Questions about the end of the career for surgeons

[qqw]

Around what age do surgeons retire?


At what age, if any, do surgeons find it harder to "keep up" or do the same tasks do to age?


If a surgeon finds he/she cannot perform the same activities due to age, what other job options do they have?

Thanks.

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[ACSurgeon]

Around what age do surgeons retire?


At what age, if any, do surgeons find it harder to "keep up" or do the same tasks do to age?


If a surgeon finds he/she cannot perform the same activities due to age, what other job options do they have?

Thanks.

1- teaching
2- research
3- critical care (1 yr fellowship)
4- admin

 

[dragonj]

1) 30% drop out of surgery residency and go into a different specialty. So those peeps are around 25-27 y/o.
2) Depends on which subspecialty is "hot" at the moment. Vascular used to be very sought after, but now all those guys have either lost their patient population and decided to retire now d/t the caths and stenting procedures going over to the interventional cardiologists......those guys are around 60 y/o.
3) It really is up to your own personal choice when you want to retire. I've seen some super old dudes still doing surgery. Ortho is never going to go out of style so if you stick to arthroscopic knee procedures or become a hand surgeon (which are less physically demanding) you can do surgery til you die. (Hand surgeon: You get to sit down while you perform.)

 

[Winged Scapula]

“‘I would not mind being operated on by a surgeon of 91.’ —Dr Michael DeBakey at age 91”

There is a great deal of published commentary, as well as anecdote, on this topic. We need to look no further than Lazar Greenfield, MD who has published on this topic. In the UK, physicians employed by the NHS must retired by 65; this is extended to 70 for private practice. Such requirements are in violation of the US Age Discrimination Employment Act. However this leaves the field and the public vulnerable to the surgeon who may be the last to recognize that he or she should retire.

According to the ACS, 63 is the average age of retirement for surgeons. As @lazymed notes, if one desires to still work, it is often in administrative positions, teaching, research, consulting, etc. And as also noted above, some just choose a less physically demanding speciality: the American Society of Breast Surgeons is filled with old male trauma and general surgeons who have decided to do just breast surgery. 😛

 

[dpmd]

There is a surgeon in his 80s in town that just first assists, while at my residency hospital we had 70 something year olds doing neurosurgery and urology, there was a general surgeon in his 80s that used to just do med student teaching until the chair forced him out (I though that was pretty mean since he did a great job teaching and saved the rest of us from having to do it) who had done clinical work into his 70s. That is an entirely different generation of surgeons we are talking about though. I don't think I am the only surgeon who would be horrified to still be working at that age.

 

[qqw]

Thank you all for the feedback!
If I decide to go into General surgery I would be done with residency by age 33, so I'm just trying to gauge how long of a career I could have in comparison with another field like IM. I would absolutely hate having to retire before I'm ready. But you've reassured me.

While I'm here, is it practical to go into general surgery and not subspecialize? I would be content with removing an appendix or gallbladder everyday. Or is it not a smart idea to not go further?

1) 30% drop out of surgery residency and go into a different specialty. So those peeps are around 25-27 y/o.

Why is this? I've heard about the high drop out rate for surgery. Is it the residency hours? Just not what they expected? It worries me to see that number.

 

[Smurfette]

“‘I would not mind being operated on by a surgeon of 91.’ —Dr Michael DeBakey at age 91”

There is a great deal of published commentary, as well as anecdote, on this topic. We need to look no further than Lazar Greenfield, MD who has published on this topic. In the UK, physicians employed by the NHS must retired by 65; this is extended to 70 for private practice. Such requirements are in violation of the US Age Discrimination Employment Act. However this leaves the field and the public vulnerable to the surgeon who may be the last to recognize that he or she should retire.

According to the ACS, 63 is the average age of retirement for surgeons. As @lazymed notes, if one desires to still work, it is often in administrative positions, teaching, research, consulting, etc. And as also noted above, some just choose a less physically demanding speciality: the American Society of Breast Surgeons is filled with old male trauma and general surgeons who have decided to do just breast surgery. 😛

Thread hijack:
The above reminded me of one of my resident counterparts, who had the misfortune of not planning his incision well or thinking about the gender of the patient during the adrenaline surge of a trauma code that prompted emergent thoracotomy. It took a very long time for others to stop referring to his "trauma mastectomy"; once he started his incision, there was....a long way to reach the pleura.
/hijack

I've seen some pretty amazing and talented surgeons in their 70s. I've also seen those who need to retire (given most surgeons operate alone, figure the skills were iffy in the OR long before other surgeons began to notice). Some just love it too much to hang it up and seem destined to "die operating", so to speak.
My residency hospital had a rule in place that surgeons over 70 needed to have younger back up immediately available when operating. I think the designated back up needed to be listed officially on the case/OR schedule. The irony was that one legendary 74+ yo attending was often called in to back up the more junior guys during particularly difficult whipples and upper GI cases. He would scrub in, cackle at what was going on while appreciating the problem, attack it full blast and teach the entire room amazing tips and techniques that only years of experience provide.

