Neurosurgery vs. Family life

[CutIt]

I know my title insinuates the two are incompatible; that is at least what you tend to hear about neurosurgery. I am a medical student who is considering a neurosugery residency, as I am greatly interested by the nervous system, its anatomy, and knowledge of that vastly relatively unexplored organ inside the cranium. However despite my interest in the field, the actual rigors of neurosurgery seem to be legendary from what you "hear"; although I have not heard this from the horse's mouth. Can anyone comment how demanding NS is on one's personal/family life compared to other surgical specialties? Furthermore since there is apparently a decline in new NS residents, is there anything being done to recruit med students and improve the quality of life? Thanks

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[apma77]

Ofcourse as you know, neurosurg is a very busy residency known to work its residents 120-140 hrs a week at certain places. now with new work hr rules things will change but no one knows how cause the amount of work wont change.
At most places the attendings in neurosurg are very much against the 80 hr work rule so this will result in them being hostile to the residents even tho its not the residents fault.

As far as fam life is concerened, you wil definitely sacrifice that big time. Be prepared to make your life your #2 priority if u choose gen surg or neurosurg.

thats just the preactical truth

goodluck!

 

[lipoyl]

I came accross several programs on the trail this year (Columbia, Hopkins, Brigham, Florida) that had some kind of work hour rule in place already. By contrast, other programs have been very reluctant to change the work hours, and still others cannot comply with the work hour rules because they have fewer residents. The bottom line is nobody knows how the 80-hr rule will affect neurosurgery. My personal feeling is that it will take several high-profile programs going on probation before the smaller ones comply. Oh, and I would NEVER mention your concern over work hours during your interviews.

 

[oldandtired]

If you even say lifestyle in the same sentence as neurosurgery then I can definetely tell you that you will be extremely unhappy in NS.

Also as a medical student it is easy to idealize a field thinking it is all about studying the beautiful nervous system, exploring the unknown, etc After you do a month you will realize that clinical neurosurgery is tedious and fairly mindless for the average trained practitioner. The lifestyle will suck!!

 

[DocnHoc]

Good thread; are there any neurosurgeons/NS residents on the board who want to add their opinion (...or are they all "too busy" )? If so, I'd like to add a question to CutIt's thread: do programs that have multiple NS positions per year have an easier workload than those with only one NS position per year, due to the extra residents?

 

[lipoyl]

No...the RRC approves the number of residents that programs can take based on the program's volume, so theoretically the workload should be equal. It is nice to have a co-resident to commiserate with though.

Several programs did petition for extra residents this year on account of the 80-hour rules...I guess it remains to be seen if that'll make the workload better (I matched at one such program, so I am definately hoping it does🙂

 

[unregistered]

Interesting thread. I originally was a gung-ho, NS-bound med student and this summer, I'll be starting a residency in.... otolarygology. Why the change of heart? While I think NS is an awesome field and two of my best friends are NS residents, I really believe that you ABSOLUTELY, without a doubt, MUST LOVE NS to go into it and be satisfied with your decision. NS residents, as I'm sure most would agree, work harder than any other residents by far. I can tell you a story from the OR on my NS rotation.... The intermediate resident had a couple photos of his wife and kids posted in the OR and I said, "It's nice that you can see pictures of your family in here while you operate." His reply, "Yeah... it's the only time I get to see them."

Best of luck with your decision.

 

[JasonDO]

Originally posted by unregistered
Interesting thread. I originally was a gung-ho, NS-bound med student and this summer, I'll be starting a residency in.... otolarygology. Why the change of heart? While I think NS is an awesome field and two of my best friends are NS residents, I really believe that you ABSOLUTELY, without a doubt, MUST LOVE NS to go into it and be satisfied with your decision. NS residents, as I'm sure most would agree, work harder than any other residents by far. I can tell you a story from the OR on my NS rotation.... The intermediate resident had a couple photos of his wife and kids posted in the OR and I said, "It's nice that you can see pictures of your family in here while you operate." His reply, "Yeah... it's the only time I get to see them."

Best of luck with your decision.

