What is the degree of OR time to floor work in integrated plastic residencies

[gregoryhouse]

I'm finishing up my 3rd year and I'm finding myself really lost. I haven't done my surgery rotation yet, I actually have a plastic rotation coming up in 2 weeks that I am really excited about but it is with private practice docs so I know it won't be an authentic experience of what residency in plastics is life, nonetheless, I have heard great things about the rotation.

I am not really bothered by the amount of time that the residency requires, although I will openly admit I do enjoy my free time and activities outside of medicine. For me though, the biggest issue is that I just do not like the floor work aspect of any of the residencies. I like talking to patients and I like treating them but I just can't stand all the other stuff that goes on with it, social work issues, tons of notes, discharge summaries, rounding, etc. I feel as though the hospital is the most inefficient system I have ever witnessed in my life and it truly drives me mad.

I will gladly go in at 2 am and repair a lac or stay late to help out with an interesting case. Those things I am not afraid of. I am just afraid that my residency will end up being mostly floor work and I'll end up hating my life. I've heard Ortho turfs most of their floor work to medicine and whether that is good practice or not, that is the mentality that I prefer and I am wondering if plastics is similar.

For me the thing that made me initially interested in surgery was quick actions and quick results. Seeing how slow the inpatient service was on medicine really took away all the excitement of medicine for me.

Right now I am battling making a decision on what specialty to apply to for away rotations. I really like microsurgery and I'm fairly sure if I end up in plastics I would end up doing a microvascular fellowship or another one with a lot of microsurgical techniques involved. The only other option I could see myself being happy in is Ophthalmology. From what I've seen in the field Glaucoma, peds, and oculoplastics would be the closest thing to actual surgery and is microsurgical in nature, but of course vastly different at the same time. The only thing I dislike about opthalmology is the lack of variety in surgeries but at least with ophthalmology I could get away from the inefficiency of the hospital system and not worry about all the other BS (rounding, following labs, etc).

I'm just hoping someone in an integrated spot can tell me what their experience has been so far. Like I said previously, 80 hours a week in the OR or doing procedures I would be pretty happy with. 80 hours a week where more than half of that time is spent on the floors I doubt I would be happy.

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[doc05]

if you plan on a career doing free flaps, get ready for some very sick postop patients (read: floor work).

 

[Valadi]

Intern year is a lot of floor work wherever you go.

Later years, I'm basically 10% floors, 60-70% OR, 20-30% clinic. When I have sick people or failing flaps, can be on the floor a lot, however. It's different when you've operated on a patient and see them on the floor, though, because you're invested.

 

[gregoryhouse]

Intern year is a lot of floor work wherever you go.

Later years, I'm basically 10% floors, 60-70% OR, 20-30% clinic. When I have sick people or failing flaps, can be on the floor a lot, however. It's different when you've operated on a patient and see them on the floor, though, because you're invested.

Thanks for the numbers. That makes me feel a bit better because it seems like regardless of specialty intern year is going to be floor work, so at least knowing that after intern year floor work is substantially less makes me feel better about possibly going into a surgical residency. I also think you are right that floor work will be a lot better when I'm actually the resident in charge. I think I just didn't like my role as a student.