What about general surgery?

[Dr JPH]

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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!

 

[Winged Scapula]

JP...

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.

 

[msl2007]

....

 

[Winged Scapula]

I'm also interested in general surgery (of the pedi variety mostly...but adults aren't bad.)
Shaving the two years of fellowship isn't bad either.

Well, most parents are going to want a pedi-fellowship trained surgeon for their little one, as will most hospitals.

 

[msl2007]

LOL. Plus two years of research to get to that point.

My current plan is to do the nine years and become a pedi general surgeon. But my second plan is to be an adult gerenal suregon, in which case (depending on WHEN I decide) I can shave of 2-4 years.

But then again, transplant is my third choice.... 😱

 

[dynx]

LOL. Plus two years of research to get to that point.

My current plan is to do the nine years and become a pedi general surgeon. But my second plan is to be an adult gerenal suregon, in which case (depending on WHEN I decide) I can shave of 2-4 years.

But then again, transplant is my third choice.... 😱

I read this post as:
I want to keep all my options and don't really know what I'm doing so I'll apply to a residency with a mandatory two years of research then decide on GS and end up spending two more years than I should have.

 

[msl2007]

I read it is: She really wants to go into PS but doesn't want to start residency with such a one track mind that she loses sight of everything else, and therefore is keeping her mind open. Also, she knows that PS is extremely competetive and has a backup plan in case she doesn't match and chooses to not go the critical care route.

But then again, I wrote it.

And I plan to do two years of research, regardless of subspecialty, and I did apply to required 7 year programs. That way I know they will let me do my two years of research! Some places I looked into won't....

 

[dynx]

I read it is: She really wants to go into PS but doesn't want to start residency with such a one track mind that she loses sight of everything else, and therefore is keeping her mind open. Also, she knows that PS is extremely competetive and has a backup plan in case she doesn't match and chooses to not go the critical care route.

But then again, I wrote it.

And I plan to do two years of research, regardless of subspecialty, and I did apply to required 7 year programs. That way I know they will let me do my two years of research! Some places I looked into won't....

🙄 when is it then that you could potentially shave off 4 years?

 

[msl2007]

🙄 when is it then that you could potentially shave off 4 years?

If I choose gen surg rather than peds surg in my first two years then I could choose to not do 2 years of research (assuming my program doens't require it), and then I also wouldn't do two years of fellowship. that equals four years.

Peds surg- 9 years post grad, 10 if you do critical care.
Gen surg- 5 years

that's a 4 to 5 year difference, so that is where I could shave it off. 😛

 

[dynx]

If I choose gen surg rather than peds surg in my first two years then I could choose to not do 2 years of research (assuming my program doens't require it), and then I also wouldn't do two years of fellowship. that equals four years.

Peds surg- 9 years post grad, 10 if you do critical care.
Gen surg- 5 years

that's a 4 to 5 year difference, so that is where I could shave it off. 😛

Now reread my original reply and when you get to that big word that starts with an m, ends with a y and has anditor in the middle let me know what you think.

 

[msl2007]

Now reread MY previous post with the words: assuming my program doesn't require it.

Only 2 programs on my list of 14 do have m-andator-y research years.

 

[dynx]

Now reread MY previous post with the words: assuming my program doesn't require it.

Only 2 programs on my list of 14 do have m-andator-y research years.

now reread MY previous post with the little blue face rolling its eyes.

 

[Entei]

Both of you. 🙄

 

[dynx]

Both of you. 🙄

Are we cluttering up the forum and making it hard to sort through all the new threads and posts? Bickering is what on-line forum's are for.

 

[Entei]

Are we cluttering up the forum and making it hard to sort through all the new threads and posts? Bickering is what on-line forum's are for.

Yes and yes, which is why I wanted to join in on the bickering fun. I like to bicker about pointless arguments that clutter up forums. I'm a paradox like that.