Surgeon with lifestyle

[BloodySurgeon]

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I'm sure this has been said a million times, but I like the OR but I just don't have the stereotypical surgeon personality. I like being at the hospital and working but I would rather come home to a wife and kids and not miss my kids dance recital or sport game.

I understand I am guaranteed to be working hard as any doctor and there will be a tendency for missing these life events, but I was wondering after residency how bad does it really get? Will I be working 80-hr weeks when I am 40+y/o?

I don't have the stats for plastics (maybe try and gun for derm/Mohs surgery?), but I think it would be reasonable to apply for the other specialties. I don't like ortho or optho (i don't mind ob/gyn but i still think it's a little weird to have male gynecologist), so what are my options for a specialty that has a reasonable lifestyle and has surgery. (e.g. 60hr/week). I don't care about the salary, the hours are a bigger issue for me.

Are the only options for me now are Urology, Otolaryngology, and General? What are their lifestyles like? All the surgeons I followed, however, were really intense and ended up working close to 80-hr weeks and they were in their 50's. I just don't want to be like any of these people.

I also know nothing about Colon and Rectal Surgery or Vascular Surgery.

Lifestyle Surgery (from most hours to least)- Please correct me if I am wrong:

Neurosurgery > Cardiothoracic > Trauma = Vascular > Orthopedic > Colon and Rectal Surgery > General > Ortolaryngology > Opthomology > OB/Gyn > Plastics > Mohs Surgery

 

[KinasePro]

I'm sure this has been said a million times, but I like the OR but I just don't have the stereotypical surgeon personality. I like being at the hospital and working but I would rather come home to a wife and kids and not miss my kids dance recital or sport game.

Does it make me a bad father-to-be that I will seek any possible excuse to skip out on these things? I'd much rather hang out with the ankle biters at home or just as a family at the park/beach/etc. I can't stand recitals and boring little league games, but I digress...

Neurosurgery > Cardiothoracic > Trauma = Vascular > Orthopedic > Colon and Rectal Surgery > General > Ortolaryngology > Opthomology > OB/Gyn > Plastics > Mohs Surgery

Unfortunately, no one is going to give you a good answer here. I personally have seen urologists who work 120 hrs/wk and neurosurgeons who work 30 hrs/wk, and everything in between. It all depends on your priorities, practice setup, desired income, call burden, etc... Take a peak at my signature to see a more objective analysis of the topic at hand.

The conventional wisdom I've received is that to be a surgeon, you need to be comfortable working 80+hrs/wk when needed, but it's not necessary to make a habit of keeping those hours. Some fields that have extremely sick patients may have a harder time working out a lighter schedule (neurosurg, gen surg), but its still possible. Just don't go into any surgical field expecting a derm-type lifestyle, or you'll be sorely disappointed. Even the more lifestyle friendly surgical fields like ENT & urology have to put in long hours from time to time.

 

[Kal EI]

I'm sure this has been said a million times, but I like the OR but I just don't have the stereotypical surgeon personality. I like being at the hospital and working but I would rather come home to a wife and kids and not miss my kids dance recital or sport game.

I understand I am guaranteed to be working hard as any doctor and there will be a tendency for missing these life events, but I was wondering after residency how bad does it really get? Will I be working 80-hr weeks when I am 40+y/o?

I don't have the stats for plastics (maybe try and gun for derm/Mohs surgery?), but I think it would be reasonable to apply for the other specialties. I don't like ortho or optho (i don't mind ob/gyn but i still think it's a little weird to have male gynecologist), so what are my options for a specialty that has a reasonable lifestyle and has surgery. (e.g. 60hr/week). I don't care about the salary, the hours are a bigger issue for me.

Are the only options for me now are Urology, Otolaryngology, and General? What are their lifestyles like? All the surgeons I followed, however, were really intense and ended up working close to 80-hr weeks and they were in their 50's. I just don't want to be like any of these people.

I also know nothing about Colon and Rectal Surgery or Vascular Surgery.

