where do all the surg dropouts go?

[neutropenic]

dropout rate for surg programs is high

20-25%?

where do they go?

i know one gs resident who dropped out after pgy 4 and is now doing anesthesia.

and one ent dropout who is pursuing an acting career.

one of my psych attendings started in surg.

but seriously where do they all go?

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[Bluemirage]

I personally know an anesthesiologist that dropped out in PGY-4 of General Surgery also. He was originally hoping to work his way into a plastic surgery fellowship after his Gen. Surgery residency, but later decided that family time/life was more important.

 

[automaton]

why did they wait so long, are you sure they weren't forced out?

 

[njbmd]

why did they wait so long, are you sure they weren't forced out?

Hi there,
Generally if you make it to PGY-4, you are not "forced out" because they have invested too much time in you. People burn out on surgery and PGY-4 is just about when you are chief on every service that you are on and the work gets much harder and you are responsible for everything.

I have one friend who made it to PGY-5, got married and had a HUGE change in priorties. This person went over to Emergency Medicine because family and relationships became more important than hours at the hospital.

People change and surgery is pretty unforgiving unless you LOVE it. Sometimes it can take four years to figure out that you just can't do this any more. I would be the first person to say "Stick it out and finish" but I do not live in anyone's shoes but my own.

njbmd

 

[Needleandthread]

Most go into fields with less prestige. If they were forced out, they probably aren't very happy, at least at first.

I know of general surgery residents that have gone into:
-emergency room work (not the residency)
-ER
-anesthesiology
-ophthalmology/retina (a very sharp guy that knows my father that was probably cheated when they forced him out of the pyramidal surgery residency about 10 years ago but got back on his feet into a more prestigous specialty and a hard to get fellowship, i.e. retina so he's probably laughing at the general surgeons)
-family practice
-pathology
-general practice work (not a FP residency)
-general practice work in a prison

 

[neutropenic]

Most go into fields with less prestige. If they were forced out, they probably aren't very happy, at least at first.

I never thought of general surgery as being particularly prestigious (if that's the implication). Is that a general perception?

I mean it seems like for "surgical" (and not medical) fields uro/ortho/oto/ophtho/neurosurg are more prestigious if one actually cared about things like that (and with lower attrition rates). Maybe even ob/gyn.

 

[LaCirujana]

The people that I know who have quit have gone into anesthesia for the most part, a couple into radiology.

 

[21JumpStreet]

I personally know an anesthesiologist that dropped out in PGY-4 of General Surgery also. He was originally hoping to work his way into a plastic surgery fellowship after his Gen. Surgery residency, but later decided that family time/life was more important.

Anesthesiology has basically the same type of hours that a surgeon does. They must be there when the surgeons are there.

 

[dry dre]

Anesthesiology has basically the same type of hours that a surgeon does. They must be there when the surgeons are there.

Are you premed or something? The local anesthesiology department must cover the ORs, this doesn't mean that the hours are the same. Moreover, the anesthesiologist's pager doesn't go off everytime a surgeon is called in to examine a belly or mangled limb...they are only woken from sleep when something needs to go to the OR, not when a surgical candidate is in the building. They also of course cover OB, but the wake from sleep principle still applies.

 

[neutropenic]

Are you premed or something? The local anesthesiology department must cover the ORs, this doesn't mean that the hours are the same. Moreover, the anesthesiologist's pager doesn't go off everytime a surgeon is called in to examine a belly or mangled limb...they are only woken from sleep when something needs to go to the OR, not when a surgical candidate is in the building. They also of course cover OB, but the wake from sleep principle still applies.

Also, anes doesn't have to round on the pts that belong to surgery they are really only "consultants" to the surgeons in the OR albeit indispensible ones. Also where I am the MD-As are only there for takeoff and landing, CRNAs cover the rest.

 

[surgrad]

Anesthesiology has basically the same type of hours that a surgeon does. They must be there when the surgeons are there.

During an average case, I see at least 1-2 change of anesthesia shifts. They definitely do not have the same type of hours.

 

[solstice118]

Anesthesiology has basically the same type of hours that a surgeon does. They must be there when the surgeons are there.

No offense... but this is the funniest thing I have read in a long time. There is no way that this is the case for all the reasons people have stated above.

