What are you doing for your fellowship? I can call these people any time any where for support. Also I just checked your daily schedule. Posted by. If you like office/clinic and spending a lot of time talking to patients, it may not be for you as well. Great question and I don’t know that I have a perfect answer. You may have to do a lung resection. We were fortunate in our program to have a lot of APP support on the floors so interns also came to double scrub bigger cases pretty frequently.-PGY2 Our PGY2s were more or less considered the equivalent of interns. Don't want to be stuck doing hernias, gallbladders, feeding tubes and lipomas while specialists get all the cool stuff? But fellowships don't really care about how you do as a med student, only about how you do as a resident. Acute Care Surgeon: This is basically non elective general surgery. In other words don’t lose the forest for the trees. 1. What is MIS surgery like? Close. But I don't kid myself - I'm not going to be the person with 3 RO1 grants and 200 publications. Plus there are several non-accredited fellowship programs that exist outside of the match. This was so awesome to read. By the time you finish training, everyone will be in group or hospital-based practices. I am a retired Plastic and Reconstructive surgeon in Santa Ana. You are the most efficient doc in the hospital, in house and ready to cut. Its you buddy. I love the environment of academics and have a hard time imagining ever practicing outside of it. They still took call (or did night float). Best of luck applying to Urology! I'm definitely enjoying it, but going back to one of the misconceptions you mentioned "General Surgery is just choles and hernias." EDIT: Also, how are outcomes, on average? General surgery used to be the most sought after branch because it provided ample scope to practice a wide range of surgeries and give the practitioner a lot of satisfaction of surgical practice. >250 Step 1/2, good grades, good school, etc. NO, the field is not "dying", please stop asking. Or you could be an acute care surgeon with fixed hours. I'm applying to Urology this year and I've spent a ton of time with the faculty at my school as well as friends who are residents at various programs, so I'll talk a bit about it. What drew you to surgery and your specific area? Also Thanks so much for the post, it's great. The four blobs of silicone extracted from his urethra and bladder were in toto five inches in length. I am trying to get a better sense of the lifestyle of urology vs. ENT vs. ortho DURING residency and afterwards. But try to focus on why you became a surgeon and the “big picture”. A General Surgeon in your area makes on average $323,228 per year, or $7,478 (2%) more than the national average annual salary of $315,750. What our junior residents (interns and PGY2s) did was do 5 night/2 night system to cover a week - so an intern did 5 nights in a row (M-F), then flipped back to days; and another intern did 2 nights (Sat/Sun). Residency years:-Intern Year Traditionally was the year where you learned how to take care of patients. If you're serious about surg onc you should do 2 years. The important concern going forward on your career pathway is the quality of your life, both in its professional and personal aspects. The acute care surgeons I've worked with are definitely doing nothing more complex than a general surgeon in a decent-sized community hospital, and I would say they have less variety but higher acuity. Hehe. I love teaching and working with students and residents. I work hard, but I do the things I like to do. Thanks for the great write-up! The amount of work hours deters many people from picking surgery. Based on recent job postings on ZipRecruiter, the General Surgeon job market in both Chicago, IL and the surrounding area is very active. Any recs on programs? I would just tell you that at many programs out there, that kind of behavior doesn't exist and won't be tolerated. Surgical critical care 2. You may have to do a distal panc/spleen. Here you are the most complete physician I can think of. If you go into private practice urology, you will be called in from home to place foley catheters at 2 AM. Lots of hours and lots of nights in the hospital For a great number of fields, the moment you graduate residency you can pretty much count on never stepping foot in the hospital at night again. I am about to go into my intern year for surgery, and I unfortunately have not met a lot of surgeons outside of my own med school/residency program whom I can ask about this stuff. Lets divide it into its parts and find out. Since I know that I … Surg Onc is one of if not the most competitive fellowships for general surgery. Now, my second block of general surgery is ortho- which is sweet because thats one of the things I was considering, but my attending is nearing retirement, and he only does knees once a week. When people come in with diverticulitis, appendicitis, cholecystitis, nec fasc, etc, you are there to get them in and out. I think our ortho and plastics colleagues work