Lifestyle-friendly Surgery Residency?

[IheartCaffeine]

Is there any General Surgery or Ortho residency in the country where a resident can work fewer than 60 hours/week from PGY1 all the way through PGY5?

I'm doing my surgery rotation right now. It's super cool. Doing procedures for a living would be amazing. I just don't know if I could handle 80+ hrs/week for 5 years.

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[maxheadroom]

No. And you won't be able to work just 60 hours per week when you get out into practice either, especially in Ortho. It sounds like Emergency Medicine might be a better fit for you.

 

[dynx]

Is there any General Surgery or Ortho residency in the country where a resident can work fewer than 60 hours/week from PGY1 all the way through PGY5?

I'm doing my surgery rotation right now. It's super cool. Doing procedures for a living would be amazing. I just don't know if I could handle 80+ hrs/week for 5 years.

you must be kidding, right? Surgery is super cool and doing it for a living is amazing...unless you suck. Then it's miserable for you and everyone around you. You might be able to pull it off if you worked 55 hours from PGY1 to PGY12 but unless you're incredibly gifted (you're not) you would probably still suck.

Do something where your general lazy attitude and subsequent crap outcomes won't add to my workload or the workload of other people that love surgery enough that they would rather spend the majority of thier time treating patients than watching TV.

 

[Blade28]

Is there any General Surgery or Ortho residency in the country where a resident can work fewer than 60 hours/week from PGY1 all the way through PGY5?

I'm doing my surgery rotation right now. It's super cool. Doing procedures for a living would be amazing. I just don't know if I could handle 80+ hrs/week for 5 years.

No. Pretty much all of the surgical fields require AT LEAST the standard 80-hr workweek for at least the first 2+ years. In fact, in general, you'll find that most residencies have at least a busy, 80-hr workweek internship.

If a 60-hr workweek is important to you, you might want to consider other fields.

 

[I am Hans]

If being a surgeon is important to you, you can and will survive 80+ hrs for residency and beyond. Plenty of people before you have survived much much longer hours than that.

However, as others have noted, it is unrealistic to expect to find a residency, unless you find a part-time one (which is rare in surgery and of course, would take you twice as long, or at least 10 years, to finish), in ANY specialty where you would work 60 hrs per week. Even residencies which tend to be shorter on in-hospital hours (ie, Derm, Ophtho, Rad Onc) spend many many hours at home studying, and in effect, work much more than 60 hrs per week as well.

Be aware that working less than 60 hrs per week as a junior attending is pretty unusual as well. Only you can decide whether or not you can "survive" a surgical residency and whether or not its worth it to you to be a surgeon. But please decide before you become a resident - as others have noted, being "the guy" who always complains about work hours, the call schedule, when he's going home, etc. will not endear you to your colleagues and will likely result in a far bit of animosity. Surgeons have a peculiar work ethic and don't take kindly to others who don't share it.

 

[rainbowman]

How do you know if you're good at surgery? I mean baseball you can just go pick up a bat and toss a ball around and see if you have a talent at that, same with writing and acting, but you can't just start slicing people open to see if you like it and you're good at it.

Is surgery more about having good hands or practice and good thinkin skills?

 

[SocialistMD]

you must be kidding, right? Surgery is super cool and doing it for a living is amazing...unless you suck. Then it's miserable for you and everyone around you. You might be able to pull it off if you worked 55 hours from PGY1 to PGY12 but unless you're incredibly gifted (you're not) you would probably still suck.

Do something where your general lazy attitude and subsequent crap outcomes won't add to my workload or the workload of other people that love surgery enough that they would rather spend the majority of thier time treating patients than watching TV.

Wow. Bitter much?

To the OP, I don't think you will find a surgery residency in the US that works less than 80-hours a week.

 

[Blade28]

Even residencies which tend to be shorter on in-hospital hours (ie, Derm, Ophtho, Rad Onc) spend many many hours at home studying, and in effect, work much more than 60 hrs per week as well.

We're supposed to read from time to time as well.

 

[Blade28]

How do you know if you're good at surgery? I mean baseball you can just go pick up a bat and toss a ball around and see if you have a talent at that, same with writing and acting, but you can't just start slicing people open to see if you like it and you're good at it.

