Day in the life + Hours

[CassieBagley]

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It's been asked before, but I'd like to hear some input on all 3 questions from anyone in the fields and/or who is familiar with the fields listed.

1. What is a typical resident's day in general surgery? How many hours per week. How about for a CT Surgery fellowship?

2. Typical day and hours/week of an attending general surgeon or CT surgeon.

3. What is the typical pay for CT surgeons?

 

[tussy]

It's hard to post a typical "day" because every day of the week is a bit different for me. As an attending I can post what I was doing this week. I am a general surgery attending in a community hospital. We get some residents rotating from time to time but not a full complement of residents.

Monday: Went into hospital at 7:30 to round on my patients, then went to my office where I saw patients until about 1pm. Nothing scheduled in the afternoon but did paperwork unti about 3, then went to the gym, then went home.

Tuesday: Arrived at hospital at 7 to round, the OR all day. on call so had to do a couple emergency cases in the evening and got home around 11pm. Luckily I had a senior resident on with me so got no calls after I got home.

Wednesday: Arrived at 7:30 for rounds, then scoping all morning. In the afternoon I was in the OR. Got home around 6pm.

Thursday: same as wednesday.

Friday/Saturday/Sunday - working all day friday in the minor procedures OR (lumps and bump). On call all weekend and no resident on, so i expect to be busy with no sleep.

 

[cpants]

Gen surg intern - most rotations, 6 days per week - get in for rounds from 5-530 cases most mornings into early afternoon. PM rounds and floorwork all afternoon. Signout and go home from 6-7. Schedule seems pretty similar as you get more senior, thought the more senior residents usually come in about an hour later since they have less patients to see. They also have a lot more OR and a lot less floorwork.

 

[Postictal Raiden]

It's hard to post a typical "day" because every day of the week is a bit different for me. As an attending I can post what I was doing this week. I am a general surgery attending in a community hospital. We get some residents rotating from time to time but not a full complement of residents.

Monday: Went into hospital at 7:30 to round on my patients, then went to my office where I saw patients until about 1pm. Nothing scheduled in the afternoon but did paperwork unti about 3, then went to the gym, then went home.

Tuesday: Arrived at hospital at 7 to round, the OR all day. on call so had to do a couple emergency cases in the evening and got home around 11pm. Luckily I had a senior resident on with me so got no calls after I got home.

Wednesday: Arrived at 7:30 for rounds, then scoping all morning. In the afternoon I was in the OR. Got home around 6pm.

Thursday: same as wednesday.

Friday/Saturday/Sunday - working all day friday in the minor procedures OR (lumps and bump). On call all weekend and no resident on, so i expect to be busy with no sleep.

This is brutal. If you don't mine me asking, how often do you do this Friday-Sunday coverage?

 

[DrDawg]

This is brutal. If you don't mine me asking, how often do you do this Friday-Sunday coverage?

I thought that was a pretty good schedule. 2 days of OR, 2 days of scopes, half day of clinic. If thats one call a week, and one weekend a month, thats pretty nice

 

[tussy]

This is brutal. If you don't mine me asking, how often do you do this Friday-Sunday coverage?

We have 7 in our group so it's 1 weekend in 7. It's actually pretty sweet to have 6 weekends off in a row!

 

[ACSurgeon]

Gen surg intern - most rotations, 6 days per week - get in for rounds from 5-530 cases most mornings into early afternoon. PM rounds and floorwork all afternoon. Signout and go home from 6-7. Schedule seems pretty similar as you get more senior, thought the more senior residents usually come in about an hour later since they have less patients to see. They also have a lot more OR and a lot less floorwork.

That's a little brutal. Most of my year has been round at 6, with some rotations being busier and starting round at 5:30 and some less busy, starting at 6:30. Interns show up to round the same time that seniors do. Either students get numbers in the morning, or we acquire them as we round. Rounds and am floor work usually done by 11 am, then consults/go to OR, or obssess over the list and minor floor work for a couple of extra hours. Some days are busier than others, and some of our PA's/NP's are better than others (read: discharge paperwork). Overall, I still average ~70-75 hrs per week. Most days end around 6-7 pm. Average 1 day off per week, often combined into a golden weekend. Weekend days that I work are either just rounding (2-5 hours) or being on call for consults (16 hrs). Usually 2-3 weekend days are call.

