Why isn't general surgery competitive like Ortho/Ophthal/ENT?

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I was talking to a young general surgeon yesterday and he cleared up a lot of misunderstandings I had about GS... First, I thought GS residency was hell and even after they become surgeons they still work 70+hrs/wk making 250k-300k... That young surgeon told me these are not necessarily true... He told me that the people in his group work an average 60hrs/wk or less. He also told me while GS residency is not easy, he thought his residency was not that bad compared to his IM counterparts at the same hospital. He also told me that he made in the high 200s in his first year as a surgeon, and after a couple of years he was making almost 400k... My question is if that is the typical experience of a general surgeon, why GS step1 average is not in the 240s like the other competitive specialies? Any general surgeon here that can debunk that guy's claim!
 
:corny:

I'm not a general surgeon (thank goodness), so you are free to take what I say and ignore it , but I have never heard of a General Surgery resident say that their residency was somehow "easier" than an IM residency, although I realize this can vary greatly by institution and "easier" can be defined so many different ways.

Yes, General Surgery has a better filter in terms of admissions they can smack down and consults they can choose to evaluate and say, "not a surgical candidate" but in terms of at the end, General Surgeon residency graduates choose in huge percentages (forget number now) to subspecialize after their 5 year General Surgery residency. They do not just remain general surgeons. That I think tells you a lot.

I would also say how a general surgeon feels at age 31 will be quite different than how a general surgeon feels at ages 50-60.
 
Because the residency is horrible, the pay is worse than subspecialties, the work is harder than all but perhaps neurosurg or spine, and the cases tend to have more complications due to the regions in which you are working as a general surgeon. If you *love* surgery and don't think you'll be able to land a specialty spot, go ahead and give general surgery a go though. You're either a surgeon or you're not, they're a different sort of people.
 
Mad Jack said:
Because the residency is horrible, the pay is worse than subspecialties, the work is harder than all but perhaps neurosurg or spine, and the cases tend to have more complications due to the regions in which you are working as a general surgeon. If you *love* surgery and don't think you'll be able to land a specialty spot, go ahead and give general surgery a go though. You're either a surgeon or you're not, they're a different sort of people.
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Trouble is sometimes figuring out if you're made to be a surgeon. Being a surgeon is truly a calling. You don't just get to do your surgery thing and then skedaddle. You take personal responsibility for everything on that patient both before and after surgery.
 
southernIM said:
Worse pay, worse hours, more spots = less competitive
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Except just saying categorical General Surgery is not competitive really is not telling the entirety of the situation. You can't just walk into a General Surgery residency and faculty are very particular on who they select.
 
DermViser said:
Except just saying categorical General Surgery is not competitive really is not telling the entirety of the situation. You can't just walk into a General Surgery residency and faculty are very particular on who they select.
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True. I don't mean not competitive; I mean less competitive than ortho/plastics/etc
 
southernIM said:
True. I don't mean not competitive; I mean less competitive than ortho/plastics/etc
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I figured that's what you meant. Just didn't want some students having enough hubris to think they can scrape by and just waltz into a categorical Surgery residency as some sort of backup plan, not that the rigor of the residency and ITE won't kick their butts anyways.
 
Wordead said:
Miserable people who are huge dicks that cant teach is pretty much gen surg in a nutshell.
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Was your rotation really that bad? Not disagreeing with you -- the Dept of Surgery at different medical schools can be quite different based on culture and the type of resident they attract.
 
Mad Jack said:
:shrug: The attendings at Yale seemed alright.
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Yeah, bc it's Yale. Yale unbelievable caters to its students like no other. I believe they can even do a tuition-free 5th year.
 
My experience is that general surgery is much more malignant than specialty surgery. The people in general surgery are just plain mean. What's more, the malignant personalities also tend to be less competent. It's the nicer people who are the better surgeons and they tend to go into specialty fields as they have better board scores.

