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Best Lifestyles

Discussion in 'Surgery and Surgical Subspecialties' started by rotty1021, Oct 31, 2002.

  1. rotty1021

    rotty1021 Member
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    I was thinking about this before, and was wondering if anybody had any idea on the lifestyles of certain specialties. They are:

    Opthalmology
    Orthopedic Surgery
    General Surgery
    Pathology
    Emergency Med.
    Dermatology
    Cardiothoracic Surgery

    Thanks in advance
     
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  3. Winged Scapula

    Winged Scapula Cougariffic!
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    I'll simplify it:

    Best: Derm, followed by Path, Optho and Emergency Med

    Worst: CT Surg, followed by Ortho and Gen Surg
     
  4. APDoc

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    What's the lifestyle for plastic surgery like? I've heard it's the most flexible of the surgical specialties-- any truth to that? Thanks
     
  5. Winged Scapula

    Winged Scapula Cougariffic!
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    Definitely one of the better surgical lifestyles, however, it highly depends on the environment in which you practice. An academic practice in which you take Trauma call can be busy (albeit usually for the resident) as you'll often have to come in for facial/hand injuries.

    Those who do primarily aesthetic work or day-surgery can have relatively relaxed lifestyles. Like all surgical specialties, you start operating early in the am (so getting in shortly after 6 am may not be unusual), but can reasonably expect to finish by late afternoon/early evening (again, depending on practice venue).

    There are lots of threads dealing with this subject, so I suggest a search might yield more information.
     
  6. rotty1021

    rotty1021 Member
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    Thanks, Kimberli.
     
  7. rotty1021

    rotty1021 Member
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    APDoc,

    I've shadowed a Cosmetic Surgeon that seemed to have a good lifestyle. He sees anywhere from 1-3 cases a day and works from 8:30 AM to around 5:00 PM. He only does this for three days a week in South Florida and spends the rest of the week in upstate NY. So he's semi-retired.
     
  8. jambola

    jambola Junior Member
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    Family Practice/Primary care is the best. (You can afford to watch 'Frida' in a theater;))

    Surgery is the worst.:mad:
     
  9. Chimera

    Chimera Member
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    Can anybody tell me what the lifestyle of a trauma surgeon at a level I academic center is like?

    Is work shift oriented like ER or endless amounts of call?
    All what about training lifestyle?

    Thanks.
     
  10. Winged Scapula

    Winged Scapula Cougariffic!
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    I can't speak for other Level I Trauma centers and their surgeons, but ours definitely do not work shifts. They work just as any other surgeons, with days filled with OR cases or clinic and they split call between them - thus someone could potentially be up all night, having to respond to serious Traumas and potentially operating on them, and have a full day following. Here the attendings trade off who rounds with the Trauma team on a weekly basis - the others are free from these academic duties for that week and can concentrate on operating.
     
  11. Winged Scapula

    Winged Scapula Cougariffic!
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    Hmmm...sounds as if Skylizard has some inside knowledge about the Trauma program here. Care to PM me with some info as to your ID?
     
  12. ortho2003

    ortho2003 Senior Member
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    Best lifestyle after residency is probably emergency med. There aren't many specialties where you can work 2-3 8 hour shifts per week. Granted, those may not always be day shifts, but it still makes for 4-5 days off and no call.

    As for the rest, in order of cushiness, Derm, Optho, path, GS, Ortho, and CTS.
     
  13. ljube_02

    ljube_02 Senior Member
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    Hey i thought ortho make the most money of those you listed. So cant they take 1/3 time vacation to bring their salary down to Dermatology level? Or they must work 50wks straight?
     
  14. ortho2003

    ortho2003 Senior Member
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    Actually, CTS makes a little more money than Ortho, but they probably work more hours to get the money. Some orthopods do cut back to 3 1/2 or 4 days a week once they have been in practice for a while. Early on, they need to put in the hours and the call to develop a good referral base. I think orthopods in general have a workaholic mentality that also makies it difficult to cut back before they are in their 50's.
     
  15. dobonedoc

    dobonedoc Senior Member
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    Ortho 2003 is right on the mark with his ortho statement and building a referal base.

    I've heard so many primary care attendings tell their patients to go to "so-n-so," and to avoid "this guy or that guy" - only because some of them are new to the community. It is total bull!