Lifestyle Surgery (from most hours to least)- Please correct me if I am wrong:

Neurosurgery > Cardiothoracic > Trauma = Vascular > Orthopedic > Colon and Rectal Surgery > General > Ortolaryngology > Opthomology > OB/Gyn > Plastics > Mohs Surgery

Seems like you already have a good idea. Oto, Uro, ophtho are probably the best. Not sure how you got OBGyn as being one of the best.

Anyway, even if 90% of surgeons work ___ hrs in a field, it's really up to you. If you have the skills and the will to search, you can find a 60 hr wk in probably nearly all of those fields. Even the worst, neurosurgery, has people who work < 60 hrs in private practice. My friend knows a doc who is in PP and takes only selective cases. You may only earn 1/2 or 3/4 of what the other guys make but that's the cost of working 40 hrs a week. Again, if you have the skills and then you can call the shots.

 

[Winged Scapula]

There are numerous lifestyles available with a surgical practice. It is a fallacy that you cannot be a surgeon and have a family and outside interests.

Specialties with unpredictable schedules tend to have the worst lifestyle, this is usually related to taking ED/Trauma call with emergent surgeries/admissions which cannot be delayed. Neurosurgery, Ortho, General Surgery, Vascular, Transplant (because of the unpredictability of organ availability) tend to fall into this category. But as others have noted, if you don't take emergent cases your lifestyle can be quite reasonable, even with Nsgy and Ortho.

You have listed Colorectal Surgery as having a bad lifestyle, however, it is conventionally known as one of the better surgical lifestyles (assuming no general surgery call). Almost all surgeries are elective, patients tend to do well without prolonged hospital stays. SLUser123 is an academic colorectal surgeon here on SDN; one of my best friends is a colorectal surgeon in a small private practice: she is on call every other weekend but no GS call and typically only goes in on the weekend to round.

Trauma has a bad rap for lifestyle, but in many places its shift work. When you're on call, you're busy but otherwise its a lot of critical care, rounding, bedside procedures, etc. during the day. My ex is a trauma surgeon and his schedule is 1 week on as SICU attending, 1 week on for GS call (meaning he takes all GS consults during the day 07-1900), 1 week research/administration (ie, he can do whatever he wants outside of clinic and doing cases) and q6 overnight trauma call; wash rinse repeat. Non-compliant patients and a certain "element" which tend to be involved in trauma are drawbacks.

Breast of course is well known for a better lifestyle; like colorectal, the surgeries are elective with few emergencies. Many men shy away from it, assuming they won't be well received, but I can tell you our male partner is the most successful in the group (part of it is his reputation as our former national society president). Some women just want the old guy with the gray hair. Several of my friends are male breast surgeons who wanted a surgical practice that was conducive to a well balanced family lifestyle. The major drawback are the needy patients who tend to call for minor things and need lots of hand-holding.

Plastics can have a good or bad lifestyle. If you take Hand/Face call, it can be a bad lifestyle. My best friend is a plastic surgeon and while she takes no mandatory ED call, she is in solo practice and never has anyone take her call, so her phone rings constantly. Again, the major drawback are needy/neurotic/non-compliant patients. OTOH, if you are in a larger group, doing mostly cosmetic rather than reconstructive procedures, your lifestyle will be better. You say you don't have the stats for Plastics, but you are talking about Integrated. There are still plenty of post-GS residency programs open that you might be competitive for, should the time come.

Vascular surgery is well reputed to have a bad lifestyle; obviously vascular patients tend to be sick and lose blood flow at the most inconvenient times. More recent developments of catheter based procedures does decrease the need for late night/weekend distal bypass grafts but there's no doubt that Vascular has a deserved bad rap. More lifestyle minded Vascular surgeons have opened vein practices - all elective, lots of case pay patients; very lucrative and better lifestyle without the ED call and "walking dead" of the usual vascular practice.

As for Ob-Gyn, I'm not sure everyone shares your belief about it being "weird" to have a male ob-gyn. Many women prefer male physicians (especially older patients) or like me, simply don't care. You will also find that there are some interesting subspecialties like Reproductive Medicine or Gyn Onc which tend to have more male practitioners.