just as hard as I do; they also take a lot of call and spend the night in the hospital a ton. I think it may be possible in the near future to have a career as a general surgeon and also have a manageable lifestyle. You also lead the team on rounds and cover senior resident call sometimes. New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. -make friends with your co residents. Change how you eat. How did you manage to integrate loved ones into your residency training? It has led to growing frustration, anger, and burnout. After three days, he could no longer keep it up. The field is small, so you get to know people. My chief class in particular, and residency program in general, was a HUGE support network and I couldn’t have done it without them. Close. Wow! The process of applying for fellowships sucks. I really think the entering generation of surgeons (myself and the residents junior to me) are very different than their forebears, and our field will continue to improve in the future. When my patients lose limbs, it's to twinkies and Marlboros, not a drunk on the highway. Someone suggested silicone caulk as a substitute for natural reaction. My general surgery program was done at a quaternary referral center with ~1000 beds and a Level 1 trauma center. How A Surgeon Balances Work & Life Dr. Buck explains how you can create what you want as far as a work life balance. Is it risky? Chief Year also means running your service at all times - I was on home call for probably 300 nights out of the year (alternated weekends with another senior to get a weekend off, and if I was really tired or had to come in the night before I would have my PGY3 cover the home call that night). This year I did over 300 cases including my first whipple, kidney transplant, esophagectomy, carotid, and many other sweet cases.PGY4 The PGY4s served as chief residents of the trauma service, so this defines your experience for the year. Lung laceration? General Surgery is just choles and hernias I see these types of comments a lot, often deriding general surgeons or saying why someone picked a “cooler” subspecialty. -spend more time with patients. General surgeons, ortho, and vascular guys work a lot on call. Without the research I probably wouldn’t have even gotten an interview at the program I matched at so to some degree yes. Discuss surgery and surgical subspecialties. And lots. You also have to find time to apply and interview during a very clinically busy residency and coordinate with your co-residents to adequately cover for each other. Shows there's a great variety of training opportunities out there for sure. Everything leads up to this. In med school the path to success is fairly straightforward - do good on step 1, get honors on the wards, etc. This is a little off topic but how do you feel about using mesh slings to treat stress urinary incontinence? Third year here and I actually scheduled my general surgery blocks as my very first rotations so that I could either rule in or rule out surgery. The 5 least healthy were general surgeons, psychiatrists, ob/gyns, pediatricians, and critical care physicians. It is also definitely the most academic, with a long history of surgical chairs being surgical oncologists/HPB surgeons. The expectations for operative volume and case complexity go way up. The specialty of plastic surgery deals with the resection, repair, replacement and reconstruction of defects of form and function of the integument its underlying anatomic systems, including the craniofacial structure, the oral pharynx, the trunk, the extremities, the breast, and the perineum including aesthetic (cosmetic) surgery of structures with undesirable form. Is it a basic, go-to treatment option or is it last resort? Endocrine system In addition, general surgeons are expected to have knowledge and experience in: 1. The only true downsides are the competitiveness of the field, the length of training (5-6 years for residency, an extra 1-2 for fellowship), the early hours, and the huge amount of work you will put in during residency. The scope of practice of general Surgery is incredibly broad, especially in training. Running hundreds of traumas in the ED, taking patients to the OR for operative traumas (hopefully! Background: I am a PGY-8, about to be PGY-9 (the flair only goes to 6 on this forum) surgery fellow. Thank you for this. Difficult outcomes It is very challenging. I pick the lifestyle of general surgery: operating, constantly improving my skills, and giving my patients the opportunity for a better life. You don't have to worry about the job market because only 250 people join the fold each year. Our duty hours system tracked the number of call days and I did exactly 100 calls in one year. Almost all of the programs are a match, but not all are done through the NRMP, and they are almost all on slightly different matching schedules. 