    CVT surgeons are too busy saving lives to have a life. Trauma in my area are surgeons who handle trauma call on top of thier regular surgical practice. Optho, ENT, and Derm have the best lives. Most ER physicians are tired of treating the dregs of society who abuse the ER, thinking it is their personal Drug Depot, or Urgent Care Clinic for stubbed toes.

    Ortho seems to enjoy variety, and if you can get with other surgeons you trust, call is not too bad. Most Ortho surgeons are not only workaholics, but also so anal that they think no other person can take care of their patients - thus they choose to handle their own call alone.

    If you want a good life, go invent something everyone "needs" (like that stupid cell phone/belt clip holder that sells for about $14) and retire tomorrow!
     
  16. OwlMyste

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    my remedy for stubbed toes: say a few swear words, jump around like an idiot....depending on severity of stubbed toe...(all this done behind closed doors when nobody's watching...), and then get over it and live life....:laugh: :laugh: :laugh:
     
  17. wack

    wack Member
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    I have heard that Neurosurgery has a really lousy lifestyle. Basically consisting of being banished from human civilization? Yet it wasn't listed on the bad lifestyles list. Doest it just go without saying that Neurosurgery sucks? Or do they actually have some prayer of living a normal life? Just a question, I don't plan on becoming a Neurosurgeon.
     
  18. OwlMyste

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    I will hafta disagree with you on that one. from what I heard in previous discussions I have been having in the Ophthamology section of SDN, an optho surgeons life can be pretty cush. I know one SDN'er who told me he is a PGY working a residency in optho and that his working hours is from 8a.m. to 5-6 p.m. with him taking call about 4-5 times per month. prety cush considering a surgical residency! he also told me that as an attending, you could work 4 day workweeks, working about 36 hours per week. the post is in the ophthamology section of SDN if ya wanna follow-up on it...:cool::cool::cool:

     
  19. neutropeniaboy

    neutropeniaboy Blasted ENT Attending
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    Just a matter of personal opinion: ophthalmology isn't a real surgical residency. It is, however, traditionally one of the more relaxed residencies.

    <sigh, two months until my life really begins>
     
  20. OwlMyste

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    to the college of surgeons, it is a very real surgical residency, even ifit is relaxed...click the link below to see for yourself:

    http://www.facs.org/residencysearch/specialties/listing.html

    :cool::cool::cool:


     
  21. Celiac Plexus

    Celiac Plexus Senior Member
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    With all due respect to "owlmyste" and the ACS, I don't consider it a real surgical residency either.
     
  22. OwlMyste

    OwlMyste Membership Revoked
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    what branches of Surgery do you consider 'real' surgical residencies then..?:confused:


     
  23. JasonDO

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    Well, ophthalmology by its very nature and job description is a surgical speciality....If you need to be up all night walking around in your scrubs in a sleep deprived state, being on call every 4 days, to call yourself a surgeon that so be it...I'll gladly take my 45-50 hr/week residency over yours anyday...like 99.9% of the world's population, I like to sleep at night.

    so what does constitute a "real" surgical residency?? this is a ridiculous argument:laugh:
     
  24. Jive Turkey

    Jive Turkey Member
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    No offense to Jason, Owl and the others, but I too do not really consider Ophtho to be a true surgical speciality.

    IMHO any field where you're not 'required' to do a surgical internship is not true surgery. There's as much surgery (if not more) involved in Interventional Cardiology or Interventional Radiology and I don't think most people would consider them surgeons.

    For the record, I'm not going into surgery. It just wasn't feasible from a family perspective for me. But I have the utmost respect for surgeons. Because of the commitment that surgeons show by entering the field I think they take a lot of pride in their title as "surgeons." And, well, to be quite honest, I can understand why many surgeons don't really consider Ophtho's to be in their "brother/sisterhood." BUT THERE'S NOTHING WRONG WITH NOT BEING A SURGEON... SO PLEASE, don't anyone take offense to my humble opinion.

    With due respect,
     
  25. JasonDO

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    you can do a preliminary year in medicine or surgery or do a general transitional year prior to a 3 year ophthalmology residency...yes you are not required to do a surgical internship...yet again, one of the beauties of this specialty...it offers you flexibility both during residency as well as afterwards when you are practicing...saying that a surgical specialty is not a surgical specialty simply because its practioners aren't stuck in the hosptital well until the night or there on a weekend afternoon or dragged in during the holidays is ridiculous
     
  26. JasonDO

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    have you ever done an ophthalmology rotation?
     
