Giving up on my dream of surgery

[anotherdecision]

I have always wanted to be a surgeon. I loved my surgery rotation but the hours really wore on my family. I have a wife and a toddler. They are FAR more important than any job to me. I also have a ton of hobbies that really help with my sanity. My spouse 100% supports me no matter what specialty I pick, but if I pick a surgical field I feel it will be detrimental to both myself and my family. I don't want my daughter to finally get some quality time with me when she's 10.

I am now down to the point where I have to pick a specialty. I want to pick a surgical field but I feel guilty for doing so, selfish, maybe even disappointed... I have never been this conflicted in my life. I am thinking about picking a field with procedures with a better lifestyle - maybe anesthesia or EM.

Has anybody been through something similar?

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[Pathman1000]

Surgery residency is bad but even as someone in a "lifestyle specialty" (path), i still work some near 80 hour weeks. Any residency you choose, you'll likely be working a lot of hours. Do what you like and you'll be happy for it. If you hate your career, I doubt you or your family will be happy in the long run.

 

[bashwell]

I have always wanted to be a surgeon. I loved my surgery rotation but the hours really wore on my family. I have a wife and a toddler. They are FAR more important than any job to me. I also have a ton of hobbies that really help with my sanity. My spouse 100% supports me no matter what specialty I pick, but if I pick a surgical field I feel it will be detrimental to both myself and my family. I don't want my daughter to finally get some quality time with me when she's 10.

I am now down to the point where I have to pick a specialty. I want to pick a surgical field but I feel guilty for doing so, selfish, maybe even disappointed... I have never been this conflicted in my life. I am thinking about picking a field with procedures with a better lifestyle - maybe anesthesia or EM.

Has anybody been through something similar?

Which surgical subspecialty are you considering?

Anesthesia is not necessarily an easier lifestyle than some surgical specialties or subspecialties, depending on what surgical specialty you're considering. I mean it's probably easier than like general surgery or neurosurgery, but almost anything else is.

EM you will be on a lot of nights, weekends, and holidays for much if not most of your career. Some don't mind this, others do.

 

[WildcatS11]

I have always wanted to be a surgeon. I loved my surgery rotation but the hours really wore on my family. I have a wife and a toddler. They are FAR more important than any job to me. I also have a ton of hobbies that really help with my sanity. My spouse 100% supports me no matter what specialty I pick, but if I pick a surgical field I feel it will be detrimental to both myself and my family. I don't want my daughter to finally get some quality time with me when she's 10.

I am now down to the point where I have to pick a specialty. I want to pick a surgical field but I feel guilty for doing so, selfish, maybe even disappointed... I have never been this conflicted in my life. I am thinking about picking a field with procedures with a better lifestyle - maybe anesthesia or EM.

Has anybody been through something similar?

Do surgery if it's literally the only thing you think you would enjoy. You better love the OR to give up that significant amount of time in your child's life. People make it happen, and it's a personal choice, but it better be worth it for you.

The poster above me quoted some "80 hour weeks in path." I can guarantee there are less of those, and for less years, than in surgery. You mentioned EM - sure there are some terrible weeks but it's a whole different animal than surgery. And it's 3-4 years of residency and 35-45 hour weeks as an attending

 

[DNC127]

I feel you, however I am trying to just pick less sucky lifestyle specialties within surgery than was I originally planned on.
For example, my whole life I wanted to do congenital cardiac surgery (was born with tetralogy of fallot), but now that I am married and we want a family I am pursuing other paths that are less time intensive. Depending on your scores, you might be able to swing a surgically specialty that is more "family friendly" for lack of a better term and this might be a good compromise? What surgical specialty did you want to do?

 

[Pathman1000]

Do surgery if it's literally the only thing you think you would enjoy. You better love the OR to give up that significant amount of time in your child's life. People make it happen, and it's a personal choice, but it better be worth it for you.

Pity you fool

 

[pimpolla]

I have always wanted to be a surgeon. I loved my surgery rotation but the hours really wore on my family. I have a wife and a toddler. They are FAR more important than any job to me. I also have a ton of hobbies that really help with my sanity. My spouse 100% supports me no matter what specialty I pick, but if I pick a surgical field I feel it will be detrimental to both myself and my family. I don't want my daughter to finally get some quality time with me when she's 10.

