Life of a CT Surgeon

[ILoveMyDawg]

Hey everyone, kind of what the title says. I'm a third year (soon to be fourth year) USMD student trying to decide what to do with my life lol. I am currently married and my wife is pregnant with our first child. I am down to work hard (and in fact, I like working) but only up to a point i.e. I refuse to sacrifice family life. Hobbies and the golf course can go if that's what it takes but I need to be available for my wife and children.

I did CT surgery during my surgery rotation and both loved and hated it. I absolutely loved the surgeries, the anatomy and physiology, the fact that these cases were big and open, and that we were dealing with life and death. What I hated is that my attendings at our big academic medical school practically lived at the hospital. I left the first 4 weeks on the rotation sad because I loved the specialty but couldn't see myself with that lifestyle. The second month of the rotation was in a community hospital with a general surgeon doing bread and butter Gen Surg. He was on vacation for a week so he put me with his buddy, a CT surgeon at the hospital. His life was a complete 180 from the academic guys I was with prior. He left everyday at 3pm-4pm after doing his 1-2 surgeries. He told me he is on call 1/4 days but does not get called in to the hospital more than a few times per year (granted, when he does he said it's bad i.e. dissection). His life seem to be fantastic and exactly what I was describing in the first paragraph.

Really my question is, are there more jobs like this out there? Or is this community guy a complete anomaly? I know this topic has been discussed elsewhere on here but figured I would ask again. Thank you in advance!

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[SociableJimmy]

Community bread and butter practice can certainly be a bit more lifestyle friendly (relatively speaking, it’s still CT surgery), especially if you’re only doing one pump case per day. That said, there are certainly plenty of busy community practices out there where the surgeons are operating just as much as at big academic centers. Big academic positions generally have the added burden (as I see it, at least) of other non-clinical & research responsibilities that really pack your schedule when your OR days may have 2-4 pump cases spread across multiple rooms. They also tend to be referral centers for major aortic & HF/MCS disasters, which are never conveniently timed.

That said, I’d still think very hard about where your priorities lie and what your family is willing to put up with before committing to the field. Regardless of where you end up, training and attending practice will absolutely have an impact on your family life and availability. I’m currently at a pretty benign family-friendly program and am married with a toddler, and to say managing family life & childcare has been difficult would be the understatement of the century. Your spouse is going to have to be ok with essentially being a single parent while you’re in training and early in your attending practice. Living near family can help alleviate some of this pressure but with the match being as competitive as it has been recently that’s far from a guarantee for most people.

 

[ILoveMyDawg]

Community bread and butter practice can certainly be a bit more lifestyle friendly (relatively speaking, it’s still CT surgery), especially if you’re only doing one pump case per day. That said, there are certainly plenty of busy community practices out there where the surgeons are operating just as much as at big academic centers. Big academic positions generally have the added burden (as I see it, at least) of other non-clinical & research responsibilities that really pack your schedule when your OR days may have 2-4 pump cases spread across multiple rooms. They also tend to be referral centers for major aortic & HF/MCS disasters, which are never conveniently timed.

That said, I’d still think very hard about where your priorities lie and what your family is willing to put up with before committing to the field. Regardless of where you end up, training and attending practice will absolutely have an impact on your family life and availability. I’m currently at a pretty benign family-friendly program and am married with a toddler, and to say managing family life & childcare has been difficult would be the understatement of the century. Your spouse is going to have to be ok with essentially being a single parent while you’re in training and early in your attending practice. Living near family can help alleviate some of this pressure but with the match being as competitive as it has been recently that’s far from a guarantee for most people.

Hey, thanks so much for the reply. I kind of figured that would be the answer. I really appreciate your honesty. If I may ask, are you in Gen Surg or CT residency?

 

[SociableJimmy]

Hey, thanks so much for the reply. I kind of figured that would be the answer. I really appreciate your honesty. If I may ask, are you in Gen Surg or CT residency?

I’m a traditional CT fellow

 

[ILoveMyDawg]

I’m a traditional CT fellow

Got it, thank you. I know it is difficult to know, but if you had to guess, what is life going to look like as an attending for you? I guess what are you anticipating hours wise based on what you see and what you are looking for in a job?

 

[SociableJimmy]

Got it, thank you. I know it is difficult to know, but if you had to guess, what is life going to look like as an attending for you? I guess what are you anticipating hours wise based on what you see and what you are looking for in a job?

Tough to say, as practice volume and service line coverage is going to vary pretty widely from place to place. Probably a better question for more senior surgeons that frequent this board. Make no mistake though, you'll still be working surgeon hours and sharing weekend call with your partners. I'd imagine as a new attending days will be longer since you're not as fast/efficient in the OR and will probably be sticking around the hospital a little longer to be entirely sure your post-ops are doing ok. If the hours worked are going to be a major concern for you though, I'd again encourage some reflection before jumping on board, as it will be a lot.

 

[ILoveMyDawg]

Tough to say, as practice volume and service line coverage is going to vary pretty widely from place to place. Probably a better question for more senior surgeons that frequent this board. Make no mistake though, you'll still be working surgeon hours and sharing weekend call with your partners. I'd imagine as a new attending days will be longer since you're not as fast/efficient in the OR and will probably be sticking around the hospital a little longer to be entirely sure your post-ops are doing ok. If the hours worked are going to be a major concern for you though, I'd again encourage some reflection before jumping on board, as it will be a lot.

Yeah totally fair, I know it’s a difficult question and a big hypothetical. Definitely agree, I’m not doing anything without serious reflection first. Another question I have is what other specialities within general surgery allow one to have a more manageable life? I guess bariatrics, breast, MIS and plastics are the obvious ones. Is trauma/ACS lifestyle any good from what you saw in residency? Again thank you so much for answering all my questions.

 

[SociableJimmy]

In addition to what you mentioned, general thoracic can be reasonable if you're not at a major referral center. There are several posts here by practicing general thoracic surgeons talking about their schedules. Still have to do CT training though. Colorectal also has the potential to be a little more lifestyle friendly if your practice manages to keep you out of the general surgery call pool. Trauma/ACS is fun, but also pretty rough at larger trauma centers. Lots of call, overnight emergencies, etc, mixed with ICU weeks. There is a trend toward shift models at many places but I would still not call it a lifestyle specialty. Can be a bit better if you’re at a level 2 or 3 center doing mostly EGS and elective general surgery with limited/no trauma or ICU coverage.