Pregnancy and Vascular Surgery

[Jolie South]

So I am curious... I am advanced maternal age and starting vascular surgery fellowship. When do female vascular surgeons have children? Do you just do it and ask for accomodations from your program regarding trimester? Do you wait for your career to start and then modify your practice to not include anything endovascular during pregnancy? Do you just wear a million leads? Do I never have children?

---

Members don't see this ad.

 

[TypeADissection]

I think you should have a kid whenever you want and as many as you can handle. Your program and yourself can then figure out the logistics of how it all works once you're pregnant. Think about how many concessions we have made to this field in order to get to this point in our lives. My wife (head-neck surgeon) and I just had our first and it's the best thing ever. She describes it as being Q1 call with the pager that goes off every 30 minutes while you're trying to sleep at night but this one you can't even get mad at. But the reality is, medicine will take as much as you give it, and even then, it will never be enough. My father once said that no one will go to their death bed wishing they had done one more aortic operation, or merged another company, or litigated another case in front of the supreme court. If having children is important to you then you should go for it. Only now am I really beginning to realize how difficult it is for women to be surgeons and mothers, but there are many female vascular surgeons and many of them do have children. Cheers.

 

[DrfluffyMD]

I've seen vascular surgery fellow doing PAD cases wearing a lead while visibly pregnant.

Scientifically, if you are under a certain dose limit, there is no deterministic effect and even the childhood cancer risk increase isn't that high.

Emotionally, my colleagues understand that a lead, which may or may not be sized to the fellow even before her pregnancy and certainly have geometric imperfections after being stretched by her gravid belly, isn't perfectly safe. I am prepared to cover for my pregnant colleagues but then I am in an radiology program. I don't think surgical fellows have the options to just not do angio for a year if they have angio rotation scheduled.

 

[doc05]

No Endovascular procedures during a vascular fellowship? Good luck with that

 

[Jolie South]

No Endovascular procedures during a vascular fellowship? Good luck with that

What I meant was changing the schedule to move non-endovascular rotations to pregnancy. Some fellowships have ultrasound months or research months that could be moved to more high risk trimesters.

And maybe I need to go back to medical school but I didn't realize human gestation these days was 2 years long.

 

[armybound]

This is why I hate medicine. It's terrible that women should have to postpone childbearing because their career paths aren't compatible with social norms.

I imagine it's hard to avoid fluoro in vascular surgery Dunno if it's worth it to ask your fellowship director to help you adjust your schedule to allow for chances of pregnancy.'

Plus life as a vascular surgeon is just rough. Kudos to you.

 

[Doctor D]

There is precedence for this in radiation workers as described by the NRC. Pregnant women are allowed to receive up to 500 mrem aka about 50 mrem per month during the pregnancy. This is tracked with a dosimeter badge. Aortic endografts have much higher doses due to body thickness. The dose in PAD is much less. Good luck.

 

[Dr.LeoSpaceman]

This is why I hate medicine. It's terrible that women should have to postpone childbearing because their career paths aren't compatible with social norms.

This isn't unique to medicine. Insert "law", "finance", "consulting" or whatever other high earning potential career and the conflicts between career advancement/development and family are still there.

 

[armybound]

"Social norms"? You mean "biology"?

I don't even remember typing that. That sentence doesn't make any sense to me.

In general, though, this is something that really bothers me. We had a resident get pregnant during her 4th year and staff still talk about it, like it's the worst thing she's ever done to a residency program. I think that's really sad. Pregnancy isn't celebrated like it should be when you're a physician.

This isn't unique to medicine. Insert "law", "finance", "consulting" or whatever other high earning potential career and the conflicts between career advancement/development and family are still there.

I get you, but I'm not in those other fields so I don't really think about it. It just sucks.

I wonder if it's different in other countries.

 

[SouthernSurgeon]

Well, you DO screw:
a.) Your program and its residents. You know the reasons very well. Why the denial?
b.) Your baby, since you'll have to return to a PGY4 schedule pretty soon, basically denying him/her a mother.

Getting pregnant during PGY4 is irresponsible/selfish/stupid. You'll be a crappy mom AND resident. Wait 1 more year, do it during research year or just don't have them.

