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workload/lifestyle of specialities
- Thread starter officedepot
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Pulmonary/Critical Care . . . while not on your list, you did say to add others as well.
We take the sickest patients that no one else will deal with (ie. blocks the admitting of), which may be a bit different from place to place - ie. in someplaces cards might be consult only and we take all of the hearts, or neurosurg might be consult only and we take all the brains and spines not directly trauma related, etc. that on top of your normal run of the mill bread and butter MICU patients. You work as long as there are new and or unstable critically ill patients, until those patients are either stable or dead. How long this takes and who comes in is unpredictable - you do when it's needed, which includes but is not limited too, staying late, coming in in the middle of the night, getting to work before the sun comes up, missing birthday parties, missing sporting events, missing anniversaries. You do a lot of varied bedside procedures including central venous lines, arterial lines, chest tubes, and intubations as well as bronchoscopy +/- interventions. You are an expert on mechanical ventilation, and it's many variations. You deal with death on a fairly regular basis.
Pulmonary clinic and pulmonary consult service is a lot of patients with shortness of breath of varying reasons, which can be very complicated to sort out. It can be interesting, but more often than not is chronic lung disease of a more mundane variety.
Your overall lifestyle is probably pretty dependent on the number of partners you have sharing the call burden for the MICU and the surrounding patient population (ie. is there enough population in the local area to keep an ICU busy?) With that said, this is definitely NOT "lifestyle" specialty, though you at least tend to be compensated relatively well for your time. This one's for people who like work too.
We take the sickest patients that no one else will deal with (ie. blocks the admitting of), which may be a bit different from place to place - ie. in someplaces cards might be consult only and we take all of the hearts, or neurosurg might be consult only and we take all the brains and spines not directly trauma related, etc. that on top of your normal run of the mill bread and butter MICU patients. You work as long as there are new and or unstable critically ill patients, until those patients are either stable or dead. How long this takes and who comes in is unpredictable - you do when it's needed, which includes but is not limited too, staying late, coming in in the middle of the night, getting to work before the sun comes up, missing birthday parties, missing sporting events, missing anniversaries. You do a lot of varied bedside procedures including central venous lines, arterial lines, chest tubes, and intubations as well as bronchoscopy +/- interventions. You are an expert on mechanical ventilation, and it's many variations. You deal with death on a fairly regular basis.
Pulmonary clinic and pulmonary consult service is a lot of patients with shortness of breath of varying reasons, which can be very complicated to sort out. It can be interesting, but more often than not is chronic lung disease of a more mundane variety.
Your overall lifestyle is probably pretty dependent on the number of partners you have sharing the call burden for the MICU and the surrounding patient population (ie. is there enough population in the local area to keep an ICU busy?) With that said, this is definitely NOT "lifestyle" specialty, though you at least tend to be compensated relatively well for your time. This one's for people who like work too.
C
cowme
Of these, neurosurgery, and neuro-IR have by far the worst lifestyles.
Gen surg/ Neurosurg, expect to be in at 6 AM and still be operating on the same case at 9 PM some days. In private practice, you have more control over your lifestyle obviously.
Neuro-IR: variable, depending on what type of practice you join. Expect to be called in at crazy hours (lots of emergencies)
IR: also variable. If you do vascular work, expect to be called in at crazy hours. If you do interventional oncology, you can have a pretty predictable 9-5 lifestyle.
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Neurosurgery is a mixed bag, at least once you become an attending. Your lifestyle during residency will be painful regardless of what program you are in - 80 hours a week, every week. Getting to the hospital at 4:30 am. Lots of call as a junior resident with absolutely no time for sleep. Cases that go 12 hours. Etc etc.
Private practice (or academic) spine neurosurgeons tend to deal with multiple patient populations - spinal mets, radiculopathy in otherwise healthy people, low back pain (these are painful patients), and so on. The lifestyle can be reasonable (although you'll see a ton of people in clinic on those days). Most cases are not more than 3 hours in the OR. Some of these guys in private practice hardly ever take call. Most of the guys i've seen probably work 60 hrs a week like this, mostly M-F.
Academic based, tumor and vascular neurosurgeons have it pretty rough. The cases are long, and lots of the patients are very sick. Those based in academic practices often take a reasonable amount of call. Throwing in research (either clinical or basic science) adds yet more time. I know plenty of these guys who also work 80 hours a week alongside the residents.
Needless to say, there are plenty of other subspecialties - peds, functional, skull base.
Private practice (or academic) spine neurosurgeons tend to deal with multiple patient populations - spinal mets, radiculopathy in otherwise healthy people, low back pain (these are painful patients), and so on. The lifestyle can be reasonable (although you'll see a ton of people in clinic on those days). Most cases are not more than 3 hours in the OR. Some of these guys in private practice hardly ever take call. Most of the guys i've seen probably work 60 hrs a week like this, mostly M-F.
Academic based, tumor and vascular neurosurgeons have it pretty rough. The cases are long, and lots of the patients are very sick. Those based in academic practices often take a reasonable amount of call. Throwing in research (either clinical or basic science) adds yet more time. I know plenty of these guys who also work 80 hours a week alongside the residents.
Needless to say, there are plenty of other subspecialties - peds, functional, skull base.
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From my understanding, most Neurosurgery programs have 88 hour/week exemptions.
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Yeah but I don't think anyone actually follows those regulations lol. It's nice for the interns but apparently the higher level residents hate it.
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Lmbo at this goat.
Pathology--40 to 60 hours a week (call and no call), usually 9-5 with one day of call possible (can be done from home if it's not an autopsy), usually over $150,000 for a salary, very little malpractice insurance
C
cowme
I'm gonna go out on a limb and assume that someone choosing between IR, neuroIR, neurosurg and Gen surg is not interested in pathology...
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Interventional cardiology might be something to look at. I shadowed a doc in the Cath Lab and asked him about lifestyle. (With a straight face) he said he had it pretty good, in around 6 or 7am, usually home by 8pm, call 1-2 days/week. 60 hours/week + call being the "good" end of the specialty's scale doesn't seem like my idea of a lifestyle specialty, so maybe it's up your alley.
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I'm guessing he works 4 days/wk? A 14 hr day sounds so miserable to me, but I'd be all about it to have 3 days off.
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Serious contender for most fatuous SDN comment ever. Even the neurosurgeons I know have hobbies, for ****'s sake.
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Nah. More like 5-6 days/week.
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Cards is a very, VERY "type A" profession... I don't think they'd be able to stand taking 3 days off a week even if they could lol.
Anyway Interventional Cardiology is but one small facet of the whole of cardio... I know cardiologists who just do caths, and work 3 days a week in the cath lab, 2 days a week in clinic. 9-5 on clinic days, 7-6 on cath days, and call every other week or every 2 weeks. Load is possibly less depending on how many patients you have in.
It's actually quite a good lifestyle but it's largely what you make of it in private practice.
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