Bottom line is that lifestyle is dependent not just on specialty, but on the practice environment and what you can negotiate. Even in my lifestyle friendly specialty, there are weeks that I work long hours due to the need to fit the cases on the schedule somewhere (and at times that means after 5 pm).

 

[BloodySurgeon]

Does it make me a bad father-to-be that I will seek any possible excuse to skip out on these things? I'd much rather hang out with the ankle biters at home or just as a family at the park/beach/etc. I can't stand recitals and boring little league games, but I digress...

lol... of course I would much rather go to a park or beach with the family but supporting their interest and helping their self esteem by going to a boring little league can be nice as well 🙂

Unfortunately, no one is going to give you a good answer here. I personally have seen urologists who work 120 hrs/wk and neurosurgeons who work 30 hrs/wk, and everything in between. It all depends on your priorities, practice setup, desired income, call burden, etc... Take a peak at my signature to see a more objective analysis of the topic at hand.

The conventional wisdom I've received is that to be a surgeon, you need to be comfortable working 80+hrs/wk when needed, but it's not necessary to make a habit of keeping those hours. Some fields that have extremely sick patients may have a harder time working out a lighter schedule (neurosurg, gen surg), but its still possible. Just don't go into any surgical field expecting a derm-type lifestyle, or you'll be sorely disappointed. Even the more lifestyle friendly surgical fields like ENT & urology have to put in long hours from time to time.

This was very helpful, thank you.

 

[tiedyeddog]

I think ENT should rank somewhere near the bottom (best lifestyle).

nice to see you still post on here, BS. I haven't seen your name pop up since the all-students subforum days. Hope all is well.

The amount of call you take really depends on how your practice is set up and the agreements the practice has with covering call. For example, I know a guy who is a single-practitioner orthopod. He does Q2 call for the local hospital in his small town along with another guy in a different practice.

In my hometown there is a group of 8 orthopods, they have Q8 call.

Also, I am a firm believer in you'll do what is important to you.

 

[BloodySurgeon]

There are numerous lifestyles available with a surgical practice. It is a fallacy that you cannot be a surgeon and have a family and outside interests.

Specialties with unpredictable schedules tend to have the worst lifestyle, this is usually related to taking ED/Trauma call with emergent surgeries/admissions which cannot be delayed. Neurosurgery, Ortho, General Surgery, Vascular, Transplant (because of the unpredictability of organ availability) tend to fall into this category. But as others have noted, if you don't take emergent cases your lifestyle can be quite reasonable, even with Nsgy and Ortho.

You have listed Colorectal Surgery as having a bad lifestyle, however, it is conventionally known as one of the better surgical lifestyles (assuming no general surgery call). Almost all surgeries are elective, patients tend to do well without prolonged hospital stays. SLUser123 is an academic colorectal surgeon here on SDN; one of my best friends is a colorectal surgeon in a small private practice: she is on call every other weekend but no GS call and typically only goes in on the weekend to round.

Trauma has a bad rap for lifestyle, but in many places its shift work. When you're on call, you're busy but otherwise its a lot of critical care, rounding, bedside procedures, etc. during the day. My ex is a trauma surgeon and his schedule is 1 week on as SICU attending, 1 week on for GS call (meaning he takes all GS consults during the day 07-1900), 1 week research/administration (ie, he can do whatever he wants outside of clinic and doing cases) and q6 overnight trauma call; wash rinse repeat. Non-compliant patients and a certain "element" which tend to be involved in trauma are drawbacks.

Breast of course is well known for a better lifestyle; like colorectal, the surgeries are elective with few emergencies. Many men shy away from it, assuming they won't be well received, but I can tell you our male partner is the most successful in the group (part of it is his reputation as our former national society president). Some women just want the old guy with the gray hair. Several of my friends are male breast surgeons who wanted a surgical practice that was conducive to a well balanced family lifestyle. The major drawback are the needy patients who tend to call for minor things and need lots of hand-holding.