  27. FireAway

    FireAway Member
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    Jive Turkey is right-

    You aren't really a surgeon unless you do a surgical internship. Period. End of story. You may not like the idea of spending nights or holidays in the hospital, but if you want to call yourself a surgeon of any sort then this is the price during your training. Now stop posing.
     
  28. JasonDO

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    you are more than welcome to do a surgical internship year prior to starting an ophthalmology residency if you so desire...you can spend the nights and weekends at the hospital...I'll spend them with friends and loved ones...life is too damn short to waste on your job no matter how fulfilling it may be...there are more important things atleast in my lifetime...
     
  29. Jive Turkey

    Jive Turkey Member
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    You're more than welcome to think that as an Opthalmologist you're a surgeon. But to be quite honest, I think every other surgical speciality would scoff at the notion that you're "one of them."

    Please don't get me wrong. I find the field to be extremely fascinating and I enjoyed the procedures I was involved in during my rotation. I even considered reapplying to Ophtho at one point.

    Let me put it this way. An ophthalmologist calling himself a surgeon is akin to a member of the coast guard calling himself a (Army/Marine) soldier. Yes they're both in the armed forces, but c'mon.
     
  30. FireAway

    FireAway Member
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    Man, just don't be a poser, that's all people are saying. There's nothing wrong with ophtho as a field, its just not a true surgical field. And damn, you better be happy with that, don't go into ophtho if what you really want/need is to think of yourself as a surgeon. Funny how most ophtho residents took the easy way out and did a transitional or medicine internship isn't it? Surgeons my arse.
     
  31. TheThroat

    TheThroat SDN Moderator
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    So what about OB/GYN? They don't do surgical internships? At the hospital I work at, the Ortho resident also don't do general surgery internships. They do a transitional year with rotations in rads and in the SICU as well.

    Also, have you seen what an oculoplastic surgeon does? He performs facial plastic surgery, for example, orbital enucleation. The size/scale of a surgical procedure does not change the fact that one is altering anatomy via surgical techniques.
     
  32. hotbovie1

    hotbovie1 Member
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    Regarding an earlier post about trauma

    We have 5 trauma attendings here at a very busy trauma center in the southeast Add one second year trauma fellow who takes call as an attending...that leaves a total of 6 warm bodies for trauma call.

    They also cover the general surgery service at that hospital. Wed are clinic/lecture days, so no elective cases on Wed. The second year trauma fellow doesn't cover general surgery elective cases.

    So basically, there are 5 attendings to cover 4 days of elective cases. They split that up, and also split up trauma call. The attending covering the elective general surgery cases does not take trauma call while doing that (however, they might take truama calll that night). So we never have elective cases postponed for trauma. The night trauma team also coveres general surgery emergencies at night (appys, bowel obstructions, etc). Generally on average, the trauma call is 2 days a week for each attending. Their shifts are a combination of 12 hour and 24 hour shifts. However, some of the more ranking faculty don't take as much call, and are more likely to be out of town for various meetings (since they are kind of big wigs in the trauma field). So the junior faculty tend to take more trauma call. One of the faculty also has a private surgery practice at another hospital. Our most junior faculty recently informed some of us that her work hours are >100 per week.


    Regarding OB...I recently learned of a discussion between a leader in the gyn-onc field and a leader in the general surgery field (both were some kind of representative to the ACS). The gyn-onc guy asked the gen surg guy what might help improve the gyn onc fellowship. The gen surg guy said make it a fellowship after gen surg rather than OB...becasue so much time in OB is non-operative time, OB docs don't have anywhere near the surgical skills that general surgeons do.
     
  33. droliver

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    I don't think in the vernacular sense most traditional surgeons & associated specialties would consider opthamologists, dermatologists, or most OBGYNs as "members of the club". The background & training of those fields has become so divergent from the core surgical training & experience of most of us that there is little contemporary relationship b/w practicioners. Gynecology had a long historical relationship, they used to often do 2 or 3 years of surgery prior to specializing & most gynecologic surgery used to be done by general surgeons. Modern OBGYN training bears little resemblence to this with little emphasis on the surgical aspect & an increasing role as primary care providers. I would however make exemptions (to my mind) for fellowship-trained Gyn Onc surgeons & the Oculoplastic subspecialty crowd (as The throat pointed out).