10 Worst Medical Specialties For Lifestyle Published on April 26, 2017 at 1:07 am by Madison Morgan in Lists Share Tweet Email try and make good career choices. Fellowship applications are also much more nebulous and secretive than med school or residency. Lots of cancer (testicular, bladder, renal, prostate), lots of lifestyle improvement (stones, incontinence, ED), lots of life-changing stuff (infertility comes to mind). Most of my friends that did well on Step 1 are the type that love surgery and are going into the surgical specialties because better pay/lifestyle (uro, ENT, ortho). One of the most important part of your surgical training is learning when NOT to operate. I think that the stress/burnout factor is significantly tied into why General Surgery has such a high attrition rate. I know that /u/Nysoz beat me to the punch, but I will try to add some thoughts and give a little bit of a different perspective as our experiences while similar have some differences. We have a true chief-run general surgery service that we all rotate on for 2 months - you have a PGY3 on service with you and the two of you do cases together with an attending present for supervision/backup. In short, it's a field with happy patients, (mostly) happy surgeons, a ton of cool procedures, and a nice lifestyle. We have an annual inservice exam called the ABSITE but I got the impression (and was told) on the interview trail that no one cared about it as long as your scores weren't abysmal. Pancreatic injury? Wondering how you’re PGY9, PGYs1-7: general Surgery + 2 yrs research, I don’t disclose my field because it narrows me down to a very small number of people and I hold out hope for some shred of anonymity. /r/medicine is a virtual lounge for physicians and other medical professionals from around the world to talk about the latest advances, controversies, ask questions of each other, have a laugh, or share a difficult moment. “General surgery residency training can be challenging at times but what makes it worthwhile, fun and memorable are the relationships you form with your colleagues during training years.” Do residents have time for a personal life? It's a well reimbursed specialty as well. For me I have definitely gotten burnt out, I think pretty severely during my second year and to a lesser extent during the latter half of my chief year. See the Grueling Life of an American Surgeon ... Gardi was up at 3:00 a.m. to meet with the chief surgical resident in General Surgery and Trauma as … Care to share where you did fellowship? This goes for both practice and training. If you're reading this and you're a resident who wants to share your specialty experience, check out this post to see some requests, and then start your own "Why you should go into X" thread in the sub. Expectations for jobs in academia are wildly misaligned with reality. :-To some extent it's basically if the above things don't ring true to you. It is a fellowship out of general surgery and its basically general surgery on steroids with more variety. New comments cannot be posted and votes cannot be cast. Former Hospital Executive, Doctors and Two Others Admit Roles; Agree to Cooperate. Press J to jump to the feed. That means interrupted sleep, missed kids events, walking out on dinners, unable to schedule anything more than 30 minutes from the ER as often as every third or fourth night, not to mention no alcohol as often as every third or fourth day. I've dealt with death and debilitating injury more often than I'd like, and I'm a trainee still. That and penises. If you manage to snag a truly pure elective practice with no general surgery call you may come close but that's about it. My father was a surgeon, practicing thoracic/abdominal surgery in New England. I'm a PGY8 and I still take in house call now. Trauma Despite the term "general", surgeons that practice general surge… Surgeries range from the very short (urolifts, vasectomies, circs, etc) to medium length (kidney stones, TURPs, PVPs, prostheses) to long (nephrectomy, prostatectomy, cystectomy) to very long (a lot of reconstructive stuff, RPLNDs, etc). It's crucial that surgeons be able to connect with patients quickly and it is painful to watch a surgeon that can't do this well. You can have tough conversations with patients General surgeons are too often the bearer of bad news. You can fix a lot of problems in clinic - BPH, incontinence, ED, etc can be treated with lifestyle modifications and medications. This is a highly moderated subreddit. By using our Services or clicking I agree, you agree to our use of cookies. I've been thinking about surgical specialties, and I'm really starting to think trauma may be for me. I have a deep, deep admiration for those who can cope with the relative youth and health of patients who have sustained tragic injuries through no fault of their own. During my residency, I did two full years of research and obtained a masters degree. Press question mark to learn the rest of the keyboard shortcuts. Thanks! When you’ve taken care of these patients together, saved lives and lost them together, there is a special bond that forms. Simply to make you more competitive for X fellowship? Surgeons of Reddit: Why is your surgical specialty or sub-specialty the best? I'm