I know I would talk about that resident as an example not to follow for a long time.

Yeah, sorry, f*** that.

Our little surgery bubble needs to get with the times.

 

[SouthernSurgeon]

Yeah,
or you could,
like,
uhm,
elaborate where exactly you disagree with my post, maybe?

Biology hasn't changed "with the times" as far as I know. If it has, please burst my little surgery bubble and explain me how, in your opinion, "the new times" has made it so getting pregnant during PGY4 doesn't make you a worse resident and mother.

Arguments, no feelings please.
Thanks.

Our current climate is toxic to new mothers and working mothers; it shouldn't have to be and we should develop a reasonable system to accommodate.

That's an "opinion", which is neither a "fact" nor an "emotion"

 

[LucidSplash]

Again, could you elaborate?

I'm simply stating that getting pregnant as a PGY4 is irresponsible/selfish/stupid because it WILL make you an inferior mother/resident, mainly due to time demands of both a new baby and residency.

Do you disagree with this? If you do, why would you? Are you saying they will perform in both areas normally, or as well as someone who did it during research or decided to wait until after residency (or fellowship)?

The cognitive dissonance is strong in this particular matter.

Then you say the "climate is toxic for new mothers". How? No one is forcing you to put yourself in a situation where you'll make things more difficult for you and the people surrounding you. You even go further and propose some kind of ambiguous system that subsidize poor life choices. Why?

Why do people hate personal responsibility so much? It's scary coming from doctors. Let alone surgeons.

Query: Are men "worse fathers" for going back to work after they become fathers? Or is this just women who bear the brunt of your personal judgement (not fact) about what is takes to be a parent? Is it only women who have given birth or does this extend to adoption and surrogacy? Saying a pregnancy is irresponsible/selfish/stupid is certainly not a fact, it is an opinion.

As for inconveniencing those around you, this is program specific. My general surgery program had several female residents give birth and not only were they fantastic moms, but our call schedule worked in such a way that it had minimal impact on the other residents. In a small program where residents are already spread very thin I can see this being an issue. But in general, there wasn't any resentment amongst us when one of the female residents had a baby. Because life goes on when you're a resident, especially when you're a resident for pretty much the entirety of your prime child-bearing years.

It sounds like you're at a program where the residents aren't very supportive of one another and I'm sorry about that. We considered ourselves a family. I took weekend call for a male resident when his wife delivered unexpectedly early so he could be home with his family for that first weekend; I didn't tell him it was irresponsible and selfish of him to knock up his wife when he already had a toddler (because it wasn't, it was just life - see where I'm going with this?). I covered for fellow residents and they covered for me when we had job/fellowship interviews. We covered for people when their spouse/kid had a special doctor appointment/hearing test that they needed to be at. We covered for people who had major family events. I started my call an hour earlier for someone so they could get to their kid's championship baseball game. We all did these things for each other because we knew our fellow residents had our backs when it was our turn. I'm glad I was at a place that fostered this atmosphere and I feel bad for those whose programs had malignant relationships with their fellow residents. That's likely worse than a program full of malignant attendings.

 

[LucidSplash]

So I am curious... I am advanced maternal age and starting vascular surgery fellowship. When do female vascular surgeons have children? Do you just do it and ask for accomodations from your program regarding trimester? Do you wait for your career to start and then modify your practice to not include anything endovascular during pregnancy? Do you just wear a million leads? Do I never have children?

At my program there are two female attendings recently out of fellowship who are preggers. They have the "circumferential" lead, not the front-facing only lead. Personally because fellowship is just 2 years I would try to avoid pregnancy now as it is easier (though certainly not easy at all) to rearrange your schedule once you're an attending. But I would talk with your PD about this. Here, it would basically be impossible to have a kid in my fellowship; it would be easy to arrange things to avoid endovascular cases for the pregnancy but it would essentially mean hamstringing the fellowship by having them down a fellow for a few weeks and also would mean having to extend fellowship. YMMV.

 

[Gastrapathy]

You'll get just as much pressure as a new attending as you did as a fellow to defer. Better to inconvenience the people you won't be working with longterm. You want kids...proceed.