I am now down to the point where I have to pick a specialty. I want to pick a surgical field but I feel guilty for doing so, selfish, maybe even disappointed... I have never been this conflicted in my life. I am thinking about picking a field with procedures with a better lifestyle - maybe anesthesia or EM.

Has anybody been through something similar?

I feel similarly. I looove the OR,". By far my favorite place in the hospital. And I actually enjoy my time there when I'm there, but I get home to see my husband and there's no time for us at all... which is OK now but not forever. I've been thinking Urology, maybe OBGyn... EM ??? I literally have no clue.

 

[PL198]

You have a family + a ton of hobbies. That alone eliminated surgery for me. It's great but there's not room for much else

 

[anotherdecision]

I always wanted neurosurgery. It would mean my daughter would be 9-10 when I finish residency. Most people tell to consider ENT or something like that as the lifestyle can be better, but the ENT residents here still work some long hours. Granted it's 5-6 years compared to 7-8 in neurosurg. I also feel I am too far behind to realistically match into ENT. I have no connections or research in it. I'm not really interested in ortho or uro.

I've heard "If you can do anything else other than surgery, do that!" I've also heard I should never give up on my dreams.

How do I make the decision? Sorry guys, I'm just really conflicted.

 

[evilbooyaa]

I always wanted neurosurgery. It would mean my daughter would be 9-10 when I finish residency. Most people tell to consider ENT or something like that as the lifestyle can be better, but the ENT residents here still work some long hours. Granted it's 5-6 years compared to 7-8 in neurosurg. I also feel I am too far behind to realistically match into ENT. I have no connections or research in it. I'm not really interested in ortho or uro.

I've heard "If you can do anything else other than surgery, do that!" I've also heard I should never give up on my dreams.

How do I make the decision? Sorry guys, I'm just really conflicted.

It's definitely a hard decision. When people say "Only do surgery if you can't see yourself doing anything else", it's actually really good advice, IMO. If you absolutely can't see yourself in any other field (rotate in them as a 3rd and 4th year), then I would go for it. Despite the fact you have a family, if you're miserable for 8-14 hours per day, every day when you're at work, you're going to eventually bring that home. If the only thing in medicine that makes you happy is surgery in the OR then forge ahead with surgery. As others have stated in the past, a love for the OR and putting sharp metal to flesh is NOT the same as anesthesia in terms of job satisfaction. If you like anesthesia that's great and consider it (although there will be calls, it won't be as frequent hell-on-earth as surgery).

No one can make this decision besides you and your family. Really think of you would only be happy in 15 years, career-wise, if you were operating on people. If the answer to that is yes, then I think your decision is made. Every field of surgery CAN get better as an attending if that's what you want out of life, so don't let the schedules of the academic attendings (which are frequently insane) dictate your decision.

 

[tiedyeddog]

If it helps you make the decision I am a neurosurgery resident and am married with a toddler. My wife is fantastic. She is the rock of the household. Most of the week she is pretty much a single parent. This past week I went 4 days straight without seeing my child and wife. There are plenty of days when I leave the house at 5 am when my child is asleep and I get home at 10 pm when she is still asleep.

I don't really have hobbies (unless you call studying for boards, writing papers, or running once a week a hobby). You have to make choices. There is so much to learn and read. When Im off work I try to take her as much as possible and try to make quality time over quantity of time. My fellow residents with hobbies (rock climbing, skiing multiple times a month, etc dont have kids).

 

[DocWinter]

I have met only a few happy general surgeons. The lifestyle is rough and the work itself is pretty routine - GB, appy, hernia, GI tract. Ask yourself why you love surgery so much. Fully agree surgery is a good field for those that absolutely love it, those that could enjoy clinic or ER or anesthesia should head there instead

 

[OrthoTraumaMD]

I have always wanted to be a surgeon. I loved my surgery rotation but the hours really wore on my family. I have a wife and a toddler. They are FAR more important than any job to me. I also have a ton of hobbies that really help with my sanity. My spouse 100% supports me no matter what specialty I pick, but if I pick a surgical field I feel it will be detrimental to both myself and my family. I don't want my daughter to finally get some quality time with me when she's 10.

