Poor Suburban Plastic Surgeon

[wioneo]

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[ram006]

If I place no importance whatsoever on my eventual salary, would it be possible to take a significant pay cut to work less hours in plastics?

For context, I am an M3, Step 1 262, AOA, Honors on rotations so far, 2 publications (surgical but not plastics), from a low-tier school without an integrated program.

I'm not at all concerned about hours during residency, but I expect that I and my wife will start having kids in the next few years, and I don't want to be missing all of their football games or whatever when it comes to that. I've shadowed physicians from a few other fields to see if anything else even seemed interesting, and I've been coming up short aside from gen surg in a "rural" area with enough surgeons for a reasonable call schedule.

Does this exist in any way?

Theoretically yes. Good luck finding that gig without paying your dues up front, though.

Plastics is a surgical specialty and although it is less intense as gen surg (in some regards, not all) it's not what anyone would call easy-- during residency or after.

It's unrealistic to assume all the hard work will be done immediately after graduation. It takes years to establish your practice and place yourself in a position to be able to make the decision to ease up for a pay cut.

Being the young guy that isn't interested in hard work won't get you very far. If you're employed, call will be a part of your contract. If you join a group, you'll be the low man. If you go solo, well, you can eventually end up where you want but you're going to hustle for a good while to get there.

Have you considered derm or ophthalmology I have a buddy who just finished derm and is now in PP absolutely loving life. He's not "killing it" at the moment, but he works zero weekends and makes more than enough money to be happy.

 

[wioneo]

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[joker2400]

I talked to a lot of our derm faculty and I just don't think that that work is for me. I am trying my best to like ophthalmology, but the relatively high amount of clinic to OR time and limited area of focus didn't seem appealing during my rotation.

What do you mean by PP concerning derm?

PP= private practice

 

[ram006]

I talked to a lot of our derm faculty and I just don't think that that work is for me. I am trying my best to like ophthalmology, but the relatively high amount of clinic to OR time and limited area of focus didn't seem appealing during my rotation.

What do you mean by PP concerning derm?

What makes you feel that the work isn't for you? Boring?

I would encourage you to keep an open mind and consider the fact that what's important to you now might not be in 10 years.

After seeing just about every surgery performed during med school and residency, I can tell you there's really nothing about any of it that makes me go "man, I would rather do this operation than see my wife and child." Certainly, I get a great amount of personal and job satisfaction from operating even with all the BS that comes with it but it's not the number 1 source of happiness in my life.

I think the surgeries in plastics are cool, there's a good variety and you can tailor your practice to suit your lifestyle. I'm not necessarily in love with DIEP flaps, breast augs or Botox. Open heart surgery is way cooler, I just have no desire to live like a CT surgeon.

So long story short -- low stress, "boring" procedures and clinic days that have (somewhat) predictable beginnings and ends may be something that you do enjoy in the future.

 

[caffeinemia]

There are a good number of "plastic surgeons" who are essentially ambulance chasers, going from ED to ED doing lacs and other small things. You could probably get by that way as a private physician taking call at small hospitals that don't have surgeons on staff. However, as far as career and practice development... that's pretty weak.

Plastics is probably not the way to go if you want to spend time with your kids in residency/first 5 years of attending. The best and most successful surgeons I know hustle like no others. When they're not actually operating, they're in the office seeing 40-60 people a day. Outside of that, they're networking, research, meetings/conferences/master courses. And if they're in any practice that is doing cases of even the most moderate complexity, they're probably taking call at least once or twice every week or two, especially if they are the most junior guy. Of course, my perspective is skewed by living in a big metropolitan area with hugely popular plastic surgery practices, but who knows, maybe you will find that less demanding gig.