 

[AcademicNeurosurgery]

Well, you DO screw:
a.) Your program and its residents. You know the reasons very well. Why the denial?
b.) Your baby, since you'll have to return to a PGY4 schedule pretty soon, basically denying him/her a mother.

Getting pregnant during PGY4 is irresponsible/selfish/stupid. You'll be a crappy mom AND resident. Wait 1 more year, do it during research year or just don't have them.

I know I would talk about that resident as an example not to follow for a long time.

Yeah,
or you could,
like,
uhm,
elaborate where exactly you disagree with my post, maybe?

Biology hasn't changed "with the times" as far as I know. If it has, please burst my little surgery bubble and explain me how, in your opinion, "the new times" has made it so getting pregnant during PGY4 doesn't make you a worse resident and mother.

Arguments, no feelings please.
Thanks.

This is not something that should need explaining.

 

[DrfluffyMD]

For far too long, the field of surgery only seem to support one version of family, where man bring home bacon and woman is barefoot and pregnant.

What needs to change is the model of surgical training. Under the current system, people with a stay at home wife have an advantage because they don't have to worry about any of that domestic stuff.

I am married to a female surgeon and life is extremely difficult for her. Women are often ask to prove that they are "better surgeons" while not having a secretary/maid/cleaning lady at home to do everyhing for them at home.

That is frankly BS.

 

[Gastrapathy]

Yeah,

Biology hasn't changed "with the times" as far as I know.
Thanks.

This is exactly why you are so wrong. The clock is ticking.

But your overall attitude is why she should do it now. Better to piss off other residents than future partners.

 

[Jolie South]

At my program there are two female attendings recently out of fellowship who are preggers. They have the "circumferential" lead, not the front-facing only lead. Personally because fellowship is just 2 years I would try to avoid pregnancy now as it is easier (though certainly not easy at all) to rearrange your schedule once you're an attending. But I would talk with your PD about this. Here, it would basically be impossible to have a kid in my fellowship; it would be easy to arrange things to avoid endovascular cases for the pregnancy but it would essentially mean hamstringing the fellowship by having them down a fellow for a few weeks and also would mean having to extend fellowship. YMMV.

My fellowship is much more flexible than that. They are able to function without me there. I am there to learn. I never take call and there is always a chief resident to do cases and NPs on the floor. There are months where I have rotations that don't involve the main vascular service. I could probably orient research/ultrasound months as I needed to to avoid endovascular cases. At the same time, I am planning on waiting until at least second year for personal reasons (will probably be better for my husband and I). I do have a two piece circumferential lead already. And I talked to the radiation safety officer who told me that there have been cardiology and other fellows with radiation exposure get through with well below the recommended exposure even doing cases. My institution says I have to be at like 10% of the what the OSHA standards are.

 

[Light at end of tunnel]

For far too long, the field of surgery only seem to support one version of family, where man bring home bacon and woman is barefoot and pregnant.

What needs to change is the model of surgical training. Under the current system, people with a stay at home wife have an advantage because they don't have to worry about any of that domestic stuff.

I am married to a female surgeon and life is extremely difficult for her. Women are often ask to prove that they are "better surgeons" while not having a secretary/maid/cleaning lady at home to do everyhing for them at home.

That is frankly BS.

What do you propose?

 

[DrfluffyMD]

What do you propose?

40 hour weeks. 7 clinical years.

 

[Light at end of tunnel]

Not sure if that was just some top quality trolling, but if not:

Less than half the hours per week and only a 40% increase in years? Do you even math bro?

Fluffy is legit

Such soft words you use! Damn

 

[DrfluffyMD]

Not sure if that was just some top quality trolling, but if not:

Less than half the hours per week and only a 40% increase in years? Do you even math bro?

Do you think surgeons need 80 hours week every week for 5 years to learn how to operate? Most of the 80 hours in the first years are periprocedural medicine, not operating. A lot of those hours can be cut with good support staff. Many of those hours are scut work or added work due to mid levels refuse to take responsiblities.

 

[DrfluffyMD]

Thanks for proving my point. A huge post filled with virtue signalling and false equivalencies.

