Surgery Lifestyle in the Military

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HaRtiGaN101

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Hi, I heard concerns about light surgical caseloads in military training in surgery and I was wondering how the caseload is as a surgical attending in the military (specifically Air Force if possible). I am interested in surgery as a career, but I am concerned about the lifestyle being on-call all the time and having heavy caseloads. I was hoping that the surgical field in the military could be a better option in terms of lifestyle and I may think about turning it into a career in the military if so.

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Methinks you may want to reevaluate your interest in surgery as a career. All specialties of medicine require one to feed to feed himself to the beast to some degree, surgery requires the greatest sacrifice of all. Good surgeons love to operate. They generally only tolerate clinic and call insofar as these activities provide more opportunities to operate. They don't complain about heavy caseloads. You indicate that you have not yet started medical school, so there is plenty of time to figure things out for yourself, but there is a reason that surgical residencies have the highest washout rate--many people like the idea of being a surgeon, but when they begin residency and truly see the magnitude of the sacrifice required to become a competent surgeon, they decide that the trade-off is not worth it.

There's a reason that surgeons tell the old Q-2 joke: there is a sadistic element of truth to it.

To answer your questions... There are 3 types of hospitals in the military: medical centers where most residents train and there are enough complicated cases to keep active surgeons content (note that I did not say happy because some want to operate even more). Quasi medical centers that do not have the volume and complexity to keep surgeons content but have sporadic larger cases and are better than being at a community hospital. And community hospitals that have very low volume and almost zero complexity. Surgeons at community hospitals are most dissatisfied because they take large amounts of call to cover the hospital but generally have to refer the best surgical cases out because they don't have the ancillary support to perform these cases; many surgeons at these community hospitals are justifiably bitter about the erosion of their surgical skills due to this low volume. Surgeons not stationed at the true medical centers generally perform fellowships that ensure that they will be able to homestead at medical centers or leave the military when their commitment has been repaid. There are rare senior surgeons who move from community hospital to community hospital whose surgical skills have long atrophied and do not leave the military because their surgical caseload would not entice any hospital or group to hire them. These individuals generally push off work onto their younger colleagues and are almost universally disliked and not respected.

Q-2 joke for those who don't know it:
What's the problem with being Q-2?
You miss half of the good cases.
 
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