Is Gen Surg as bad as people make it out to be?

[emergentmd]

For example, If I work from 5 am to 6 pm 5 days a week, that’s a 65 hour work week. I see my kids one hour in the evening before bedtime, 5 hours per week. Someone who works 40 hours per week (let’s call it 8-5 with a one hour lunch) might see their kid for 1 hour in the am getting ready for the day and one extra hour in the evening, so 15 hours per week. So I’m working 25 extra hours but only losing 10 with my kids. If I take call one night, I add another 11 hours (6 pm to 5 am) and now I’m working 76 hours but have lost no extra hours with kids. So it’s simply not the case that someone who works 40 hours a week spends 36 extra hours with their kids than someone who works 76 hours.

I mostly don’t work weekends and do nothing but spend time with my kids all weekend - zero personal activities or hobbies while kids are awake. When I take a vacation, it’s all about making it fun and memorable for my kids.

My children are little and I’m very new at this. Certainly residency puts on strain on home life, more on spouse than kids I would say, but on the whole family. However, between me, my spouse and other people who love and care for my children, I don’t feel they are being shortchanged, at least for now.

I commend you for doing your best and structuring residency around your kids. This must be something new because when I did residency, you had no control over your schedule and weekends were no different than weekdays. I was in the hospital every day of the month. Each surgical block I went into had fix call days. Came in 2 hrs before rounds. Stayed as late as we needed to be many times til 7-10p, and did call = 36 hrs q 3. In no way could these residents see their kids but a few hrs a week.

Its great you have support and having a loving environment is great for kids but my contention is the bond between the parent and the child will not be great. you could hire a nanny who can be a surrogate parent producing great adults, but that doesn't mean you have created any real bond with your kid.

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[VA Hopeful Dr]

Interestingly, several years ago I was talking with a child psychiatrist classmate of my wife who said that basically if you spend 30 minutes of one-on-one time with each child, that's really all you need for normal development.

Granted that was closing on 9 years ago so maybe things have changed.

 

[emergentmd]

Interestingly, several years ago I was talking with a child psychiatrist classmate of my wife who said that basically if you spend 30 minutes of one-on-one time with each child, that's really all you need for normal development.

Granted that was closing on 9 years ago so maybe things have changed.

This is one child psychiatrist who I would not ever refer to.

That is like telling my kid that he just needs to practice basketball 30 min a day to be a good basketball player. uhhhh.... no

 

[VA Hopeful Dr]

This is one child psychiatrist who I would not ever refer to.

That is like telling my kid that he just needs to practice basketball 30 min a day to be a good basketball player. uhhhh.... no

I think you misunderstand me. I'm not saying that spending 30 minutes a day in your house total is sufficient.

What I think he was saying is our generations overestimate how much quality time we need to spend with kids for them to form a connection with us and to be reasonably well adjusted.

Channel do you also is not that good. If I started playing 30 minutes of basketball every single day a week the day I graduated college I'd be pretty damn good right now. Not NBA level good, but probably better than 99% of the guys my age

 

[emergentmd]

I get your point but I think basketball is alittle diff than shooting basketball. Maybe I picked a poor comparison.

Try spending 30 min with your wife daily and see how fast she will find a boy toy while you are at work.

 

[VA Hopeful Dr]

I get your point but I think basketball is alittle diff than shooting basketball. Maybe I picked a poor comparison.

Try spending 30 min with your wife daily and see how fast she will find a boy toy while you are at work.

Once again you're missing my point.

I get home from work around 430. My wife gets home around 530. We go to bed around 9. So that's 3.5 hours every day we spend together. But that's not quality one-on-one time. If we spend that whole 3.5 hours cooking, helping the kids with school work, cleaning, or whatever then things do get stressful. If, on the other hand, we take some period of time (around 20-30 minutes) where its just us we do very well.

Same thing with the kids. Their bedtime is around 8 so I get 2.5 hours every evening with them. But, most of that is fixing their supper, getting ready for bed, making sure their homework is done. That's not quality one-on-one time. So I try and give each child around 15 minutes of one-on-one time. Reading a book, talking about their day, helping me cook. Whatever works for that day. That's the time that matters. If I'm home with them for 8 hours but doing my own thing, that's not good time.

