switching from surgery

[supercut]

---

Members don't see this ad.

I'm a surgery resident (PGY 3, just came back from a lab year). Since I came back from the lab I have been a lot less happy with surgery than I was before. I still like the OR for the most part (though there are a number of operations I don't like) But the hours are really getting to me...and now that I"m more senior, I'm the one staying late more often. Rotine 14-15 hours a day, day after day, is far worse than overnight call.

I'm also getting more and more annoyed at rounding, patient interaction, and most especially pts families. Plus floor nurses who can't tell an urgent issue from a non urgent one.

Bottom line: except for some times in the OR, most days I'm finding myself increasinlgy miserable. Plus the more I learn about reimbursement for surgery, the less I like it...it doesn't seem worth the effort.

So I'm thinking about switching. I'm looking at the "lifestyle" areas. Path is probably the field I know the least about, never really considered it during med school. I liked histology and gross anatomy in med school (though I can't ID normal tissues on slides anymore)

I"m specifically interested in hearing from any former surgery residents(a comparison would be awesome). But I'd also like to know generally what you guys think are the bad/annoying aspects of pathology.

One thing that bothers me a bit is that from what I've found on the 'net, seems like pathology pays less than surgery (starting salaries seem about $100K less), and pay is an issue for me since I'm older and have less time to save for retirement.

 

[xTinaBna]

I'm a surgery resident (PGY 3, just came back from a lab year). Since I came back from the lab I have been a lot less happy with surgery than I was before. I still like the OR for the most part (though there are a number of operations I don't like) But the hours are really getting to me...and now that I"m more senior, I'm the one staying late more often. Rotine 14-15 hours a day, day after day, is far worse than overnight call.

I'm also getting more and more annoyed at rounding, patient interaction, and most especially pts families. Plus floor nurses who can't tell an urgent issue from a non urgent one.

Bottom line: except for some times in the OR, most days I'm finding myself increasinlgy miserable. Plus the more I learn about reimbursement for surgery, the less I like it...it doesn't seem worth the effort.

So I'm thinking about switching. I'm looking at the "lifestyle" areas. Path is probably the field I know the least about, never really considered it during med school. I liked histology and gross anatomy in med school (though I can't ID normal tissues on slides anymore)

I"m specifically interested in hearing from any former surgery residents(a comparison would be awesome). But I'd also like to know generally what you guys think are the bad/annoying aspects of pathology.

One thing that bothers me a bit is that from what I've found on the 'net, seems like pathology pays less than surgery (starting salaries seem about $100K less), and pay is an issue for me since I'm older and have less time to save for retirement.

hi!
first i'd like to let you know that i am by no means a resident..i'll only be starting med school next august 😳 But, i do work in a pathology department and work closely with the pathologists everyday. one young pathologist was a surgery resident himself, then switched to pathology after a year. like you, he switched for lifestyle purposes. i think a pathologist's lifestyle is dependent on the hospital, but for the most part it is a 9-5 job (with being on call of course, but usually the docs i work for do not get called in at night). generally they only have to come in for frozen sections and those surgeries needing frozen section diagnoses are performed in the afternoons. the hospital i work at is not a teaching hospital, plus there are no major grossings and adult autopsies performed are not there so the docs do not have as heavy a workload as larger hospitals. To me, pathology is such a fascinating field, the pathologists can look at any tissue slide and know exactly from what tissue/part of the body that slide was made from just by looking through a microscope. i think its worthwhile for you to speak with a pathologist at your current facility to get a more accurate idea of what their daily lifestyle is like in your area...good luck! 🙂

oh also, i guess one 'bad' aspect of path, is when your frozen section specimen comes later than scheduled..this happens alot to the pathologists i work for and they get mad when they end up waiting for 3 hrs =)

 

[LADoc00]

There are FAR less jobs in pathology than surgery. Other than that, I think salary is comparable and if you did a per work hour calculation, path would come out way ahead. If you have your heart set on one particular place to practice, something like rads, gas, derm or ophtho might be a better lifestyle bet.

Path can definitely be a true 9-5 gig. I get maybe 2-3 calls per month on call, and in 2 years have had to actually go into the hospital to do a frozen 4-5 times. Lots of downsides too tho. Need to look at the big picture.

If you really dig the operating room but dont dig the hours/trauma call, then it seems ophtho or derm Mohs surgery would be more up your alley. If you dont care where you train, and you went to fairly good med school, did well and have some research under your belt, I wouldnt think switching to one of those 2 is that hard.