Plastics can have a good or bad lifestyle. If you take Hand/Face call, it can be a bad lifestyle. My best friend is a plastic surgeon and while she takes no mandatory ED call, she is in solo practice and never has anyone take her call, so her phone rings constantly. Again, the major drawback are needy/neurotic/non-compliant patients. OTOH, if you are in a larger group, doing mostly cosmetic rather than reconstructive procedures, your lifestyle will be better. You say you don't have the stats for Plastics, but you are talking about Integrated. There are still plenty of post-GS residency programs open that you might be competitive for, should the time come.

Vascular surgery is well reputed to have a bad lifestyle; obviously vascular patients tend to be sick and lose blood flow at the most inconvenient times. More recent developments of catheter based procedures does decrease the need for late night/weekend distal bypass grafts but there's no doubt that Vascular has a deserved bad rap. More lifestyle minded Vascular surgeons have opened vein practices - all elective, lots of case pay patients; very lucrative and better lifestyle without the ED call and "walking dead" of the usual vascular practice.

As for Ob-Gyn, I'm not sure everyone shares your belief about it being "weird" to have a male ob-gyn. Many women prefer male physicians (especially older patients) or like me, simply don't care. You will also find that there are some interesting subspecialties like Reproductive Medicine or Gyn Onc which tend to have more male practitioners.

Bottom line is that lifestyle is dependent not just on specialty, but on the practice environment and what you can negotiate. Even in my lifestyle friendly specialty, there are weeks that I work long hours due to the need to fit the cases on the schedule somewhere (and at times that means after 5 pm).

This was extremely helpful and informative, thank you! I guess it is a lot more flexible if I join a practice with good partners and less emergency case patients.

Which specialties include a good number of elective surgeries then?

P.S. I did mention I didn't know much about colon and rectal surgery 😛

 

[BloodySurgeon]

I think ENT should rank somewhere near the bottom (best lifestyle).

nice to see you still post on here, BS. I haven't seen your name pop up since the all-students subforum days. Hope all is well.

The amount of call you take really depends on how your practice is set up and the agreements the practice has with covering call. For example, I know a guy who is a single-practitioner orthopod. He does Q2 call for the local hospital in his small town along with another guy in a different practice.

In my hometown there is a group of 8 orthopods, they have Q8 call.

Also, I am a firm believer in you'll do what is important to you.

My identity was somewhat jeopardized during medical school so I didn't feel comfortable posting at that time. Right now it's not a problem so I figured I hit the forums again. And I guess that makes sense, but being on-call for 8 practitioner's patients can be quiet hard!

 

[tiedyeddog]

And I guess that makes sense, but being on-call for 8 practitioner's patients can be quiet hard!

I didn't think about that, I have no idea how that works.

 

[Winged Scapula]

This was extremely helpful and informative, thank you! I guess it is a lot more flexible if I join a practice with good partners and less emergency case patients.

Which specialties include a good number of elective surgeries then?

P.S. I did mention I didn't know much about colon and rectal surgery 😛

Most any specialty can be tailored to have elective surgeries.

If you practice in an academic environment, you are often made to take ED call as part of your appointment.

Some community hospitals also require mandatory ED call as a stipulation of privileges; others have found that this tends to make specialists go elsewhere with their operative cases and have rescinded that requirement.

Thus, the first goal once out in practice is to obtain hospital privileges where ED call is not required. You can always take it if and when you wish (ie, when we get a call from the ED we can decide whether or not we want to see that patient).

Secondly, there are some specialties which are more geared toward elective cases. In no particular order:

Ophtho
Derm
Surg Onc
Breast
Bariatrics (HOWEVER, these patients tend to have serious and emergent complications and are very needy which means the practice may be less lifestyle friendly)
Colorectal
ENT - if no trauma call
Uro
PRS - if no trauma call
Ortho - if no trauma call (ie, doing lots of arthroscopy, elective joints)
Colorectal
Surgical Critical Care (emergencies but tends to be shift work)
Thoracic (not to be confused with CV)

 

[Winged Scapula]

I didn't think about that, I have no idea how that works.