Why spend one-on-one time with your child

Interested in boosting your child’s self-confidence, brain development, language and social skills? More one-on-one time may be part of the answer, contributing

www.firstfiveyears.org.au

 

[njtrimed]

It’s seems clear you are to me. If I wanted an easy path I never would have chosen medicine. Someone wanting improvements doesn’t equal wanting an easy path. Not wanting to work insane hours after already sinking so much time, effort, pain (sacrificing everything outside of education) into this path already isn’t the same as wanting an easy path. That’s such an odd conclusion to come to. I’m pushing 30 and I haven’t even graduated med school yet. I’m not some young adult that has forever to build a family. The age of the average matriculant is getting higher as more and more gap years are necessary to be competitive for med school. You seem out of check with reality. The average suicide rate of med students is 3x higher than the population. The average suicide rate of physicians is 2x higher, in fact last I read it’s the highest of any profession. Y’all really think medical training has nothing to do with that? Harsh medical school demands and then hop into residency which is arguably worse. Spending 10+ years in which you’re unable to dedicate any time to a personal life essentially? Low pay in residency for long hrs? Barely being able to afford a place of your own as a grown ass adult with a MD? Barely having time to finally start building a life outside of medicine despite the pain and sacrifice already given? This is something y’all have an issue with people complaining about? Nothing needs to change? It’s so odd to see so many medical professionals promoting an unhealthy life balance for such an extended period of time that we would never promote to anyone else for their own sanity/mental health.

I lurk more than I comment, but I have to say: you are the only one here who seems upset, and you clearly do not understand surgical training, at least not yet.

First off, I’m a surgical resident roughly halfway through training with young kids. I started med school in my 30s. My eldest will be the only one to remember my med school graduation and my first day of residency, but my kids understand the sacrifices I am making and are super proud to call their mom a surgeon. They love hearing about what I do every day; they ask really insightful questions and enjoy engaging in discussions about my work. I spend as much time with them now as I did back when I was working full time plus extra shifts before med school to make ends meet. I’m on nights now and I get to hang out and read with them and have breakfast before they go to school, and help them with homework or watch their after school activities before I go in each evening. On other rotations, I’m on q3 call and only get to see them via FaceTime every 3 days. It varies from month to month. But they get it, and I don’t miss out much more than many working parents. My only requests for time off revolve around being there for the important things for them: birthdays, holidays, first day of school, big events, etc. I also make time to work out most days, and even still do endurance racing when my schedule allows. I would say my work-life balance is pretty great, all things considered. We go on family vacations, date nights, and hang out with friends. While a few parent friends are in medicine, the ones who have schedules as tough as mine are actually in other fields.

To the other point, until you’re a surgical resident realizing that in a few short (yes, short! They fly by!) years you will be 100% responsible for every decision you make and everything that happens in the OR, you just do not grasp why surgical training actually never feels quite long enough, and why you’ll need to find mentors when you become an attending. It’s a massive responsibility and it is and should be daunting. You should want to read and learn as much as possible for your patients. You should want to do as many cases as you can while you’re still in training…as @operaman explained beautifully.

While we have a long way to go and tons of room for improvement in certain cultural aspects of training, the reality is that it is infinitely better today than it was even 15-20 years ago. But the things that need to change are really not related to the time invested in training.

 

[DarkBluMage]

I lurk more than I comment, but I have to say: you are the only one here who seems upset, and you clearly do not understand surgical training, at least not yet.

First off, I’m a surgical resident roughly halfway through training with young kids. I started med school in my 30s. My eldest will be the only one to remember my med school graduation and my first day of residency, but my kids understand the sacrifices I am making and are super proud to call their mom a surgeon. They love hearing about what I do every day; they ask really insightful questions and enjoy engaging in discussions about my work. I spend as much time with them now as I did back when I was working full time plus extra shifts before med school to make ends meet. I’m on nights now and I get to hang out and read with them and have breakfast before they go to school, and help them with homework or watch their after school activities before I go in each evening. On other rotations, I’m on q3 call and only get to see them via FaceTime every 3 days. It varies from month to month. But they get it, and I don’t miss out much more than many working parents. My only requests for time off revolve around being there for the important things for them: birthdays, holidays, first day of school, big events, etc. I also make time to work out most days, and even still do endurance racing when my schedule allows. I would say my work-life balance is pretty great, all things considered. We go on family vacations, date nights, and hang out with friends. While a few parent friends are in medicine, the ones who have schedules as tough as mine are actually in other fields.

To the other point, until you’re a surgical resident realizing that in a few short (yes, short! They fly by!) years you will be 100% responsible for every decision you make and everything that happens in the OR, you just do not grasp why surgical training actually never feels quite long enough, and why you’ll need to find mentors when you become an attending. It’s a massive responsibility and it is and should be daunting. You should want to read and learn as much as possible for your patients. You should want to do as many cases as you can while you’re still in training…as @operaman explained beautifully.

