General Surgery

Discussion in 'Pre-Medical - MD' started by license2kill, May 28, 2008.

  1. license2kill

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    What does general surgery entail? It is surgery, but without a specialized area? Do you just basically do surgery that doesn't require the attention of a specialist?
     
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  3. osumc2014

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    My friend's father is a general surgeon and seems to issue warnings every chance he gets about how tough the hours are and how it is much better to specialize in surgery than just do general surgery.
     
  4. license2kill

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    What is the specific nature of his work? I'm sure it is better to specialize, but then again it is that much more difficult to get into a specialized surgery residency.
     
  5. Alexander99

    Alexander99 Ghetto Fabulous

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    General surgery typically refers to surgery involving the abdomen. General surgeons would take appendicitis, ruptured bowels, abdominal hernias, etc. You can sort of replace "general" with "abdominal" when it comes to defining what general surgeons do.

    General surgeons can also subspecialize and do vascular surgery, plastic surgery, transplants, etc (it's a long list.) So despite what the name implies, general surgery doesn't really imply that the surgeons do simple surgeries only--it pretty much stands for intraabdominal surgery.

    There is no specialized surgery residency (unless you want to do ortho surgery, neuro surgery, etc which are their own residency programs.) To specialize, you do a general surgery residency and then do specialized training called a fellowship which occurs after the general surgery residency.

    What osumc said is correct. General surgery has pretty much the worst hours of any medical speciality and taking that into account, they don't get paid very much per hour. Future female physicians who want to have (happy) children--avoid this speciality!

    MD
     
  6. license2kill

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    Thanks for the information. Although they work long hours, they do get well compensated, correct? Is it due to the long hours that many MD's don't pursue a career as a GS? I am assuming this because it is known to be a not so competitve specialty?
     
  7. Alexander99

    Alexander99 Ghetto Fabulous

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    It depends on what you mean by well compensated. They definitely make more than general practitioners (family practice, peds, internal med) but they can make the same or less than radiologists, dermatologists, anesthesiologists depending on where they work while working close to twice the hours; if you do the math, that means they're making 1/2 what the other specialties do per hour.

    I think the long hours are a huge part of why general surgery is not a competitive residency. Nowadays, the "lifestyle specialties" such as the ones I mentioned above where you make good money while working minimal hours (40-50 per week) are the most competitive ones out there.
     
  8. license2kill

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    That is exactly what the MS1/MS2's were saying at the local starbucks I go to. One more question, while we are on this topic. Why are university based residency programs less competitive? Thanks.:) BTW, what residency are you in?
     
  9. Alexander99

    Alexander99 Ghetto Fabulous

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    I think university based residencies tend to be busier but that doesn't mean they are always less competitive. If you try to apply to programs that belong to big named universities like UCLA, UCSF, etc, then it's competitive.

    I won't tell you exactly which one but I will say it's not gen surg and it's definitely more money for less hours of work. :)
     
  10. jelly476

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    my father is a general surgeon and his salary has gone down by 50 % since the early 1990's. The sub specialties are getting more and more of the work that general surgeons used to do (i.e. vascular surgery is its own sub specialty), and the sub specialty surgeries are being better compensated while general surgury fees that insurance companies are willing to pay are going down and down. The hours also suck with my dad being on call every other night and every other weekend as he only had one partner. Much better to specialize.
     
  11. Bradstein

    Bradstein Friendly R3

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    That's not the only path anymore. There are specialized residencies now, such as plastics. It's 2 or 3 years of general surgery residency, then 3 or 2 years of plastics (I think the total time is 5 or 6 years, so faster than general surgery + fellowship). The downside of doing an "integrated" residency is that you become board certified plastics (or whatever you do), but NOT board certified general surgeon. If you spend longer in training you can do it all, but the value of that probably varies from specialty to specialty (I imagine it's not important at all in plastics).
     
  12. StevenJ128

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    The same thing has happened with CV. Medicare/Medicaid (and insurance companies follow suit) is now paying more for certain elective, outpatient, 30 minute back procedures, than a CABG.
     
  13. Alexander99

    Alexander99 Ghetto Fabulous

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    You're right. I forgot to mention plastics but aside from plastics, what other integrated programs are there? There's no integrated vascular surgery program, cardiothroacic program, etc. I think plastics is the only exception.
     
  14. shemarty

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    The med school affiliated w/ my undergrad institution has a new integrated 5 year Vascular Surgery residency as well as a new 8 year CT Surgery residency starting next year.

    Hopefully, I'll match into one of those come 2013, haha...
     
  15. Bradstein

    Bradstein Friendly R3

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    Thanks, shemarty. Yeah, there are a few programs that are integrating these things. I think what can be integrated is. I think that transplant surgery, for example, NEEDS the full general surgery residency.
     
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  17. smq123

    smq123 John William Waterhouse
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    Yes, there are.

    There are a few integrated/"fast track" CT programs as well.
     
  18. MossPoh

    MossPoh Textures intrigue me

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    Twice the hours might be a bit of a stretch. Reimbursement is down across the board and workload is up across the board. I'll use radiology as the example, since it is a bit better than the others. A "busy" day in radiology is considered around 90-110 cases usually, but now with the advances in CT that let you speed right along with the scans, they can pump the images out. (Oftentimes without any clinical need and subjecting the patient to more radiation than needed...but that is another story). My dad is making about the same per day (not hour) that he did 10 years ago, but he did over 250 cases Saturday, 260 cases Sunday, and 200 cases Monday. Even on a non-holiday weekend, he is reading 150+ cases. Last weekend he was in there at 6 a.m. reading and partly due to incompetency of ancillary staff and partly because of the sheer number of cases was back at home by 11:15 p.m. That was 3 days in a row.

    General surgery has gone up in popularity lately. The general perception is that they ONLY deal in the belly, but they are exposed to a bit of everything during residency. A small town general surgeon is much more likely to show a bit more variety and take cases a specialized surgeon would take in the city/burbs. If you feel comfortable with a procedure then you can do it. Many guys/gals pick up the fellowship because it only helps with future career prospects.
     
  19. jelly476

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    i would have to diagree with you rassertion that a small town general surgeon sees more variety and take cases that a specialized surgeon would do in the burbs. In my experience, small town surgeons do less than if they lived in a bigger city, as a small town hospital usually is not equipped to do larger procedures that requre multiple nights in the hospital with round the clock supervision and nursing care. Most small community hospitals are equipped for outpatient or less risky general surgical procedures and anything that requires a long term visit or needs a larger staff to deal with will get bused or airlifted to the nearest large medical center.

    For example, my father works in a small town rural hospital and while before he lived in a community of 35,000 with a hospital serving a patient base of around 100,000, the community he lives in now is only 5,000 and served a 35,000 patient base. In the larger community he did everything a normal general surgeon would do with vascular/cardiac surgeons coming in for the specialized. However, in the small community he only does outpatient (read colonoscopy) or minor surgery (gall bladder, appendicitis, etc). Anything bigger (anuerisms etc - forgive the spelling im in a hurry), and he has to farm the patient out to the regional medical center.
     

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