I am now down to the point where I have to pick a specialty. I want to pick a surgical field but I feel guilty for doing so, selfish, maybe even disappointed... I have never been this conflicted in my life. I am thinking about picking a field with procedures with a better lifestyle - maybe anesthesia or EM.

Has anybody been through something similar?

Have you asked your wife what she thinks? Because she will be your savior during those years and will carry the family socially and emotionally. Residency would have been very tough for me without my SO, and even with his support, we were extremely strained and almost ended things. Lots of marriages and relationships, even good ones, end due to the stress of surgical residency. It may not be a risk your wife is willing to undergo. On the other hand, as a surgeon, I will agree with the above posts that you must love what you do. If you hate it, you will hate yourself even if you work 30 hrs/wk. if you really can't see yourself doing anything other than surgery--it's really that black or white-- "I will be unhappy with anything else" --then go for it and don't look back. It's worth the risk. But if you can see yourself being happy elsewhere, then do that. Feel free to PM me if you wish to discuss further.

 

[ProfMD]

I find these threads especially entertaining because the most anti-surgery posts are from non-surgeons.

Surgical fields have this myth of being life-stealing specialities. There is no denying that you will work hard and there will be long hours, but there is also time for family and a life. Your time is not really your own as a resident, but once you finish you will have more control.

In addition to overplaying the negatives of surgery re: time, I think people also underplay the time commitment of other fields. Residency is long hours and hard work no matter the field, some more than others for sure.

In the end, you need to take a career-long view. Decide what you want to do based on the career, not the residency. Also, don't discount the importance of enjoying what you do. I would much rather do the 60-70 hour weeks I do as a surgeon than 40 hours as anything else.

 

[Rippy087]

I find these threads especially entertaining because the most anti-surgery posts are from non-surgeons.

Surgical fields have this myth of being life-stealing specialities. There is no denying that you will work hard and there will be long hours, but there is also time for family and a life. Your time is not really your own as a resident, but once you finish you will have more control.

In addition to overplaying the negatives of surgery re: time, I think people also underplay the time commitment of other fields. Residency is long hours and hard work no matter the field, some more than others for sure.

In the end, you need to take a career-long view. Decide what you want to do based on the career, not the residency. Also, don't discount the importance of enjoying what you do. I would much rather do the 60-70 hour weeks I do as a surgeon than 40 hours as anything else.

It's actually kind of funny, but I think everyone looks at other fields with grass is greener mentality. If you go on the rads forums here or auntminnie, there are a bunch of radiology attendings telling medical students to "just do surgery" instead of radiology.

 

[OnePunchBiopsy]

In the end, you need to take a career-long view. Decide what you want to do based on the career, not the residency. Also, don't discount the importance of enjoying what you do. I would much rather do the 60-70 hour weeks I do as a surgeon than 40 hours as anything else.

This x1000.

Never pick a field based on the time off you get, in residency or in practice. Instead pick a field you could see yourself loving the good and tolerating the bad. I believe one of the reasons physician burnout is going up in most specialties is bc of false expectations going in. One misperception potentially being they are entering a specialty for the "lifestyle."

As a resident, your time will not be your own, no matter what your specialty is. Heck, we have family medicine residents arriving at 6:30am to round and don't get to leave until 8pm some nights.

As an attending your time/work environment will be more up to you. I would say 50% of the general surgeons I work with have a great lifestyle outside the hospital. They either work at a non-trauma hospital, or work at a level II/III trauma community residency program that has residents to take almost all the calls. They show up at 7am to round/operate and have gone home by 5-6pm.

If you love surgery and see yourself doing nothing else, but choose a different non-surgical specialty because of the notion you will get more time off, I believe you will deeply regret your career path.

 

[CCC_MD]

I have always wanted to be a surgeon. I loved my surgery rotation but the hours really wore on my family. I have a wife and a toddler. They are FAR more important than any job to me. I also have a ton of hobbies that really help with my sanity. My spouse 100% supports me no matter what specialty I pick, but if I pick a surgical field I feel it will be detrimental to both myself and my family. I don't want my daughter to finally get some quality time with me when she's 10.

I am now down to the point where I have to pick a specialty. I want to pick a surgical field but I feel guilty for doing so, selfish, maybe even disappointed... I have never been this conflicted in my life. I am thinking about picking a field with procedures with a better lifestyle - maybe anesthesia or EM.

Has anybody been through something similar?

