Is there Nothing Bad about being a General Surgery resident?!?!

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Leukocyte

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It seems that the GS residents who contribute to this forum always give a "rosy" picture of General Surgery residency.

Is there nothing bad about being a General Surgery resident?

Are there no "unhappy" General Surgery residents?

Please "unhappy" residents, We want to hear from you!!!!

PLEASE. Your contributions are very helpful.

Thank You.
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First of all, every residency has it's unhappy qualities, and every specialty has residents who are unhappy for one reason or another.

I've known of many GS residents who have been unhappy and quit to do other things. Usually they just found it was not "their thing" and that they didn't enjoy it enough to continue with it...not that surgery was "bad" but that it just didn't fulfill their interests like they had thought it would. The hours are long, it's physically demanding and stressful...but all specialties are in their own ways. The better question to ask rather than if any GS residents are unhappy is what are the bad things about surgery that are not program-specific....sometimes the people you work with or the environment is what is making residents unhappy, not the work itself.
 
Smurfette said:
The better question to ask rather than if any GS residents are unhappy is what are the bad things about surgery that are not program-specific....sometimes the people you work with or the environment is what is making residents unhappy, not the work itself.
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Well that is what I am asking - What are the "bad" things about being a GS resident in general. There are no right or wrong answers here. Just simply what are the things that YOU PERSONALLY hate about being a GS resident. What makes you Angry? What makes you sad? What makes you depressed? What makes you want to vomit?....Anything!

Smurfette said:
The hours are long, it's physically demanding and stressful..
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This is what I thought also, BUT then you have people here posting "80 hour q3 schedules" that negates the above statement. They make GS residency seem like "Disney Land"!

I am confused.

I just want to hear "the real deal" from GS categorical residents.....

....so that we lowly new grads and med students can make informed decisions. Yes I have rotated at 4 programs, but I do not know what is going on at other places.

Thanks for posting, Smurfette!
 
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Pilot Doc said:
Search for posts by apma77
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If I am not mistaken, APMA77 is an Anesthsia resident now, after switching from GS early in his/her career.

That is nice and dandy,....but AMPA77 seems to hate GS as a career.

It would be nice to hear from current GS residents who "love" Surgery as a career, but "hate" certain aspects of being a GS resident....

We all know that you love Surgery, but there must be things that make you "tick", sad, angry, depressed as a GS resident.....

What are those things (if you do not mind sharing it with us)? You never know, other GS residents might share your sentiments.

Thanks Pilot Doc!
 
Surgery residency is difficult and it probably always will be, often for good reasons.

The one thing I think people make the mistake of glossing over when considering surgery is how much of a sacrifice it really is. You'll hear it again and again, but let me stress how important it is to consider whether you would have entered surgery if the 80 hour "rule" didn't exist. It is not strictly enforced everywhere, and even more pertinent is that it does *not* exist once residency is over.

Don't fool yourself into thinking that it is all shift work that is signed out promptly after being up all night. While I don't beleive in people getting the crap beat out of them for the fun of it, surgery residency tends to be self-selecting towards those who inherently have a very strong work ethic. Showing up to work and either not working your hardest or leaving & dumping work on others is a easy way to become notorious in a program. How would you feel if you made plans for a nice outing weeks in advance only to have it fall through by an emergent case that comes in at the last minute? Or never making it home for Thanksgiving, Christmas, birthdays, etc? Would you horribly resent your work or do you feel that the above stated is worth the sacrifice?

No doubt that there are times where I would have rather been going out having a good time or been curled up in bed. On the other hand, as I have gained responsiblity as residency has moved on, I am almost constantly working on something either at the hospital or at home related to a case when I am awake. This is because I really do like knowing about my patients, knowing how to take care of them, making sure things get done, etc. It has become clear that I obviously like it enough to put it in front of my friends, romance, my family, holidays, outside hobbies, heck, even my pets. I think the 80-hour rule unfortunately overshadows to those considering surgery what a huge sacrifice it really is to make. However, to me it is undoubtedly worth it.
 
Bad things about being a GS resident (some of which are the flip side of good things). Many of these are most notable in comparison to other procedural specialties. I have made no efforts to balance this list with the many good things about Surgery.