While we have a long way to go and tons of room for improvement in certain cultural aspects of training, the reality is that it is infinitely better today than it was even 15-20 years ago. But the things that need to change are really not related to the time invested in training.

I already said I’m not about to argue or discuss this any further. Y’all can keep responding to me if you want but just know I’m not reading all that.

 

[DOVinciRobot]

I already said I’m not about to argue or discuss this any further. Y’all can keep responding to me if you want but just know I’m not reading all that.

That post should be stickied. Ignoring it is the height of foolishness

 

[operaman]

That post should be stickied. Ignoring it is the height of foolishness

Yeah I think their attitude is going to endear them to their chiefs and faculty and then carry them right to the top pediatric surgery programs.

My money is on they match Gen surg, then bail for anesthesia. I just can’t decide whether they bail after intern year or pgy2 year.

OP- if you want to work like a surgeon then Gen surg residency isn’t so bad. If you want to work like a dermatologist, you may find it not to your liking. If you like to blatantly disregard the advice of those who’ve gone before you, well…. may the odds be ever in your favor.

 

[Future_Bone_Docta]

I feel like you don't understand why surgical residency is the way that it is. If you did you wouldn't be saying these things.

Don't worry, give it 10 years and we'll have surgical NPs performing lap choles with 300 online clinical hours.

 

[yeasports]

summary:
1. Op wants to achieve one of the highest skillsets in the world but wants an easy pass.
2. When the op asks people in the field and when they don't immediately vindicate-- the op argues.
3. When people in the field give real world experience and life lessons the op will no longer listen.

One would think the lesson would be: Don't be like the op. I think that is wrong.
To me the lesson is: Watch out gen surg residency programs, the op may apply to your program.

 

[DOVinciRobot]

summary:
1. Op wants to achieve one of the highest skillsets in the world but wants an easy pass.
2. When the op asks people in the field and when they don't immediately vindicate-- the op argues.
3. When people in the field give real world experience and life lessons the op will no longer listen.

One would think the lesson would be: Don't be like the op. I think that is wrong.
To me the lesson is: Watch out gen surg residency programs, the op may apply to your program.

Actually it’s worse, that poster isn’t even OP….

 

[DarkBluMage]

summary:
1. Op wants to achieve one of the highest skillsets in the world but wants an easy pass.
2. When the op asks people in the field and when they don't immediately vindicate-- the op argues.
3. When people in the field give real world experience and life lessons the op will no longer listen.

One would think the lesson would be: Don't be like the op. I think that is wrong.
To me the lesson is: Watch out gen surg residency programs, the op may apply to your program.

1. I’m not OP, thread got derailed because people wanted to argue.

2. Imagine being so bothered by someone refusing to continue to entertain a discussion that’s simply going no where. If y’all want to continue to argue or @ me when I already said I’m done talking about it that’s your business. I’m not obligated to further engage.

3. I don’t care about anyone trying to say I want an easy path or trying to antagonize me with insulting quips while under the guise of “giving advice” to try to get me to respond. This is an online platform. None of you know me to try and make determinations about my future. I don’t have to agree with someone that working excess of 80hrs a week yields a good quality of life and doesn’t make someone an absent parent. It’s obvious I disagree on both points and that’s not going to change just because someone feels like their couple of hours with their family is enough time for them. It’s honestly hilarious how toxic some of these responses are just because I’m not interested in arguing/responding to every newcomer trying to @ me and I don’t agree with the statements made about quality of life after the info given from some of the residents on here. There’s a lot of rose colored glasses and cognitive dissonance going on because reality isn’t adding up to quality of life. It’s one thing to make the best of a situation, it’s another to pretend there’s nothing wrong with a situation.

4. If you want to beat a dead horse then you’re more than welcome to. Just know I’m not about to continue to do it with you. That doesn’t make me a bad person. Some of y’all need to learn discretion of when to leave something alone. Go outside and touch some grass. Someone disagreeing with you isn’t the end of the world.

 

[OptionOffense]

I think it all depends on what your definition of "bad" is. And whatever it is, it varies between programs. And once residency is over, being an attending surgeon is no cakewalk either whether thats in ENT or gen surg.

On the attending side, I think the hardest part is the unpredictability. If someone rolls into my clinic with a surgical emergency, guess who's not getting home on time? If one of my post-ops has a complication, guess who comes in to fix it? That's the flip side of getting to do some really fun cases and have what is generally a great life with high pay.