What about surgery do you like the most? Is it actually fixing something, or the process of long surgical procedures? Is it gastrointestinal pathology? Consider ophthalmology, cardiac electrophysiology, gastroenterology, plastics if its the former.

As well, there is often large variation in residency programs and how "harsh" they are. Some community surgical programs are not that bad in terms of hours as far as surgical residencies go as they may have prelims/NPs help with the paperwork aspect which enables you to focus and cut down on your hours quite a bit during training. Much of what will make your time worse is the efficiency of your hospital system, your program director and how much he/she protects from scut etc...

I married in medical school and had a child in residency/fellowship in a very busy IM subspecialty. Its been tough, there are no questions about it. Sometimes I had thoughts of quitting and simply working regular 9-5 in an office practice or becoming a hospitalist. But, then I thought - what example would I be for my kids if I tell them to "do what you enjoy the most" and I don't practice that myself. Children see your example and follow suit rather than listen to you IMO.

If you decide to do something very busy, the biggest variable that will help your personal life I have found is discretionary income. If you live in a low cost of living area and don't have to worry about financial aspect of your life on a residents salary, that will take another element away from your life and allow you to pay for services that free up more of your own and family's time. It may allow your spouse to not work at all or part-time and this allows much more of a balance IMO as you'd be working enough hours for two people. Just my two cents.

 

[ACSurgeon]

Most community general surgeons have very nice work-life balance. Those with no life are doing it to themselves. The money isn't bad either.

 

[speedyxx626]

Hey in the end you can always be a surgeon at the VA. The surgeons at the VA hospitals I've been at have had some pretty sweet hours...

 

[Stagg737]

This x1000.

Never pick a field based on the time off you get, in residency or in practice. Instead pick a field you could see yourself loving the good and tolerating the bad. I believe one of the reasons physician burnout is going up in most specialties is bc of false expectations going in. One misperception potentially being they are entering a specialty for the "lifestyle."

As a resident, your time will not be your own, no matter what your specialty is. Heck, we have family medicine residents arriving at 6:30am to round and don't get to leave until 8pm some nights.

As an attending your time/work environment will be more up to you. I would say 50% of the general surgeons I work with have a great lifestyle outside the hospital. They either work at a non-trauma hospital, or work at a level II/III trauma community residency program that has residents to take almost all the calls. They show up at 7am to round/operate and have gone home by 5-6pm.

If you love surgery and see yourself doing nothing else, but choose a different non-surgical specialty because of the notion you will get more time off, I believe you will deeply regret your career path.

Agree with the general sentiment of "do what you love", but I think it also depends what field you're comparing surgery to. If the options are genuinely Surgery vs. psych or hospitalist we're talking about a potential 20 hour/wk difference or 7 am-5pm vs 2 weeks on 2 weeks off it's a different story. Not saying surgeons can't have a decent lifestyle after residency, but some fields have a nice enough lifestyle that you could work a legit 40 hour week, spend more time with family than most other professionals, and still pull in 6 figures easily.

 

[OnePunchBiopsy]

Agree with the general sentiment of "do what you love", but I think it also depends what field you're comparing surgery to. If the options are genuinely Surgery vs. psych or hospitalist we're talking about a potential 20 hour/wk difference or 7 am-5pm vs 2 weeks on 2 weeks off it's a different story. Not saying surgeons can't have a decent lifestyle after residency, but some fields have a nice enough lifestyle that you could work a legit 40 hour week, spend more time with family than most other professionals, and still pull in 6 figures easily.

OP is looking for a procedure-based specialty. Psychiatrists and hospitalists don't do/rarely do procedures.

Plus OP, if you go into surgery residency you are never stuck there. You could always change specialties. IMO, I think it would be easier to switch from surgery into EM/anesthesia than vice versa. But keep in mind that residency is going to take time from your family no matter what, might as well be stuck at the hospital doing what you enjoy than stuck there when you're not enjoying your job and wondering what could have been.

 

[BurghStudent]

Ophthalmology. Cool surgeries and a decent lifestyle.

 

[Kahreek]

If you love surgery and see yourself doing nothing else, but choose a different non-surgical specialty because of the notion you will get more time off, I believe you will deeply regret your career path.

Yes.
And the advice of "if you see doing something else then do that" is very misleading, because a job is a job is a job.

