Trauma Surgery/ACS attending lifestyle

[jaw93]

I did a month long trauma surgery rotation as an MS3 and loved it. I went in thinking I was 100% EM, but I found that trauma combined the critical patient aspect of EM with the occasional emergent surgical management of GS. I even enjoyed the more medicine long term care. Now I'm torn on what to pursue. I understand EM's lifestyle pretty well: less hours, but the hours can be draining and the shift work wears on you. but overall, fewer shifts and more days off

For trauma, I followed a resident schedule, 80ish hours a week. It was long but I enjoyed the work. I didn't get a good clear picture of how the attendings shifts were patterned. Even though I directly asked a few attendings about their schedules, my perspective is only from one single tertiary academic center. I would like to hear a broader perspective of what an attendings workload is like at other hospitals or settings.

hours a week, days per month, number of overnights/backup call?
are the shifts scheduled 7 on 7 off, 2 weeks on 1 week off, or something entirely different?

Any insight is much appreciated, I'm trying to gather as much info as I try to make this decision and figure out what to do with my life

Thanks!

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[Raney Schauer]

How much EM have you seen?

 

[Instatewaiter]

Then problem with trauma is that as an attending your schedule often doesn't get better. There are some programs that have gone to a shift work model but it is not a specialty that leads you to have your nights and weekends to yourself.

So that kinda sucks.

 

[Tenk]

Was in the same boat as a student but trauma attending lives are a buttload of work because they also do acute care surgery and sometimes routine cases to make money for the hospital a lot of times. You just aren’t seeing that when you’re a student on the trauma service.

 

[jaw93]

How much EM have you seen?

I did a year as a scribe before school and recently did a month rotation as well

 

[jaw93]

Was in the same boat as a student but trauma attending lives are a buttload of work because they also do acute care surgery and sometimes routine cases to make money for the hospital a lot of times. You just aren’t seeing that when you’re a student on the trauma service.

Yeah, my hospital does the combined emergency general surgery. The attendings rotate through trauma, ACS and ICU (usually they cover ICU/ACS at the same time). I just wanted to get more details and specifics, because there really isn't that much info out there for this field

 

[jaw93]

Then problem with trauma is that as an attending your schedule often doesn't get better. There are some programs that have gone to a shift work model but it is not a specialty that leads you to have your nights and weekends to yourself.

So that kinda sucks.

do you see the field trending towards shift work model?

 

[whatisthisstuff]

I've heard of some shift work set ups that can be a 7 on 7 off kind of gig. Dr. Buck Parker is a prominent media/social media personality who works this way I think. Tough to know how common this is and the surgeons at my institution sleep in the hospital every 4 nights as well as managing ICU patients, routine cases, etc. That said, life as an attending can probably be what you make it if you are flexible with location and practice environment.

Ultimately I would think about if you want to do surgery or not. You will have to do a 5 year surgical residency + fellowship. You will spend ALOT of your time in the OR so I would make sure thats important to you.

 

[TypeADissection]

It really depends what kind of setup you eventually get yourself into. In academia, there will some sort of rotation model where you're the SICU attending for a week, cover traumas another, ACS and elective stuff another, etc. If you end up providing trauma coverage in a non-academic setting it may just be 24H of whatever comes through the door. I think the unfortunate thing about trauma/ACS is that you really don't know enough to decide until you're a resident. That's when you're running down for the activations and then managing all the other stuff that comes afterwards. Old lady falls and breaks hip. Old lady falls and has head bleed. Found down for who knows how long. So on and so forth. You find yourself doing a lot of medicine and managing patients while ortho and neurosurgery do a lot of the operating. Keep your options open. If this is the road you want to go down then decide if you actually like general surgery first because that's what you'll eventually have to get boarded in first. Cheers.