Lifestyle & Future of Colon & Rectal Surgery?

[nyap]

I was curious if any attendings/residents have any insight on the field and it's future. For those fellowship trained in CR surgery is the job market secure? Do you feel that colonoscopy is here to stay for a while will it be replaced by other imaging modalities? Where do you see the field in he next 10-20 years? Also, I heard that with many people fellowship training after a GS residency that there is a shortage of general surgeons and b/c of this some colorectal surgeons pick up a bunch of general surgery cases (i.e. lap choles, hernia repair). Just curious if this is common or necessary to secure a job in most areas?

...On another note I was just curious about lifestyle of a Colo-rectal surgeon? Hours? Call frequency or required gen surg coverage? weekends?
Thanks!

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[JackADeli]

...Do you feel that colonoscopy is here to stay for a while will it be replaced by other imaging modalities?...

All your other questions, I will leave to more knowledgeable folks and such... but I suspect it will be a "it depends" type answer...

As for scoping, it is here to stay for now. Yes, imaging has an increasing role. However, you still need biopsies and such. Also, NOTES is a growing field, where it goes I don't know. Long and short of it, I think scopes will continue as a means of screening, surveillance, tissue diagnosis, and treatments. How much of each? Well, it depends.

 

[SLUser11]

I was curious if any attendings/residents have any insight on the field and it's future. For those fellowship trained in CR surgery is the job market secure? Do you feel that colonoscopy is here to stay for a while will it be replaced by other imaging modalities? Where do you see the field in he next 10-20 years? Also, I heard that with many people fellowship training after a GS residency that there is a shortage of general surgeons and b/c of this some colorectal surgeons pick up a bunch of general surgery cases (i.e. lap choles, hernia repair). Just curious if this is common or necessary to secure a job in most areas?

...On another note I was just curious about lifestyle of a Colo-rectal surgeon? Hours? Call frequency or required gen surg coverage? weekends?
Thanks!

I'm not going to give a long winded response, but colonoscopy is very much alive and well, and will continue to be important until we somehow invent a therapeutic CT colonography.

Sure, you can diagnose polyps (with less sensitivity and accuracy) with CT colonography, but you can't do anything about it.

In the next 10-20 years, the field of CR surgery will continue to evolve just like everything else. There will be NOTES and robots, and still plenty of poo.


As for lifestyle, it is surgeon-dependent. Many surgeons want a colorectal-only practice, and don't take general surgery call. This leads to a much better lifestyle.

 

[opr8n]

CRS still fight a constant battle with GI over scopes
the GI guys dont like it when the CRS take scopes away, especially if they are doing alot of them. If fact one group went as far as to say that they would send ALL the colon cancer their way if they stopped scopping

i have found that many GS atlast in my town dont do hemorrhoids, so it becomes the speciality of the CRS to do all of them
Uless the GI guys get ahold of those patients and TRY to do a hack job with banding and lasers and such

 

[45408]

SLUser - do CR fellows get more practice with scopes in fellowship? Would you feel comfortable doing endoscopy on your own now?

Where I am, the graduates who go into private practice usually do a fair bit of scoping because there aren't many GI docs in smaller towns.

 

[SLUser11]

SLUser - do CR fellows get more practice with scopes in fellowship? Would you feel comfortable doing endoscopy on your own now?

Where I am, the graduates who go into private practice usually do a fair bit of scoping because there aren't many GI docs in smaller towns.

I am relatively comfortable with endoscopy, but our numbers in Wichita are more that 2 standard deviations above the mean. Much to my benefit, surgeons in Wichita get a fair % of the referrals for screening colonoscopies. I personally have well over 300 scopes.

As for comfort doing them alone, I do them alone on our unassigned/chief service, where I frequently TA the junior residents through colonoscopies/EGDs/PEGs, etc.

Some programs are better than others, but most colorectal fellowships have a significant amount of endoscopy, anywhere from 150 (low end) to 500+ colonoscopies in a 1-year fellowship.

 

[45408]

300?? holy chit. That's a lot of rectums.

 

[nyap]

Thanks for the comments thus far. Any thoughts on whether or not colon and rectal is likely to become over saturated with people in the specialty anytime soon? I realize that the answer to this is probably very location dependent.

A general surgeon I'm working with says that at the hospital he covers there are 3 general surgeons & in addition apparently 6 CR surgeons have privileges at the hospital. Not sure how frequently they operate there, do procedures or consults there, or if they operate at other hospitals as well, but it makes me wonder, is there enough work to go around for someone considering entering the specialty a few years from now?

Any thoughts?