- "Are men worse fathers for going back to work...". No. Men are biologically different than women. I assume you understand this. The role of mothers vs fathers during the first months of life of a newborn is not a conservative/liberal or "old school"/"new times" issue, regardless of your feelings about it.

Actually, besides the few days of actually giving birth, a man and woman can share the same amount of responsiblity in child care. The biological difference ends there. Women can pump their milk and a guy can be the full time care taker as soon as the baby is out of the birth canal. The issue is that as a society we give **** to women if they don't fit the whole "do it all" mantra or God forbid if they want to spend time with their kids. If a female resident wants to spend time with her kids, it's a "bad resident", and if a guy wants to, he is "being a good father".

And no, I am not a liberal. I did not vote for Hillary.

 

[Light at end of tunnel]

Actually, besides the few days of actually giving birth, a man and woman can share the same amount of responsiblity in child care. The biological difference ends there. Women can pump their milk and a guy can be the full time care taker as soon as the baby is out of the birth canal. The issue is that as a society we give **** to women if they don't fit the whole "do it all" mantra or God forbid if they want to spend time with their kids. If a female resident wants to spend time with her kids, it's a "bad resident", and if a guy wants to, he is "being a good father".

And no, I am not a liberal. I did not vote for Hillary.

I want that for a bumper sticker.

 

[DrfluffyMD]

I want that for a bumper sticker.

I am not with her. Happy now?

 

[Light at end of tunnel]

Holy hell no.

For one, you can't plan for pathology. Pathology doesn't present itself on a 40 hr workweek schedule.

For two, having just gone through seven years (5 clinical) - regardless of hours per week, the years drag on. If I had to do two more years of residency, even at reduced hours, I don't think I mentally would be able to handle pursuing fellowship, etc. No thanks. If anything we should (my personal opinion) be looking into hybrid models for residency/fellowship that knock a year off the existing totals (i.e. Your final year of residency is differentiated and really more like the start of a fellowship).

For three, even if you've expanded the number of years, that is like a 30% reduction in the workforce. It sounds great to say "just make the attendings do it" or "just hire more PAs" - but that is not a reality based solution.

Staff doing more of the scut work (or any work) is really the only way to decompress the current system. But, as you say, that is not a reality based solution because no one goes into academics so they can decompress the residents.

 

[DrfluffyMD]

No, it's not reality based because it's not something the staff can just do. Staff don't, believe it or not, go into academics to abuse residents and sit back in their chairs laughing. They spend their hours chasing down grant money, dealing with their own levels of BS. My attendings all work plenty hard too. There are tons of surgical attendings here who've talked about how difficult their transition into attending-hood was.

I did not at any point allude to a 40 hour week just doing 8 to 5. You can have overnight shifts, transplant procurements, etc while still maintaining a reasonable schedule.

A lot of those scut work can also be filled by mid levels. A bigger problem is the lack of accountability of mid levels.

A mid level rapidly realize that he/she doesn't have to do work on time, as the resident/intern will be faulted for those problems and compared to a mid level, who can find job elsewhere, a trainee has a lot more to lose.

I did not chose surgery when I was younger due to precieved issue with toxicity and its culture, and much of that is validated by what my wife experience.

In my estimation, only 50% or so of her time in the hospital actually contributes to real learning. A lot of that is useless make work or scut. If we elminiate that, we can probably train better surgeons with less hours.

Say what you will about radiologists, but from the moment we hit the hospifal, we hit the list until the end of our shift. Our trainee gets trained in reading the whole time they are here.

I think there is a huge problem with the culture of surgery if women cannot get pregnant during training or practice without pissing people off.

 

[Light at end of tunnel]

I did not at any point allude to a 40 hour week just doing 8 to 5. You can have overnight shifts, transplant procurements, etc while still maintaining a reasonable schedule.

A lot of those scut work can also be filled by mid levels. A bigger problem is the lack of accountability of mid levels.

A mid level rapidly realize that he/she doesn't have to do work on time, as the resident/intern will be faulted for those problems and compared to a mid level, who can find job elsewhere, a trainee has a lot more to lose.