    Hotbovie- I would not underestimate the prowess of some of the Gyn-Onc crowd. By the time they finish they are usually pretty slick in the pelvis (Mayo clinic has the premier fellowship for this I hear). I would agree that it looks like to me that most OBGYN resident training is very poor quality for their surgical experience, that has to do with the death of the routine elective TAH & the increasing demand on their training as PCP's. I agree that you'd prob. get the best gyn oncs after gen. surgery training prior, but that's just not realistic I think in contemporary medicine.
     
  34. icebreakers

    icebreakers Member
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    I'm interested in ortho...are there lifestyles really as bad as have been mentioned above? can anyone share their experience on this?

    I definetely want to give my family priority...however I am really really interested in ortho (met a great mentor).

    is there any hope?

    how many hours does they practice on avg?
     
  35. medstud721

    medstud721 Member
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    The most commonly performed surgery in the United States in 2002:

    Cataract Surgery

    I will concede, however--have a brother who is an ophthalmologist working 4 days a week making over $500K a year--doesn't really give a damn what you call him...

    However, for fun, I'll say the following folks aren't real surgeons:

    1)ENTs aka "snot doctors"--have to call themselves head and neck surgeons to feel like the real deal. Notice opthos don't walk around with "eye surgery" embroidered on their coats!!

    2)Urologists--plumbers aka "pecker checker"

    3)OB/GYNs

    and, of course, OPTHO

    However, the worst are the wannabes--interventionalists--the posers if you will--calling themselves "endovascular surgeons".

    General surgeons and any direct subspecialty of gen surgery(including plastics) are the real deal.

    Peace
     
  36. tunica

    tunica Junior Member
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    I suppose that you are just trying to stir controversy with your comments, but I will go ahead and defend urology. If you don't consider nephrectomies (laparascopic or open), kidney transplants, cystectomies with neobladder construction from ileum or some other part of intestine for either continent or incontinent urinary diversion (around a 7 hour surgery), radical prostatectomies (whether nerve sparing or not, possibly done laparascopically), retroperitoneal lymph node dissections for metastatic testicular cancers, bladder augmentations for people with voiding disorders such as kids with meningomyeloceles, adrenalectomies, hypospadias repairs, and other procedures that urologists do to be "surgical", then I am not sure what will qualify. They spend plenty of time in the belly and retroperitoneally. Mind you, they also typically spend two years in general surgery, before starting their urological training which is 4 years. I'd say they are real surgeons.

    Cheers
     
  37. maxheadroom

    maxheadroom Rhinestone Cowboy
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    Gotta step up for the dick-docs. While most aren't doing 2 years of gensurg (at least as reported by my friends who matched uro), they do lots of tough stuff in the abdomen/pelvis.

    ENTs not surgeons? That's a joke, right? Radical neck dissections? Free flaps (OK, not often)? Skull base surgery? While there's the option of doing tubes and tonsils, they are kick-ass surgeons.

    Three procedures performed by OB/Gyns?
    1) Enterotomy
    2) Cystotomy
    3) Ureteral transsection

    Gyn Oncs are surgeons, but that first year of fellowship is a tough year of learning how real surgeons hold the knife, tie knots, and close a wound.

    I'm saying all of this with three years of GenSurg in my future, starting July 1.
     
  38. Jive Turkey

    Jive Turkey Member
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    I understand Interventional Radiology is more demanding (time-wise) compared to Diagnostic Radiology. But I'm curious as to how the IR "lifestyle" compares with other surgical specialties.

    Are Interven Rads docs living the life of a general surgeon, or is it more like ENT?

    Where on the spectrum is Interven Rads?
    (Can anyone "rank" it among gen surg, ENT, ophtho, Diag Rad, and interventional cards).

    Thanks.
     
  39. womansurg

    womansurg it's a hard life...
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    There are facile, experienced people and fumblers in every procedural discipline. Urologists do a six year residency(!), so you'd think they should be pretty smooth - and some are.