I don't think there's an age cutoff for when a surgeon's skills drop; everyone is different and what may start as one surgeon not being able to function after a certain number of hours of work/operating/call, may start as a bad tremor or subtle memory loss in another. Or simply long term effects of stress. The thing is, the OR and office support staff usually recognize this in a surgeon long before their physician colleagues do.

 

[dpmd]

Thank you all for the feedback!
If I decide to go into General surgery I would be done with residency by age 33, so I'm just trying to gauge how long of a career I could have in comparison with another field like IM. I would absolutely hate having to retire before I'm ready. But you've reassured me.

While I'm here, is it practical to go into general surgery and not subspecialize? I would be content with removing an appendix or gallbladder everyday. Or is it not a smart idea to not go further?

I do just general surgery and enjoy my practice. Others may have specific needs or desires that are better suited towards subspecialties. Just depends on what you like. However, I take call in a community setting so I do a lot more than appys and choles. Oddly enough, at night I am considered a competent colorectal, bariatric, surg-onc, whatever specialist.

 

[ThoracicGuy]

Thank you all for the feedback!
If I decide to go into General surgery I would be done with residency by age 33, so I'm just trying to gauge how long of a career I could have in comparison with another field like IM. I would absolutely hate having to retire before I'm ready. But you've reassured me.

So if you did pure IM, you'd be starting at 30. What's three years when you can pick what you really want to do? I think people get too worked up over 2-3 years when they are in med school. Besides, if you did IM and decided to do a fellowship, that could end up taking 6 years total, more than a general surgery residency.

 

[qqw]

So if you did pure IM, you'd be starting at 30. What's three years when you can pick what you really want to do? I think people get too worked up over 2-3 years when they are in med school. Besides, if you did IM and decided to do a fellowship, that could end up taking 6 years total, more than a general surgery residency.

I didn't even think of that. That's a good point.

 

[Winged Scapula]

To answer your question about the attrition rate: its not 30% but rather historically 20%.

Across all years (including research), there is a 19.5% cumulative risk of resignation. Attrition is highest in PGY-1 (5.9%), PGY-2 (4.3%), and research year(s) (3.9%). Women are no more likely to leave programs than men (2.1% vs. 1.9%). Of several program/resident variables examined, postgraduate year-level was the only independent predictor of attrition in multivariate analysis. Residents who left GS whose plans were known most often pursued nonsurgical residencies (62%), particularly anesthesiology (21%) and radiology (11%). Only 13% left for surgical specialties. http://www.ncbi.nlm.nih.gov/pubmed/20739854

For some reason, I found the following amusing: Multiple studies have looked at the predictors of attrition based on residency application data, with no clear answers. The University of Texas Southwestern Medical Center found that academic variables were not associated significantly with attrition, with univariate analysis showing that predictors of attrition include age greater than 29 years at program entry, female sex, courses repeated, “C” grade on the transcript, lack of participation in team sports, and lack of superlative comments in the dean’s letter. The multivariate models showed age greater than 29 years, the dean’s letter, lack of participation in team sports, and merit scholarship in medical school all were significantly associated with attrition. In contrast, a recent study from the University of Tennessee at Knoxville found that USLME Step 1 scores, performance on the interview, and high-performance accomplishments outside of the medical field such as performing arts and college athletics were predictive of the successful completion of surgery residency. There was no correlation with attrition in this study for female sex, medical school grades, and Alpha Omega Alpha Honor Society status. The 80 hour work week did not seem to affect attrition rates. https://www.facs.org/education/reso...n-the-dos-and-donts-of-winning-the-match-game

I think the major reason for attrition is students not really understanding what surgical training is like and being unable to see a future in the field that meets with their needs.

 

[DermatoFIGHT]

“‘I would not mind being operated on by a surgeon of 91.’ —Dr Michael DeBakey at age 91”

There is a great deal of published commentary, as well as anecdote, on this topic. We need to look no further than Lazar Greenfield, MD who has published on this topic. In the UK, physicians employed by the NHS must retired by 65; this is extended to 70 for private practice. Such requirements are in violation of the US Age Discrimination Employment Act. However this leaves the field and the public vulnerable to the surgeon who may be the last to recognize that he or she should retire.

According to the ACS, 63 is the average age of retirement for surgeons. As @lazymed notes, if one desires to still work, it is often in administrative positions, teaching, research, consulting, etc. And as also noted above, some just choose a less physically demanding speciality: the American Society of Breast Surgeons is filled with old male trauma and general surgeons who have decided to do just breast surgery. 😛

James Andrews, 72 year old ortho surgeon HIGHLY sought after by all professional athletes. 👍

 

[SLUser11]

1- teaching
2- research
3- critical care (1 yr fellowship)
4- admin

I've seen a lot of people "retire" into administration, but I've never really seen someone retire into research, and I have a hard time grasping the concept of a 70 year old surgeon beginning a basic science career....still, whatever makes him/her happy.

I wouldn't want a retired surgeon doing critical care, especially given the rate at which the literature and best practices change in that field.