I did not chose surgery when I was younger due to precieved issue with toxicity and its culture, and much of that is validated by what my wife experience.

In my estimation, only 50% or so of her time in the hospital actually contributes to real learning. A lot of that is useless make work or scut. If we elminiate that, we can probably train better surgeons with less hours.

Say what you will about radiologists, but from the moment we hit the hospifal, we hit the list until the end of our shift. Our trainee gets trained in reading the whole time they are here.

I think there is a huge problem with the culture of surgery if women cannot get pregnant during training or practice without pissing people off.

Dr. Bahnson of Ohio State had it figured out: he forced his female residents to take OCP's during residency (no joke).

The status quo is pathethic. But hey, it makes you stronger!

 

[DrfluffyMD]

And we're back to the usual SDN gold standard of non-surgeons telling surgeons how to train surgeons, and ascribing any criticism of their suggestions to malignancy.

Oh, just like how surgeons tell me daily how they think they can read a scan just as well as me or vascular surgeons telling me how angiogram work?

It goes both ways. And you know, if I make a mistake on intepretation and my surgery colleague point them out, I appreciate their insight and accept it, even though they aren't radiologists.

And here you are, arguing that you are beyond criticism because you checked a different box on ERAS compared to me.

Just as you should accept that if a system of training is leading to increased chance for a woman to fail out (backed by literature produced by surgeons), it's got a problem.

 

[Light at end of tunnel]

And we're back to the usual SDN gold standard of non-surgeons telling surgeons how to train surgeons, and ascribing any criticism of their suggestions to malignancy.

Why so short in your willingness to hear the other side?

We're not attacking you or your field...

 

[DrfluffyMD]

Why so short in your willingness to hear the other side?

We're not attacking you or your field...

My wife can have similar issues. Appearently there is a sentiment that since I am not a surgeon, a lot of the issue I raise doesn't apply.

It's true to a degree. I am not going to debate with her how to work with tissues and do dissection, but we both do invasive procedures and manage people perioperatively. We both are in training and an hour violation is an hour violation.

 

[DrfluffyMD]

I heard the other side and presented my counterpoint, the sole response to which was "hire more PAs".

And then there's your usual contributions which amount to nothing but talking out your a**

No. Hire more PAs that actually do perioperative work and alleviate the burden of trainees.

I don't get why trainees are responsible to do ALL surgical documentation and floor work while medicine have teaching and nonteaching teams. For her particular training program (which is well regarded, by the way, and isn't known to be malignant per SDN), there is a lot of work that is noneducational.

I have no problem with the field of surgery. It's a great field and great art. I have problems when training program abuse their trainees. And believe me, this is from a guy who is expected to pull 90-100 hrs weeks during fellowship and have pulled those hours on IR. So it's not just about the hours. It's the amount of BS that made up those hours that plague surgery.

 

[Light at end of tunnel]

I heard the other side and presented my counterpoint, the sole response to which was "hire more PAs".

And then there's your usual contributions which amount to nothing but talking out your a**

Strong work representing your field.

You've restored our faith.

 

[ACSurgeon]

Actually, besides the few days of actually giving birth, a man and woman can share the same amount of responsiblity in child care. The biological difference ends there. Women can pump their milk and a guy can be the full time care taker as soon as the baby is out of the birth canal. The issue is that as a society we give **** to women if they don't fit the whole "do it all" mantra or God forbid if they want to spend time with their kids. If a female resident wants to spend time with her kids, it's a "bad resident", and if a guy wants to, he is "being a good father".

And no, I am not a liberal. I did not vote for Hillary.

Disclaimer: I'm all for getting accommodations and trying to accomplish personal and professional goals.

That said: biology doesn't end there. Post-partum emotions (and worse blues or depression) is certainly biology that father doesn't have to experience.

Also, pumping is a very time consuming chore. Surgical residency seemed impossible to get through at times, I have no idea how the multiple multiple women at my program managed to have kids and pump and still go through residency. Good for them.

Finally: about havig your cake and eating too: this isn't a man vs. woman thing. However, our current generation is very big on anyone being able to do anything and everything. Just search through sdn about people who want to become doctors and even surgeons despite a number of ailments. It is hard to define what can be accomplished despite the limitations of time and health. It becomes a slippery slope when you try to generalize.