Im not a former surgery resident but I knew some during my training that made the switch to path and IMO their personalities were very very contrary to everyone else who I think really loved path as their first choice. Im not saying you are a dickwad, but if I was path PD I would look the other way from former surgery or ob (even worse) residents.....

 

[LADoc00]

I want to add that the money from something like path or surgery is crap, anyway you slice it. If take into account the opportunity cost, the numbers tell you its a piss poor investment in the long run. Someone telling me they are gonna do this or that speciality due to 20-50K difference in average pay are idiots because quite frankly if they had their eye on the bottom line they would have never went to med school to begin with. Medicine in general is the problem, not surgery per se. The entire system sucks.

To compare, I just got off the phone with my lil bro, he recently got an offer for a project manager gig that will bring down with bonuses 250K/yr..and that is starting and get this, he is only 25 years old. By the time someone like dermpathlover hits full stride with the dermpath empire, the 25 year old will have millions of dollars in the lifetime income lead and likely retire 10 years before DPL even sniffs economic freedom. And he doesnt have malpractice or any student loans to worry about.

I forgot what my point was and now Im behind 2 bone marrows before I have to gross....but needless to say, if you are going for cashola, be wise, use pathology as a stepping stool to something bigger and better and not the final goal.

 

[mcfaddens]

I agree with LADOC Path is only a stepping stone. If you plan to have a life/retire/send you kids to private school then take your path money (or what ever) and the extra time and invest it in someting worhwhile outside the medical profession (like real estate (when the market crashes) or another business. Open a business where your workers work on commission only like a nain salon. low overhead + commission only employees = cash cow

 

[yaah]

I dunno, I think if I was more than halfway through a residency I would finish it before ditching it for something else...After one year of training, I can see it, but not three.

 

[supercut]

I want to add that the money from something like path or surgery is crap, anyway you slice it. If take into account the opportunity cost, the numbers tell you its a piss poor investment in the long run. Someone telling me they are gonna do this or that speciality due to 20-50K difference in average pay are idiots because quite frankly if they had their eye on the bottom line they would have never went to med school to begin with. Medicine in general is the problem, not surgery per se. The entire system sucks.

To compare, I just got off the phone with my lil bro, he recently got an offer for a project manager gig that will bring down with bonuses 250K/yr..and that is starting and get this, he is only 25 years old. By the time someone like dermpathlover hits full stride with the dermpath empire, the 25 year old will have millions of dollars in the lifetime income lead and likely retire 10 years before DPL even sniffs economic freedom. And he doesnt have malpractice or any student loans to worry about.

I forgot what my point was and now Im behind 2 bone marrows before I have to gross....but needless to say, if you are going for cashola, be wise, use pathology as a stepping stool to something bigger and better and not the final goal.

Actually you are right on the money! That is one of the things I've come to realize and part of my dissatisfaction with surgery is that I don't have time to read and learn about investing. In fact, I'd like to start buying some rental real estate, but can't do that with surgery hours! Plus I'm really starting to dislike pt interaction (as well as interaction with floor nurses). At this point I kinda wish I never went to med school in the first place, but I have no marketable skills in any other area.

 

[1Path]

I know that being in my 40's gives me somewhat of a different perspective as far as life is concernedin many ways, but isn't it common knowlewledge by now that the most lucrative fields are NOT in medicine?

When I went to undergrad in the 80's, a person looking to get paid majored in engineering or business, or BOTH if she/he REALLY wanted to get paid quickly.

Or is it that the prestige of being a physician has such an enormous pull on folks that they completely forget one of life's other important missions, happiness?😕

 

[yaah]

Well, being a physician is also basically a guaranteed good paycheck (at least, eventually). Other fields, not as much. So I think the security of knowing this plays a role at times.

 

[mlw03]

Well, being a physician is also basically a guaranteed good paycheck (at least, eventually). Other fields, not as much. So I think the security of knowing this plays a role at times.

i think the security of knowing we're going to be in the top 10% or so of income earners is something no other field offers. if you complete med school and a FP residency and then set up shop and work "only" 40 hours a week, you're going to make enough to put you in the upper eschelon of wage earners. other fields have the security we do (teachers, nursing, EMTs, garbage collectors), and some fields can be much more lucrative (law, CEO, business, engineering), but i can't think of anything else that offers both and that's very appealing.

to the OP: try not to focus solely on the money and think about what you want to do for the next 30 years. if the thought of being a general surgeon turns you off, then go back and do another residency. try talking to path residents at your hospital and see if you can somehow find the time to see what they do day to day before deciding to re-enter the match. 2 or 3 years "wasted" has to be better than 30 years of regret. best of luck to ya.

