I see. I'd like to know more, care to elaborate, sir?
Hmm, where to start...
So when you are an undergrad, surgery can feel like the holy grail of medicine. It is one area in medicine where there is tons of money, lots of prestige, lots of procedures, very little chance of being taken over by another profession. The image that you have of surgery makes it seem like you are basically gonna be a boss, running around, fixing everything and rolling in fat stacks.
So now my experience when shadowing. I shadowed a DO in a group of 5 surgeons (4 MD, 1 DO). Ortho surgeon who works 2 days of surgery, 3 days of office, various weekend call. I shadowed over 3 months of time.
The good:
-The cases in ortho were a lot more varied than I expected and every case really is different. It was cool spending time with elderly who slipped on ice and busted a hip, but then also spending time with kids who broke their arms playing sports. You deal with every age group in ortho. (so this pro is really just to ortho, not necessarily all surgery classes)
- The mixture of clinic and OR is VERY appealing. I think this provides the opportunity to have hard days and easy days and gives you some rest and variability. I could maybe see myself being burnt out by doing just clinic, I feel like I will need to either teach, or do some research, or healthcare admin so that way I would not burn myself out if I was a PCP running a clinic all day every day. I know that I would want to play several different roles in healthcare. I am just one of those that has to always burden myself with too much work haha....
- The money in surgery is still very good. Even with reimbursement rates lowering on some procedures, they still make a lot more than many other specialties.
- The act of surgery seems interesting and every case can be different (I will elaborate in the cons)
- No nurses are going to take your job
The bad:
- It is VERY physically demanding. Like I had no clue how hard it would be. Now I am a young strong buck, but after like 10 hours of standing with little to no food or drink I was pretty spent (and I wasnt even doing the surgery!). After my 10 hours in the OR were up, he left to another hospital to do more surgeries, late into the night. And this is a doc who is wayyy out of school, is partner in his business etc, and he is still running around doing insane days like he is a resident. I have the general impression from other specialties that I shadowed that after residency things do slow down a bit, and especially after 10-20 years out of school things are much much slower. For instance a peds doctor I shadowed was 9-5, 4 days a week with 1 saturday a month... With surgery it doesnt seem that way, seems like you mildly work like a resident until the very end (but this is just n=1).
- You have to LOVE surgery. Like you have to be very very happy in the OR. Like even in the one day I could see a shift in my attitude on different procedures. Like in the beginning I was thinking "wow this is the coolest stuff ever! You get to use this instrument, and this one, and you really get to fix people!" Which is all well and good, but by the end I was like "wow I could see myself increasingly frustrated by having to deal with the minutiae of some anatomy, things slip, parts dont fit in correctly, tools are not working properly or do not fit the cavity like you wish it could." First tendon reattachment of the day seems amazing, last one of the day seems tedious and annoying.
I asked a wise doctor (FM doc) that mentored me "so is it exciting when you get fun procedures to do and have to sort of get messy and think on your feet to fix stuff?" (as he was stitching up a gash in my back... dont ask haha). His response was "when I was young that was exciting, and I almost went into surgery because of that, but now that I am older a perfect day for me is when I do not have to do anything like that and everything is calm." I think some fields of surgery are a young mans sport. I could see how when you get older you might have other things on your mind (billing stuff at work, sick kid, family problems, hobbies you would rather be doing) and I could see how doing intense procedures/surgery would be annoying, time consuming, and physically challenging on days where you really would rather just be back at the office, do your time, and go home that day. I mean I intend to be a passionate doctor who loves his job and loves helping patients, but I am also a realist and know that practicing medicine when you are 50 is going to be different than when you are practicing at 30. Dont believe me? Go shadow some young and old docs. The struggle to perform like a resident when you are old can be taxing (which as a side note is probably why I also believe EM is also not all that its cracked up to be).
Having said all of that, surgery and Ortho in particular has one of the highest rate of job satisfaction of all specialties, and the docs who are in that field tend to work until a very late age (they just start doing hand work instead of big bone and hip work). I definitely intend on going into medical school with a completely open mind and I am absolutely still considering surgical specialties just as much as every other specialty, but my rose colored glasses are off. I think a lot of people say they do not want to deal with all of the crap that is entailed in other specialties (paperwork and insurance crap). Well good and bad news. Bad news is that you will be doing that in every specialty (except maybe rads or path), its not like being a surgeon makes you immune to it. You still have to deal with all of what a FM doc would have to, on top of the 20+ hours of surgery you need to perform a week and the 30+ hours of clinic time. Good news is that I think within the next 10-15 years that ALL specialties will have worked out a lot of these issues that is really drawing people away from medicine and into surgery.
Things are cyclical, there are ups and downs that swap every 10-20 years. I think as the insurance stuff gets settled down and scribes/electronic scribing services pick up and are utilized in more specialties that medicine will again have more of an allure than surgery, as physicians will be able to PRACTICE MEDICINE instead of dealing with bureaucracy and treading through billing crap. We now have like twice the amount of physicians in the senate and in congress than we did 5 years ago. Change is coming. Its just the times man...
So there is my long winded take on surgery.