 

[jayman]

My wife, SphinxyMinx, who's doing path says that there are several ex-surgery residents that she knows of in her department. This seems to be a pretty consistent finding around the country (we just finished doing a country-wide tour for interviews). For a fleeting moment, I considered path instead of surgery, but then realized I did not like necrophilia.

Wait a minute...if my wife's in path, what does that say about me?

 

[Pilot Doc]

I never thought of general surgery as being particularly prestigious (if that's the implication). Is that a general perception?

I mean it seems like for "surgical" (and not medical) fields uro/ortho/oto/ophtho/neurosurg are more prestigious if one actually cared about things like that (and with lower attrition rates). Maybe even ob/gyn.

I think you're confusing competitive and prestigious. People like doing less work for more money - it makes the subspecialties competitive. But with the exception of neurosurgery, I don't think the surgical subspecialties exceed the prestige/respect afforded general surgery. General surgeons take care of some very sick patients and are generally well regarded for that.

 

[pamchenko]

I think you're confusing competitive and prestigious. People like doing less work for more money - it makes the subspecialties competitive. But with the exception of neurosurgery, I don't think the surgical subspecialties exceed the prestige/respect afforded general surgery. General surgeons take care of some very sick patients and are generally well regarded for that.

I wholeheartedly agree. Though I'm painfully biased, I believe that general surgeons are well respected in a hospital. When people get into trouble, we're the last line for patients. General surgeons are trained to know hardcore medicine (SICU), and life saving technical interventions. I think we get respected because we work the hardest for the patient.

 

[Molly Maquire]

A good number of them seem to land in Radiology. If you surf radiology websites, there are several posts from urology and general surgery residents attempting to switch. There is even a post from a plastics guy.

On the radiology interview trail, I met people from ortho and optho attempting to match. I think many of them are probably interested in interventional.

 

[Celiac Plexus]

the residents that i know who have left surgery have gone into less prestigious/ easier to get into fields...

-family medicine
-psychiatry
-anesthesia
-pathology

one of the surgery residents from my own program is currently a radiology resident at my own program. although he switched (went from pgy-3 surgery to pgy-1 radiology) before i arrived, now he wishes he had stuck it out. go figure.

also, it's my guess that people who leave surgery at the pgy-4 or 5 level are people that probably have been thinking about dropping out since they were interns, and were just waiting for a good reason to leave (e.g. - family). surgery is very demanding, no matter what specialty you are in. it's normal to second-guess yourself on occasion. but i guess that's probably true about every field.

 

[supercut]

From my program, most commonly surgery dropouts go to anesthesia. A few have gone into radiology or EM.

Note the similarities...most of the dropouts wind up in lifestyle friendly specialties.

 

[DrDawg]

During an average case, I see at least 1-2 change of anesthesia shifts. They definitely do not have the same type of hours.

and thats a 1hour case!

 

[DLmd]

Gas, gas, and more gas; all the general surgery dropouts this yr at my program are passing gas!

 

[thenavysurgeon]

I think you're confusing competitive and prestigious. People like doing less work for more money - it makes the subspecialties competitive. But with the exception of neurosurgery, I don't think the surgical subspecialties exceed the prestige/respect afforded general surgery. General surgeons take care of some very sick patients and are generally well regarded for that.

I disagree.

General Surgeons are dumped on continously. There is no prestige about the profession.

 

[deleted87716]

dropout rate for surg programs is high...where do they go?

A guy I went to med school with got accepted into a pretty top-notch plastic surgery program. Midway through his first year, he realized he hated it, and quit after he completed internship. He's been working in public health ever since.

One of the FPs in my group did a year in general surgery before his FP residency, and the wife of one of our general surgeons, who's an internist boarded in infectious disease, was also a surgery resident before switching to IM.

I guess they wind up where they want to be.

 

[deleted87716]

the residents that i know who have left surgery have gone into less prestigious/ easier to get into fields.

I never thought of general surgery as being particularly prestigious

General Surgeons are dumped on continously. There is no prestige about the profession.

What's up with this "prestige" nonsense? Who are you guys trying to impress, anyway?

 

[sacrament]

I disagree.

General Surgeons are dumped on continously. There is no prestige about the profession.

In terms of who most strongly thinks surgery is prestigious, it's been my observation that surgeons come in first, with everybody else a very distant second. Yeah, I don't know about prestige, but I agree that it's generally recognized that the surgeons are some of the hardest working people in the hospital, and that carries a certain cache.

