Baby on the way- Now thinking more about lifestyle/compensation

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chupachups

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Hello,

I am an incoming General Surgery PGY-1. My wife and I recently found out that we're expecting our first baby, and we are beyond excited. However, with the baby on the way, this has now made me think a little bit more about future lifestyle and income as an attending. I chose General Surgery because I loved my Gen Surg/specialties-off-GenSurg rotations and because of the variety of fellowships training available. Specifically, I currently have an interest in Plastics, Endocrine surgery/Head and Neck Oncology, Surgical Oncology and Cardiac Surgery.

For the above specialties, would anyone be able to comment on:
1) Lifestyle (hours, call, flexibility etc)
2) Income (approximately)
3) Competitiveness (including how essential it is to take dedicated research years vs. no research years needed to match)
4) Job market

I am aware that lifestyle and income can vary greatly based on the practice environment, academics vs. PP, number of people we share call with, rural vs. large city etc. I am just trying to get a very general idea. For example, I am certain it is possible for a neurosurgeon to work less hours and earn less than a urologist, but generally speaking, I would imagine the neurosurgeon typically works longer hours and earns a higher salary.

Thank you very much.
All the best,

CC

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Hello,

I am an incoming General Surgery PGY-1. My wife and I recently found out that we're expecting our first baby, and we are beyond excited. However, with the baby on the way, this has now made me think a little bit more about future lifestyle and income as an attending. I chose General Surgery because I loved my Gen Surg/specialties-off-GenSurg rotations and because of the variety of fellowships training available. Specifically, I currently have an interest in Plastics, Endocrine surgery/Head and Neck Oncology, Surgical Oncology and Cardiac Surgery.

For the above specialties, would anyone be able to comment on:
1) Lifestyle (hours, call, flexibility etc)
2) Income (approximately)
3) Competitiveness (including how essential it is to take dedicated research years vs. no research years needed to match)
4) Job market

I am aware that lifestyle and income can vary greatly based on the practice environment, academics vs. PP, number of people we share call with, rural vs. large city etc. I am just trying to get a very general idea. For example, I am certain it is possible for a neurosurgeon to work less hours and earn less than a urologist, but generally speaking, I would imagine the neurosurgeon typically works longer hours and earns a higher salary.

Thank you very much.
All the best,

CC

I hate to be a punk, but I'm a bit surprised that your career choices thus far have been so fragile that a pregnancy is enough to make you re-evaluate everything. I would hope that you had thought of this possibility a year ago (or earlier). Similarly, I would not have jumped into a surgical residency without a remedial understanding of #1-4 above that equals what can be gained on SDN.

Still, all of your mentioned subspecialties are well-reimbursed. Only surgical oncology would require 2 research years. Job market will be different 7 years from now, so our opinions are not helpful there.

In general, your lifestyle will be better in specialties that don't have many emergencies, which includes all of the above except CT. CT has the potential to torture you the most, but certainly it would depend on your chosen practice environment.

Hope that helps?
 
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Hello,

I am an incoming General Surgery PGY-1. My wife and I recently found out that we're expecting our first baby, and we are beyond excited. However, with the baby on the way, this has now made me think a little bit more about future lifestyle and income as an attending. I chose General Surgery because I loved my Gen Surg/specialties-off-GenSurg rotations and because of the variety of fellowships training available. Specifically, I currently have an interest in Plastics, Endocrine surgery/Head and Neck Oncology, Surgical Oncology and Cardiac Surgery.

For the above specialties, would anyone be able to comment on:
1) Lifestyle (hours, call, flexibility etc)
2) Income (approximately)
3) Competitiveness (including how essential it is to take dedicated research years vs. no research years needed to match)
4) Job market

I am aware that lifestyle and income can vary greatly based on the practice environment, academics vs. PP, number of people we share call with, rural vs. large city etc. I am just trying to get a very general idea. For example, I am certain it is possible for a neurosurgeon to work less hours and earn less than a urologist, but generally speaking, I would imagine the neurosurgeon typically works longer hours and earns a higher salary.

Thank you very much.
All the best,

CC

I tend to agree with @SLUser11 how one can end up in residency with out at least a rudimentary understanding of 1-4 is scary. You are 2+ years away from needing to think about specialization. Your most immediate issue is dealing with family in the context of being an intern/junior resident. Survive that first, then shift your focus to the future.
 
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Disclaimer: I don't have children

The users above are correct in that it is premature to worry about this. We are all Type A planners and I understand you (perhaps your wife's concerns and worries) but job market changes, employment situations change and your life will change.

I can understand that your priorities and which question you want to ask differ now than they did last year when applying. There are options for lifestyle well reimbursed surgical practices out there which may or may not work for you.