The real secret to having a good life in gen surg or anything else is this: you have to be good. I don't know why this never gets talked about, but your surgical skill is largely what will determine your quality of life (in addition to a few other things). If it takes you until 8pm to do cases that I can finish by 4pm, guess who has a better life? We had a free flap surgeon in residency who could finish cases by 1pm that faculty in my med school would take until 10pm, and she would pick her kids up from school every day. She was also really good so rarely had late night takebacks. Others had more complications and their lives sucked a lot more. IF you can get good training and develop excellent skills in clinic and the OR, you can definitely have a good QOL in any surgical field. One of my free flap surgeon partners is stupidly awesome and he does 5-7 flaps a week and usually works from 9-2 and no call other than his own patients and maybe does one late night takeback a year if that. That's what skills can buy you.

So how do you do this? This is where working hard in training comes in, and take all this with a grain of salt because I'm not a general surgeon, but I've certainly worked with them and went through training with a lot of them. But surgical residency does require a certain investment of time so you can develop the skills you will rely on for your career. This comes in the form of long hours, long cases, busy calls, etc., so you can learn how to do surgery and care for perioperative patients and manage your complications. As a junior GS resident this means a lot of busy weeks, weekend rounds, etc. Many gen surg programs will have senior and chief residents taking frequent backup call as well. At my program, the GS chiefs were on call 24/7 for their service while in ENT we had senior level call rotate q10-12. So for GS they have brutally long hours as juniors and then more frequent call as seniors, and call as seniors is usually with interns/2s so they get called quite a bit. Things are always service specific, so some rotations have fewer late night issues/calls, but some may have the chief coming in to operate quite a bit and those tend to be services that have longer more complex cases during the day as well.

The other flip side to the hours is the amount of reading you'll need to do if you want to get good, and getting good is what gives you a good life later.

So yes GS and other surgical fields can be brutal. Some programs are cushier than others, but no program is going to turn a surgical field into a Derm residency lifestyle. You do surgery because you want to be a surgeon. If that's what makes you happy, then go for it. Develop your skills and you'll be able to have a decent QOL.

There is a difference between being a plastic surgeon focusing on breast augs and other cosmetic procedures which are purely elective and can be done in the outpatient surgery center and general surgery where many of your cases are emergent, urgent, semi- elective and need an icu admission. Even the best of general surgeons feel the impingement on one's lifestyle; i dont care how good you are.

Want to have a good life as a Gen Surgeon, become a breast surgeon or an endocrine surgeon.

 

[guytakingboards]

There's a not-small amount of irony that the poster with the least real world experience is decrying that everyone else has rose-colored glasses and cognitive dissonance.... and needs to go experience the real world.

Classic SDN

 

[Smurfette]

I already said I’m not about to argue or discuss this any further. Y’all can keep responding to me if you want but just know I’m not reading all that.

I'm sure the male ER doctor who did surgery rotations pre-80 hours work restrictions started in 2004 knows better than the current female surgical resident with kids. You're not the OP of THIS thread, but you are the OP of another thread where you specifically ask about having kids as a resident and other stuff she addressed above. Picking and choosing to listen to only the stuff that fits your narrative is going to give you a chip on your shoulder later when things are different from what you expect.

I've been thinking for a while that you're trolling, because I can't see how you could think peds surgery is your calling based on your posts.

Yeah I think their attitude is going to endear them to their chiefs and faculty and then carry them right to the top pediatric surgery programs.

My money is on they match Gen surg, then bail for anesthesia. I just can’t decide whether they bail after intern year or pgy2 year.

OP- if you want to work like a surgeon then Gen surg residency isn’t so bad. If you want to work like a dermatologist, you may find it not to your liking. If you like to blatantly disregard the advice of those who’ve gone before you, well…. may the odds be ever in your favor.

Gotta love a surgery related hunger games reference.
My money's on a peds subspecialty. If gen surg is too many hours, anesthesia surely would be too. Someone has to keep the patients asleep during their emergency appy!

 

[ChordaEpiphany]

I got curious and asked every surgical resident I know with kids what it's like. Granted this is mostly one institution, but the answers were basically invariably, "if you want to be a surgeon and you want kids, you should do both." They were all happy to talk about it. The answers were amazingly optimistic from a group I consider very pessimistic.

Nearly all said it's manageable, but you'll need help. One said that it's costly, because you don't just need daycare but also extra care for when things run over. They added that if you plan on having kids in residency, and you like gen surg because of some of the lucrative subspecialties, it's basically better to do anything else. You will train very long and lose years of salary. You won't moonlight at all. You will pay out the nose and potentially go into debt funding your 80+ hours/week lifestyle while supporting children.

 

[ACSurgeon]

I got curious and asked every surgical resident I know with kids what it's like. Granted this is mostly one institution, but the answers were basically invariably, "if you want to be a surgeon and you want kids, you should do both." They were all happy to talk about it. The answers were amazingly optimistic from a group I consider very pessimistic.