It's a huge turn off for a lot of people having to deal with seniors that have personality issues in general surgery. Ortho, ENT, and Neurosurgeons are much more humble even though they are more accomplished. The attendings will personally take students out for expensive dinners every day and answer 3 hours worth of questions. In general surgery, you're not even allowed to talk when the attending is in the same room and you are told by the residents to just stand in the corner all day. They rip apart your progress notes for spelling errors and throw surgical instruments at you from across the room.
 
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DermViser said:
Yeah, bc it's Yale. Yale unbelievable caters to its students like no other. I believe they can even do a tuition-free 5th year.
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They also reserve like, all of their IM rotations for Yale students. If you go to Yale, you're going to get catered to. But I was talking more on the attending-resident level than the attending-med student level. There weren't nearly as many malignant personalities as one would expect in the surgical department.
 
I want to be a surgeon because surgery looks fun and having an excuse to be an arrogant dingus would be awesome.

But I hate working disgustingly long hours, so **** that.
 
Mad Jack said:
They also reserve like, all of their IM rotations for Yale students. If you go to Yale, you're going to get catered to. But I was talking more on the attending-resident level than the attending-med student level. There weren't nearly as many malignant personalities as one would expect in the surgical department.
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I know, but that type of culture pervades through out Yale. It starts from the bottom and continues up. The institutions in which students are treated just like a number or treated like **** -- that type of behavior goes up the chain with respect to attending-resident interactions. There's a reason places like Yale and Stanford have such high alumni donor bases from former medical students. Students very much enjoyed their time at these institutions where they didn't feel like they were just a number.
 
circulus vitios said:
I want to be a surgeon because surgery looks fun and having an excuse to be an arrogant dingus would be awesome.

But I hate working disgustingly long hours, so **** that.
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I swear you're like an upper level of EMDO2018. And surgeons (at least residents) aren't allowed to be arrogant dinguses (dingii?) any more.
 
HoboCommander said:
My experience is that general surgery is much more malignant than specialty surgery. The people in general surgery are just plain mean. What's more, the malignant personalities also tend to be less competent. It's the nicer people who are the better surgeons and they tend to go into specialty fields as they have better board scores.

It's a huge turn off for a lot of people having to deal with seniors that have personality issues in general surgery. Ortho, ENT, and Neurosurgeons are much more humble even though they are more accomplished. The attendings will personally take students out for expensive dinners every day and answer 3 hours worth of questions. In general surgery, you're not even allowed to talk when the attending is in the same room and you are told by the residents to just stand in the corner all day. They rip apart your progress notes for spelling errors and throw surgical instruments at you from across the room.
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:laugh:

I get a feeling from your previous posts that you didn't have a very good experience on your general surgery rotation - but I don't think that qualifies you to declare general surgeons everywhere are terrible people who throw things at students (?). If your surgery experience was actually the way you describe it, that sounds miserable and very much outside the norm for a medical school. I doubt it was that bad.
 
DermViser said:
I know, but that type of culture pervades through out Yale. It starts from the bottom and continues up. The institutions in which students are treated just like a number or treated like **** -- that type of behavior goes up the chain with respect to attending-resident interactions. There's a reason places like Yale and Stanford have such high alumni donor bases from former medical students. Students very much enjoyed their time at these institutions where they didn't feel like they were just a number.
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Makes sense. Give me "anonymous exams" all through preclinical years and these 2 years would have been pure awesome.
 
DermViser said:
Was your rotation really that bad? Not disagreeing with you -- the Dept of Surgery at different medical schools can be quite different based on culture and the type of resident they attract.
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Not really just my rotation - I would have just chalked it up to my hospital being a crappy general surgery residency. But seeing and talking to the general surgery residents and subIs at ~4 top programs while on subIs and comparing their experiences and what they learned each day to what I was going through was a joke. Their rotations seemed like giant wastes of time (and was pretty much what they said). And I never saw a gen surg resident that was happy - just miserable, miserable, miserable.
 