The most pressing issue is how you and your wife will adjust to having a child during intern year. Get through that and then start thinking about subspecialties.
 
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I hate to be a punk, but I'm a bit surprised that your career choices thus far have been so fragile that a pregnancy is enough to make you re-evaluate everything. I would hope that you had thought of this possibility a year ago (or earlier). Similarly, I would not have jumped into a surgical residency without a remedial understanding of #1-4 above that equals what can be gained on SDN.

Still, all of your mentioned subspecialties are well-reimbursed. Only surgical oncology would require 2 research years. Job market will be different 7 years from now, so our opinions are not helpful there.

In general, your lifestyle will be better in specialties that don't have many emergencies, which includes all of the above except CT. CT has the potential to torture you the most, but certainly it would depend on your chosen practice environment.

Hope that helps?

@SLUser11
Yes it does, thank you very much.

Perhaps I am misunderstanding or did not make it clear, but I am not "re-evaluating everything". I was and am still interested in the General Surgery subspecialties mentioned above; and that is why I am going to a General Surgery residency in July, pregnancy or not, which I'd like to think makes sense. Now that I have a baby on the way, I do want to start thinking a little more about the potential differences in #1-4 between those subspecialties, which may or may not be some of the factors that will me guide towards a specialty vs. another in the future.

However, I understand that it is too early to think about it. I will most definitely focus on surviving intern year in the context of an expanding family.

All the best,

CC
 
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Breast
Thyroid

Congratulations on your baby.
I think it is a very important milestone in life and something you should be thrilled with achieving!
 
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Warm beer, cold pizza and babies. All consequences of leaving it in too long. Hey oh!
 
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Not sure why some responded so dismissively to the OP.
 
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People have had families and made enough money to support them doing all of those specialties. No, you don't need to just think about breast or Endo.

I have to say, it's starting to annoy me that all of these types of conversations are framed as being about "balance", but the central conceit seems to be "What specialty will pay me the most for the least amount of work."

Can you be a surgical oncologist that works reasonable hours and supports their family on a single income? Sure you can. But you also probably won't have an HPB-only practice. And in your personal life, you won't have monkey butlers and drive a Ferrari to work.
 
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People have had families and made enough money to support them doing all of those specialties. No, you don't need to just think about breast or Endo.

I have to say, it's starting to annoy me that all of these types of conversations are framed as being about "balance", but the central conceit seems to be "What specialty will pay me the most for the least amount of work."

Can you be a surgical oncologist that works reasonable hours and supports their family on a single income? Sure you can. But you also probably won't have an HPB-only practice. And in your personal life, you won't have monkey butlers and drive a Ferrari to work.

Since you seem to have the inside scoop... what do I have to do to get the monkey butlers?
 
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Since you seem to have the inside scoop... what do I have to do to get the monkey butlers?

I just want to point out that monkey butlers these days have no work ethic. They're overly reliant on technology, constantly worried about lifestyle, and they're always trying to get the most bananas in the least amount of time.

Sometimes, I wonder why we even HAVE monkey butlers.....
 
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People have had families and made enough money to support them doing all of those specialties. No, you don't need to just think about breast or Endo.

I have to say, it's starting to annoy me that all of these types of conversations are framed as being about "balance", but the central conceit seems to be "What specialty will pay me the most for the least amount of work."

Can you be a surgical oncologist that works reasonable hours and supports their family on a single income? Sure you can. But you also probably won't have an HPB-only practice. And in your personal life, you won't have monkey butlers and drive a Ferrari to work.

And what in the world is wrong with that?!?!? I want to be paid well for my work and I want to spend time with my family. If you want to leave your job to go do doctors with our borders, great, I'm going to support my wife and try to be there for every moment of my son's life I can be - and if you think that there is anything wrong with that, I think your nuts.
 
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My advice is don't Ever over leverage yourself with a very large mortgage and be happy with a Regular persons car. Future you may say thank you down the road.


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babies have poor vision and really bad memories. you could probably get by with a dad doll for the first 4-5 years. then be more involved after that.
 
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People have had families and made enough money to support them doing all of those specialties. No, you don't need to just think about breast or Endo.

I have to say, it's starting to annoy me that all of these types of conversations are framed as being about "balance", but the central conceit seems to be "What specialty will pay me the most for the least amount of work."

Can you be a surgical oncologist that works reasonable hours and supports their family on a single income? Sure you can. But you also probably won't have an HPB-only practice. And in your personal life, you won't have monkey butlers and drive a Ferrari to work.

At the same time I think some would rather have the time with family instead of more stuff.
 
