Chief of surgery at my hospital: “Applicants with interesting backgrounds and interests outside of medicine don’t do well in surgery”

[odyssey2]

This was a near verbatim quote by her when she was discussing attrition rates in general surgery. This was specifically in regard to two people who had careers in the arts prior to starting surgery and had dropped out of residency. Essentially, she was saying that people with varied interests outside of medicine don’t do well in surgery since it requires too much of a sacrifice of your time and effort. Do you agree with this?

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[dienekes88]

I would say its a half-truth at best.

Are there people who struggle with the sacrifices needed to pursue a career in surgery? Absolutely. Are there people who have interests outside of surgery who are successful in training and beyond? Also yes. Are there people who are 100% committed to surgery and have no outside interests and subsequently quit? Also yes.

I think that it just depends on how much it bothers you that you don't have time for those activities. If you're a competitive runner, will it bother you that you will be jogging (not running) once a week. If you're a musician, you might be talking about playing your instrument once a week and not being near the level you once were. If that's a problem, then you'll struggle. In my opinion, its not the hours spent in the hospital (which is a lot) that is an issue. Its the hours spent in the hospital when you're trying to be somewhere else or wishing you were doing something else. Unfortunately, for some people this is every moment they are in the hospital. For some people, they pursue fields that are more lifestyle friendly because it gives them the opportunity to pursue these interests. The problem is that their interest in the field is limited, so they spend the entire time at work wishing they were pursuing their outside interest.

I think there's probably also some degree of interaction with a variety of other factors: family, individual resilience, co-resident camaraderie, and the program feel.

 

[LucidSplash]

I once heard someone say that in surgical residency, “you can have two hobbies outside of work; if you have a relationship that counts as 1, if you have kids that’s the other.” I personally found that maintaining a relationship took up most of my spare time and didn’t have kids so I can’t comment on that.

After residency/fellowship can be different, you have more control over your schedule in most specialties (but call is still a fact of life for most specialties).

You have to really love surgery for what the training requires of you.

 

[deleted50541]

You have to really love surgery for what the training requires of you.

I love surgery and indeed it consumed nearly all my time for 8 years as a trainee. It cost me a relationship, and at times, my well-being and sanity. Burnout was rampant in my residency and had similar effects on my colleagues.

When I was a CT fellow, I struggled with deciding whether do cardiac surgery or not. I did the training and could practically do a pump case in my sleep by the end. There were some days I was so tired and the cases were so routine that I could hardly remember going on and off bypass. But when I got around others who were really passionate about cardiac surgery, I knew I didn't share their love.

My priorities changed when I got married as a fellow and started a family. I didn't love cardiac surgery enough to commit the time and effort I knew would be required of me as an attending. One of my cardiac attendings, whom I spent most of my training with, was disappointed when I told him I wasn't doing cardiac. But he understood and was very supportive of whatever path I chose.

One of my favorite anecdotes from him was when his wife and daughter were driving by our hospital one day. His daughter pointed at the hospital and said, "Look! That's where daddy lives." We both laughed about it, but I didn't want my child to say that about me.

 

[LucidSplash]

I love surgery and indeed it consumed nearly all my time for 8 years as a trainee. It cost me a relationship, and at times, my well-being and sanity. Burnout was rampant in my residency and had similar effects on my colleagues.

When I was a CT fellow, I struggled with deciding whether do cardiac surgery or not. I did the training and could practically do a pump case in my sleep by the end. There were some days I was so tired and the cases were so routine that I could hardly remember going on and off bypass. But when I got around others who were really passionate about cardiac surgery, I knew I didn't share their love.

My priorities changed when I got married as a fellow and started a family. I didn't love cardiac surgery enough to commit the time and effort I knew would be required of me as an attending. One of my cardiac attendings, whom I spent most of my training with, was disappointed when I told him I wasn't doing cardiac. But he understood and was very supportive of whatever path I chose.

One of my favorite anecdotes from him was when his wife and daughter were driving by our hospital one day. His daughter pointed at the hospital and said, "Look! That's where daddy lives." We both laughed about it, but I didn't want my child to say that about me.

