Trauma Surgery Schedule?

[Dr.SPAC3MAN]

Hey everyone, I am an OMS2 planning to apply for gen surg and I am looking into what a fellowship in Trauma entails. I have heard that they work shifts, but I have a hard time believing the shifts are like ED shifts. Can anyone shed a little light on what their shift/call looks like? Thanks!

---

Members don't see this ad.

 

[DOVinciRobot]

Hey everyone, I am an OMS2 planning to apply for gen surg and I am looking into what a fellowship in Trauma entails. I have heard that they work shifts, but I have a hard time believing the shifts are like ED shifts. Can anyone shed a little light on what their shift/call looks like? Thanks!

Lots of different set ups. A common one at bigger centers is 7 days of trauma days, 7 days of trauma nights, 7 days running the ICU, and 7 days off on a rotating schedule.

Shifts are typically 12 hrs. Most jobs incorporate an ACS component

Trauma is not nearly as glorious as it sounds, and most change their minds when they get to residency and realize what the actual job entails.

 

[Calizboosted76]

Lots of different set ups. A common one at bigger centers is 7 days of trauma days, 7 days of trauma nights, 7 days running the ICU, and 7 days off on a rotating schedule.

Shifts are typically 12 hrs. Most jobs incorporate an ACS component

Trauma is not nearly as glorious as it sounds, and most change their minds when they get to residency and realize what the actual job entails.

To echo this. I have a buddy who is a trauma surgeon and he said that unless you are at a level 1 trauma center a majority of your work is dealing with butt pus and bowel impactions. You are the ortho surgeons "helper" for any of their post op complications as well. He made it sound terrible and completely turned me away from even thinking about trauma. Obviously this is just his experience.

 

[Surgeon D.O.]

I've only been to 2 places that have "trauma surgery" and the model @DOVinciRobot discussed is exactly what I saw.

These places saw very little penetrating trauma and really not what the TV shows make trauma surgery out to be. Although I know gun and knife clubs exist out there lol.

Trauma surgeons at places where I rotated at seem more akin to Critical Care docs who are more comfortable managing patients in the ICU that may have operative trauma which falls under the realm of ortho, neurosurgery, facial trauma / plastics.

 

[DOVinciRobot]

I've only been to 2 places that have "trauma surgery" and the model @DOVinciRobot discussed is exactly what I saw.

These places saw very little penetrating trauma and really not what the TV shows make trauma surgery out to be. Although I know gun and knife clubs exist out there lol.

Trauma surgeons at places where I rotated at seem more akin to Critical Care docs who are more comfortable managing patients in the ICU that may have operative trauma which falls under the realm of ortho, neurosurgery, facial trauma / plastics.

I’m at a knife and gun club with a LOT of operative trauma overall and it is still largely ICU management and coordinating care between the various subspecialists.

Trauma is functionally the IM of the surgery world.

 

[Dr.SPAC3MAN]

I’m at a knife and gun club with a LOT of operative trauma overall and it is still largely ICU management and coordinating care between the various subspecialists.

Trauma is functionally the IM of the surgery world.

Right on. So they pretty much handle ICU management on top of typical GenSurg practice and cases? What is the biggest pro of becoming of sub-specializing in trauma/critical care?

 

[Calizboosted76]

Right on. So they pretty much handle ICU management on top of typical GenSurg practice and cases? What is the biggest pro of becoming of sub-specializing in trauma/critical care?

Shift work lol

Just kidding. From what I understand there is a slight pay increase in community practice but a drastic decrease in academics. Just from my convos with the surgeons on here that I have bothered the past few weeks as I gear up to figure out what surgical electives I want to do lol.

 

[Dr.SPAC3MAN]

Shift work lol

Just kidding. From what I understand there is a slight pay increase in community practice but a drastic decrease in academics. Just from my convos with the surgeons on here that I have bothered the past few weeks as I gear up to figure out what surgical electives I want to do lol.

honestly I might just do if for the shift work. haha. but essentially all the surgery is the same as Gensurg?