Hello,

I am an incoming General Surgery PGY-1. My wife and I recently found out that we're expecting our first baby, and we are beyond excited. However, with the baby on the way, this has now made me think a little bit more about future lifestyle and income as an attending. I chose General Surgery because I loved my Gen Surg/specialties-off-GenSurg rotations and because of the variety of fellowships training available. Specifically, I currently have an interest in Plastics, Endocrine surgery/Head and Neck Oncology, Surgical Oncology and Cardiac Surgery.

For the above specialties, would anyone be able to comment on:
1) Lifestyle (hours, call, flexibility etc)
2) Income (approximately)
3) Competitiveness (including how essential it is to take dedicated research years vs. no research years needed to match)
4) Job market

I am aware that lifestyle and income can vary greatly based on the practice environment, academics vs. PP, number of people we share call with, rural vs. large city etc. I am just trying to get a very general idea. For example, I am certain it is possible for a neurosurgeon to work less hours and earn less than a urologist, but generally speaking, I would imagine the neurosurgeon typically works longer hours and earns a higher salary.

Thank you very much.
All the best,

CC


I'm not sure why you're not getting more honest responses. I'm an incoming PGY1 and am also a bit terrified of the lifestyle; matching has made it more real. As students we honestly have no idea since we are just basically tourists for a few months during sub-Is, and we spend much more time with residents than attendings. I picked surgery because it was a way to do medicine and surgery things, and now realize I was influence by a lot of the surgery residents who trash-talked the other specialties saying they don't DO anything. Reading these forums and talking to people provides so much contradictory information it is overwhelmingly confusing.

Among the specialties you listed, I have heard Endocrine can have a pretty good lifestyle (except for that guy at Yale who is the busiest surgeon they have). Breast too. On the surface, surg onc seems lifestyle friendly since almost all the cases are scheduled/elective BUT those patients are SICK so unforeseen things arise. Plastics at my hospital works very hard but if you were pursuing cosmetic that's obviously lifestyle friendly. Cardiac is intense. Not sure about straight thoracic (lots of lung cancer but again pretty sick patients).

For those who are critical, maybe the OP shares my view but it's not about 'making the most money for working the least hours...' For me it's the illogic of it that anesthesia or others who have more family time are also earning more, which then necessitates the question 'is surgery worth it?' As medical students we really couldn't know. Hopefully as interns we'll figure it out (and potentially propagate that 20% attrition). My impression is that the grass is always greener, and even though things like EM look great on paper, they have their own downsides. Anesthesia may be a bit better. Unquestionably, though, surgery and medicine in general will continue to change as more 'millennials' comprise the workforce.

The whole surgeon machismo is dying out. One of our trauma surgeons said he feels good because he knows he does a job that so few people in the world can do. Maybe that's how he justifies missing family time. The reality is however our 6 other trauma surgeons can do the same thing, along with all of the ones in NY, Boston, LA, etc...

OP you are right to question and constantly re-evaluate your situation. You worked so hard to get where you are, you deserve to be happy :)
 
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And what in the world is wrong with that?!?!? I want to be paid well for my work and I want to spend time with my family. If you want to leave your job to go do doctors with our borders, great, I'm going to support my wife and try to be there for every moment of my son's life I can be - and if you think that there is anything wrong with that, I think your nuts.

But my point being that if the only thing that mattered was the money and working the least, why even choose medicine in the first place? It completely excludes the other part of the equation, which is job satisfaction. I guess some people would be willing to do a job they loathe if it meant getting the other two, however I would argue that it's a recipe for being miserable. If you're miserable at work, you're going to be miserable at home and all that time and money you have isn't necessarily going to fix it.

Second, my experience is that surgeons who enjoy their work view it more as a vocation, not a job. They accept that they may make sacrifices in other areas of their lives to do something that they find fulfilling. Some may call that a sentiment that only belongs in a personal statement, but I still find it to be true. And when people people try to boil the career choice down to time spent at work and money, it ignores this aspect.

At the same time I think some would rather have the time with family instead of more stuff.

So would I. Hence given a choice to balance between family time, work and material posessions I weigh the first two ahead of the third.

For me it's the illogic of it that anesthesia or others who have more family time are also earning more, which then necessitates the question 'is surgery worth it?'

My initial point being that "compensation" can be more than what's in your paycheck. Is it worth it to you to do something every day that you don't necessarily like doing, as long as you get paid more? I suspect the majority of people in surgery who are happy with their career choice would answer "No" to that question.

Anesthesia may be a bit better. Unquestionably, though, surgery and medicine in general will continue to change as more 'millennials' comprise the workforce.

