Ask a general surgery resident anything

[moneyman698]

Hello, I'm a current PGY3 general surgery resident at an academic program in the northeast. I used to float on these forums a lot when I was a premed student and figured I'd give back some perspective on what it's currently like to be a general surgery resident. I loved when residents would come back and give some insight into medical and surgical training as a whole. I have the weekend off and headed back to work next week so forgive me if my responses are delayed.

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[NotADoctor1]

Thanks for doing this!!
Why gen surg? What are the bread and butter operations you do? What are your favorite operations to do?

 

[moneyman698]

Thanks for doing this!!
Why gen surg? What are the bread and butter operations you do? What are your favorite operations to do?

Coming into medical school I wanted nice lifestyle and balance. I was originally interested in emergency medicine but my first 3rd year rotation was general surgery and I developed a passion for surgical critical care and trauma surgery. I realized to most exciting aspects of trauma happens in the operating room, not the ER, at least for me. I'm sure ER docs feel differently. I struggled with the lifestyle but then spoke to a few attendings on the field of acute care surgery and how it can be conducive to a nice lifestyle.

Bread and butter operations are lap choleys, lap appys, hernias, and wound debridements. Oddly enough, I love going into chest so open thoracotomies, generally in a trauma setting are my favorite operaitons.

 

[apple_juice]

Hi, what does a typical day look like for you? Thanks!

 

[Doctoscope]

Coming into medical school I wanted nice lifestyle and balance. I was originally interested in emergency medicine but my first 3rd year rotation was general surgery and I developed a passion for surgical critical care and trauma surgery. I realized to most exciting aspects of trauma happens in the operating room, not the ER, at least for me. I'm sure ER docs feel differently. I struggled with the lifestyle but then spoke to a few attendings on the field of acute care surgery and how it can be conducive to a nice lifestyle.

Bread and butter operations are lap choleys, lap appys, hernias, and wound debridements. Oddly enough, I love going into chest so open thoracotomies, generally in a trauma setting are my favorite operaitons.

Thank you for the AMA. Are you at an academic or community program? What do you think are the pros/cons of each?

 

[moneyman698]

Hi, what does a typical day look like for you? Thanks!

Depends on the day. Usually get to hospital around 530, lookup new patients and overnight events then round from 6-7. At 7 or 730 cases usually start so will go to operating room and catch up with floor stuff in between cases. If i'm not in operating room i'll see consults throughout the day and oversee the juniors complete floor work. Signout is at 5 but if cases go late or there still work to be done then will stay a little later.

 

[moneyman698]

Thank you for the AMA. Are you at an academic or community program? What do you think are the pros/cons of each?

I'm at an academic program that rotates at community hospitals as well. Pros of academic are obviously prestige, access to research, generally attendings are hospital employed and have more of an obligation to teach. However, there may be fellows who will take the best cases, egos can be a little bit more malignant. Community hospitals can be high volume, however, may have physicans who are private practice or not necesarily employed by the hospital so they don't have more of an obligation to teach or give autonomy in medical decision making. Obviously every program is different. If you want to go for something ultracompetitive like peds surgery then need top tier academic, but community wont limit fellowships for the most part.

 

[cookie_munster]

Are you currently satisfied with your work/life balance while in residency?

What's the work/life balance like for attendings?

 

[moneyman698]

Are you currently satisfied with your work/life balance while in residency?

What's the work/life balance like for attendings?

I've made an effort to main a good work/life balance but as you can imagine with an 80 work week theres still going to be a good chunk of events you'll have to miss out on. Theres weddings, family vacations, and high school reunions I missed and will never get back. It's not also gloom and doom. I've gone on dates, celebrated holidays, and gone on vacations and weekend getaways as well. With general surgery however, your workday does not end when you get home, theres countless hours outside of the hospital required for reading and perfecting your craft.

I can't speak to the life of attendings as I'm not there yet, but theres a spectrum depending on location, specialty, and other factors. A transplant surgeon working at a university hospital with a robust transplant program is going to have a different schedule than a minimally invasive surgeon who only does elective bariatrics.

 

[la flame]

Do most general surgery residents work 80~ hour work weeks?.........besides academics, what did you do during med school to make yourself a competitive candidate for your resident spot? Thank you!