Absolutely. To be clear, I am not saying that anyone is better or worse for defining their priorities in the way you have. You’ve done what is right for you. I’m sad you weren’t in a position where you felt you could find a balance post training. I have a good friend who went into community cardiac and thoracic surgery and while he was largely miserable as a trainee (and single) he married a wonderful woman (pediatrician) a couple years ago. They have a 2 year old and she had a couple of kids from her 1st marriage (she was widowed in a tragic situation from my understanding). He is religious and always wanted a big family and seems to really be thriving both at work and at home. I relay this anecdote not to suggest you did the wrong thing (you did what was right for you 💯) but to relay to others who might be reading that there ARE happy endings where people find some degree of balance. There are always some sacrifices in both ends, the degree to which you choose what gets sacrificed is variable person to person.

I have heard this analogy before: we are all juggling a lot of balls in the air. And it is inevitable that occasionally you will drop a ball. The secret comes from clearly delineating which balls are glass and which are plastic, so you know which ones to protect the most.

 

[bluv1212]

I love surgery and indeed it consumed nearly all my time for 8 years as a trainee. It cost me a relationship, and at times, my well-being and sanity. Burnout was rampant in my residency and had similar effects on my colleagues.

When I was a CT fellow, I struggled with deciding whether do cardiac surgery or not. I did the training and could practically do a pump case in my sleep by the end. There were some days I was so tired and the cases were so routine that I could hardly remember going on and off bypass. But when I got around others who were really passionate about cardiac surgery, I knew I didn't share their love.

My priorities changed when I got married as a fellow and started a family. I didn't love cardiac surgery enough to commit the time and effort I knew would be required of me as an attending. One of my cardiac attendings, whom I spent most of my training with, was disappointed when I told him I wasn't doing cardiac. But he understood and was very supportive of whatever path I chose.

One of my favorite anecdotes from him was when his wife and daughter were driving by our hospital one day. His daughter pointed at the hospital and said, "Look! That's where daddy lives." We both laughed about it, but I didn't want my child to say that about me.

So did you end up in thoracic?

 

[deleted50541]

Yes, I'm a thoracic surgeon. That was my original intention going into fellowship, but cardiac really caught my attention in a way I hadn't anticipated. I'm happy with my choice and ultimately my passion was for thoracic and not cardiac.

There are days when I miss cardiac surgery, but not when I'm hearing about re-dos, late night dissections, and emergent bring backs by my colleagues. Two years was enough of that.

 

[HighwayVagabond]

I could write an entire book about this, and have considered it....but I'll try to hit some high points here.

I worked in an 'artistic' field for many years before transitioning to pursuing a career in medicine. I am now in my final year of training in vascular surgery via the traditional 5+2 route. I have found that my other interests keep me sane. (I am also an endurance athlete). That said, my perspective is very different and I sometimes feel like an outsider in the world of surgery. This perspective is something I've used as a strength, and I've been able to be very successful clinically and academically because I persevere and contribute to innovative thinking. The world of surgery needs more people with a different perspective, because what we're doing isn't working. Vascular surgery released a report on burnout this year and it was disappointing and suggests our culture is not sustainable. My opinion is this has little to do with the hours we spend in the hospital and much to do with the environment in which we spend those hours.

But I'm digressing a bit from your original comment, which is that outside interests take up too much time and sacrifice. I learned an incredibly important lesson about letting go of that type A perfectionistic attitude with my other interests. There is a tendency to think 'why do this at all if I'm doing it half ass'. I can't go into detail on how I changed this attitude, because it would take 100 pages, but once I let go of that I was able to balance the rigors of training and keeping some amount of room in my life for other things. I learned to focus on the joy in the 'doing' of these activities, rather than eyeing the end result or outcome of them. And when you do that, the outcome ends up being pretty great, too. Turns out this is an important lesson for how to have a successful surgical career, so it all came full circle.

Anyway, that was a very long way of saying, with all due respect to the chief of surgery at your hospital, she's full of ****.