The whole surgeon machismo is dying out. One of our trauma surgeons said he feels good because he knows he does a job that so few people in the world can do. Maybe that's how he justifies missing family time. The reality is however our 6 other trauma surgeons can do the same thing, along with all of the ones in NY, Boston, LA, etc...

Yes, it will continue to change. And if the past few years is any indication, not for the better. Queue the "Back in my day criticisms", but even in the time I've been in residency, the attitude of interns and junior residents has changed. People can disagree if they like, but surgery is materially different than other specialties. I'd be fine if the surgery machismo is dying out, but I would be disappointed if new interns don't understand that inherent to the act of operating on someone are responsibilities that can supersede your own comfort and convenience.
 
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I have always found it interesting that people compare annual salary. I think hourly salary is a more important metric. 500000 at 80 hrs or 300000 at 40 hours. Etc


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I think it is good for OP to consider these factors now, while he still has a chance at modifying them for his career. After he finishes a transplant fellowship, it will be pretty hard to get into a more lifestyle-oriented field. I also get the pregnancy impetus for the soul searching. Having a kid changes everything. While you may love your job, not many people love missing lots of baseball games and dance recitals. There are a lot of trade offs to think about. I feel like a lot of people on here act like the only factor you should consider is professional satisfaction. It's not.

OP, I vote plastics.
 
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And what in the world is wrong with that?!?!? I want to be paid well for my work and I want to spend time with my family. If you want to leave your job to go do doctors with our borders, great, I'm going to support my wife and try to be there for every moment of my son's life I can be - and if you think that there is anything wrong with that, I think your nuts.

Dont ever forget who you are talking to. Surgeons tend to display standard traits such as microaggresion and illogical beliefs about their work.
 
Dont ever forget who you are talking to. Surgeons tend to display standard traits such as microaggresion and illogical beliefs about their work.

south-park-s10e08c05-the-slaughter-16x9.jpg


Don't worry, I'm sure we can find a safe space for you somewhere.

I'm still unsure what strikes me most about your postings. The fact that they are so frequently provide objectively poor advice, or that you entire history seems rooted in an insecurity about how the career choices of other people have negatively impacted you. Note that most people on this forum don't go around evangelizing about why people should do surgery. We recognize that everyone won't like it. You, on the other hand, seem hell-bent on trying to convince people of why it's a terrible idea. Its been awhile since my psych rotation, but one might consider that your continued need to deride our career choice says less about surgery and surgeons, and more about your own personal satisfaction.
 
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I thought some of those numbers looked a little low, but what does a lowly M1 like me know

They are lower than what is seen on other similar websites. Looking specifically at CRS and general surgery, the median and highest reported are both too low.
 
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south-park-s10e08c05-the-slaughter-16x9.jpg


Don't worry, I'm sure we can find a safe space for you somewhere.

I'm still unsure what strikes me most about your postings. The fact that they are so frequently provide objectively poor advice, or that you entire history seems rooted in an insecurity about how the career choices of other people have negatively impacted you. Note that most people on this forum don't go around evangelizing about why people should do surgery. We recognize that everyone won't like it. You, on the other hand, seem hell-bent on trying to convince people of why it's a terrible idea. Its been awhile since my psych rotation, but one might consider that your continued need to deride our career choice says less about surgery and surgeons, and more about your own personal satisfaction.


Inaccurate! I typically drink Monster and the occasional NOS....
 
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south-park-s10e08c05-the-slaughter-16x9.jpg


Don't worry, I'm sure we can find a safe space for you somewhere.

I'm still unsure what strikes me most about your postings. The fact that they are so frequently provide objectively poor advice, or that you entire history seems rooted in an insecurity about how the career choices of other people have negatively impacted you. Note that most people on this forum don't go around evangelizing about why people should do surgery. We recognize that everyone won't like it. You, on the other hand, seem hell-bent on trying to convince people of why it's a terrible idea. Its been awhile since my psych rotation, but one might consider that your continued need to deride our career choice says less about surgery and surgeons, and more about your own personal satisfaction.

Just looking out for the innocent.
 
south-park-s10e08c05-the-slaughter-16x9.jpg


Don't worry, I'm sure we can find a safe space for you somewhere.

I'm still unsure what strikes me most about your postings. The fact that they are so frequently provide objectively poor advice, or that you entire history seems rooted in an insecurity about how the career choices of other people have negatively impacted you. Note that most people on this forum don't go around evangelizing about why people should do surgery. We recognize that everyone won't like it. You, on the other hand, seem hell-bent on trying to convince people of why it's a terrible idea. Its been awhile since my psych rotation, but one might consider that your continued need to deride our career choice says less about surgery and surgeons, and more about your own personal satisfaction.

I wish I could like this post twice.
 
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