Nearly all said it's manageable, but you'll need help. One said that it's costly, because you don't just need daycare but also extra care for when things run over. They added that if you plan on having kids in residency, and you like gen surg because of some of the lucrative subspecialties, it's basically better to do anything else. You will train very long and lose years of salary. You won't moonlight at all. You will pay out the nose and potentially go into debt funding your 80+ hours/week lifestyle while supporting children.

Not to forget financial stress and stress of children and stress of surgical residency combined could break the best of marriages…

 

[ACSurgeon]

I'm sure the male ER doctor who did surgery rotations pre-80 hours work restrictions started in 2004 knows better than the current female surgical resident with kids. You're not the OP of THIS thread, but you are the OP of another thread where you specifically ask about having kids as a resident and other stuff she addressed above. Picking and choosing to listen to only the stuff that fits your narrative is going to give you a chip on your shoulder later when things are different from what you expect.

I've been thinking for a while that you're trolling, because I can't see how you could think peds surgery is your calling based on your posts.


Gotta love a surgery related hunger games reference.
My money's on a peds subspecialty. If gen surg is too many hours, anesthesia surely would be too. Someone has to keep the patients asleep during their emergency appy!

I wonder if the poster who is asking about peds surgery and having kids is having a hard time resolving the internal conflict of wanting two things that are at odds with each other. Sounds like she wants to be more present with her kids than what surgical training allows. But still would want to be a surgeon. I wonder if what we are seeing isn’t stubbornness but rather a struggle to potentially let go of one precious goal for another…

 

[osler21]

I'm a rare contributor and occasional visitor to this site.

Practicing sub specialist surgeon here now16 years in. I do about 14K RVU's each year and am just about never doing clinical work after 4pm. What the contributor above wrote and I've copied below is absolutely true. This comment should be put somewhere where it can be read over and over.

One thing to add is that, for a host of reasons, surgeons who end up with careers in academia often just aren't all that good. It takes a few years of being in practice to figure this out since while in training you looked up to these guys. This distorts student/resident perceptions of what life as a surgeon can be. Be honest with yourself, figure out if you are able to be good (there's no one factor, it's an emergent process, consider other things you've done in life; was school easy? were you good at sports? have you been in situations before where those around you seemed to be working vey hard and under a lot of stress and you found yourself wondering why?) if you are not able to perform at a cognitive, mechanical, emotional level equal to the demands of surgery, factor that into your consideration for the sake of your future life as well as the well-being of your patients.



/////////////////

"The real secret to having a good life in gen surg or anything else is this: you have to be good. I don't know why this never gets talked about, but your surgical skill is largely what will determine your quality of life (in addition to a few other things). If it takes you until 8pm to do cases that I can finish by 4pm, guess who has a better life? We had a free flap surgeon in residency who could finish cases by 1pm that faculty in my med school would take until 10pm, and she would pick her kids up from school every day. She was also really good so rarely had late night takebacks. Others had more complications and their lives sucked a lot more. IF you can get good training and develop excellent skills in clinic and the OR, you can definitely have a good QOL in any surgical field. One of my free flap surgeon partners is stupidly awesome and he does 5-7 flaps a week and usually works from 9-2 and no call other than his own patients and maybe does one late night takeback a year if that. That's what skills can buy you.

So how do you do this? This is where working hard in training comes in, and take all this with a grain of salt because I'm not a general surgeon, but I've certainly worked with them and went through training with a lot of them. But surgical residency does require a certain investment of time so you can develop the skills you will rely on for your career. This comes in the form of long hours, long cases, busy calls, etc., so you can learn how to do surgery and care for perioperative patients and manage your complications. As a junior GS resident this means a lot of busy weeks, weekend rounds, etc. Many gen surg programs will have senior and chief residents taking frequent backup call as well. At my program, the GS chiefs were on call 24/7 for their service while in ENT we had senior level call rotate q10-12. So for GS they have brutally long hours as juniors and then more frequent call as seniors, and call as seniors is usually with interns/2s so they get called quite a bit. Things are always service specific, so some rotations have fewer late night issues/calls, but some may have the chief coming in to operate quite a bit and those tend to be services that have longer more complex cases during the day as well.

The other flip side to the hours is the amount of reading you'll need to do if you want to get good, and getting good is what gives you a good life later.

So yes GS and other surgical fields can be brutal. Some programs are cushier than others, but no program is going to turn a surgical field into a Derm residency lifestyle. You do surgery because you want to be a surgeon. If that's what makes you happy, then go for it. Develop your skills and you'll be able to have a decent QOL.