    I recently did a colo-conduit for chronic incontinence with one of the newbie uro's who just graduated from an *ahem* esteemed academic program. When he was tying his knots on the neoureterostomies I kept squirming and saying, 'hey, that one's an air knot....um, you really gotta cinch that Maxon down - it likes to slip!' So forth. When we were bringing out the ostomy his entire suture lines started coming apart, while mine held solid (mine actually being TIED down...)

    He just handed me the needle driver and stood there in silence while I re-did the nasty-moses. :)
     
  40. womansurg

    womansurg it's a hard life...
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    Our two IR guys work their asses off - very similar to the hours of our general surgeons. And that's with our vascular surgeons absorbing most of the angiography. We're extremely fortunate - they are extremely talented and capable. I can't remember the last time that they were unable to complete a technically difficult maneuver.
     
  41. tunica

    tunica Junior Member
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    Your uro story is a good one. Perhaps he needed loops for his ureteral implant. I agree that there are good and bad surgeons in every field. Certainly, while urologists like to make fun of OB/Gyns all the time and often complain about needing to do a ureteral repair, there are plenty of very good gyn surgeons. Anyhow, I'll be staring my uro residency out on the West coast in July (looking forward to those 2 years of G-surg!), and hopefully will not become proficient at throwing "air knots".
     
  42. vuillaume

    vuillaume Member
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    Who gives whether ophtho is "really" a surgical specialty, or for that matter any other specialties?

    We receive no medals for entering a residency that is accredited as a "surgery" program. If I had a cataract I'd be glad as heck that there's someone who's trained to cut on my eye. The distinction of whether that ophtho doc has run the bowel ad nauseum or not is lost on me.

    I think the debate about what is a genuine "surgical" specialty encourages purported surgeons to feel entitled to making an ass out of themselves because they got hammered as junior residents.

    You do the job you were trained to do, and hopefully do that well whether that means not tying air-knots or knowing how to lase someone's trabeculae properly.

    The only criterion a doc should concern herself with is whether she does the right thing for her patients.

    [Edit: missing word]
     
  43. Eyesore

    Eyesore Member
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    So does that mean that within an ophthalmology residency, those that did a surgical internship are surgeons and those that did a transitional internship are not? Or will you take away that surgical title from those that did a surgical internship also?

    Frankly, I could care less if you think ophthalmologists are surgeons, but that argument over the internship year is ridiculous. How many surgeries did you actually perform as an intern. In my transitional year, during my surgical months, I was scrubbed in 4-5 days per week, one on one with the attendings, all day long. I wasn't "used and abused" to run the floor and service so the upper level residents could spend all day in the OR.
     
  44. Jive Turkey

    Jive Turkey Member
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    sounds like some people here *do* care about titles... otherwise this post wouldn't have gone on for so long.
     
  45. tunica

    tunica Junior Member
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    I agree that questioning whether certain specialities are surgical or not is ridiculous. However, it has been pretty fun to read about other people's opinions and to learn about their biases, etc. There is nothing wrong with a good debate. You'd better believe that if I had to have a cataract removed, I would be very happy to go to an ophthalmologist. And if I had to have an appendix removed, I'd see my general surgeon. I'd venture to say that most people's objections as to whether ophtalmologists are surgeons or not has to do with how "super-specialized" they are. Whereas a general surgeon is proficient with the anatomy of a lot of the body, ophthalmologists probably remember very little outside of their own little domain of the eye since they are never requred to operate anywhere else for their procedures (correct me if I am wrong, I'm sure there are a few exceptions). But the bottom line is that if you cut, you are a surgeon whether that means you are in the head, belly, bone, pelvis, chest, or in the eye.
     
  46. eddieberetta

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    Too bad we often care more about who does the procedure than how well it is done!
     