I guess you'll have to title this reply as one of the "sad but true" realities of being a neurosurgeon...I believe that one of the reasons that neurosurgeons are so well respected amongst their peers and colleagues is the personal sacrifice they must endure for their patients' well being...tough job...but well reserved for those with a true calling and love for the field

 

[DarkChild]

it just struck me today, that as a neurosurgery resident you'll have to live in your 30s for 6-7 years on a salary of ~$40K thats a really really tough ask. maybe i've got expensive tastes, but short of a sugar mama, i couldnt imagine trying to support a family with that 😕

 

[lipoyl]

Not that cash is the determining factor, but it's not uncommon for neurosurgeons in private practice to make upwards of 450K without fellowship. If you want to make that kind of ballpark in any other subspecialty it'd probably require a comparable amount of time in training (ie GI=3years medicine+3-4years fellowship research/chief residency). Most surgical fellowships work out longer because of the research time that is tacked on.

 

[Airborne]

Of course there is always radiology...

A similar salary, 10+ weeks of vacation and much, much less call time...

Hmmm....

Airborne

 

[Aaargh]

Originally posted by oldandtired
Also as a medical student it is easy to idealize a field thinking it is all about studying the beautiful nervous system, exploring the unknown, etc After you do a month you will realize that clinical neurosurgery is tedious and fairly mindless for the average trained practitioner. The lifestyle will suck!!

Anybody have more thoughts on the above?

Also, to what extent are hours a resident issue vs. manageable post-residency?

 

[samsoccer7]

Everyone talks about how much NS RESIDENCY will suck so hard... but what about when you're done?

I should be done with my residency by 32. I'm willing to be a bizznatch for 5 yrs (remember, 1.5-2 yrs of neuro is research, so easy hours) if I can have control over my destiny when I'm done.

This is the real question I think people want to know, that is, what is the lifestyle like AFTER residency? I don't have a family yet, but I'll be a family man, but that means my family until 32 will have to deal if it pays off (literally and figuratively) in the end.

 

[Been there]

Not so fast my friends,

NS residents are the most overwork bunch in the hospital period. That is why it is well known as Neuro-Slavery. Yes, there are the 80hr/wk work rule. And yes, the attendings hated it. They don't hate it enough to do the works themselves.

In order to be with in line with ACGME and RRC, many have hired PAs for help in clinic, daily notes, and discharge summary. The problem is PAs usually don't take calls. Most residency have switched the majority of the neurosurgery residents to "home call" (what a joke?). However, they still need at least one resident to be in house to take care of inpatients, consults, and trauma (esp for level I trauma centers). That is where the research resident comes into play. They are usually call the ghost. They are not there in the day times, but on every fourth night, they become slaves again. They become slaves again when some one is out on vacation. They can become slaves again when there is an unexpected leaves of absence. Yes, the research years "were" nice, but no so anymore.


I am not saying NS is not worth it, that is something for you to decide. I just stating the facts.

 

[bustbones26]

Okay, right now in the state of PA, the malpractice premiums are so high, there are two docs you will hardly find, OB/GYN's and neurosurgeons.

What that means is, the neurosurgeons that stayed in PA, and decided to pay out the astronomical malpractice, are a rare breed. So of course, they are overworked, because they may be one of the few neurosurgeons on staff at a particular hospital. And if that hospital has a trauma service, then they most certainly are overworked!!

Anybody have any thoughts about, what if we could control malpractice? Do you think people might go into more highi risk fields such as NS or OB/GYN if we could keep the malpractice premiums down?

Remember, medicine works in waves! Right now, nobody wants to be an NS because they do not want to be overworked and pay out enourmous malpractice fees. Yet, maybe 5-10 years from now, perhaps there will be laws controlling malpractice, and the word will get out that there is a neurosurg shortage and people may run to the field.

Its just my thoughts that medicine works this way. Some fields are "black-balled" and then years later those fields are hot. Remember, 5-10 years ago nobody wnated to be a radiologist because everybody's attitude was, I don't want to sit in a dark room and read films all day. Try to get a rad residency today!

 

[Carbon Klein]

Geez, how many of these Neurosurgery and Family Life threads are there? We should just merge all of these threads into one long thread with one conclusion:

Neurosurgery=100 hr/week commitment. If you can fit a family life with the left over time, then there's your answer!

 

[Airborne]

I think that one should look at the international fields in this case?

In Australia, they are facing a similar crisis ? many OB/GYN?s and NS?s are leaving the clinical realm because the indemnity is too much to support a viable clinical practice (due to rising malpractice issues)? Indeed this has caused a tumult in their national health care system?. I have heard from many colleagues that one can easily walk right into an NS residency (i.e., their equivalent) because no one wants to do this kind of work ? too high stress, too little remuneration and too much impact on ones personal life.

