What About General Surgery (2nd Attempt)

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Dr JPH

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Lets try again...

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Dont make fun of me, but I really have enjoyed these last 2 months as a Sub-I on a general surgery service. Perhaps its the group I am working with, the variety of cases or the schedule but its really growing on me.

In a few months I will be preparing to start my surgical training. I have thought about what I might want to do and so far everything seems interesting...well, except vascular...not into that.

But Recontructive surgery, Colorectal and HPB have all been great. I have even enjoyed the oncological cases I have been a part of. As of yet, nothing has really stood out as the "ah-ha!" specialty.

So what about general surgery? In talking with attendings they all light up when I mention to them that I really enjoy general surgery. They tell me I will never be out of a job, never have a slow service and still be able to make good money. But I also see how hard these guys n gals work. The hours are tough and its often a lot of BS stuff.

Any attendings or future GS out there care to comment on what drives them towards general surgery? What sort of practice type, reimbursement, demand and schedule are you looking at?

I dont have many people to bounce ideas off of...all of my chiefs and upper years are trauma or plastics junkies!

Thanks!

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KIMBERLI COX WROTE:

it took me awhile longer than some of my colleagues to really find my niche as well. So there really is no hurry to do so, at least not before 4th year, or before you go into the lab (if that it what you will be doing).

I'm not suprised that others seem excited about your interest in general surgery; it certainly is not as popular as it once was, with most residents, especially those at academic programs, pursuing fellowships.

I cannot tell you the number of calls, emails and flyers I get, looking for general surgery. Now I cannot opine about the appeal of it, because it holds little for me, but wanted to let you know that I agree with what your attendings are telling you.

The general surgeons I will likely be working with in a few months, have it pretty easy (comparatively speaking)....

the hospital system has hired an Emergency Surgery Service who take all ER hits and consults from the floors

that means that the hospital employs general surgeons to do almost all elective cases; the exception would be emergencies on one of their own patients (ie, take backs, previous patient who requests them, etc.). Many hospitals are finding that having this system is a way to recruit general surgeons who don't necessarily want to be up, coming in to operate, every few nights.

the group does take call, FOR ITS PATIENTS (ie, not ER calls unless again, its one of theirs), q5 and rounds on all in-house patients once every 5th weekend. Since most of the cases are not long-term stayers, there are not a lot of in-house patients over the weekend to round on.

Of course, I don't know their income, and they are on a pay for performance schema (which has its pluses and minues) but they all told me that they are making more than average general surgery income for the area (which would include those on salary at other area hospitals).

My point is that there are a lot of practice options - everything from traditional university based practice with call every few nights and the good possibility of coming in (although you would have residents to do some of the work), to community based practices with largely elective cases to the scheme above. You'll have lots of time to figure out what you want to do and the need for good general surgeons definitely exists as the specialists do less and less.

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I agree with Kimberli... you have plenty of time to decide, and no one can do that for you. I went into MS3 year thinking I would do anything except surgery, and loved it. I went into residency thinking I would do anything except vascular, and I loved it. You just have to experience different services, including your general surgery services, to decide what you want to do. There is plenty of time to do that!

Good luck. :luck:
 
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