at a medium sized community hospital and pretty much everything surgically related is outpatient. Toll free: 800-621-4111 (P) 312-202-5000 (F) 312-202-5001 (E) postmaster@facs.org I trained at an academic/University general surgical residency program and am now in training at another heavily academic center as a fellow. You have to be the one to stand your ground and tell a consulting team that no, you won't be operating on their patient even though everyone wants you to. 136. To be reading this, you either already are or are on the way to becoming a cardiothoracic surgeon. Wide range of pathology. But science shows that people who eat seven or more portions of fruits or vegetables have a 42% re… - Thats honestly all I saw on my first block. I have hobbies I enjoy outside of work. I took PGY3s through some awesome cases including perfed ulcers, gallstone ileus, sigmoid volvulus - all with the attending hanging out and not scrubbing. Lots of opportunities for research and tons of new technologies being used every year, so the field is cutting edge and you get to constantly improve as a surgeon. Hernias fixed. You can say no/You can handle death The flip side of the above is that not every patient will be helped with an operation. And unlike medical intensivists, if the patient needs to go to the OR, thats you too! Happy patients, less time spent on the floors. -I would encourage people though not to focus too much on the difficulty of the residency. It was wildly unpopular, and we were in the process of developing a month long night float rotation to replace it when the most recent hours changes came along. On our ICU month it meant closer to 30 - had to stay for formal ICU rounds and present all the new admits from that day.Night Float After 2011 my program introduced a semi night-float system. The best part? Most of us went into medicine in general because of a drive to help people. General surgery is known for an intense residency: 30 hour calls and four days off in a month. If I had wanted to I could have applied to any of the subspecialties. But then i work my extra jobs because i'm bored, but that's a personal decision. My experience was a little different than the prior write up - we never rotated in the ED or on a medical service (I didn't actually know anyone did that). I did well as a medical student yes. You also run the show at the VA for two months. Plus my Urologist has 2 Ferraris a Maserati and a brand new mp412c mclaren so i assume he is doing quite well. Learning how to not just operate but show someone else how to operate is a whole new learning curve (that I am still very much working on). I picked surgery because it was my favorite, but I could see myself doing other specialties and having a reasonably good time of it. Press question mark to learn the rest of the keyboard shortcuts. A lot of burnout comes from a misalignment of expectation and reality. It's five years; your career afterwards is 25-30 years. You have the opportunity to add to the collective body of knowledge of medicine. Good luck out there in practice! On his second arrival, he was somewhat more compliant and got a suprapubic catheter. Alimentary tract (esophagus and related organs) 2. Heather Yeo is an academic surgeon who is publishing a lot of interesting stuff on this issue right now. Don't know his long-term outcome, but it's safe to say he won't do that again anytime soon. I don't have kids but I know a ton of surgery residents who do and they love their kids and are incredibly committed parents. Yes I'll admit theres 10 pairs of socks for every xbox but when that arrives, you are in for a fun night. Don't want to be stuck doing hernias, gallbladders, feeding tubes and lipomas while specialists get all the cool stuff? A subforum for discussions related to training programs , applications, the interview and matching process for Surgery General surgeon here with an MIS fellowship. Surg onc and peds need 2-3 research years for sure, unless you did a phd in med school and had a ton of GOOD publications. Thanks for your post, I really hadn't realized how much variety was in the field. If you don't like adrenaline inducing cases and operative challenges then you may not like this specialty. I will be pushed to my limits and then some. My attempt at an inclusive list although I'm sure I will forget something:-Trauma/Acute Care-Endocrine-Breast-MIS-Surgical Oncology-HPB-Colorectal-Transplant-Cardiothoracic-Vascular-Pediatrics-Plastics. The gruesome stuff) die than survive, or is it completely subjective? You do have to love surgery, but it is neither my first nor my only love in life. You can do small procedures in clinic (cystoscopy, vasectomy). What is your "bread and butter" surgery? After residency (when you're called in at 2 AM to place foleys), your schedule is a lot less variable. That directness evolves in all of us over time in our training. Dismissing some misconceptions:The Asshole Trope I am often mystified when I read the comments on reddit from med students about the way their surgery attendings/residents behave.