 

[dpmd]

This was a near verbatim quote by her when she was discussing attrition rates in general surgery. This was specifically in regard to two people who had careers in the arts prior to starting surgery and had dropped out of residency. Essentially, she was saying that people with varied interests outside of medicine don’t do well in surgery since it requires too much of a sacrifice of your time and effort. Do you agree with this?

Perhaps it is just that people with varied interests outside of surgery and interesting backgrounds don't put up well with the bull**** at your particular institution? Sure, no one who was a competitive level athlete or musician is going to be able to keep that up and do residency, but if you give them a reason to divert their dedication they would have every reason to be successful. Some programs merely abuse their residents with education as an afterthought and attrition of any people with other options makes sense. There is no need to coddle the residents but a program like mine where you feel like an important and valued member of the team from day 1 goes a long way towards preventing attrition due to factors besides just realizing surgery isn't the right specialty for them.

 

[droliver]

Essentially, she was saying that people with varied interests outside of medicine don’t do well in surgery since it requires too much of a sacrifice of your time and effort. Do you agree with this?

I kind of get what they're saying. There are many people who just can't compartmentalize their life the way you have to in order to be the best resident (or even medical student) you can be. It's why a lot of marriages (of those married before their residency started) fail and why a lot of people just aren't very happy as surgery residents.

OTOH, I personally had a blast during surgery residency both personally and professionally. Met my wife, Got married, Started a family. It was exhausting to be certain, we spent waaaay more time in the hospital then with Q2 or Q3 in house the norm then they do now with the new night float systems that have come up, but it was such a life and character defining experience to me i will always look back fondly at it.

 

[Medstart108]

I think most people with hobbies they truly love don't choose surgery, but I agree that it takes up your time full stop. You can't have it all, so you kind of have to pick one or the other. Nothing wrong with dropping out either, its funny because outside of medicine people switch careers and focus all the time and no one cares but in medicine it's always viewed as such a bad thing and yet I think for some people they just need to give it a shot and if it doesn't work out for them so be it.

 

[LadyDustyBlue]

I would say its a half-truth at best.

Are there people who struggle with the sacrifices needed to pursue a career in surgery? Absolutely. Are there people who have interests outside of surgery who are successful in training and beyond? Also yes. Are there people who are 100% committed to surgery and have no outside interests and subsequently quit? Also yes.

I think that it just depends on how much it bothers you that you don't have time for those activities. If you're a competitive runner, will it bother you that you will be jogging (not running) once a week. If you're a musician, you might be talking about playing your instrument once a week and not being near the level you once were. If that's a problem, then you'll struggle. In my opinion, its not the hours spent in the hospital (which is a lot) that is an issue. Its the hours spent in the hospital when you're trying to be somewhere else or wishing you were doing something else. Unfortunately, for some people this is every moment they are in the hospital. For some people, they pursue fields that are more lifestyle friendly because it gives them the opportunity to pursue these interests. The problem is that their interest in the field is limited, so they spend the entire time at work wishing they were pursuing their outside interest.

I think there's probably also some degree of interaction with a variety of other factors: family, individual resilience, co-resident camaraderie, and the program feel.

Speaking as someone who was a full-time musician AND attended a performing arts school at one point, it takes a lot of dedication and if you're trying to be that - you just are. IF you're trying to maintain your varying interests whilst trying to do surgical residency and such, it's not impossible. But I wouldn't be a full-time gigging musician and try to do residency at the same time. That would just be unwise if you already knew how much time is put into your "arts-centered" project. It also really depends what kind of arts careers these people OP was referring to had prior to surgical residency.

Like... if they wanted to be a mixed media artists or something, nothing is stopping you from submitting your work to an arts gallery for selling work on commission or something. Performance-based arts are a different ballgame though.

OP's chief of surgery isn't 100% wrong that people will struggle if they have outside interests that they want to prioritize above their chosen residency program. You have to know which interests you can make time for and which ones you don't.

So I agree with @dienekes88 . If those former residents dropped out, it's for whatever reason(s) they decided meant that surgical residency ultimately wasn't what they wanted to do. That shouldn't discourage OP or anyone else to not attempt or follow-through w/ their surgical residency. Perhaps it's just that some people... start it and then find out that something else was more important to them at the time. C'est la vie. It happens.