 

[naus]

This is a great thread. Really eye-opening. Does specializing reduce the hours at all?

 

[Winged Scapula]

This is a great thread. Really eye-opening. Does specializing reduce the hours at all?

It depends on what you specialize in.

Some, like breast, surg onc and colorectal, if you don't have to take general surgery call may have better hours than straight up general surgery.

Others like vascular, transplant or CT may be worse.

And of course, that doesn't take into account whatever contractual obligations you can bargain for.

 

[Special Delivery]

My wife is considering going GS, but everyone is always cautioning her about the lifestyle. Are there any "success stories" about surgeons who have happy marriages and family life?

 

[SLUser11]

My wife is considering going GS, but everyone is always cautioning her about the lifestyle. Are there any "success stories" about surgeons who have happy marriages and family life?

I have a happy marriage, but I will admit that it's MUCH easier for a male surgical resident to have a family life than a female resident. While it is possible, it's always difficult for females to start and raise a family during residency. Surgery is generally not a part-time profession, and many mothers want to have protected time with their kids that residency (and then later on a busy practice) will not allow.

 

[naus]

With the 80 hour work week limit, a lot of programs now have night floats. How is that working out now? How much are you assigned to night float?

 

[ajimd]

WOW...Night float... "how's that working out now?"
Thats a loaded question, but I'll give you my impression:
True that with the 80 hour work week, "strategic naps", 16 hour "on duty" restrictions for interns and junior residents, I would assume that they have a much better quality of life than when I was an intern (and that was not too long ago) -
However, I think that the system and work hour restrictions will rear its ugly head and cause many small programs in the country to either shut down or extend the time it takes to educate, and properly train residents to become surgeons; unless you train at a very large academic surgical center where you have the 20-30 resident manpower it takes to run a good call schedule OR you hire PA's to take care of the BS in the middle of the night.
I think you overall have more time, but it's not quality time spent either on the floor, ICU, or in the OR. I feel a lot of junior residents, and not just at my program, will be less equipped to take out a gallbladder as a third year (for example) simply because they have not put in the time needed to know how to operate because THEY ARE NOT THERE! It's hard to operate from home...
I think there are some very definite pros to the night float system, but personally I feel it is purely service-oriented and not so much educational. That being said, seniors at my program did not do night float. We took "old fashioned" call and would go through 2-3 new groups of residents inside one shift...weird
I'll get off my soap box

 

[WentForitandWon]

I have a happy marriage, but I will admit that it's MUCH easier for a male surgical resident to have a family life than a female resident. While it is possible, it's always difficult for females to start and raise a family during residency. Surgery is generally not a part-time profession, and many mothers want to have protected time with their kids that residency (and then later on a busy practice) will not allow.

Many hospital are developing acute care surgery services. basically a surgical hospitalist. The attendings work a 12 hour shift then leave, the patients they operate on have followup with whoever is in clinic when they arrive.

the acute care attendings at my hospital cover general surgery and trauma while on their shift. They also have a backup who can come into cover if they are in surgery when something else comes in.

this system allows them a pretty reasonable schedule and drastically decreases their clinic responsibility. also for those attendings who want to have elective cases as well they can book those/see clinic patients during the weeks when they are not on shift (they tend to do a week at a time).

 

[ESU_MD]

The surgical hospitalist leads to a good life for the surgeons. Esp the 12 hr variety. Typically you come in, do whatever cases the last guy dumped on you the first 6 hours, then spend the next 6 hours figuring out how to to push off the cases to the next guy by ordering tests,etc..

Its probably bad for patient care because with all the handoffs, nobody ever really takes an ownership of the patient. The exception woud be a true resident service, where at least te chief will be the continuity and the surgical hospitalist just watches tv in the call room until theres a problem.

The good thing is that alot of patients in the acute care realm probably dont care who their doctor is and are just as happy seeing the nurse with the long white coat