Is surgery more about having good hands or practice and good thinkin skills?

Early on, assuming you don't have ridiculously shaky hands or terrible hand-eye coordination, more important traits include a strong work ethic, eagerness to learn, and a (relatively) thick skin. Technical skills are developed during residency - you'll find that very few people are "naturally gifted" surgeons right out of the gate. Clinical judgment and decision-making also comes with experience.

There's much more to surgery than just having steady hands.

 

[I am Hans]

We're supposed to read from time to time as well.

'sposed to and have time to are two different things!

Anyway, yeah I know general surgery residents have to study too, just wanted to point out that even the traditionally more lifestyle friendly residencies involve a lot of out of hospital work (which people don't think about).

 

[VAspa]

Is there any General Surgery or Ortho residency in the country where a resident can work fewer than 60 hours/week from PGY1 all the way through PGY5?

I'm doing my surgery rotation right now. It's super cool. Doing procedures for a living would be amazing. I just don't know if I could handle 80+ hrs/week for 5 years.

There is nothing more that bolis my blood than when my interns come to me and say, "I'm at 78 hours, and might go over my 80." I typically tell them to go home and come back to the hospital when they feel like taking care of patients.

I would strongly suggest you consider a different path if you can't go through the motions as a medical student for 80 hours a week. Go into surgery for the love of patients that you can help from a surgery...you can do procedures in derm as well. I'd advise you not advertise during your residency interviews that you don't know if you can't handle 80 hours/week while a season surgeon is interviewing you.

 

[Pilot Doc]

Agree with above in that there is absolutely no way in the world you will stay under 60 hours/week for an entire surgery residency. It would be very unusual for that to happen for a single month out of five years. Also agree that there will be very few residencies in any field with less than 60 hrs/week work. Maybe occupational medicine or something like that.

As for the, you can never work under 60 hrs/week as an attending .... that's not true. Attendings can work however many hours they want if they are willing to make the necessary tradeoffs. Most people with the drive/desire to finish a surgical residency don't find those tradeoffs worthwhile, but you can certainly work well under 60hrs/wk as an attending if you so choose.

 

[boston]

You're the chief? Your interns have every right to expect you to work with them on their hours. I have yet to not lie on my hours so as to keep my program in nominal compliance. But the first time I express worries about my hours, and I am met with a dismissive "come back when you feel like taking care of patients", you better believe I'm going to start reporting them down to the minute.

We're just interns, but we're not stupid: we know that when we leave work behind, it falls to you. Perhaps the "I'm at 78hrs" is a passive-aggressive middle finger at you?

We are all in this together. Surgery residency is tough, no two ways about it. As a senior, I try to look out for my juniors, try to make them look good in front of attendings, try to chip in and help out with scut when I can, try to send them home early when it's not busy and I'm on call anyway. I will do discharge summaries, fill out scripts, discharge papers, wheel the patient to CT, fill out the reqs, update the list, etc -- I don't feel above that. I do it because I remember compassionate chief residents who did the same for me when I was an intern. Even when I said I could do it and handle it, they would help me out if they saw that I was getting killed. In return for loyalty to my juniors though, I ask for some loyalty in return... like if the s*** hits the fan, let's all chip in and do what needs to be done to take care of the patient. That is all I ask, to divide up the pain amongst all so that it is bearable for each of us individually.

My long-winded point is... I know where VAspa is coming from. Don't be passive aggressive. If there is a problem, let me know about it and I will do my best to sort it out. I don't want juniors to lie about work hours because ultimately we all lose if we play that game (...accrediation, that is). But I do find the work ethic and attitude behind it admirable.

 

[Blade28]

I don't feel above that. I do it because I remember compassionate chief residents who did the same for me when I was an intern. Even when I said I could do it and handle it, they would help me out if they saw that I was getting killed. In return for loyalty to my juniors though, I ask for some loyalty in return... like if the s*** hits the fan, let's all chip in and do what needs to be done to take care of the patient. That is all I ask, to divide up the pain amongst all so that it is bearable for each of us individually.

That's an outstanding attitude.

