Is the lifestyle always that bad?

[psycho-matic]

I know it's been said that the lifestyle of a neurosurgeon is horrible and leaves little time for anything else. That might be true for some positions, escpecially those that are academic or at level 1 trauma centers. However, if one does a search on physician job sites, there are jobs listed, some in smaller cities, that say such things as spine clinic or no trauma. I've also seen some 1:4 or 1:5 calls. One position in Montana specifically stated "lifestyle neruosurgeon." So isn't the option out there to have a better lifestyle if you're willing to relocate or live in a more remote area? I was just wondering what your opinions are on that. I have always been interested in neruosrugery.

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[FatPigeon]

I know it's been said that the lifestyle of a neurosurgeon is horrible and leaves little time for anything else. That might be true for some positions, escpecially those that are academic or at level 1 trauma centers. However, if one does a search on physician job sites, there are jobs listed, some in smaller cities, that say such things as spine clinic or no trauma. I've also seen some 1:4 or 1:5 calls. One position in Montana specifically stated "lifestyle neruosurgeon." So isn't the option out there to have a better lifestyle if you're willing to relocate or live in a more remote area? I was just wondering what your opinions are on that. I have always been interested in neruosrugery.

Like most other things in medicine, and life in general, the hours are exaggerated. In reality, you can work however often you want to in private practice...just be prepared to be paid considerably less for it.

The one unavoidable thing is that you'll have 5 hard years during residency (2 of the 7 are research years and are therefore somewhat better). Even during this difficult time, you'll probably have a full day off each week. But for the other 6 days be prepared, quite LITERALLY, to wake up at 3:30am, rush to the hospital, rush home at 8pm and go straight to bed. Rinse and repeat. And look forward to that saturday or sunday you'll likely have off.

 

[beaverfetus]

short answer: the hype on sdn doesn't seem to sync with reality. the life of a surgeon is busy, but neurosurgeons can definitely sculpt practices that have an abundance of elective spine procedures and little else. Their life is give or take, similar to an ortho. Busy but dooable. Neuros at academic centers and in certain smaller coverage areas work their butt off covering trauma. But again, you can find similar set ups in any branch of surgery.

It's hilarious how incensed people on this board get about comparing it to other fields. Just check out the flames which issued forth from a similar thread called "lifestyle of neurosurgeon."

http://www.nepsteinspine.com/

check out her schedule

 

[FatPigeon]

Agreed. I would venture to say that general surgery's hours are actually worse.

 

[psycho-matic]

I realize I may well change my mind and select a different specialty once I get into med school but this does give me some hope that maybe I can have the best of both worlds, private neurosurgery and a good life

 

[mpp]

http://www.nepsteinspine.com/

check out her schedule

I think those are just the hours that her clinic is open and probably do not represent at all the hours that she works. When there is a problem with one of her patients (or the patients she covers when her partners are not available) she needs to be available, 24 hours a day. Even for a private practice elective spine neurosurgeon, just like most doctors of any specialty, they are working more than 40 hours a week. If this neurosurgeon is busy enough to have 3 operating days per week, she gets plenty of complications and off hour phone calls, etc., that also need to be dealt with.

It is true that just doing a simple elective spine practice you will not have the same working hours as the skull base neurosurgeon that is clipping 100+ aneurysms per year, removing tumors that 5 other neurosurgeons have said they won't touch, and taking trauma call one night in three. But when pre-meds say they are "interested in neurosurgery" as the original poster states, they usually don't get that interest from the "exciting" work of the elective spine surgeon. And, unfortunately, to do a lot of the other work a neurosurgeon does, and especially to be competent at it, requires a lot of time. I would venture to guess that if you polled all the neurosurgeons in practice that do only elective spine, 90% or more would say that they weren't planning on doing this when they started on the long road of becoming trained in neurosurgery. Most people get interested in neurosurgery because of the rush of treating these patients with very complicated disease.

If you are interested in neurosurgery for elective spine and want a life, go for it...you can make your life pretty sweet. Just realize that the residency is usually the considered the most grueling (the residency programs are small so there are few residents, there are tons of patients demanding your time, patients can be very sick, and emergencies happen often). If you are interested in the cool cases (like aneuryms, tumors, functional/epilepsy, trauma...and you'll get plenty of that in any residency worth it's salt plus all the spine you could want) realize that you will be committing a lot of your life doing that (both in residency and in practice). Taking care of patients that have entrusted their lives in your competent skills (skills that don't come easy) requires some personal sacrifice.