1) HIV/HEP C needlesticks
2) Unprofessional behavior by your superiors. (Overblown in the stereotypes, but based in truth.)
3) Heirarchy that, at best gives little autonomy to residents and at worst leaves them subject to the capricious and sometimes questionable patient care whims of their superiors
4) Old, sick patients whose serious disease processes require urgent/emergent intervention leading to long, unpredictable schedules. (i.e. missing out on other important aspects of your life)
5) A decade long, steadily worsening reimbursement/malpractice/regulatory climate that marginalizes residents. (In my observation, this burden has fallen more heavily on GS than other surg subspecialties.)
6) Trauma - an unpleasant, risky patient population whose care is increasingly non-operative and/or babysitting of other specialties injuries.
7) Decreasing viability of general surgery as a practice, leaving many people feeling compelled to complete a fellowship and lengthen their training.
8) Declining reimbursement/status compared to other specialties
9) Anecdotally high rates of burnout/disability long term
10) Long cases leading to varicose veins, kidney stones, back aches, etc.


That's all that comes to mind right now.
 
leukocyte, are you sitting on the fence and trying to get people to convince you not to go into surgery?
 
Dire Straits said:
leukocyte, are you sitting on the fence and trying to get people to convince you not to go into surgery?
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Acctually, the opposite. As you might already know, I am interested in Surgery. It is good (in fact, important) to know everything I need to know about the path that I am going to take....both the "good" and the "bad".

The "good" things are pretty obvious (since we all love surgery), and have been discussed many times. It is important to know about the "bad" things since they are the ones that are most likely to take us by surprise and leave us dissapionted and regretful. To avoid this, It is good to know that they are expected so that we can be prepared for them, if and when we face them as we go through our path.

This is more important in the case of us who do not want to be General (adult) Surgeons. If I go into "surgery", It is only to become a Pediatric Surgeon, or a Pediatric CT surgeon. So, as you can see, going through 5-7 years of General Surgery (before doing what I really want to do) can be pretty painful. So it is important to know all the "bad" things that make General Surgery residency painful before hand, so that I can better survive this "transit" path (before reaching my final destination).

Thanks Pilot and Cleopatra for your great inputs. :)
 
I know someone has told you this before, but Peds Sx (and I'd imagine Peds CT Sx) is very competitive...if you wouldn't be happy doing general surgery upon not being able to get a peds sx fellowship, it might not be worth the risk. There are other surgical specialties that let you work with kids much earlier without a fellowship. Have you looked into these and just don't like them?
 
JudoKing01 said:
I Have you looked into these and just don't like them?
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Well, I am looking into OB/GYN as well - I can take care of kids "in utero" ;)

No, I am not really interested in Bones, Eyes, URT/EAR, Male genitalia, Spinal Cord/Intra-cranial tumors,....

What I am interested in are:

-Surgery
-Kids
-Cardiac disease and anomalies.

I know. Peds Sx/CT Sx is a HUGE commitment/risk. That is why I am still debating/undecided/confused, and posting all these "annoying" threads. ;)....Sorry Guys. :oops:
 
hey leukocyte, i know i've asked this before but have you had a chance to read "walk on water"? it really is a great book that explains what pediatric heart surgeons go through.
 
Dire Straits said:
hey leukocyte, i know i've asked this before but have you had a chance to read "walk on water"? it really is a great book that explains what pediatric heart surgeons go through.
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Man, I have to go to B & N tommorow and get me a copy.

Thanks for the reccomendation Dire Straits! :)
 
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Ah, a fellow surgeon-to-be interested in CT (albeit peds CT)...gotta give you props! :)
 
Let me know how you like it leuk. I loved the book.

And I've been thinking about OB/GYN too. Basically I want a specialty where I can provide a primary care type service as well as do surgery, and OB/GYN seems to be the ticket. Plus I love the pathology and everything. Blah I have even less of an idea as what I want to do than you do, of course I also have a lot more time to decide.
 
Dire Straits said:
hey leukocyte, i know i've asked this before but have you had a chance to read "walk on water"? it really is a great book that explains what pediatric heart surgeons go through.
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that book is great~ another good book for future surgeons is 'complications'...i forget the author, but it is an awesome read!
 