Wordead said:
Not really just my rotation - I would have just chalked it up to my hospital being a crappy general surgery residency. But seeing and talking to the general surgery residents and subIs at ~4 top programs while on subIs and comparing their experiences and what they learned each day to what I was going through was a joke. Their rotations seemed like giant wastes of time (and was pretty much what they said). And I never saw a gen surg resident that was happy - just miserable, miserable, miserable.
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Medical students have been relegated to pretty much doing nothing esp. in high acuity fields like General Surgery. Pretty much everyone who rotates is not expected to do General Surgery so the bar to get a "Pass" is ridiculously low. Your general surgery rotation though is not necessarily indicative of General Surgery.
 
Frazier said:
Makes sense. Give me "anonymous exams" all through preclinical years and these 2 years would have been pure awesome.
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My understanding might be wrong but they still have to take the exams. If they score under a certain number the student doesn't do anything to improve it, I believe that anonymity is then broken. Yale does a lot of things different in many ways, for example, they do not do NBME shelf exams, due to the notion of having that exam dictate learning (which it does).
 
DermViser said:
Medical students have been relegated to pretty much doing nothing esp. in high acuity fields like General Surgery. Pretty much everyone who rotates is not expected to do General Surgery so the bar to get a "Pass" is ridiculously low. Your general surgery rotation though is not necessarily indicative of General Surgery.
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Im talking about the residents. They are very poorly taught. I wonder if the push towards fellowships is out of necessity rather than desire.
 
DermViser said:
I know, but that type of culture pervades through out Yale. It starts from the bottom and continues up. The institutions in which students are treated just like a number or treated like **** -- that type of behavior goes up the chain with respect to attending-resident interactions. There's a reason places like Yale and Stanford have such high alumni donor bases from former medical students. Students very much enjoyed their time at these institutions where they didn't feel like they were just a number.
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The funny thing is that Yale otolaryngology has a reputation for being malignant.

So maybe Yale is just crazy land where up is down and black is white.
 
Wordead said:
Im talking about the residents. They are very poorly taught. I wonder if the push towards fellowships is out of necessity rather than desire.
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That's unusual for a university program directly connected to a medical school. Although I'm sure teaching quality greatly varies by who are actual faculty. It's not an easy residency regardless of whether it's at Yale or any other institution. The difficulty is inherent to the specialty which many med students are unwilling to sacrifice for.
 
Wordead said:
Im talking about the residents. They are very poorly taught. I wonder if the push towards fellowships is out of necessity rather than desire.
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I'm sorry your experience was like this.

My experience at multiple hospitals as a medical student and as a surgery intern has been the opposite.
 
VisionaryTics said:
The funny thing is that Yale otolaryngology has a reputation for being malignant.

So maybe Yale is just crazy land where up is down and black is white.
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Yes, it's not 100% across the board. The idiosyncrasies of faculty members at an institution can greatly color one's impression of the field a lot. Gotta love tenure.
 
DermViser said:
I swear you're like an upper level of EMDO2018. And surgeons (at least residents) aren't allowed to be arrogant dinguses (dingii?) any more.
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I think dinguses is correct unless the root word is Latin.


I actually liked my med student surgery rotation (at a non-academic center with laid back attendings and the same awesome resident for the entire rotation).
 
TooMuchResearch said:
I think dinguses is correct unless the root word is Latin.


I actually liked my med student surgery rotation (at a non-academic center with laid back attendings and the same awesome resident for the entire rotation).
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Probably bc it was at a non-academic medical center. Everything is nice in suburbia.
 
HoboCommander said:
throw surgical instruments at you from across the room.
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i-wish-a-mf-would.jpg
 
HoboCommander said:
My experience is that general surgery is much more malignant than specialty surgery. The people in general surgery are just plain mean. What's more, the malignant personalities also tend to be less competent. It's the nicer people who are the better surgeons and they tend to go into specialty fields as they have better board scores.