 

[anotherdecision]

If it helps you make the decision I am a neurosurgery resident and am married with a toddler. My wife is fantastic. She is the rock of the household. Most of the week she is pretty much a single parent. This past week I went 4 days straight without seeing my child and wife. There are plenty of days when I leave the house at 5 am when my child is asleep and I get home at 10 pm when she is still asleep.

I don't really have hobbies (unless you call studying for boards, writing papers, or running once a week a hobby). You have to make choices. There is so much to learn and read. When Im off work I try to take her as much as possible and try to make quality time over quantity of time. My fellow residents with hobbies (rock climbing, skiing multiple times a month, etc dont have kids).

Thanks for this example. I'm not sure I could make this type of schedule work for my own sanity. My wife is a pretty amazing woman and I think we could make it work, the question is do I want your lifestyle for the next 7-8 years until I can make it as an attending. Obviously life as a neurosurg attending isn't exactly cush either. Then again I think I would love my job. So there is the decision I need to make.

Have you asked your wife what she thinks? Because she will be your savior during those years and will carry the family socially and emotionally. Residency would have been very tough for me without my SO, and even with his support, we were extremely strained and almost ended things. Lots of marriages and relationships, even good ones, end due to the stress of surgical residency. It may not be a risk your wife is willing to undergo. On the other hand, as a surgeon, I will agree with the above posts that you must love what you do. If you hate it, you will hate yourself even if you work 30 hrs/wk. if you really can't see yourself doing anything other than surgery--it's really that black or white-- "I will be unhappy with anything else" --then go for it and don't look back. It's worth the risk. But if you can see yourself being happy elsewhere, then do that. Feel free to PM me if you wish to discuss further.

She 100% supports me if I choose surgery. This hesitation is really coming from me as I think it is easier for anyone (including me) to say that and another to live it for 5+ years. If it came down to a career in surgery versus my marriage, I would hands down pick my marriage. I would literally leave residency if it could save my marriage. Hopefully it would never come to that, but I am very much in the mindset that this is a job, a very cool job, but there is no job I would pick over my family.

I guess this thread really comes down to professional happiness vs personal happiness. I think they are very related but also different. I would be very fulfilled professionally by doing surgery, but it would take away from my family particularly in residency. That would decrease my personal happiness which could make me resent residency. I know things get better after training. But with a less intense specialty, I could be very fulfilled personally and still have satisfaction at work. Hence the conflict. Sorry, I'm thinking aloud here.

I find these threads especially entertaining because the most anti-surgery posts are from non-surgeons.

Surgical fields have this myth of being life-stealing specialities. There is no denying that you will work hard and there will be long hours, but there is also time for family and a life. Your time is not really your own as a resident, but once you finish you will have more control.

In addition to overplaying the negatives of surgery re: time, I think people also underplay the time commitment of other fields. Residency is long hours and hard work no matter the field, some more than others for sure.

In the end, you need to take a career-long view. Decide what you want to do based on the career, not the residency. Also, don't discount the importance of enjoying what you do. I would much rather do the 60-70 hour weeks I do as a surgeon than 40 hours as anything else.

I agree other residencies can be intense. But ER 50 hours a week vs surgery "80" hours per week (read 100+) is quite a difference for several years. If I can get through training I could certainly find an attending job that is reasonable. Would I be as happy in another specialty compared to the OR? Probably not but I think I would like my job. How much of a difference? I'm not sure.

This x1000.

Never pick a field based on the time off you get, in residency or in practice. Instead pick a field you could see yourself loving the good and tolerating the bad. I believe one of the reasons physician burnout is going up in most specialties is bc of false expectations going in. One misperception potentially being they are entering a specialty for the "lifestyle."

As a resident, your time will not be your own, no matter what your specialty is. Heck, we have family medicine residents arriving at 6:30am to round and don't get to leave until 8pm some nights.

As an attending your time/work environment will be more up to you. I would say 50% of the general surgeons I work with have a great lifestyle outside the hospital. They either work at a non-trauma hospital, or work at a level II/III trauma community residency program that has residents to take almost all the calls. They show up at 7am to round/operate and have gone home by 5-6pm.

If you love surgery and see yourself doing nothing else, but choose a different non-surgical specialty because of the notion you will get more time off, I believe you will deeply regret your career path.