You will find out when you're a resident and cross-covering more than that!

We have 6 in our practice. When on call, all after hours calls are transferred to the cell phone of the physician on call. Most calls are routine things that are fairly easily solved even if you are not familiar with the patient.

 

[thefritz]

I don't have the stats for plastics (maybe try and gun for derm/Mohs surgery?)

You should rotate through a MOHS clinic before you start lumping it under surgery.
Also getting into derm is no cakewalk. If you can do derm you can do plastics. Plastics at least has the backdoor option of going through general surgery.

 

[RIPSanto]

There are numerous lifestyles available with a surgical practice. It is a fallacy that you cannot be a surgeon and have a family and outside interests.

Specialties with unpredictable schedules tend to have the worst lifestyle, this is usually related to taking ED/Trauma call with emergent surgeries/admissions which cannot be delayed. Neurosurgery, Ortho, General Surgery, Vascular, Transplant (because of the unpredictability of organ availability) tend to fall into this category. But as others have noted, if you don't take emergent cases your lifestyle can be quite reasonable, even with Nsgy and Ortho.

You have listed Colorectal Surgery as having a bad lifestyle, however, it is conventionally known as one of the better surgical lifestyles (assuming no general surgery call). Almost all surgeries are elective, patients tend to do well without prolonged hospital stays. SLUser123 is an academic colorectal surgeon here on SDN; one of my best friends is a colorectal surgeon in a small private practice: she is on call every other weekend but no GS call and typically only goes in on the weekend to round.

Trauma has a bad rap for lifestyle, but in many places its shift work. When you're on call, you're busy but otherwise its a lot of critical care, rounding, bedside procedures, etc. during the day. My ex is a trauma surgeon and his schedule is 1 week on as SICU attending, 1 week on for GS call (meaning he takes all GS consults during the day 07-1900), 1 week research/administration (ie, he can do whatever he wants outside of clinic and doing cases) and q6 overnight trauma call; wash rinse repeat. Non-compliant patients and a certain "element" which tend to be involved in trauma are drawbacks.

Breast of course is well known for a better lifestyle; like colorectal, the surgeries are elective with few emergencies. Many men shy away from it, assuming they won't be well received, but I can tell you our male partner is the most successful in the group (part of it is his reputation as our former national society president). Some women just want the old guy with the gray hair. Several of my friends are male breast surgeons who wanted a surgical practice that was conducive to a well balanced family lifestyle. The major drawback are the needy patients who tend to call for minor things and need lots of hand-holding.

Plastics can have a good or bad lifestyle. If you take Hand/Face call, it can be a bad lifestyle. My best friend is a plastic surgeon and while she takes no mandatory ED call, she is in solo practice and never has anyone take her call, so her phone rings constantly. Again, the major drawback are needy/neurotic/non-compliant patients. OTOH, if you are in a larger group, doing mostly cosmetic rather than reconstructive procedures, your lifestyle will be better. You say you don't have the stats for Plastics, but you are talking about Integrated. There are still plenty of post-GS residency programs open that you might be competitive for, should the time come.

Vascular surgery is well reputed to have a bad lifestyle; obviously vascular patients tend to be sick and lose blood flow at the most inconvenient times. More recent developments of catheter based procedures does decrease the need for late night/weekend distal bypass grafts but there's no doubt that Vascular has a deserved bad rap. More lifestyle minded Vascular surgeons have opened vein practices - all elective, lots of case pay patients; very lucrative and better lifestyle without the ED call and "walking dead" of the usual vascular practice.

As for Ob-Gyn, I'm not sure everyone shares your belief about it being "weird" to have a male ob-gyn. Many women prefer male physicians (especially older patients) or like me, simply don't care. You will also find that there are some interesting subspecialties like Reproductive Medicine or Gyn Onc which tend to have more male practitioners.

Bottom line is that lifestyle is dependent not just on specialty, but on the practice environment and what you can negotiate. Even in my lifestyle friendly specialty, there are weeks that I work long hours due to the need to fit the cases on the schedule somewhere (and at times that means after 5 pm).