It's a huge turn off for a lot of people having to deal with seniors that have personality issues in general surgery. Ortho, ENT, and Neurosurgeons are much more humble even though they are more accomplished. The attendings will personally take students out for expensive dinners every day and answer 3 hours worth of questions. In general surgery, you're not even allowed to talk when the attending is in the same room and you are told by the residents to just stand in the corner all day. They rip apart your progress notes for spelling errors and throw surgical instruments at you from across the room.
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tumblr_inline_mobnegy7Oa1qz4rgp.gif
 
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Every general surgery resident at my program, save for the chiefs, was miserable. 90% of the students on my GS M3 rotation, did not have a good time on their general service.

As stated above, worse hours (with a horrible, brutal residency in which you are constantly **** on), worse pay and more spots leads to it being less competitive.
 
Chronic sleep deprivation brings out people's true character. There are super nice people in gen surg but one of the meanest, most self serving residents i ever met was gen surg. Now you want some super chill people, check out ortho.
 
giantswing said:
Chronic sleep deprivation brings out people's true character. There are super nice people in gen surg but one of the meanest, most self serving residents i ever met was gen surg. Now you want some super chill people, check out ortho.
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You can call it true character if you want, but sleep deprivation would make anyone pissed off. Sleep allows your brain to recalibrate and I believe it also replenishes neurotransmitter levels. Cut that off and you have decreased level of those neurotransmitters thus not surprisingly resulting in issues like depression, etc. I hardly believe it's that person's "true character".
 
DermViser said:
You can call it true character if you want, but sleep deprivation would make anyone pissed off. Sleep allows your brain to recalibrate and I believe it also replenishes neurotransmitter levels. Cut that off and you have decreased level of those neurotransmitters thus not surprisingly resulting in issues like depression, etc. I hardly believe it's that person's "true character".
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Yeah but I've found that nice people are generally nice tired people, and mean well rested people get way, waaaaaaaay meaner when tired. I get dumber.
 
HoboCommander said:
My experience is that general surgery is much more malignant than specialty surgery. The people in general surgery are just plain mean. What's more, the malignant personalities also tend to be less competent. It's the nicer people who are the better surgeons and they tend to go into specialty fields as they have better board scores.

It's a huge turn off for a lot of people having to deal with seniors that have personality issues in general surgery. Ortho, ENT, and Neurosurgeons are much more humble even though they are more accomplished. The attendings will personally take students out for expensive dinners every day and answer 3 hours worth of questions. In general surgery, you're not even allowed to talk when the attending is in the same room and you are told by the residents to just stand in the corner all day. They rip apart your progress notes for spelling errors and throw surgical instruments at you from across the room.
Click to expand...

Considering you've shown the depth and maturity of a 13 year old Bieber fan when it comes to your choice of field and blind adoration of neurosurgeons, it's unsurprising you've fallen into believing such a broad and horribly crude stereotype.

Oh wait. I guess this means I'm just another mean general surgeon.
 
southernIM said:
Considering you've shown the depth and maturity of a 13 year old Bieber fan when it comes to your choice of field and blind adoration of neurosurgeons, it's unsurprising you've fallen into believing such a broad and horribly crude stereotype.

Oh wait. I guess this means I'm just another mean general surgeon.
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quiet down, I am calling your attending!



ps: i think i have what it takes to be a surgeon
 
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southernIM said:
Considering you've shown the depth and maturity of a 13 year old Bieber fan when it comes to your choice of field and blind adoration of neurosurgeons, it's unsurprising you've fallen into believing such a broad and horribly crude stereotype.

Oh wait. I guess this means I'm just another mean general surgeon.
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Believe it or not, most people (if not all) outside of medicine think neurosurgeons are the smartest of all docs...
 
W19 said:
Believe it or not, most people (if not all) outside of medicine think neurosurgeons are the smartest of all docs...
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And people outside of medicine also think vaccines cause autism. Why should we care what they (or anyone) thinks about who's the smartest?
 
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