I do love surgery. Do I see myself doing nothing else? No. I can see myself doing the other specialties like I mentioned, but I don't think I would be living my "dream".

What about surgery do you like the most? Is it actually fixing something, or the process of long surgical procedures? Is it gastrointestinal pathology? Consider ophthalmology, cardiac electrophysiology, gastroenterology, plastics if its the former.

As well, there is often large variation in residency programs and how "harsh" they are. Some community surgical programs are not that bad in terms of hours as far as surgical residencies go as they may have prelims/NPs help with the paperwork aspect which enables you to focus and cut down on your hours quite a bit during training. Much of what will make your time worse is the efficiency of your hospital system, your program director and how much he/she protects from scut etc...

I married in medical school and had a child in residency/fellowship in a very busy IM subspecialty. Its been tough, there are no questions about it. Sometimes I had thoughts of quitting and simply working regular 9-5 in an office practice or becoming a hospitalist. But, then I thought - what example would I be for my kids if I tell them to "do what you enjoy the most" and I don't practice that myself. Children see your example and follow suit rather than listen to you IMO.

If you decide to do something very busy, the biggest variable that will help your personal life I have found is discretionary income. If you live in a low cost of living area and don't have to worry about financial aspect of your life on a residents salary, that will take another element away from your life and allow you to pay for services that free up more of your own and family's time. It may allow your spouse to not work at all or part-time and this allows much more of a balance IMO as you'd be working enough hours for two people. Just my two cents.

I like the ability to fix things. I also like the blood and guts, the ability to get your hands dirty, to see anatomy living between your hands. Thank you for your advice.

 

[anotherdecision]

To summarize, I think it is a question of loving what I do (surgery) with an enormous sacrifice vs liking what I do (ER, anesthesia, etc.) with less of a sacrifice.

 

[Entadus]

Do you think your child will benefit more from spending lots of time with an unfulfilled father who settled? or from having limited, quality time with a father who is passionate about his work, achieving his dreams fearlessly in the selfless service of others?

Admittedly I'm not a parent yet but I have always believed in the importance of being a great example. As long as you can have other loving people present in your child's life, you should do what will make you happy

 

[SunsFun]

As previously mentioned, In my experience advice like "if you can be happy not doing surgery..." usually comes from people in fields outside of surgery. It almost implies that you really must try to find another field that makes you happy before you can settle on surgery. I disagree. One thing people neglect to mention is that the culture and mentality of people differs from field to field. And even more importantly motivations and goals in life can differ widely. I personally am kind of perfectionist and enjoy having a disciplined approach to all aspects of my life. Working with people who just want to put in their daily hours and whine if they cannot go home early annoys me. Having other obligations outside of work is, of course, different and I respect that. But if my goal is to push myself harder while at work, being paired to people who just want chill average life with minimal effort is not going to work.

So my advice to you OP is to also consider what kind of person you are, what are your motivation, and what type of people are your people who you connect with on a deeper subconscious level.


Sent from my iPhone using SDN mobile app

 

[PatsyStone]

Have you thought about derm --> procedural derm/Mohs? I have about 35 hours a week of clinic as a resident with about 5-7 hours of lecture per week. The hours are great, and you can make a tremendous impact on people's lives.

 

[Stagg737]

OP is looking for a procedure-based specialty. Psychiatrists and hospitalists don't do/rarely do procedures.

Plus OP, if you go into surgery residency you are never stuck there. You could always change specialties. IMO, I think it would be easier to switch from surgery into EM/anesthesia than vice versa. But keep in mind that residency is going to take time from your family no matter what, might as well be stuck at the hospital doing what you enjoy than stuck there when you're not enjoying your job and wondering what could have been.

I realize that, I was speaking more to the general statement that one shouldn't consider hours worked or lifestyle when choosing a specialty. For OP's case I agree that lifestyle should probably carry a little less weight since most procedure-based fields require a decent number of hours worked anyway. The only aspect of that I'd consider would be residency/fellowship length. Imo there's a big difference between 4-5 years of post-grad and 7-8 or even 9 years of residency/fellowship, especially when those years are during prime years of his child's life.

I'm actually surprised Ophtho hasn't gotten more votes though. It seems like one of the procedure heavy fields that I've heard has a pretty nice lifestyle...