 

[NotADoctor1]

I'm at an academic program that rotates at community hospitals as well. Pros of academic are obviously prestige, access to research, generally attendings are hospital employed and have more of an obligation to teach. However, there may be fellows who will take the best cases, egos can be a little bit more malignant. Community hospitals can be high volume, however, may have physicans who are private practice or not necesarily employed by the hospital so they don't have more of an obligation to teach or give autonomy in medical decision making. Obviously every program is different. If you want to go for something ultracompetitive like peds surgery then need top tier academic, but community wont limit fellowships for the most part.

Do you plan on pursuing a fellowship? Do most people? What are some of the more competitive fellowships and why?

 

[moneyman698]

Do most general surgery residents work 80~ hour work weeks?.........besides academics, what did you do during med school to make yourself a competitive candidate for your resident spot? Thank you!

Yes most general surgery residents work 80 hour work weeks. General surgery is pretty broad and you need to put in a lot of time to become well versed.

When I was applying for residency, step scores got you through the door but they also value 3rd year rotation grades, having LORs from well known surgeons, research, and audition rotations can help too.

 

[moneyman698]

Do you plan on pursuing a fellowship? Do most people? What are some of the more competitive fellowships and why?

Yes, plan on pursing a trauma/ACS fellowship. I would say most general surgery graduates pursue some type of fellowship for two reasons. The current trend in medicine is headed toward sub specialization so if you want to practice in a desirable location you'll benefit from having some sort of specialization. Also, theres an increasingly number of graduates who don't feel comfortable going straight into practice after residency.

In terms of more competitive fellowships, pediatric surgery and surg onc are up there. Plastics is pretty competitive. The competitiveness is linked to the number of seats available. Peds surg allows you to work with kids and has some pretty cool operations.

 

[Dunkthetall]

How often do you have to deal with literal 💩? As in have to see, touch, or smell it? General surgery seems really cool, but I absolutely hate stool haha.

 

[moneyman698]

How often do you have to deal with literal 💩? As in have to see, touch, or smell it? General surgery seems really cool, but I absolutely hate stool haha.

Almost every single day. With that being said, there are people who into general surgery who don't like bowel and opt to do other things, thoracic, plastics etc

 

[Dunkthetall]

Almost every single day. With that being said, there are people who into general surgery who don't like bowel and opt to do other things, thoracic, plastics etc

Opf😂
Do you just get used to it? Then bread and butter like appendectomies and cholecystectomies look cool, and general thoracic seems awesome; but running into a little present like 💩 during surgery or something seems awful. I don’t know why, but I’m fine with blood, pee, and other fluids, but stool just gets to me.

 

[Med16484]

How much would you say the prestige of your medical school factors into getting a surgical residency?

 

[nibhighfootballrules]

Hi- what advice would you give someone starting medical school that is interested in pursuing a general surgery residency? Thanks!

 

[Gilakend]

Yes most general surgery residents work 80 hour work weeks. General surgery is pretty broad and you need to put in a lot of time to become well versed.

Do you find or feel that you work more than those in surgical subspecialties because of this? Excluding nsurg.

Did you do gen surg because you enjoyed the variety/day-to-day or was it viewed as more of a stepping stone to get to the ultimate goal of trauma/ACS?

Thanks for doing this!

 

[7thAndLASTPoopoftheDay]

How much of your time do you have to spend dealing with administrative/bureaucratic BS?
Is your specialty better or worse than others in this respect?
Do you expect the amount will go up or go down when you become an attending?

 

[DNAJB6]

Do duty hour restrictions adversely affect your training or necessitate that you pursue fellowship training after graduation from residency?

 

[moneyman698]

Opf😂
Do you just get used to it? Then bread and butter like appendectomies and cholecystectomies look cool, and general thoracic seems awesome; but running into a little present like 💩 during surgery or something seems awful. I don’t know why, but I’m fine with blood, pee, and other fluids, but stool just gets to me.

If stool really gets to you, gen surg is not the field for you.

 

[moneyman698]

How much would you say the prestige of your medical school factors into getting a surgical residency?

Very much so. More prestigious medical school will obviously open doors. Applicant from a top medical school has leverage when competing for lesser competitive residencies.

 

[moneyman698]

Hi- what advice would you give someone starting medical school that is interested in pursuing a general surgery residency? Thanks!

