Alternatives to General Surgery?

[Maxilla54]

I went through most of med school with the intent of doing ENT but discovered I really enjoy General Surgery. There is a lot of medicine involved (esp Upper GI) and I prefer operations that work with tissue. However, the lifestyle is brutal.

Are there any suggestions for specialities that might be similar to GS but with a better lifestyle? I was thinking maybe Urology with a focus on renal (lots of abdominal surgery + medical mx?) but I haven't actually experienced this properly myself. I still wouldn't mind going back to my original plan of ENT, with perhaps a focus on head and neck.

Or alternatively is it worth going through GS training to subspecialise in 'cushier' areas e.g. UGI, endocrine....or would the on calls for this still be onerous? I can imagine in some centres they'd share on calls with the CRCs etc.

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[slowthai]

As much as I make fun of GS on here for having a crappy lifestyle, you can definitely have a decent to cush one if you pick the right location/setup. The only thing that's almost guaranteed to suck is your lifestyle during residency, but that's temporary.

You can do endocrine for sure. Breast and colorectal also have good lifestyles.

For ENT, head and neck has a terrible lifestyle. You're dealing with very sick patients that require a lot of attention.

 

[Maxilla54]

As much as I make fun of GS on here for having a crappy lifestyle, you can definitely have a decent to cush one if you pick the right location/setup. The only thing that's almost guaranteed to suck is your lifestyle during residency, but that's temporary.

You can do endocrine for sure. Breast and colorectal also have good lifestyles.

For ENT, head and neck has a terrible lifestyle. You're dealing with very sick patients that require a lot of attention.

I was under the impression that CRC bears the brunt of the acute abdo and has the worse lifestyle?

I should also add that I'm in the UK (made this account as originally planned to move to the US but now have permanent ties to UK). Perhaps the call setups are different?

For me, the main aspect re:lifestyle is night-time on calls. I don't mind working very long hours - in fact I'm a bit of a workaholic. However, I do enjoy having decent sleep so would prefer something that gives more room for that, relatively speaking. I wouldn't have thought that HNS has as many night time emergencies?

 

[AnatomyGrey12]

I was under the impression that CRC bears the brunt of the acute abdo and has the worse lifestyle?

No. Trauma does that.

CRS is often used as a way to a theoretical better lifestyle, because you can do a lot of elective cases. Especially if you manage to get in a set up where you aren't taking general surgery call.

 

[slowthai]

I was under the impression that CRC bears the brunt of the acute abdo and has the worse lifestyle?

I should also add that I'm in the UK (made this account as originally planned to move to the US but now have permanent ties to UK). Perhaps the call setups are different?

For me, the main aspect re:lifestyle is night-time on calls. I don't mind working very long hours - in fact I'm a bit of a workaholic. However, I do enjoy having decent sleep so would prefer something that gives more room for that, relatively speaking. I wouldn't have thought that HNS has as many night time emergencies?

I would defer to someone else on this, as I have no knowledge of the NHS system

 

[ACSurgeon]

I went through most of med school with the intent of doing ENT but discovered I really enjoy General Surgery. There is a lot of medicine involved (esp Upper GI) and I prefer operations that work with tissue. However, the lifestyle is brutal.

Are there any suggestions for specialities that might be similar to GS but with a better lifestyle? I was thinking maybe Urology with a focus on renal (lots of abdominal surgery + medical mx?) but I haven't actually experienced this properly myself. I still wouldn't mind going back to my original plan of ENT, with perhaps a focus on head and neck.

Or alternatively is it worth going through GS training to subspecialise in 'cushier' areas e.g. UGI, endocrine....or would the on calls for this still be onerous? I can imagine in some centres they'd share on calls with the CRCs etc.

Most surgical fields will have some bad days. Some emergencies etc etc. I don’t think any are truly “cush”.

General surgery at a large academic or community hospital can either be acute care with lots of time off to make up for the brutal call, or “elective” fields with call that is mostly easy.

Colorectal, minimally invasive (bariatric or foregut), breast, endocrine, surgical oncology, and hernia surgery (evolving as a new stand alone field). A busy surgeon will have some long days, and if you’re covering multiple surgeons on call you’re gonna have fall days where someone comes in bleeding/leaking/other complication and you have to operate urgently. But on average you’ll be home at a reasonable hour most days of the week if you’re not trying to make a million dollars a year.

 

[IMG69]

If your UK I wouldn't worry about this too much, just worry about landing a ST spot first and then hope consultant spots open up later on. This is super far down the line and you'll get a much better picture of exactly what each of the ST guys schedules are like during F1, F2 where you can reassess properly. This is 10 years away assuming your M4, things will change a lot in 10 years.

 

[Tangerine123]

I'm not sure how it is in the UK, but in some countries (like Spain) you can do oral and maxillofacial surgery as an MD directly. Maybe that might be of interest to you.

Also, Pediatric Surgery has a really wide scope. I enjoyed rotating there as a medical student.

 

[ACSurgeon]

I was under the impression that CRC bears the brunt of the acute abdo and has the worse lifestyle?

I should also add that I'm in the UK (made this account as originally planned to move to the US but now have permanent ties to UK). Perhaps the call setups are different?

For me, the main aspect re:lifestyle is night-time on calls. I don't mind working very long hours - in fact I'm a bit of a workaholic. However, I do enjoy having decent sleep so would prefer something that gives more room for that, relatively speaking. I wouldn't have thought that HNS has as many night time emergencies?

If you like to work hard/play hard then some combination of acute care/trauma might work for you. You’ll work hard when you’re scheduled to work but you’ll have time off to make up for it. Some are 12 hour shifts, some are 24 hour calls. This model isn’t for everyone and involves working nights/weekends/holidays more than average.

 

[slowthai]

If you like to work hard/play hard then some combination of acute care/trauma might work for you. You’ll work hard when you’re scheduled to work but you’ll have time off to make up for it. Some are 12 hour shifts, some are 24 hour calls. This model isn’t for everyone and involves working nights/weekends/holidays more than average.

Do you have to deal with circadian rhythm issues due to shift changes like they do in EM?

 

[ACSurgeon]

Do you have to deal with circadian rhythm issues due to shift changes like they do in EM?

This will depend on the setup, which has infinite possibilities.

If you do a lot of home call, I don’t think the circadian rhythm gets screwed up because you often get to sleep at night, at home. It’s just some nights you’ll be getting little sleep and dealing with sleep deprivation.

I haven’t felt my circadian rhythm get disrupted even with doing some 12 hour night icu shifts.