Teaching is a nice approach, although it frequently ends up being teaching a lower-level learner, e.g. first and second year medical students, rather than surgical residents (who don't have a ton of classroom time).

Surgery is a fast-paced career. When I'm too old to operate, I plan to just simply retire, and spend time with grandkids, etc. Granted, since I'm colorectal, I have the option of limiting my practice as I get older to endoscopy and anorectal surgery, which is a common approach.

 

[ACSurgeon]

I've seen a lot of people "retire" into administration, but I've never really seen someone retire into research, and I have a hard time grasping the concept of a 70 year old surgeon beginning a basic science career....still, whatever makes him/her happy.

I wouldn't want a retired surgeon doing critical care, especially given the rate at which the literature and best practices change in that field.

Teaching is a nice approach, although it frequently ends up being teaching a lower-level learner, e.g. first and second year medical students, rather than surgical residents (who don't have a ton of classroom time).

Surgery is a fast-paced career. When I'm too old to operate, I plan to just simply retire, and spend time with grandkids, etc. Granted, since I'm colorectal, I have the option of limiting my practice as I get older to endoscopy and anorectal surgery, which is a common approach.

I mean for those who actively incorporate teaching/research/admin/critical care throughout their career, they can stop operating when they are older and only do one of the above as they can be less physical. I agree, you can't pick up a critical care gig as a 60+ yo general surgeon who hasn't been doing critical care all along.

 

[Winged Scapula]

Another option I can't believe I forgot is that of surgical assisting.

I had a fabulous new assistant today who is a 67 year old retired general surgeon who had a vacation home here for years, but moved out here permanently from Washington DC. His on-line reviews are great and it sounds like he had a thriving practice but he simply wanted to slow down and now can make his own hours and work when he wants. He does only general surgery because, despite the old canard that GS is for those who can't get into Ortho, "those things are boring and don't interest me" (even though he could make more doing A/P exposures and multi level spines).

BTW, I also found it intriguing that I knew within 2 minutes of meeting him (not knowing anything but his name) that he was a surgeon. It was his demeanor, the way he handled instruments, the way he scrubbed. He laughed when I asked him when he left his surgical practice, "so its that obvious is it?" I always enjoy working with MD assists, but this guy (the others are retired OBs and Family Medicine) was something special.

 

[dpmd]

Another option I can't believe I forgot is that of surgical assisting.

I mentioned it above (with an octogenarian that does it here in town). It can be a pretty good deal. I assist for some of the guys here in town and it is amazing how much some of it pays (plus it is pretty good for me as a young surgeon because I get to learn new tricks sometimes, while on the flip side I have had an experienced surgeon "assisting" me on some tough cases where their expertise was what really got me through it).

 

[Winged Scapula]

I mentioned it above (with an octogenarian that does it here in town). It can be a pretty good deal. I assist for some of the guys here in town and it is amazing how much some of it pays (plus it is pretty good for me as a young surgeon because I get to learn new tricks sometimes, while on the flip side I have had an experienced surgeon "assisting" me on some tough cases where their expertise was what really got me through it).

Ah sorry - I was reading this thread on my phone earlier and missed that.

I've assisted a few friends on short notice doing some GS cases; more than just a favor rather than anything but its a good way to keep up with GS practices.

 

[Postictal Raiden]

Thank you all for the feedback!
If I decide to go into General surgery I would be done with residency by age 33, so I'm just trying to gauge how long of a career I could have in comparison with another field like IM. I would absolutely hate having to retire before I'm ready. But you've reassured me.

While I'm here, is it practical to go into general surgery and not subspecialize? I would be content with removing an appendix or gallbladder everyday. Or is it not a smart idea to not go further?



Why is this? I've heard about the high drop out rate for surgery. Is it the residency hours? Just not what they expected? It worries me to see that number.

Isn't this around the average age of GS residency grads? I mean, if you are done with residency by 33, this implies that you were 28 when you graduated med school. The average age for matriculating students at my school is 26, so the average student in my class would be finishing GS residency two years older than you when you are done.

 

[joker2400]

We have a pair of trauma surgeons here that are late 60s to mid-70s by all accounts still going strong, but my understanding is that they have primarily moved out of the OR into critical care and administration/teaching. One of the anatomy professors is a mid-80s "retired" surgeon.

 

[VisionaryTics]

Additionally, in some of the subspecialties (ENT and urology for sure, not sure otherwise), some attendings switch to a non-operative practice. They follow-up on their patients, see medical ENT patients, and refer to other surgeons for any patients that might need an operation.

 

[joker2400]

Additionally, in some of the subspecialties (ENT and urology for sure, not sure otherwise), some attendings switch to a non-operative practice. They follow-up on their patients, see medical ENT patients, and refer to other surgeons for any patients that might need an operation.

Met a few in ortho who have done this

 

[funshi baba]

I intend on getting an executive MBA degree and look into consulting/administration jobs in health care.
I don't plan on being in my 60s and still taking call.