 

[ProfMD]

I agree other residencies can be intense. But ER 50 hours a week vs surgery "80" hours per week (read 100+) is quite a difference for several years. If I can get through training I could certainly find an attending job that is reasonable. Would I be as happy in another specialty compared to the OR? Probably not but I think I would like my job. How much of a difference? I'm not sure.

This is one of those myths that comes from non-surgeons. Even as a chief resident I worked ~85 hours per week (we had the extension to 88 hours). While there are certainly programs that break the rules, they are becoming less and less common.

As a husband and a father, I agree 100% that family is most important. However, there is definitely balance to be found.

In the end, do what fulfills you personally and professionally. However, just make sure you are not basing your decision on myths.

 

[anotherdecision]

This is one of those myths that comes from non-surgeons. Even as a chief resident I worked ~85 hours per week (we had the extension to 88 hours). While there are certainly programs that break the rules, they are becoming less and less common.

As a husband and a father, I agree 100% that family is most important. However, there is definitely balance to be found.

In the end, do what fulfills you personally and professionally. However, just make sure you are not basing your decision on myths.

I'm glad to hear it is different at other programs. At my school I personally heard the chief resident tell the intern to put down 80 hours otherwise it puts their program at risk. I later asked that intern and he was at 105 for the week. I know the hours can be averaged over 4 weeks but I didn't see the intern or chief have any more time off the 3 weeks I was on rotation. I realize n=1 but I do think the hour rules are being broken fairly often depending on the program.

Unfortunately, asking these types of questions on the interview trail or to other applicants seems to flag them as lazy or weak.

 

[anotherdecision]

Have you thought about derm --> procedural derm/Mohs? I have about 35 hours a week of clinic as a resident with about 5-7 hours of lecture per week. The hours are great, and you can make a tremendous impact on people's lives.

I have not considered this yet. Thank you for the tip.

 

[Smurfette]

As a surgeon, I can tell you that if you really want to be in an OR, going into a field that does "procedures" as opposed to "operations" is not going to be equally satisfying. I'd much rather do a lap chole any day than an I&D/chest tube/LP or whatever else is deemed a "procedure". Procedures are not an equal substitute for me (or any surgeon I know). Would you be ok not setting foot in an operating room again? If not, you may be a surgeon and just need to figure out your specialty. GU and ENT come to mind as two fields that are pretty good for lifestyle balance once you get through residency. But you have to get through residency and realize residency does not represent what actually being in practice is like.

 

[operaman]

Chiming in here as a current surgical junior resident. There is substantial variability even between programs and even more variability between years of training.

Every program distributes the innate suckage in different ways. Number of residents, attendings, hospitals, call pools, call frequency, split of juniors and seniors, etc. -- lots of things can make a big impact on your quality of life. Home call vs in house call is another.

For me, this is the busiest year of my training and it really isn't that bad. It has its moments, but I'm off more weekends than not, home at a reasonable hour most days. Next year will be even better with fewer calls, no holiday call. All while getting a truly ridiculous volume of cases. This is all program specific, but I think it's definitely possible to have a decent lifestyle as a resident in a surgical field if you find the right program.

Above all, as previously stated, think about the long haul. There are definitely more lifestyle friendly surgical practices out there, though obviously with their own set of drawbacks and compromises.

Really what I think sets surgical fields apart from others with respect to lifestyle is the unpredictability more than the number of hours. MOST days are fine, but some can go really late and you can't always predict it.

 

[ohioguy]

I have always wanted to be a surgeon. I loved my surgery rotation but the hours really wore on my family. I have a wife and a toddler. They are FAR more important than any job to me. I also have a ton of hobbies that really help with my sanity. My spouse 100% supports me no matter what specialty I pick, but if I pick a surgical field I feel it will be detrimental to both myself and my family. I don't want my daughter to finally get some quality time with me when she's 10.

I am now down to the point where I have to pick a specialty. I want to pick a surgical field but I feel guilty for doing so, selfish, maybe even disappointed... I have never been this conflicted in my life. I am thinking about picking a field with procedures with a better lifestyle - maybe anesthesia or EM.

Has anybody been through something similar?

I think a large number of my IM buddies would have picked surgery if the hours were reasonable. I thought I was going to do general surgery, then urology because it has a better lifestyle, then realized I could do without the OR, then ultimately chose IM.