 

[Sweet Tea]

We are all in this together. Surgery residency is tough, no two ways about it. As a senior, I try to look out for my juniors, try to make them look good in front of attendings, try to chip in and help out with scut when I can, try to send them home early when it's not busy and I'm on call anyway. I will do discharge summaries, fill out scripts, discharge papers, wheel the patient to CT, fill out the reqs, update the list, etc -- I don't feel above that. I do it because I remember compassionate chief residents who did the same for me when I was an intern. Even when I said I could do it and handle it, they would help me out if they saw that I was getting killed. In return for loyalty to my juniors though, I ask for some loyalty in return... like if the s*** hits the fan, let's all chip in and do what needs to be done to take care of the patient. That is all I ask, to divide up the pain amongst all so that it is bearable for each of us individually.

My long-winded point is... I know where VAspa is coming from. Don't be passive aggressive. If there is a problem, let me know about it and I will do my best to sort it out. I don't want juniors to lie about work hours because ultimately we all lose if we play that game (...accrediation, that is). But I do find the work ethic and attitude behind it admirable.

You sound like my senior and chief. And that's a good thing.

 

[SocialistMD]

I always find it funny when crappy chiefs (and I'm not trying to say VAspa is one, just describing what I've seen so far at my institution) who hang their interns out to dry with the attendings, are constantly in a bad mood, insult anyone who wants to sleep once in a while, and won't help out when times get bad, then turn around and wonder why their interns won't lie about their hours.

What is lost on VAspa's post is what is lost often on this internet forum; the use of tongue-in-cheek. I've known VAspa since he was an intern and I was an MS-3. He would help his medical students get their work done so the work was done, kidding them along the way (with comments like the one he made above), but sincerely helping them. He was also the intern who would take his medical students out for drinks after the day was over. I spent several nights at the Velvet Melvin with him, only to have him say, "Hey, buddy, I have a salary and you don't; I've got the tab." I can't imagine he has changed so much in the last three years that he would actually mean what he said in the first paragraph of his post.

Secondly, it is easy to understand from where he is coming. He is one of three categorical interns from his class of six who are now chiefs. Translation; he was a co-resident with some people who got into surgery because of the 80-hour workweek and had to pick up their slack. That is a very frustrating thing as anyone who has had to deal with it can attest.

If you are just doing surgery because the duty hours now allow it to fit into your goal of a lifestyle and you think "it's super cool" to do procedures, there are other careers in medicine (even surgical subspecialties) that are not nearly as painful (both physically and emotionally), that allow you to do many procedures and that have a better lifestyle, both during residency and beyond. If you are already asking if there are places that work less than 20 hours/week than the cap (where every program in the country hovers), the writing is already on the wall that you won't be happy as a surgical resident and that you should look more to something else so as to save yourself and (even moreso) the other interns with whom you match a lot of pain.

 

[boston]

I kill myself for my chiefs because they back me up. My only point was that, were they derisive and insulting, I would not. Kudos to you for backing up your guys; no doubt they (at least the good ones) back you as well.

I always find it funny when crappy chiefs (and I'm not trying to say VAspa is one, just describing what I've seen so far at my institution) who hang their interns out to dry with the attendings, are constantly in a bad mood, insult anyone who wants to sleep once in a while, and won't help out when times get bad, then turn around and wonder why their interns won't lie about their hours.

Got it... I feel your pain -- it does seem like the ones who are clinically bad are also insecure and try to compensate with bullying.

Secondly, it is easy to understand from where he is coming. He is one of three categorical interns from his class of six who are now chiefs. Translation; he was a co-resident with some people who got into surgery because of the 80-hour workweek and had to pick up their slack. That is a very frustrating thing as anyone who has had to deal with it can attest.

If you are just doing surgery because the duty hours now allow it to fit into your goal of a lifestyle and you think "it's super cool" to do procedures, there are other careers in medicine (even surgical subspecialties) that are not nearly as painful (both physically and emotionally), that allow you to do many procedures and that have a better lifestyle, both during residency and beyond. If you are already asking if there are places that work less than 20 hours/week than the cap (where every program in the country hovers), the writing is already on the wall that you won't be happy as a surgical resident and that you should look more to something else so as to save yourself and (even moreso) the other interns with whom you match a lot of pain.

well said Socialist.