Just curious, what is the general consensus about the lifestyle of bariatric/MIS? Specifically, what about focusing on just roux en y, bands etc?
Thanks

nvm, I just read your above post regarding this. Interesting to hear that general thoracic isn't that bad. I assumed it was similar to cardiac surgery

 

[Winged Scapula]

Just curious, what is the general consensus about the lifestyle of bariatric/MIS? Specifically, what about focusing on just roux en y, bands etc?
Thanks

MIS - usually do general surgery, so there's that.

Bariatrics? Speaking from experience during residency, they were amongst the most difficult patients to deal with. They often do not mount typical post-operative responses to leaks, are hard to examine due to adipose tissue and have a propensity to PEs, post-operative MIs, etc. Bands less of an issue than bypass but still have the psychological issues to deal with, band erosion etc.

nvm, I just read your above post regarding this. Interesting to hear that general thoracic isn't that bad. I assumed it was similar to cardiac surgery

General thoracic is typically an oncologic elective surgery based practice which is why it tends to be more lifestyle friendly than CV. Chest work tends to be divided between CV/CT, Surg Onc, and Peds depending on patient, presentation and local politics.

 

[Winged Scapula]

You should rotate through a MOHS clinic before you start lumping it under surgery.
Also getting into derm is no cakewalk. If you can do derm you can do plastics. Plastics at least has the backdoor option of going through general surgery.

👍

 

[Umyo]

Profiled

 

[circulus vitios]

Not a med student or a surgeon but http://archinte.jamanetwork.com/article.aspx?articleid=1105820 might be useful.

 

[tiedyeddog]

Not a med student or a surgeon but http://archinte.jamanetwork.com/article.aspx?articleid=1105820 might be useful.

Is it just me or is the neurosurg data weird? The average hours per annum over family medicine was 270 but the 95% confidence intervals are 418 to 958? I am guessing I am interpreting this incorrectly or what?

Edit: that data has to be wrong...

 

[tco]

Can you deal with poor lifestyle during residency/fellowship if you know it's going to get better? If you truly want to be a surgeon, but have better hours as an attending, I'd consider ENT, Ortho --> Hand, Uro. All awesome fields and all with good lifestyles.

 

[Silent Cool]

I'm sure this has been said a million times, but I like the OR but I just don't have the stereotypical surgeon personality. I like being at the hospital and working but I would rather come home to a wife and kids and not miss my kids dance recital or sport game.

I understand I am guaranteed to be working hard as any doctor and there will be a tendency for missing these life events, but I was wondering after residency how bad does it really get? Will I be working 80-hr weeks when I am 40+y/o?

I don't have the stats for plastics (maybe try and gun for derm/Mohs surgery?), but I think it would be reasonable to apply for the other specialties. I don't like ortho or optho (i don't mind ob/gyn but i still think it's a little weird to have male gynecologist), so what are my options for a specialty that has a reasonable lifestyle and has surgery. (e.g. 60hr/week). I don't care about the salary, the hours are a bigger issue for me.

Are the only options for me now are Urology, Otolaryngology, and General? What are their lifestyles like? All the surgeons I followed, however, were really intense and ended up working close to 80-hr weeks and they were in their 50's. I just don't want to be like any of these people.

I also know nothing about Colon and Rectal Surgery or Vascular Surgery.

Lifestyle Surgery (from most hours to least)- Please correct me if I am wrong:

Neurosurgery > Cardiothoracic > Trauma = Vascular > Orthopedic > Colon and Rectal Surgery > General > Ortolaryngology > Opthomology > OB/Gyn > Plastics > Mohs Surgery

Dude, Ophtho.

If you want something more interesting/intense, do Retina.

Done.

 

[BloodySurgeon]

You should rotate through a MOHS clinic before you start lumping it under surgery.

I did a couple MOHS surgeries myself and I agree its not really surgery but its working with your hands and is procedural medicine.

Also getting into derm is no cakewalk. If you can do derm you can do plastics. Plastics at least has the backdoor option of going through general surgery.