 

[mpp]

The one unavoidable thing is that you'll have 5 hard years during residency (2 of the 7 are research years and are therefore somewhat better). Even during this difficult time, you'll probably have a full day off each week. But for the other 6 days be prepared, quite LITERALLY, to wake up at 3:30am, rush to the hospital, rush home at 8pm and go straight to bed. Rinse and repeat. And look forward to that saturday or sunday you'll likely have off.

Actually just one year of research is required so most programs just have one (although there are some with two years). Programs vary in length from six years (there are just a few of these) to eight years (I know only of one of these) with seven being the norm. And even in that research year, at some programs, you are still taking overnight call. Most neurosurgery programs have exemptions to work beyond the 80-hour work week to 88 hours. And because the board has felt that the quality of training since implementation of the 80-hour work week has declined, starting this year they have in added an extra year of neurosurgery training by removing the previously required general surgery internship which was previously included in the seven years of training.

 

[beaverfetus]

I think those are just the hours that her clinic is open and probably do not represent at all the hours that she works. When there is a problem with one of her patients (or the patients she covers when her partners are not available) she needs to be available, 24 hours a day. Even for a private practice elective spine neurosurgeon, just like most doctors of any specialty, they are working more than 40 hours a week. If this neurosurgeon is busy enough to have 3 operating days per week, she gets plenty of complications and off hour phone calls, etc., that also need to be dealt with.
.

No absolutely, I accept this. I just posted her schedule to show that in private practice, the NS work load is similar to other surgical sub specialties. it's not uniquely horrible as so many would have you believe.

I also have to guess she's a tad less busy than say a private practice heart surgeon or vascular surgeon who have sicker patients, although one can only speculate about the extent or presence of trauma call.

Me I want the option of having a crazy life where I'm working round the clock to help critically ill people, and I want the option of cruising in a more humane 50~60 hour, elective schedule. It seems like most specialties can offer this if you really look hard at your options.

 

[dphoenix]

Neurosurgery and lifestyle should never be used in the same sentence, at least not with a straight face. You're talking about a field where the minimum OR time is likely 4 hours and the max can run 14+. Compare that to ANY other surgical field, and tell me how you plan to fit these surgeries (+ preop eval, postop eval, clinic, administrative duties) into a 10-12 hr/day schedule.

Neurosurgery is for those personalities that are willing to dedicate their life to the cause. If you aren't ready to do that, be ready to be very unhappy.

 

[mpp]

Me I want the option of having a crazy life where I'm working round the clock to help critically ill people, and I want the option of cruising in a more humane 50~60 hour, elective schedule. It seems like most specialties can offer this if you really look hard at your options.

I think you are right. You can be less busy is many different specialties, including neurosurgery. But what you do when you are less busy is probably not what gets someone interested in the field. Then what is really the point of going into the specialty...just for the title is what I presume is the case for some people.

Don't go into neurosurgery thinking that you can be a great brain surgeon and still work a normal 40 hour workweek (or even 50 or 60). You'll more likely end up as an average spine surgeon (not that there is anything wrong if that if that's what your after).

 

[beaverfetus]

Neurosurgery and lifestyle should never be used in the same sentence, at least not with a straight face. You're talking about a field where the minimum OR time is likely 4 hours and the max can run 14+. Compare that to ANY other surgical field, and tell me how you plan to fit these surgeries (+ preop eval, postop eval, clinic, administrative duties) into a 10-12 hr/day schedule.

Neurosurgery is for those personalities that are willing to dedicate their life to the cause. If you aren't ready to do that, be ready to be very unhappy.

this is the misinformation I'm talking about. It's as reflexive as a gag on these forums. A private neurosurgeon who worked in a rural area and so did a relatively high number of intracranial cases (for a private NS) recently posted an analysis of his caseload over his entire career. His average craniotomy load per year was 26... 50 if you include stereotactic procedures an burrholes. I'm guessing his 4-14 hour surgeries happen about 2-3 times a month... max.