 

[sacrament]

What's up with this "prestigue" nonsense? Who are you guys trying to impress, anyway?

I don't think that "pursuit of prestige" is a particularly horrible thing, at least so long as it isn't your only reason for entering a field that you'd hate otherwise (and maybe not even then, if the prestige makes it worth it to you). Prestige, or at least the illusion of prestige, makes some people happy, and that's fine. It's optimal to choose work that you love to do for its own sake, but I honestly think I know people who love their work because it's "prestigious" and, hell, more power to 'em. Frankly I'm jealous of anybody who can find any sort of motivation at all.

 

[PatrickBateman]

Frankly I'm jealous of anybody who can find any sort of motivation at all.

Loser

 

[fishmonger69]

guys i know that left went to gas. i spent time in gas just to ensure it wasn't even on the radar for a future switch. damn boring if you ask me. 2 seconds of work followed by 2 hours of absolute boredom.

 

[avgjoe]

guys i know that left went to gas. i spent time in gas just to ensure it wasn't even on the radar for a future switch. damn boring if you ask me. 2 seconds of work followed by 2 hours of absolute boredom.

I know!! Exactly .. very little thinking if any throughout the whole process as even those 2 seconds of work (intubation, etc) are repeated so many times a day that it becomes totally boring.
Too bad .. it might have been nice to finish in 4 years and make lots of $$ after .. but like you say, it's not even on the radar screen anymore!

 

[sacrament]

Loser

How about you expand on this for me.

 

[Plinko]

For all these people that pull the ripcord on their surgery residencies to go elsewhere, do they have to start from scratch in another residency and do the intern year over again? If someone resigned half way through a Gen Surg PGY 2 year and then wanted to do EM or something would they be in the same position as fourth year med students trying to scramble into a PGY 1 position, PGY 2 postion, etc? Would they go through the match again or would it be more like applying for a job wherever there are openings?

 

[njbmd]

For all these people that pull the ripcord on their surgery residencies to go elsewhere, do they have to start from scratch in another residency and do the intern year over again? If someone resigned half way through a Gen Surg PGY 2 year and then wanted to do EM or something would they be in the same position as fourth year med students trying to scramble into a PGY 1 position, PGY 2 postion, etc? Would they go through the match again or would it be more like applying for a job wherever there are openings?

Hi there,
I had a colleague go into EM after doing a PGY-2 year in General Surgery. He did not go through the Match or the Scramble but accepted a PGY-2 position outside the match. He was an excellent General Surgery resident and has been doing great in EM. He became a father in the middle of his PGY-2 surgery year and decided that General Surgery was too demanding with the family. He's loving life as a EM doc.
njbmd

 

[driverabu]

The people that I know who have quit have gone into anesthesia for the most part, a couple into radiology.

They saw the light on the other side of the curtain and said....screw this, the grass is definitely greener on the other side!!! No pun intended! From my experience in talking to surgery residents who switched over to anesthesiology, the main reason was because of
1. Lifestyle
2. More lucrative
3. More exciting

Hey, don't get me wrong, if I didn't have a family and wasn't planning on having one, surgery would have been my cup of tea....trauma surgery to be more specific. Since we only live once, I decided to do exactly that...live!

 

[driverabu]

Anesthesiology has basically the same type of hours that a surgeon does. They must be there when the surgeons are there.

um...that's true...but take a closer look at who the anesthesiologist is....they can be relieved in the middle of a case for the most part....surgeons cannot for obvious reasons

 

[driverabu]

guys i know that left went to gas. i spent time in gas just to ensure it wasn't even on the radar for a future switch. damn boring if you ask me. 2 seconds of work followed by 2 hours of absolute boredom.

You have absolutely no idea what anesthesiologists do, do you? I would expect that statement from a layperson, not someone as educated as yourself. While the surgeons are busy cutting or suturing, the anesthesiologists are busy anticipating what will happen next, what to do if the surgeon cuts a vessel, etc. etc. It's more intellectually stimulating than most people think

 

[neutropenic]

You have absolutely no idea what anesthesiologists do, do you? I would expect that statement from a layperson, not someone as educated as yourself. While the surgeons are busy cutting or suturing, the anesthesiologists are busy anticipating what will happen next, what to do if the surgeon cuts a vessel, etc. etc. It's more intellectually stimulating than most people think

Yes, especially since you can read Ladies' Home Journal during cases.
Remember the ABCs of anaesthesia:

Airway
Book
Circulation

Many are shocked how much more the gas(wo)men are making compared to their GS colleagues. It's obscene. Even my general surgeon attending told me to go into gas.