Not really. Plastics stats are a bit higher and both specialties have a small community that know each other. I did some academic medicine that worked closely with a good number of well known academic dermatologists and my stats fall just on the borderline for this specialty. In addition I don't go to an ivy league school which most these specialties tend to prefer (maybe less than neurosurg but still important)

Can you deal with poor lifestyle during residency/fellowship if you know it's going to get better?

I am all about working hard now and reeking the benefits in the future. In undergrad I went to school full-time (12+units), worked full time (48+ hr/week), and did research (12+hr/week). Some weeks I only slept 5 hours total. Now I feel like medical school isn't that bad. I'm sure I'll complain a little with 80-100 hour residency, but if I know it will get better when its over I wont mind as much.

If you truly want to be a surgeon, but have better hours as an attending, I'd consider ENT, Ortho --> Hand, Uro. All awesome fields and all with good lifestyles.

That's kind of what I am leaning towards, ENT and Urology. I just don't think I am cut out for ortho though. I'm not a big guy and don't care much for an intense work out at the table. Hand specialty sounds like an option but I don't think I can bare through 5 years of orthopedic surgery

Dude, Ophtho.

If you want something more interesting/intense, do Retina.

Done.

My two good friends both got into optho residency and believe its the best. Maybe it is, but I just always had a phobia for the eye. Nothing really ever bothers me except touching the eye for some reason. That's why I ruled out Optho early on.

 

[Vermicious Knid]

I am all about working hard now and reeking the benefits in the future. In undergrad I went to school full-time (12+units), worked full time (48+ hr/week), and did research (12+hr/week). Some weeks I only slept 5 hours total. Now I feel like medical school isn't that bad. I'm sure I'll complain a little with 80-100 hour residency, but if I know it will get better when its over I wont mind as much.

hmm?

 

[DoctorDermis]

In addition I don't go to an ivy league school which most these specialties tend to prefer (maybe less than neurosurg but still important)

ENT and Urology... from my understanding, these are both very competitive specialties, and if you can become adequately competitive for ENT or Urology, you should be able to do so for derm.
I was planning on applying for Urology along with one of my best friends before switching to derm - after conversing with him throughout the interview cycle last year, I can confirm that Urology is tough.

Just wanted to note that I went to a lower tier US allopathic medical school ranked in the 70's in the US News listings for research (which I am aware doesn't mean a whole lot).
http://grad-schools.usnews.rankingsandreviews.com/best-graduate-schools/top-medical-schools/research-rankings?int=85a732&int=85a732

5 of us matched into derm from my year, and I feel that we did very well as a class in matching to a variety of competitive specialties. So going to a top 20 school is not a critical component of matching into your desired specialty.

 

[Geekchick921]

I did a couple MOHS surgeries myself and I agree its not really surgery but its working with your hands and is procedural medicine.



Not really. Plastics stats are a bit higher and both specialties have a small community that know each other. I did some academic medicine that worked closely with a good number of well known academic dermatologists and my stats fall just on the borderline for this specialty. In addition I don't go to an ivy league school which most these specialties tend to prefer (maybe less than neurosurg but still important)



I am all about working hard now and reeking the benefits in the future. In undergrad I went to school full-time (12+units), worked full time (48+ hr/week), and did research (12+hr/week). Some weeks I only slept 5 hours total. Now I feel like medical school isn't that bad. I'm sure I'll complain a little with 80-100 hour residency, but if I know it will get better when its over I wont mind as much.



That's kind of what I am leaning towards, ENT and Urology. I just don't think I am cut out for ortho though. I'm not a big guy and don't care much for an intense work out at the table. Hand specialty sounds like an option but I don't think I can bare through 5 years of orthopedic surgery



My two good friends both got into optho residency and believe its the best. Maybe it is, but I just always had a phobia for the eye. Nothing really ever bothers me except touching the eye for some reason. That's why I ruled out Optho early on.