I matched this year to a GS program. One of the things that made me go with surgery - after taking almost a year to decide - was the fact that during my rotations in surgery.....with the 18 hour days and the LONG cases....I NEVER, not once wished I was at home. It consumed me to the point that the hours flew by. Even when I was exhausted...sure I would think about my daughter and husband and wonder what they were doing and think about how nice it would be to be in bed....but it wasn't like I sat in the OR lounge during down time and cried that I couldn't be home. I had a blast and hours passed without even a thought of things that existed outside the hospital.

I know the "new" will wear off as I become a resident, and things that I find fun and fascinating will begin to annoy me. But, my experiences so far have shown me that this specialty has a sincere grasp on me.

Also, when deciding to go with surgery....and continuing rotations...I played a game where I tried to talk myself INto every other specialty. I'm a mom..of course surgery wasn't what I WANTED to want to do. So, each month, I would dive into the rotation and think about what it would be like to be an FP, rads, or anesthesiologist....and each month - for some reason or another - I would eliminate that specialty. Seriously, surgery was the only thing left!

Be careful about talking to too many people and asking for advice from too many people. After a while, others feel free to be straight-up rude and negative to you. One of my classmates actually said to me "I thought you loved your kid...obviously not if you're going into surgery." Once you begin asking for advice and insight, others will feel compelled to give it - even when you've had enough and your decision is made. Select a few people you trust to give you the good and the bad. Talk to residents and tell them your fears and see if they felt the same and how they handled it. Talk to your friends or the people around you every day...see if you were "different" during your surgery rotations than the other rotations. My husband is the one that eventually brought me back around to surgery after he saw how miserable I was on other rotations. He said even though I wasn't home much, I was much more pleasant and excited about everything during those surgery months. I seriously thought I needed an antidepressent during the primary care months!

You've seen the threads on here where people geared towards primary care can't imagine why some of us choose surgery at all....when you post on here, you may get those negative comments from them as well. Try PMing some of the other female residents on here and asking specific questions - that way, you can avoid comments that may not be helpful. Best of luck - it's a tough decision to make. I thought it was tougher than deciding to get married!
 
Thanks Double Elle for the great advice! :)

Good Luck!
 
Complications is written by Dr. Atul Gawande. A very good read.


Also, probably already know about it, but Gifted Hands by Dr. Ben Carson is a great book too.
 
A nurse I know worked with Dr. Gawande for a while. She said he's a really nice guy and a pretty good surgeon. Great book too.
 
Bads:

1. Lack of control of your life
2. Attendings who decide to round at the last minute and make you wait for 2 hours while they "finish up something" until they call you and say "nevermind" :mad:
3. Waking up EVERYDAY and 4:30 or 5:00 AM :sleep:
4. Not seeing your kids off to school or being able to pick them up from school :(
5. Total unpredicatbility of your schedule at times (i.e. lack of control again)
6. Risk of being sued by worthless trauma patients who are hopped up on meth while you're giving them the best medical care you can possibly give
7. Lack of moonlighting (the F.P. and Anesthesia guys double their salary often)
8. You get to operate everyday. Oh wait, that's the part that keeps me going!
9. Lack of control of your day/life/5-7 years

All that and I still can't think of another specialty I would do. Maybe radiology.
 
neilc said:
that book is great~ another good book for future surgeons is 'complications'...i forget the author, but it is an awesome read!
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The book is Complications: A Surgeon's Notes on an Imperfect Science, by Atul Gawande. I just finished it, and it is a great read.
 
Another great book is "When the air hits your brain." It's about the experiences of a neurosurgoen but I think everyone who enjoys surgery will enjoy this book. I'm not sure who the author is, but it's one of my favorite books (and I have many surgery books, as many as I can get my hand on!)
 
Leukocyte,
would peds cards be fulfilling enough. Do some procedures. All heart and peds. Competitive specialty (for peds) but you could "plan" on getting a fellowship...
 
DrDre' said:
Leukocyte,
would peds cards be fulfilling enough. Do some procedures. All heart and peds. Competitive specialty (for peds) but you could "plan" on getting a fellowship...
Click to expand...


I am thinking about it, BUT......

....I am just not a "medicine" person. I am more of a "do-er" than a "think-er". I just want to quickly diagnose the problem and then go in and fix it. I HATE long and detailed H & Ps and Loooong rounds. "Medicine" people love beating aroung the bush, even though they might know the diagnosis and treatment of the problem at hand. This sort of thing annoys me very much.