I would say learn your anatomy thoroughly. After first years, you really don't use anatomy that much up until maybe your surgery clerkships. Having a solid base will help you in residency when relearning all of that knowledge.

 

[moneyman698]

Do you find or feel that you work more than those in surgical subspecialties because of this? Excluding nsurg.

Did you do gen surg because you enjoyed the variety/day-to-day or was it viewed as more of a stepping stone to get to the ultimate goal of trauma/ACS?

Thanks for doing this!

NO subspecialties often have it harder. Having two residents in each year to handle call across 3 hospitals can be overbearing.

I do enjoy general surgery. I very much embrace it, in fact one of the things I love about trauma is its really one of the last fields that let you practice as a true general surgeon.

 

[moneyman698]

How much of your time do you have to spend dealing with administrative/bureaucratic BS?
Is your specialty better or worse than others in this respect?
Do you expect the amount will go up or go down when you become an attending?

Very minimal do I deal with administrative BS. As a resident, most of your administrative tasks deal with the residency program itself such as making resident schedules, academic schedules, clinic schedules etc.

 

[moneyman698]

Do duty hour restrictions adversely affect your training or necessitate that you pursue fellowship training after graduation from residency?

I dont think duty hours adversely affect training, you can always choose to lie about your hours if you want to snag an extra case. I think more residents are pursing fellowship due to decreased autonomy in the operating room, and decreased cases as there are more conditions which can be successfully treated conservatively.

 

[NY_Med]

Hello, I'm a current PGY3 general surgery resident at an academic program in the northeast. I used to float on these forums a lot when I was a premed student and figured I'd give back some perspective on what it's currently like to be a general surgery resident. I loved when residents would come back and give some insight into medical and surgical training as a whole. I have the weekend off and headed back to work next week so forgive me if my responses are delayed.

I am actually pursuing general Surg > trauma! (still got a long way to go though obviously) Thank you so much for the insight! Very very helpful!

 

[Medstudent00]

Hi there! I’m in the spring of my M1 and wanting to do surgery, but I’ve had a rough start so far and am working hard to increase my grades. My school does Honors/Near Honors/P/F and I have just passed all of my classes. Do you think this will majorly hurt my ability to match?
I go to University of Iowa, and I have decent extracurriculars so far, including summer research (which we are planning to publish/present), a leadership position, volunteer hours with mobile clinic, and a part-time job as an EMT.

 

[Banco]

Hi there! I’m in the spring of my M1 and wanting to do surgery, but I’ve had a rough start so far and am working hard to increase my grades. My school does Honors/Near Honors/P/F and I have just passed all of my classes. Do you think this will majorly hurt my ability to match?
I go to University of Iowa, and I have decent extracurriculars so far, including summer research (which we are planning to publish/present), a leadership position, volunteer hours with mobile clinic, and a part-time job as an EMT.

You will be fine. Clerkship grades + test scores are most important. Pre-clinical grades really don't matter 99% of the time. Do well on your clerkships, Step 1/2, and get some research with pubs in and you will be good to go.

 

[Medstudent00]

You will be fine. Clerkship grades + test scores are most important. Pre-clinical grades really don't matter 99% of the time. Do well on your clerkships, Step 1/2, and get some research with pubs in and you will be good to go.

Thank you! I have been a little worried since my class will be the first to have Step 1 P/F. Although, I’m assuming Step 2 will just take all of the weight now.

 

[Banco]

Thank you! I have been a little worried since my class will be the first to have Step 1 P/F. Although, I’m assuming Step 2 will just take all of the weight now.

Probably yeah setp 2 will become the next thing. And it's likely somewhat school dependent, but pre-clinical may only play a role in AOA selection (maybe), but for it was literally never mentioned in my dean's letter, I was never asked about it in any interview - no one cares.

 

[NY_Med]

Hello, I'm a current PGY3 general surgery resident at an academic program in the northeast. I used to float on these forums a lot when I was a premed student and figured I'd give back some perspective on what it's currently like to be a general surgery resident. I loved when residents would come back and give some insight into medical and surgical training as a whole. I have the weekend off and headed back to work next week so forgive me if my responses are delayed.

I know that residency is rigorous with a lot of commitment. Do you believe you have adequate time during residency to pursue a hobby (working out, hiking, etc) or is basically all your time soaked up with work? Thank you!