 

[bannie22]

I did not at any point allude to a 40 hour week just doing 8 to 5. You can have overnight shifts, transplant procurements, etc while still maintaining a reasonable schedule.

A lot of those scut work can also be filled by mid levels. A bigger problem is the lack of accountability of mid levels.

A mid level rapidly realize that he/she doesn't have to do work on time, as the resident/intern will be faulted for those problems and compared to a mid level, who can find job elsewhere, a trainee has a lot more to lose.

I did not chose surgery when I was younger due to precieved issue with toxicity and its culture, and much of that is validated by what my wife experience.

In my estimation, only 50% or so of her time in the hospital actually contributes to real learning. A lot of that is useless make work or scut. If we elminiate that, we can probably train better surgeons with less hours.

Say what you will about radiologists, but from the moment we hit the hospifal, we hit the list until the end of our shift. Our trainee gets trained in reading the whole time they are here.

I think there is a huge problem with the culture of surgery if women cannot get pregnant during training or practice without pissing people off.

Spectacular. Well said.

So much of the duty hours are dedicated to pure scut.

There are two types of people. Those who are truly ignorant, and those who are hypocrites.

 

[ACSurgeon]

Do you think surgeons need 80 hours week every week for 5 years to learn how to operate? Most of the 80 hours in the first years are periprocedural medicine, not operating. A lot of those hours can be cut with good support staff. Many of those hours are scut work or added work due to mid levels refuse to take responsiblities.

And when do you propose learning peri-operative medicine? Learning to recognize and treat complications? Learning when to operate and when not? Also, it's difficult I set a training paradigm where you show up and just operate. A huge chunk of time is spent out of the OR no matter what you do.

Finally, most surgeons work 50-60 hours per week. It's ridiculous to think you can train residents while having them work less hours then what a normal surgical practice entails.

 

[DrfluffyMD]

Disclaimer: I'm all for getting accommodations and trying to accomplish personal and professional goals.

That said: biology doesn't end there. Post-partum emotions (and worse blues or depression) is certainly biology that father doesn't have to experience.

Also, pumping is a very time consuming chore. Surgical residency seemed impossible to get through at times, I have no idea how the multiple multiple women at my program managed to have kids and pump and still go through residency. Good for them.

Finally: about havig your cake and eating too: this isn't a man vs. woman thing. However, our current generation is very big on anyone being able to do anything and everything. Just search through sdn about people who want to become doctors and even surgeons despite a number of ailments. It is hard to define what can be accomplished despite the limitations of time and health. It becomes a slippery slope when you try to generalize.

Are you a woman? Just curious

 

[ACSurgeon]

Staff doing more of the scut work (or any work) is really the only way to decompress the current system. But, as you say, that is not a reality based solution because no one goes into academics so they can decompress the residents.

And when will residents learn how to do this "scut"?

I think it take 2-3 years for a resident to become proficient at managing surgical patients and being able to manage things while scrubbed in a case. Once you're an attending at a private hospital, it's just you, and you better be ready.

 

[Dr.LeoSpaceman]

In my estimation, only 50% or so of her time in the hospital actually contributes to real learning. A lot of that is useless make work or scut. If we elminiate that, we can probably train better surgeons with less hours.

Please provide examples of the things included in this 50% block that aren't educational to surgeons.

This came up recently in another thread (which I believe you posted in), but surgeons aren't pure mechanics. You know how we get proficient at surgical diagnosis, preoperative workup and periprocedural care? We spend time outside of the operating room learning how to do them. Training in the time increments you suggest may allow us to be good at one or the other...but not both.

So could surgery change to this model? Sure. But then the next generation of surgeons would be back here posting about how they were sure that they were going to be the ones to go above and beyond and round on all their patients the next day. Unfortunately, they won't have ever had the experience of what that actually entails since their PAs/NPs were the ones that handled all that "scut" in training.

 

[bannie22]

And when will residents learn how to do this "scut"?