 

[driverabu]

Yes, especially since you can read Ladies' Home Journal during cases.
Remember the ABCs of anaesthesia:

Airway
Book
Circulation

Many are shocked how much more the gas(wo)men are making compared to their GS colleagues. It's obscene. Even my general surgeon attending told me to go into gas.

I think being neutropenic is affecting your brain in some way...that old ABC is just that, OLD! Probably takes more neurons to intubate somebody than to use 1 neuron to cut and the other to suture....wow, a whole 2 neurons to become a surgeon, amazing! Also, just remember that when you "accidentally" clip a vessel and the ABC doc saves your arse....just remember when your wife needs an epidural or when the epidural or spinal doesn't work and we have to put her under. If there is one thing you surgeons and future surgeons need to realize is that we are a TEAM...you cannot do your cutting without us and we do not have a job without you guys/gals.....I just hope that the new generation of surgeons are not as arrogant as the older farts

 

[The_Sensei]

Most go into fields with less prestige. If they were forced out, they probably aren't very happy, at least at first.

I know of general surgery residents that have gone into:
-emergency room work (not the residency)
-ER
-anesthesiology
-ophthalmology/retina (a very sharp guy that knows my father that was probably cheated when they forced him out of the pyramidal surgery residency about 10 years ago but got back on his feet into a more prestigous specialty and a hard to get fellowship, i.e. retina so he's probably laughing at the general surgeons)
-family practice
-pathology
-general practice work (not a FP residency)
-general practice work in a prison

I don't think I'd put anesthesiology in the "less prestigious" catergory. Unless of course you equate less prestigious with more money and free time.

 

[The_Sensei]

Yes, especially since you can read Ladies' Home Journal during cases.
Remember the ABCs of anaesthesia:

Airway
Book
Circulation

Many are shocked how much more the gas(wo)men are making compared to their GS colleagues. It's obscene. Even my general surgeon attending told me to go into gas.

Typical diatribe from a frustrated pre-med/general surgery resident.....

Oh well, pal.....it only get's worse....it only gets worse - FOR YOU!!

(Typed while at work supervising CRNAs and making $400K)

 

[Tater]

(Typed while at work supervising CRNAs and making $400K)

Honestly, that's the main reason I would never choose anesthesiology. Why have a job that can replace you so easily? You are just waiting for problems to arise, so you can leap in and fix them. It just seems that a huge portion of the job is the "boring part" so just let the CRNAs take care of it.

Of course, that is oversimplifying and that is my own opinion. I will say that I have seen some great anesthesiologists in action, and its a sight to behold. I think its all more the better when people truly love their job.

Also, I think anyone would agree that it takes a little more than 2 neurons for either anesthesiology and surgery.

 

[bostonsurg]

Typical diatribe from a frustrated pre-med/general surgery resident.....

Oh well, pal.....it only get's worse....it only gets worse - FOR YOU!!

(Typed while at work supervising CRNAs and making $400K)

I guess the ABC's need to be updated...

Airway
Billing
Coffee...

I wouldn't do it for a million a year- sitting around filling out paperwork and supervising nurses (nothing wrong with them-they are great and at least they are around to do the work that needs to be done...)

 

[driverabu]

I guess the ABC's need to be updated...

Airway
Billing
Coffee...

I wouldn't do it for a million a year- sitting around filling out paperwork and supervising nurses (nothing wrong with them-they are great and at least they are around to do the work that needs to be done...)

Now that is an ABC of anesthesiology I can live with!! About sitting around doing paperwork, I'll admit, that will get old after a short while, but that's why we have pain mang, CCM and other fellowships we can go into in order to change the scenery a bit....Kind of like a general surgeon, after a while, you get tired of hernias, choles, appys and chopping away at colon after a while and that is why you specialize. The 2 neuron comment was most definitely a joke, I honestly think that surgeons are very skilled and if the lifestyle didn't suck so much, I would have definitely gone into trauma surgery.

 

[Blade28]

3. More exciting

Well, that's debatable - I think most specialties will think their field is incredibly exciting.

Personally, I don't understand the constant switching-out of the anesthesiologist/anesthesia resident/PA/CRNA during the case. Wouldn't it be easier not to have to constantly sign-out to your colleague?