Having said that....Pediatric Cardiologists (so I have been told) do not perform as many interventional procedures as the Adult Cardiologists do. So most of my work will be doing consults and reading echos, with occasional interventional procedures here and there. Most of the Interventional procedures are DIAGNOSTIC rather than therapeutic.

Also....what if I do not get accepted into a Cards program? I will be stuck with General Pediatrics... :scared: I love kids, but dude, I hate " the medical specialties" and above all, I hate Primary care.
 
if you have the grades, you should consider ENT. you'll see tons of kids in general ent, and can also subspecialize in very intricate pediatric cases.

Leukocyte said:
I am thinking about it, BUT......

....I am just not a "medicine" person. I am more of a "do-er" than a "think-er". I just want to quickly diagnose the problem and then go in and fix it. I HATE long and detailed H & Ps and Loooong rounds. "Medicine" people love beating aroung the bush, even though they might know the diagnosis and treatment of the problem at hand. This sort of thing annoys me very much.

Having said that....Pediatric Cardiologists (so I have been told) do not perform as many interventional procedures as the Adult Cardiologists do. So most of my work will be doing consults and reading echos, with occasional interventional procedures here and there. Most of the Interventional procedures are DIAGNOSTIC rather than therapeutic.

Also....what if I do not get accepted into a Cards program? I will be stuck with General Pediatrics... :scared: I love kids, but dude, I hate " the medical specialties" and above all, I hate Primary care.
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My GS residency was great. However there were some really bad parts.

As a R2 and R3 I was on call q2-3 and literally worked 120-130 hours per week. I once had 9 call days in 20 days and no days off for 4 weeks. My chief as an R2 was complete bastard. He made several good medical students cry. He would go home, eat dinner and then come back for evening rounds which would last 2-2.5 hours.

Let's see, what else...50% of married residents in my program got divorced before they finished.

I think I could go on and on and on, but I think that all of the pain, hardship and sleepless nights made me a stronger, more competent and knowledgable surgeon. On the bright side...I am negotiating a contract that will pay me 9 times what I made as an intern. I love my job, so I can't complain.
 
doc05 said:
if you have the grades, you should consider ENT. you'll see tons of kids in general ent, and can also subspecialize in very intricate pediatric cases.
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That's what I said, but he said he doesn't like noses.
 
Ok...its all been said, but I'll add my "ditto" here:

- lack of control over your life. Most of the time I can handle it, but the time I was post-call, it was my birthday, my BF had something special planned, and I was still in the hospital at 830 pm, I started to get pretty upset...bordering on weepy.

- assumption by other residents and allied health professionals that you're an arrogant *^%& or ^&%$*

- doing things just because you were told "that's the way I've always done it", ie, the capricious nature of some attendings and senior residents

- the hours. I'm old school so I've been around pre-80 hr/24+6 regulations. I still think the hours are too long for most rotations -- maybe I'm just getting too old.

- the assumption by the general public that a) you're a nurse (for females) and/or b) you must hate children or if you have children, neglect them

- having to do cases you have little interest in or with attendings who teach by humilation

- having to listen to the attending's choice of music in the OR :laugh:

- having those gung-ho "CTS" or "Trauma" types deride those of us choosing more lifestyle friendly fellowships, as being dilettantes or less than a "real" sugeon
 
Kimberli Cox said:
- having those gung-ho "CTS" or "Trauma" types deride those of us choosing more lifestyle friendly fellowships, as being dilettantes or less than a "real" sugeon
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hey kim you can have the last laugh when those ct guys are unemployed after spending 3 more years in a ct fellowship. by the way didn't u say your bf was a trauma surgeon?
 
Kimberli Cox said:
having those gung-ho "CTS" or "Trauma" types deride those of us choosing more lifestyle friendly fellowships, as being dilettantes or less than a "real" sugeon
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Are Breast Surgeons "real surgeons"? :smuggrin:
 
you're not a real surgeon unless you still work more than 80 hours per week after you finish residency and have been through at least one divorce with another one pending.
 
Leukocyte said:
Are Breast Surgeons "real surgeons"? :smuggrin:
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I like to think so...but to some, including my Trauma/Crit Care fellow BF (only 4 more weeks!), they aren't. Unless you take in house call, deal with life and death situations and work more than 100 hrs per week, I guess you aren't a "real surgeon" in some realms. :rolleyes:
 
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