 

[1Path]

.

 

[1Path]

Well, being a physician is also basically a guaranteed good paycheck (at least, eventually). Other fields, not as much. So I think the security of knowing this plays a role at times.

So the question then becomes what is a "good" paycheck? Given the hours a doctors works, not to mention the nontangibles like dealing with insurance companies, malpractice, patients, ect I don't know if I agree that the time in equals the paycheck either.😕

and some fields can be much more lucrative (law, CEO, business, engineering), but i can't think of anything else that offers both and that's very appealing.

I'm a past, present, and futrue fed and I can tell you that from living in the metro DC area, there are a LOT of folks ie gov't employess making SECURE bank and only working 10 hours/week! (That's a JOKE) And they don't have to worry about their practices being purchased by a mega insurance company!

 

[mlw03]

So the question then becomes what is a "good" paycheck? Given the hours a doctors works, not to mention the nontangibles like dealing with insurance companies, malpractice, patients, ect I don't know if I agree that the time in equals the paycheck either.😕


I'm a past, present, and futrue fed and I can tell you that from living in the metro DC area, there are a LOT of folks ie gov't employess making SECURE bank and only working 10 hours/week! (That's a JOKE) And they don't have to worry about their practices being purchased by a mega insurance company!

i don't disagree that time may not equal paycheck - that's a subjective thing. to me a 'good' paycheck is city-dependent, but in general it means being able to afford a nice home that's at least 2500 square feet, a new $25K car every 5 years, 1 or 2 nice annual vacations, and a lot (but not all) of cool 'toys'. regarding those goverment employees - how many are making $70K per year? There may be some, but my i doubt the majority make that much.

on a similar topic, is anyone else somewhat surprised by the frequent discussions about money in this forum? do the other specialty forums talk about money this much? do doctors in general talk about money this much? i'm certainly not averse to making a good living, but i just don't want to focus on money as much as LADoc and others make it sound like doctors have to. i'm willing to make slightly less money and focus on medicine rather than have to deal with both and bring home more - am i alone on this one?

 

[yaah]

i'm willing to make slightly less money and focus on medicine rather than have to deal with both and bring home more - am i alone on this one?

Not at all. I would wager that for every person for whom money trumps all else there are 5-10 for whom money is a secondary (or tertiary, etc) consideration. Of course, this is all relatively speaking. Making $100k per year (which is a low salary for almost any specialty in medicine) allows you to live fairly comfortably in most situations, and you are well above the average national household average. To some people though, especially those who never really learned the value of a dollar (or alternatively, are overcompensating for a scrimped childhood or continuously trying to impress people not worth impressing), it can never be enough. As an example - look at this: http://www.boston.com/business/articles/2006/10/13/cell_phones_making_a_fashion_statement/ . It blows my mind that people would spend money on bull**** like this, yet for some, this is crucial spending and their life is lessened without it. For them, median household income is not nearly enough.

For me, the best job will be the one that has many factors (including location, type of work, benefits, intangibles, etc). Obviously I am not going to ignore salary considerations, but I won't be looking for the job with the highest income possible.

 

[1Path]

iregarding those goverment employees - how many are making $70K per year? There may be some, but my i doubt the majority make that much.

The "average" income in the DC area is almost 90K. You don't really think only doctors make the average so high, do you? Not only that Gov't is the largerst employer in this area and to give you an example, the houses in my neighboorhood are well over 1 million. There's an EASY inference to make here!😉

 

[b&ierstiefel]

Well, being a physician is also basically a guaranteed good paycheck (at least, eventually). Other fields, not as much. So I think the security of knowing this plays a role at times.

Job security is important. Given all the moaning that goes on by medical professionals, I think the overall job security in medicine is quite nice.

I mean compare to industry, for example. I know a guy who has been bouncing from city to city because his whatever company he was doing research for kept getting bought by someone else. I like stability and security even if it means I don't make 100 billion dollars. Oh wait...if I made 100 billion dollars...hmm...