  47. neo

    neo Member
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    You know, its childish and illogical but people DO care about title and being part of a group. Someone up there said that if you cut people, you're a surgeon. By this definition, almost everyone is a surgeon. internists and anesthesiologists put in central lines, there's some cutting a sewing there. family medicine doctor do all kinds of minor surgery. hell, dermatologists cut people all the time. usually its about respect. people want respect. for example, if you went through med school and residency you probably want to be considered a medical doctor. and you probably consider other people who went through the same thing, medical doctors as well. now what if a chiropractor wanted to call himself a medical doctor... well, he treats patients. or how about a nurse practitioner? or how about a podiatrist or optometrist? i mean, if i have a foot problem that podiatrists can handle, i'll goto a good podiatrist. if i need glasses, i'll goto an optometrist.

    anyway, the point about ophthalmologists being surgeons. well some ophtho people want to be considered surgeons. but if you ask "surgeons" who they consider to be surgeons, you'll get the same answers 99% percent of the time: g surg, plastics, ent, uro, ct, vascular, neuro, ortho, ped surg. you ask a g surgeon, he'll give you that list, you ask a neuro, he'll give you that list, you ask a plastics, she'll give you that list, etc. now does this really mean anything? not really. all it means that if you want to be part of a group, you have to be accepted by that group. and for the most part, ophthalmologists are not accepted by surgeons as being "one of them" most likely because most surgeons are jealous of their lifestyle :) i know i am.

    some people will argue that being part of a group is defined by some intrinsic criteria but i will submit that de facto membership in a group is by the consent of the group in question.
     
  48. JasonDO

    JasonDO Membership Revoked
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    hah...the truth finally comes out:laugh: :D ;)
     
  49. Eyesore

    Eyesore Member
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    One reason it may be important for ophthalmologists to refer to themselves as "Eye Surgeons" is so the lay public can differentiate them from optometrists. Optometrists cannot perform surgery, ophthalmologists can and do. But the main reason is that that is what we do. We take patients to surgery.

    It is funny how the people who know the least about ophthalmology are the ones to judge. Most people who have seen the types of surgeries that we do respect what we can do. Most people don't realize the amount of manual dexterity/practice it takes to perform the microsurgery that ophthalmology requires. A lot of the stuff we deal with are microns thick. One little slip, someone could go blind. Have any of you ever seen retinal surgery? Some of that stuff would blow your mind. Those of you who have experience operating under the microscope, using 9-O, 10-O suture, please chime in.

    As a lot of you have said, much of this mentality comes from "well if you don't have to suffer like I did during internship, then you are not a surgeon." I can just see it now. The old school guys are going to be saying, "since you wussies only work 80 hrs/week unlike the 120 hrs/week that I worked, then you are not surgeons either!!!"
     
  50. Jive Turkey

    Jive Turkey Member
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    Just look at the people on this board who have chimed in.

    All the Ophtho people are defending their "surgery" title...
    and all the Gen Surg's, ENT's, Uro's, etc are saying otherwise.

    I think this fact alone speaks to the very questino we're debating about.

    You guys just don't get it. Who cares what the ACS says? What we're debating about is not the formal definition of surgery. I think everyone on this forum would agree Ophtho falls under the wing of Surgery by any dictionary definition. But the real debate is whether they're in the club. And if you haven't figured it out by now, they're not. Just look at all the posts by the non-Ophtho guys.

    If you don't care about the club, then good for you. Being a surgeon isn't the greatest thing in the world, and not being one isn't the worst thing in the world. No one is ridiculing the field of Ophtho. You guys are taking this too personally. The surgeons on this board are just pointing out the "real world" definition of surgery -- the one that doesn't encompass Optho.

    Jealous? I for one am not, and I don't think many of the surgeons on this board ar either. They're doing what they do (gen surg, uro, ent, etc) cuz they love surgery.

    I'll end with my own two cents... and I'll go back to the military analogy:

    You gotta earn your stripes to call yourself a surgeon in the OR locker room.
     
  51. maxheadroom

    maxheadroom Rhinestone Cowboy
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    Of course Ophthomalogists are surgeons . . . good point about making the difference clear to the lay public.

    I agree, though, that in the surgical fraternity, ophtho is usually not included as a serious member. While the lack of a surgical internship may be part of it, I would argue that personality is a major factor. Ophthomalogists typically do not exhibit the characteristics of the surgical field. Look at the intensity of most of the surgical residents that you work with in all of the different surgical arenas. While ENT and Uro are laidback, ortho is athletic/fun-loving, and plastics is a closet-control freak masquerading as easygoing, the basic surgical intensity remains in all of the subspecialists. Ophthos just don't fit with the surgeons on that visceral, social level.

    That being said, I've done nerve repairs under the scope with 10-0 nylon. I have great respect for anyone who can keep the jeweler's pickup's steady to throw a knot under the scope. I have tremendous respect for ophtho's ability.
     

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