much easier. Once your a senior call is better, but you have much more responsibility.

    I hope this answers your questions. I'm sure kimberli or droliver will have more insight to add.
     
  4. Sheerstress

    Sheerstress Senior Member
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    I might add that as a Senior, you might have a slightly kinder call schedule, but you will still have your hands full with trying to fill all your case quotas (the number of cases of a given surgical procedure that you have done throughout your residency), as well as preparing for M&M each week.

    The program at my institution (Michigan State University Kalamazoo Center for Medical Studies) was community-based, and relatively kind to the residents (call Q3-4, minimal scutwork, "reasonable" hours), although I think tussy is right by pointing out that in order to get adequate training, you've got to put in a given number of hours, which will mean a significant part of your life during residency will be spent in the hospital.
     
  5. MD Dreams

    MD Dreams Senior Member
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    Hello there everyone. This is my first post, although I have been reading a long time. I've enjoyed all the insights I've gained. Thank you.

    My question is to all aspiring surgeons or those in surgical residencies. I've pretty much got my heart set on becoming a surgeon. Through much research I've narrowed my list to the following types of surgery that I think I would enjoy: Cardiothoracic surgery, Transplant surgery, Orthopedic surgery, Neurosurgery. I would like to see what your take is on these specialties. I would appreciate any type of information you can give me. I see a lot of people mentioning General surgery (or its fellowships) and Ortho, but very few people seem to be interested in Neuro. I'm curious as to why that is. Which type of surgeon do you think can have the greatest impact on an individuals life and which one gets the greatest amount of satisfaction. Also, Dr. Cox mentioned that she would not want to be a transplant surgeon in one of her posts. I'm curious as to why that is. I appreciate everyones insight. Thank you.
     
  6. JGDL

    JGDL Junior Member
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    What about integrated plastics? How many hours each week ? Do they have the first years the same call as gen surgery? salary?
    I like cosmetic surgery but I don?t know if plastics or dermatological surgery, which would be better?
    thanks
     
  7. Winged Scapula

    Winged Scapula Cougariffic!
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    I'll deal with the more recent query directed toward me first. Transplant Surgery doesn't appeal to me for a few reasons:

    1) little variety in the surgeries

    2) extremely poor outcome for the livers

    3) extremely poor hours; organs often become available in the middle of the night, weekends, etc. and you must be available to harvest and/or transplant

    4) patients tend to be a difficult lot and there are lots of complications, even with the renal txp who tend to do well (as long as they continue to take their meds, take care of themselves, etc. which many do not).

    Secondly, the hours and ability to have a family life will vary widely depending on the program and the rotation. Right now I'm doing a CT rotation and am on-call tonight. I have to pre-round and write all the notes on the SICU patients before we round with the Chief at 5:30 am. This means I will start seeing patients at 3:30 am which is pretty late because we have much fewer SICU patients than usual. When doing Peds, I came in everyday at 4:30 am to pre-round and often did not go home before 8 or 9 pm post-call (because we had to wait for the Chief to come out of the OR before we could round and were responsible for responding to traumas). Then again, on Vascular we rounded at 6 am and generally were done by 6 am - nice short days.

    In general, community programs tend to be more lifestyle friendly, especially for those with families. However, the hours will be difficult at best regardless of where you train, especially during the first few years.
     
  8. droliver

    Moderator Emeritus 10+ Year Member

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    Having just finished my chief resident months on transplant, I'll agree with most of Kimberli's comments. The hours are VERY unpredictable where several slow days will alternate with not going home for several days. As a whole, it is a sick group of patients with a lot of comorbities & inherant complications due to being immunosuppresed. The surgeries themselves are OK (liver transplants are big sexy cases) but tend to be limited to just a few major kinds of cases and post-op complications (unless your transplant service does a lot of endocrine, vascular access, or liver resections for CA).

    As far as hours go with orthopedics (mentioned earlier), I think by in large that they work signifigantly less hours than general or neurosurgery except when they're on the ortho trauma services @ level I trauma centers.

    My hours are signifigantly different than Kimberli's now. I'm currently chief on pediatrics & I usually show up @ 6:45a & run the list with my 3 junior residents. My days are usually 10-14 hrs/day during the week with another 5-15 hrs over the weekends (70-80 hrs/week). I go in at night for signifigant traumas (very rare) or for surgeries on the NICU patients (I've been back in 3 times today for NEC perfs twice and an indomethacin perf). Most nights my beeper does not even go off.

    As a junior I worked somewhat similar services to Kimberli, but I can honestly say I don't remember working some of the crazy hours she is doing right now during her internship. In fact, we have gotten rid of all our Q2 call since I was an intern, as well as working out ways to get junior residents a day off (each of my 3 will get 3 days off this month) and home early (I send the post-call intern home most days by noon).
     
  9. tussy

    tussy Senior Member
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  10. surg

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  11. Leon

    Leon Member
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    Hello, guys ...

    I have a question for all of you ... actually 2 questions.

    The first one might seem REALLY stupid to all of you, but still ... what is PGY ?

    The second one - how old were you when you began your surgery residency ?

    Thanks ! :)
     
  12. Winged Scapula

    Winged Scapula Cougariffic!
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    PGY = Post Graduate Year (ie, the number of years you are past medical school graduation. Hence, PGY-1 is usually the intern year.)

    I was/am in my mid 30s starting a surgical residency.

    Hope this helps.
     
  13. tussy

    tussy Senior Member
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  14. hndrx1a

    hndrx1a electric medical haze
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    Kimberly...is there a cut-off age for surgery programs?
     
  15. Winged Scapula

    Winged Scapula Cougariffic!
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  16. Toadkiller Dog

    Toadkiller Dog Senior Member
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    Allright, I'm back (finals were a killer).

    I just wanted to say "thanks" to the surgical residents who responded (surg, Kim, droliver). I am going to continue looking for a good community program that will allow me to at least spend an adequate amount of time with my kids.

    Any suggestions to this effect would be appreciated. Anyone know of programs making deliberate changes to their working conditions in an effort to make their programs more appealing (i.e, to reverse some of the recent downturn in General Surgery's popularity)?
     

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