And this for a surgeon who works outside the comfort of access most people have in higher population density areas. His bread and butter lumbar laminectomies/ decompressions do not take close to 4 hours. Probably more like an hour from incision to closure.

my source


http://thejns.org/doi/abs/10.3171/foc.2005.19.4.10

 

[beaverfetus]

But what you do when you are less busy is probably not what gets someone interested in the field.

fair enough. I'll bet boredom / burnout is rampant in the private/ elective world

 

[andexterouss]

this is the misinformation I'm talking about. It's as reflexive as a gag on these forums. A private neurosurgeon who worked in a rural area and so did a relatively high number of intracranial cases (for a private NS) recently posted an analysis of his caseload over his entire career. His average craniotomy load per year was 26... 50 if you include stereotactic procedures an burrholes. I'm guessing his 4-14 hour surgeries happen about 2-3 times a month... max.

And this for a surgeon who works outside the comfort of access most people have in higher population density areas. His bread and butter lumbar laminectomies/ decompressions do not take close to 4 hours. Probably more like an hour from incision to closure.

my source


http://thejns.org/doi/abs/10.3171/foc.2005.19.4.10

I read the doctor's report and it's very telling and somber at the same time:

He only took 3-4 weeks vacation a year. I wonder if he had a family? Doesn't sound like a lot of family time went into his vacation hours. Although he didn't state what his day to day schedule were in terms of hours worked and even how many days a week he worked.

Never took sick day except maybe once or twice his entire career of 26 years.

Retired at a young age of 59 due to malpractice cost and governmental intervention.Will that be the fate future neurosurgeons?

Considered himself very lucky to only have had 6 malpractice lawsuits filed against him.All of which was dismissed. He mentioned the constant threat of lawsuits contributed his frustration and early retirement. Is life for a big city neurosurgeon truculent? I remember hearing about the chairman of neurosurgery at SUNY, Stony Brook quitting and entering radiology residency.That is quite a leap. It's one thing to change specialty during residency and it quite another to jump ship after being the chairman of a department.I guess neurosurgery is a profession to be entered with an unwavering mind.

 

[beaverfetus]

I read the doctor's report and it's very telling and somber at the same time:

He only took 3-4 weeks vacation a year. I wonder if he had a family? Doesn't sound like a lot of family time went into his vacation hours. Although he didn't state what his day to day schedule were in terms of hours worked and even how many days a week he worked.

Never took sick day except maybe once or twice his entire career of 26 years.

Retired at a young age of 59 due to malpractice cost and governmental intervention.Will that be the fate future neurosurgeons?

Considered himself very lucky to only have had 6 malpractice lawsuits filed against him.All of which was dismissed. He mentioned the constant threat of lawsuits contributed his frustration and early retirement. Is life for a big city neurosurgeon truculent? I remember hearing about the chairman of neurosurgery at SUNY, Stony Brook quitting and entering radiology residency.That is quite a leap. It's one thing to change specialty during residency and it quite another to jump ship after being the chairman of a department.I guess neurosurgery is a profession to be entered with an unwavering mind.

nothing you say here isn't true, but all of it can be said for just about all surg specialties and much of medicine. it's just the reality of practice now. My father is in an internal medicine sub specialty and he's had 3 dismissed law suits (4 if you count being named in residency), and takes about 2 weeks a year off max because his overhead is so large. I remember my mother having to basically plead with him to take 2 weeks consecutively as opposed to two shorter vacations.

I'd say the biggest difference between the surgeon who wrote that article, and my father in internal medicine, is that my father doesn't have the financial option to retire at 60 so he took a job as a hospitalist. The life of neurosurgeon is busy, but that can be said for many surgical specialties. It's not 14 hour days, and round the clock head trauma for every practitioner; like this forum would have you believe. Unless of course, that's what you seek out.

I read that article and thought.... damn he had a really cool mix of cases. I think the pride he had in his good work shows through.

 

[zdogg]

http://www.nepsteinspine.com/
check out her schedule

I just wanted to point out that, i think she joined or took over an older practice, i think it was her fathers. If that is the case, then she may of already had a nice referral base to that practice, some patients already, so sticking to specific cases might of been easier. Otherwise, you would have to take on various cases and sorta "work your way up" and get more patients and then maybe narrow down to say spine only. Nevertheless, that is a pretty sweet schedule, but she is far in her career. I could be wrong, just giving my 2 cents.

 

[dphoenix]

this is the misinformation I'm talking about. It's as reflexive as a gag on these forums. A private neurosurgeon who worked in a rural area and so did a relatively high number of intracranial cases (for a private NS) recently posted an analysis of his caseload over his entire career. His average craniotomy load per year was 26... 50 if you include stereotactic procedures an burrholes. I'm guessing his 4-14 hour surgeries happen about 2-3 times a month... max.