Just out of curiosity, what are you doing for your intern year, TY, prelim med or surg? I always wonder if it makes a difference.

 

[ZigZag]

I keep hearing all the stories about general surgery residents switching to anesthesia, EM, ets. Did anybody actually switch to general surgery from other specialties? Would that be hard to switch from EM to surgery?

 

[driverabu]

Well, that's debatable - I think most specialties will think their field is incredibly exciting.

Personally, I don't understand the constant switching-out of the anesthesiologist/anesthesia resident/PA/CRNA during the case. Wouldn't it be easier not to have to constantly sign-out to your colleague?

Just out of curiosity, what are you doing for your intern year, TY, prelim med or surg? I always wonder if it makes a difference.

Well, once the case is going, there is not much to signing out, usually takes a couple of minutes. I matched into a categorical position so my intern year will be divided into 3 mo IM, 2 mo nephro, 2 mo cards, 2 mo pulmo, 1 mo EM, 1 mo eICU, 1 mo neuro. I honestly think that an intern year geared more towards IM is better for anesthesiology b/c we learn to medically manage the patient which is the direction the field is moving in....even if it wasn't moving in that direction, learning the pathophysiology of diseases helps us optimize the anesthesia plan for the patient at hand. No offense, but hardly anybody going into anesthesia does their intern year in surgery unless they absolutely had no choice simply because we prefer not to be scutmonkeys for a year.

 

[Blade28]

I keep hearing all the stories about general surgery residents switching to anesthesia, EM, ets. Did anybody actually switch to general surgery from other specialties? Would that be hard to switch from EM to surgery?

One of our residents switched from peds - wants to go into peds surg.

 

[Zummy]

I keep hearing all the stories about general surgery residents switching to anesthesia, EM, ets. Did anybody actually switch to general surgery from other specialties? Would that be hard to switch from EM to surgery?

When I was on the interview trail, I met a girl who was finishing her PGY1 in EM and was switching to G surg. We were interviewing at her home program... so they must have been open to it. I don't suppose it's any more difficult than any other switch.

 

[drrouz]

One of my best friends just told me of a rural general surgeon in upstate New York he worked with who switched into IM after his GS intern year. He lasted 6 weeks before begging his way back into the same GS program. Probably unusual, but what a story! The moral of the story is that the grass is always greener on the other side of the fence...sometimes even after you switch sides.

 

[kbrown]

surgeons are considered invaluable to hospital admin b/c of the money they generate from procedures. i don't think makes them more presitigous. but hospitals will fall all over themselves to please the OR crew.

 

[sblau001]

Personally, I find it funny how people try to convince themselves that what they are doing with their lives is more prestigious than everyone else! The bottom line is that you should do whatever makes you happy. That being said, although general surgery is a competitive field to get into, first off it is not THE MOST competitive field by a long shot. Furthermore, there is no denying that surgeons have a reputation for being pr@#cks and a#$holes, and not necessarily the next messiah (go ahead, I dare you, ask any nurse, PT, secretary,etc. etc. who works in your hospital). So yeah, while it might be cool to cut someone open, the rest of us will be spending time with our families while you're on the phone with your laywer trying to figure out how you will defend yourself against the 7th frivilous lawsuit to be brought against you in as many months.

It took one year of a gen surg internship to realize what no one tells you in medical school- there is a good chance that as a surgery attending you will have to work as many hours as your interns just to make ends meet. Every year you will make less and less money as your malpractice insurance rises. You may even be forced to participate in questionably unethical behavior to help pay your bills (eg; AKA's on little old demented nursing home patients who are immobile- I have seen this done plenty of times). So enjoy your so-called prestige while I enjoy my life.

 

[Ergo]

Yes, especially since you can read Ladies' Home Journal during cases.
Remember the ABCs of anaesthesia:

Airway
Book
Circulation

Many are shocked how much more the gas(wo)men are making compared to their GS colleagues. It's obscene. Even my general surgeon attending told me to go into gas.

Pay scales fluctuate. Derms were bottomw of their class in the early 70's. In he mid to late 70s the top grads of the big ivy schools fought over hot spots in the new field of Rheumatology, and now make less in some cases than internists. Rads was all FMGs in the 80s because of pay. Anesthesia went unfilled in the past too.

Careful picking something thats hot now just for the money if it bores you.