 

[Calizboosted76]

honestly I might just do if for the shift work. haha. but essentially all the surgery is the same as Gensurg?

The bread and butter cases yea. I was told that your scope is what a general surgeon would do and then whatever trauma comes in.

Plus any complications post op patients may have etc.

 

[Calizboosted76]

I just want to reiterate though that this is just what I have heard from the surgeons Ive spoke to and the few trauma surgeon friends I have. Its probably like any other aspect of medicine and can be what you make of it.

 

[DOVinciRobot]

Right on. So they pretty much handle ICU management on top of typical GenSurg practice and cases? What is the biggest pro of becoming of sub-specializing in trauma/critical care?

They can run an ICU, yes. The shift work is often cited, most people that do it like the lack of home call

honestly I might just do if for the shift work. haha. but essentially all the surgery is the same as Gensurg?

Trauma surgeons operate less than your average general surgeon. Trauma is non-operative most of the time.

But yes, the cases are similar. Especially if you take ACS call which is how most trauma jobs are set up

 

[Lem0nz]

Trauma pay is equivalent to general surgery - there is no difference in pay usually or if it is, it is somewhat minor. You can expect 350-400k starting and top off at 450-500k. In academic practice subtract 100-150k.

Big difference is shift type work and number of shifts. Most trauma contracts have a finite number of shifts you will work. This can be anywhere from 180-270. You will get paid a flat amount for working extra shifts and can use this to boost your pay. You can also locums to boost your pay as coverage is highly needed all the time for trauma everywhere (particularly CC). You do not have to worry about how many patients you operate on which is a blessing and a curse. Blessing if you're more community/rural and your service doesn't get dumped on. Huge curse if you're in a high volume center.

It is not competitive to get into and many (but of course not all) choose this route if they don't want to do elective general surgery but are not the best resident for a host of reasons.

The non-operative component is much larger than any of discipline of general surgery by orders of magnitude. This can be really good or really bad depending on what you want from your life. When you finish residency there are definitely a group of people that find they would rather operate less and it makes them happier.

You are more likely to have residents. This is also a blessing and a curse. Not all are meant to teach and not all can stomach it.

 

[NecrotizingFasciitis]

Lots of different set ups. A common one at bigger centers is 7 days of trauma days, 7 days of trauma nights, 7 days running the ICU, and 7 days off on a rotating schedule.

Shifts are typically 12 hrs. Most jobs incorporate an ACS component

Trauma is not nearly as glorious as it sounds, and most change their minds when they get to residency and realize what the actual job entails.

I did my intern year in surgery & spent 2 months in trauma, 3 in SICU & 4 in emergency general surgery (EGS); this is pretty much exactly what the schedule was like for the attendings.

Additionally, the attendings covering overnight would cover both emergency general surgery & trauma (there would be a separate SICU attending for obvious reasons), which can be extremely overwhelming/borderline dangerous during "trauma season" (which for where I live is ~April - ~November). Thankfully they have backup coverage, but of course try not to use it if they don't have to for those night. Most of the time when one (or all... RIP) of the services (trauma, EGS & inevitably.. SICU) get busy, residents & attendings on all services help whenever/wherever. There were many nights I'd be technically assigned to SICU, but I would go to all trauma activations, write the resuscitation note/throw in all the trauma orders then immediately start placing orders & writing the H&P for SICU admission, text the trauma intern to let them know there needs to an H&P on the new admission for the trauma side, & then go see a consult in the ED for acute appendicitis for the EGS team because everyone is frantically trying to keep up. When those nights are over you feel like a g** d*** champion, don't get me wrong, but it's stressful as HECK & extremely easy to get overwhelmed/make errors if you don't have a good system for organization (check boxes... key)... I can't eve begin imagine how the attendings feel in those situations though or how they sign out everything that happened at night to the day shift attendings.

The trauma service is only "exciting" during activations & when patients need to go to OR immediately after the primary/secondary surveys are done in the trauma bay. There is a TON of care management/discharge/consult coordination outside of that.