I could have written these last two paragraphs myself, pretty much word for word. I just finished my surg rotation and loved the OR, but I'm wiped and I feel like I barely saw my kids for two months. I've always been most interested in Ob/Gyn and I know it won't be much better but I expect I will love it (and I liked gen surg a lot) and could probably suck up the long hours a little more, plus the residency is one year shorter. Some of the attendings on gen surg also seemed to think OB/Gyns has gotten better at working out call schedules and coverage and basically improving their own lifestyle, largely motivated by the largely female (read: mothers) physician population. I have yet to see it for myself.

I am debating ENT, urology and plastics electives next year, as they all generally offer better lifestyles than gen surf down the road. Like you, I am completely freaked out by eyeballs and ophtho is totally out. I did well on step 1 and in that regard would be competitive for those specialties. I know residency will be a b**** regardless. You just have to find what makes you happy enough to deal with it. I think you can make almost any specialty jive with your personal life eventually, if you get into the right practice, are willing to tailor your patient population, etc.

 

[DoctorDermis]

I could have written these last two paragraphs myself, pretty much word for word. I just finished my surg rotation and loved the OR, but I'm wiped and I feel like I barely saw my kids for two months. I've always been most interested in Ob/Gyn and I know it won't be much better but I expect I will love it (and I liked gen surg a lot) and could probably suck up the long hours a little more, plus the residency is one year shorter. Some of the attendings on gen surg also seemed to think OB/Gyns has gotten better at working out call schedules and coverage and basically improving their own lifestyle, largely motivated by the largely female (read: mothers) physician population. I have yet to see it for myself.

I am debating ENT, urology and plastics electives next year, as they all generally offer better lifestyles than gen surf down the road. Like you, I am completely freaked out by eyeballs and ophtho is totally out. I did well on step 1 and in that regard would be competitive for those specialties. I know residency will be a b**** regardless. You just have to find what makes you happy enough to deal with it. I think you can make almost any specialty jive with your personal life eventually, if you get into the right practice, are willing to tailor your patient population, etc.

There seems to be a large number of people who are intimidated or turned-off by eyeballs.
I will admit that I was intimidated by the eyes and visual system - however, doing an ophtho rotation quickly diminished any preconceptions I had about the field - in fact, I learned a huge amount that is not taught in med school or other residencies and lost my squeemishness in regards to the eyes.

The ophto elective was definitely one my favorite and most valuable rotations in med school and I highly recommend it to everyone

 

[ThePostureMan]

Does it make me a bad father-to-be that I will seek any possible excuse to skip out on these things? I'd much rather hang out with the ankle biters at home or just as a family at the park/beach/etc. I can't stand recitals and boring little league games, but I digress...



Unfortunately, no one is going to give you a good answer here. I personally have seen urologists who work 120 hrs/wk and neurosurgeons who work 30 hrs/wk, and everything in between. It all depends on your priorities, practice setup, desired income, call burden, etc... Take a peak at my signature to see a more objective analysis of the topic at hand.

The conventional wisdom I've received is that to be a surgeon, you need to be comfortable working 80+hrs/wk when needed, but it's not necessary to make a habit of keeping those hours. Some fields that have extremely sick patients may have a harder time working out a lighter schedule (neurosurg, gen surg), but its still possible. Just don't go into any surgical field expecting a derm-type lifestyle, or you'll be sorely disappointed. Even the more lifestyle friendly surgical fields like ENT & urology have to put in long hours from time to time.

Thank you for your insight @KinasePro ! I've never heard of/met neurosurgeons working 30 hrs / week (or any specialty for that matter). Is that some sort of highly unique edge case? Is that only possible in late career? How much would such a neurosurgeon earn annually?

 

[GoSpursGo]

Thank you for your insight @KinasePro ! I've never heard of/met neurosurgeons working 30 hrs / week (or any specialty for that matter). Is that some sort of highly unique edge case? Is that only possible in late career? How much would such a neurosurgeon earn annually?

Just letting you know, the post you're replying to is 8 years old and the user you're quoting hasn't logged in in the last 4 months. So, don't be shocked if you don't get a reply 🙂 Of course, others are welcome to give their perspectives.