Can those of you attendings who are saying how bad it is please elaborate? It's a given GS residency is tough, but I'm sort of surprised to hear it doesn't get much better once you are an attending.
There are some aspects of general surgery that get better as an attending when compared to residency:
1) you make more money, but as noted above, it can be FAR lower than your colleagues in other fields, often fields with less rigorous hours or workload
2) you get a *tad* more respect-from patients, colleagues and nurses. When I need something, especially if at a hospital that wants my business, they get it for me instead of shrugging their shoulders (except one facility that drives me nuts when ever I operate there).
But general surgery and general surgeons do still have the worst of the lot: BS consults, consults for stuff no one else wants to do (EC fistulas, chronic wounds, lines, ports, trauma, etc.). ALL fields have crap to deal with but general surgery, especially for the young practitioner can seem filled with such crap and without the lifestyle benefits of other fields.
And you likely underestimate the stress with having your name on the chart. I am constantly worried about being sued. Not because I think I am doing a crappy job but rather because I worry now about inadvertently missing something or being told something and not verifying it for myself (remember those Chief residents who always double checked what the intern told them? Yep...that's me...trust no one is my motto.)
And what's up with people saying you have to come in at 3 a.m. as an attending? Where I did my surgery rotation it was the residents on call who handled things after hours and if an emergency had to go to the OR then it was the on call attending who was already in-house who took the patient to the OR.
Like most SDNers you have fallen into the academic medicine, blinders on focus. The vast majority of general surgeons do not work in academic medical centers with surgical residents. So when the ED calls at 3 am, its YOU, the attending who comes in to see the patient. Community hospitals do not have general surgeons in house; someone is on call for the ED at home. When its your turn, you come in. When its your patient who shows up, you come in. No residents to work them up and call you.
Even academic medicine doesn't always work the way you have experienced. My residency program did not have general surgeon attendings in house. Sure the residents *tended* to get the first call (although sometimes the ED or floor would call the attending first) and see the patient, but whomever was on call got the call at home and came in if needed. EVERY service I worked on had someone on call - ie, you did not call the acute care surgeon on call for the colorectal or vascular patient. Those calls went to CR or Vascular attending on call.
I miss having residents, especially in the sense of having some eyes and ears for what is going on in house. Trust me, I will scream if I go into round tomorrow and find that half of my orders have been ignored or that the patient is in pain and I was not called or the patient was told, "there is nothing else written for you, sorry charlie."
Lean out your window and turn your ear west because I can guarantee you that there will be something wrong. It will undoubtedly be something like SCDs off because they were "too noisy" or patient not being walked because they "needed their rest". Maybe it will be something like the 82 yo with SBP in the 70s that nursing just figured needed her Lisinopril held and to continue her fluids and that didn't warrant a call to me. Yeah thanks...when she has an MI, DVT or her PE and dies, guess who's fault it is? Not nursing staff.
<off my soap box>
At any rate, as others have noted, pick surgery if you cannot envision doing anything else. I'll complain and it chaps my hide that general surgeons are so underpaid, but I still love what I do. I would never discourage someone from going into surgery unless I really thought they weren't cut out for it but I also want to make sure they have fully considered what they are getting themselves into. General surgery residents are pretty miserable, but there are several surveys which also note that general surgery attendings are pretty unhappy as well.