Although I can appreciate this is one system and not that of the US ? One must consider that this may be what the bell may toll for our own high indemnity specialties, especially in light of the rising indemnity costs in certain states?.

What ever the future may foretell for either of these?. It can be sure that current students must be, and indeed are aware, of these uncertainties and truly choose these specialties for an innate desire to help and contribute to them (or conversely an insight into the problems that each of these face!)?

I can say that although I will not be entering either, I am looking forward to my interactions with each.

With kind regards,

Airborne

 

[dr barb]

My mentor and her husband are both neurosurgeons at a top institutions and are both directors of their respective programs. They have two little kids, and they seem very happy and not terribly overworked. Don't get me wrong, they both work a lot of hours, but they still have time for a life.

Whatever field of medicine you decide to go into, there will be a million reasons not to go into it...paperwork, malpractice insurance, hours, etc. But the most important factor - the deciding factor - should be whether you really enjoy what you are doing? You should spend as much time as possible with neurosurgeons and see what they really do and how they really do spend their time. If you take the time to really get a sense of the field and you feel like this is what you want to do, then you should go for it. All the other stuff will, hopefully, fall into place.

And just something to think about: Whenever I express my interest in neurosurgery to non-neurosurgeons, I'm always told how hard it is and horrible it will be. Whenever I express the same interest to practicing neurosurgeons (and thankfully, now I've been able to spend a decent amount of time with quite a few of them, so it's not so it's not all coming from the same one) I'm incredibly encouraged. My advice, and no offense to any of you who offered advice, don't take the advice of people who aren't doing it themselves, and that's including myself. You need to get it straight from the source, and if they're too busy to come to you (via this thread) then you need to seek them out and your school.

That said. Good luck to you in whatever you wind up doing!

 

[Airborne]

Completely agree with Dr Barb's assessment that one should not take the advice of people of this forum -

Indeed, it is best to talk to practicing Neurosurgeons to see how they perceive their family lives -

Or better yet - how do their children perceive their parents time away?

Oh yes - Methinks that is the way to go -

Although a practioner MAY think that they have plenty of time for their kids - do the children and nanny think the same thing? Who is really raising the kids? Whose ideals of right and wrong are instilled? Who is there at 2am when some SDH arrises from a motorcycle accident. What about Friday night football for the teenagers - who is on call for the local hospital?

Who would admit their professional life interferes with their children's?

But then again, maybe they have heeps of time, and lots of money in LA (and NOT Louisiana?).

Airborne

PS - Good luck to you in whatever you wind up doing!

 

[Pravda]

Here's a joke I heard, of course, there are many versions I'm sure you've heard before...

1. How do you hide a $100 bill from an orthopod?
Put it in the chart.

2. How do you hide a $100 bill from a plastic surgeon?
You can't.

3. How do you hide a $100 bill from a neurosurgeon?
Give it to his kids.

But I agree with what some of the others have posted. Most of what people say on these forums is hearsay and speculation, but then again, most rumours are grounded in some truth. I know of a neurosurgeon who fanagled his schedule so that he made it to every one of his kid's baseball games. Residency is going to suck no matter what (unless of course you D.O.R.A.P.E. yourself with success, read: derm, optho, rads, anesth, path, and ER). But afterwards, you can control the craziness by maybe taking less patients, working for a large group, doing just research, or not bothering to work at all. You should really talk to neurosurgeons about this, because they will give you the best advice.

 

[ent_doc]

Originally posted by dr barb


And just something to think about: Whenever I express my interest in neurosurgery to non-neurosurgeons, I'm always told how hard it is and horrible it will be. Whenever I express the same interest to practicing neurosurgeons (and thankfully, now I've been able to spend a decent amount of time with quite a few of them, so it's not so it's not all coming from the same one) I'm incredibly encouraged. My advice, and no offense to any of you who offered advice, don't take the advice of people who aren't doing it themselves, and that's including myself. You need to get it straight from the source, and if they're too busy to come to you (via this thread) then you need to seek them out and your school.

That said. Good luck to you in whatever you wind up doing!

Residents and faculty (several) in neurosurgery at my medical school counseled me to avoid neurosurgery. These are people that I highly respect.

Your advice is sound