Of course there are always persons in any field which have better hours, particularly if you only do elective procedures such as spine (why one would train for so long such to be essentially an orthopod is beyond me, but i digress). But from my experience in the hospital with neurosurgeons, it's pretty incredible the amount of time/effort/sacrifice one gives to become a neurosurgeon. And its justified, because these guys are working with some of the sickest and most complicated patients.

My point here was not to say "it is NOT possible to work <60 hrs" in neurosurgery. Obviously it is if you are in the right situation. My point is that if one is truly interested in lifestyle, neurosurgery then should be crossed off the list, this is the reality of it.

 

[Surgeonizer]

The lifestyle of a neurosurgeon isn't necessarily bad.

The chiefs who graduated from my program last year have great jobs. One of them, for instance, joined a private practice in Seattle. His schedule:

2-3 days of OR per week (arrive at the hospital by 7:30 AM, leave around 4 PM)
2-2 1/2 days of clinic per week (arrive at clinic by 9 AM, leave at 3:30 PM)all All weekends off
Benign call schedule (after 5 months of call, he's only been called into the hospital once)
2 months of paid vacation

Sounds pretty sweet to me, especially in light of the fact that he's making a ton of money.

Just my $0.02.

 

[Bigpwn]

The key to having decent life style during NS residency is to match into a program that isn't a level one trauma center. A buddy of mine is doing NS at Hopkins, U of Maryland takes all the trauma, so his life style is really good. My program is a level 1 trauma center. The NS residents are always getting called.

Private world is all up to you I guess.

 

[Kogaion]

I do not want to make a new thread about NS lifestyle so I'll post here.

What do you think of NS training martial arts? I don't want to ask wether NS has got time to train or not but IF he can train.

Can you tell me what happens when a surgeon has his finger spraind?

I'm thinking of taking NS residency but I do not want to stop my training in martial arts. Can I reconcile those two things?

Thanks in advance for your reply.

 

[mpp]

Should be no problem. Surgeons tend to be risk takers by their very nature and do all sorts of things (motorcycle racing, hang-gliding, base jumping, etc.).

 

[GH253]

I'm just a pre-med so I may be unqualified to have an opinion, but I would think that neurosurgery demands a workaholic personality... someone who doesn't consider 100 hour weeks sacrificial because all he wants to do is work

 

[neurochirrurgie]

"neurosurgery demands a workaholic personality... someone who doesn't consider 100 hour weeks sacrificial because all he wants to do is work"
but the time spent totally worth it.... yesterday i just got back from my *suppose to be* 24 hours shift but instead became 38-39 hours shift, still felt curious and wondered about the operations that we just performed..i haven't even realized how exhausted i was until i got home and lying on my bed....
to me there aren't enough words to describe...
but, hey, maybe its just me...i think not everyone could understand, its about passion in life, things that you like to do the most....
that's how you stop counting the hours you spent..

 

[dmniarb]

just out of curiosity, how many of you are currently doing your residency in neurosurgery? how far along are you? what has been your personal experience, both with your schedule and with the lifestyle you witness of your attendings?

 

[Kiroro]

I know it's been said that the lifestyle of a neurosurgeon is horrible and leaves little time for anything else. That might be true for some positions, escpecially those that are academic or at level 1 trauma centers. However, if one does a search on physician job sites, there are jobs listed, some in smaller cities, that say such things as spine clinic or no trauma. I've also seen some 1:4 or 1:5 calls. One position in Montana specifically stated "lifestyle neruosurgeon." So isn't the option out there to have a better lifestyle if you're willing to relocate or live in a more remote area? I was just wondering what your opinions are on that. I have always been interested in neruosrugery.

If lifestyle is a big concern to you, I would recommend you to look into other surgical speciality as well. Plastic, ENT, Urology, Vascualr etc... many of them are equally exciting but more time friendly. I know an MS4 end up changing to other specialty after SubI in neurosurg, which I thought was a waste of valuable SubI month that you could've spent on another surgical speciality where you could have lifestyle and also be happy with performing surgery. Try and get exposed with more fields

 

[beaverfetus]

Vascualr

really? doing cea's on fat diabetics and cold limb surgery seems a hell of a lot more hectic than 3 days a week of elective spine...


and yes, I'm being facetious, community neurosurgeons work hard, but I'm guessing it would be a toss up with a vascular guy.