I think it take 2-3 years for a resident to become proficient at managing surgical patients and being able to manage things while scrubbed in a case. Once you're an attending at a private hospital, it's just you, and you better be ready.

you mean you need practice writing paper scripts 10000 times before you know how to do it? o man. then i hope u get enough training at your program.
or the other 10000 meaningless tasks that u do 10000 times over and over again. well if thats training thats great.

well maybe just maybe if you get lucky you will work at a private hospital where ur nurse can pull drains! fancy that! i wonder if they went through years of perioperative training!?

 

[TypeADissection]

This is getting good. *Grabs popcorn* Keep going...

 

[Light at end of tunnel]

You'll get just as much pressure as a new attending as you did as a fellow to defer. Better to inconvenience the people you won't be working with longterm. You want kids...proceed.

Co-residents often become long term/lifetime friends, not just potentially exploitable associates...I'd rather fall on a grenade than let it roll down hill to the next poor bloke.

I hope most residents don't have this "better them than me" mentality you seem to be advocating.

 

[ThoracicGuy]

you mean you need practice writing paper scripts 10000 times before you know how to do it? o man. then i hope u get enough training at your program.
or the other 10000 meaningless tasks that u do 10000 times over and over again. well if thats training thats great.

well maybe just maybe if you get lucky you will work at a private hospital where ur nurse can pull drains! fancy that! i wonder if they went through years of perioperative training!?

Maybe that's what they do in podiatry training...

 

[Light at end of tunnel]

Maybe that's what they do in podiatry training...

It may be time for some new material.

Just some friendly MD/PhD level advice.

 

[ThoracicGuy]

It may be time for some new material.

Just some friendly MD/PhD level advice.

Maybe I should consult a lawyer about it.

 

[Light at end of tunnel]

Maybe I should consult a lawyer about it.

Always sage advice.

 

[TypeADissection]

Is that shade being thrown around? I think that's shade. *Puts on sunglasses* Continue...

 

[Dr.LeoSpaceman]

you mean you need practice writing paper scripts 10000 times before you know how to do it? o man. then i hope u get enough training at your program.
or the other 10000 meaningless tasks that u do 10000 times over and over again. well if thats training thats great.

well maybe just maybe if you get lucky you will work at a private hospital where ur nurse can pull drains! fancy that! i wonder if they went through years of perioperative training!?

Ok, drains and scripts. I spent roughly an hour a day doing this as an intern, half that as a second year, and on much rarer occasions in 3rd-5th. So assuming an 80 hour week over 5 years, this made up about 2.5% of my training. So where is the other 47.5% coming from?

 

[TraumaLlamaMD]

As a 3, the majority of my day is spent doing cases, with time set aside on certain days for educational conference or our resident clinic. We spend probably 2-2.5 hours daily on morning rounds and afternoon signout. None of these activities can be delegated to a PA or NP because they are at the heart of my surgical education.

 

[DrfluffyMD]

Ok, drains and scripts. I spent roughly an hour a day doing this as an intern, half that as a second year, and on much rarer occasions in 3rd-5th. So assuming an 80 hour week over 5 years, this made up about 2.5% of my training. So where is the other 47.5% coming from?

Walk rounds. How much of that is actual rounding, vs education, vs walking?

Bull**** consults in an environment where one cannot refuse consult.

Duplicated effort due to miscommunication.

And lastly, what about a teaching vs nonteaching service? Not all patients are educational.

I am not a surgical educator, but I do participate in the hospital GME committee as a resident as well as my own radiology and IR GME. IRs work surgeon hours but the amount of BS we deal is far less. Why?

A lot less documentation.

A lot less hierarchy.

Look, again, I have no disrespect or ill wills toward surgeons. I work with them, they work with me. We rely on each other.

However, when some response to difficulties of training, disporportionately so for a woman, are crap like "biological differences" or "post partum emotions", you have a hard time gaining my sympathy.

In 2017, in a board which moderator is a welll known woman in surgery, instead of addressing the well known disparity of training satisfication and sustainability for women, people toss out stuff like that? Emotions!?

Just antedotal stuff, but five of the residents we take from surgery departments in the last 5-6 years were unfortunately, all women. All cite childcare and lifestyle as issue.

Can we make that better or continue to put our heads in the sand?