 

[Ismet]

I agree other residencies can be intense. But ER 50 hours a week vs surgery "80" hours per week (read 100+) is quite a difference for several years. If I can get through training I could certainly find an attending job that is reasonable. Would I be as happy in another specialty compared to the OR? Probably not but I think I would like my job. How much of a difference? I'm not sure.

Take my input with a grain of salt because I'm not in a surgical field, but...

I've done the EM "50 hours a week" and it is exhausting. I felt more exhausted after a 10 hour ED shift than I have after a 16 hour inpatient or ICU shift. On your EM shift you are always "on," seeing patient after patient, juggling several patients at a time with some traumas thrown in. There's no downtime in a busy ED, I usually had to stay for an hour or two afterwards to write my notes because there's no time during the shift itself. Not to mention the shift work means that you're never on days or nights consistently, rather you're constantly changing back and forth, which is exhausting in itself. My "days off" were largely unproductive because I was trying to change gears to work at night or shift back to working during the day, I was tired all the time and frankly burned out after just a 1 month rotation. Especially for someone who is not that interested in the field and would rather be doing something else. I'm sure surgery is exhausting too, but you really need to look at it in terms of what you're doing and not just the hours that are involved.

Look at the attendings and not the residents. Residency is going to be hard no matter what you choose, even if you choose family med or peds or psych. I'm in an "easier" specialty and I've had months where I have worked 90-100 hour weeks. One of our residents has had days upon days where she leaves before her daughter wakes up and gets back after her daughter is asleep. But we're happy with our field and we love what we do, and we know residency is not forever. If you're not going to be happy if you're not in the OR, you should go with surgery. You even say your wife is 100% behind you. I don't claim to know what is involved in a neurosurgery residency program, but if it's like any other field I'm familiar with, you're probably going to have hard rotations mixed with "lighter" rotations, difficult years mixed with lighter years. You're not going to be living at the hospital for 7 years straight.

 

[Anicetus]

I realize that, I was speaking more to the general statement that one shouldn't consider hours worked or lifestyle when choosing a specialty. For OP's case I agree that lifestyle should probably carry a little less weight since most procedure-based fields require a decent number of hours worked anyway. The only aspect of that I'd consider would be residency/fellowship length. Imo there's a big difference between 4-5 years of post-grad and 7-8 or even 9 years of residency/fellowship, especially when those years are during prime years of his child's life.

I'm actually surprised Ophtho hasn't gotten more votes though. It seems like one of the procedure heavy fields that I've heard has a pretty nice lifestyle...

Because people don't "just go into optho". Same with the guy who suggested derm. Unless op listed his godly stats somewhere in this thread.

 

[YoungDoc25]

I know absolutely nothing, but, from what I have been told, critical care and IR might be good fits too.

 

[Ismet]

I know absolutely nothing, but, from what I have been told, critical care and IR might be good fits too.

Procedures vs operating.

 

[Mad Jack]

I find these threads especially entertaining because the most anti-surgery posts are from non-surgeons.

Surgical fields have this myth of being life-stealing specialities. There is no denying that you will work hard and there will be long hours, but there is also time for family and a life. Your time is not really your own as a resident, but once you finish you will have more control.

In addition to overplaying the negatives of surgery re: time, I think people also underplay the time commitment of other fields. Residency is long hours and hard work no matter the field, some more than others for sure.

In the end, you need to take a career-long view. Decide what you want to do based on the career, not the residency. Also, don't discount the importance of enjoying what you do. I would much rather do the 60-70 hour weeks I do as a surgeon than 40 hours as anything else.

I'd rather do 40 hours a week of something I hate and keep the ones I love than 60 hours a week doing something I love that costs me those I care about. Everyone has priorities.

 

[anotherdecision]

OP referenced an interest in Neurosurg and ENT so one would hope his qualifications are at least decent, or else the whole conversation is moot

My stats are good. I won't post specifics as this thread wasn't made to brag or anything like that. But I am fairly confident I could match to most any specialty if I applied broadly enough.

Procedures vs operating.

Yes, procedures would give me a little bit of what I'm looking for but may not give me that feeling you can't put your finger on when you're in the OR.

I'd rather do 40 hours a week of something I hate and keep the ones I love than 60 hours a week doing something I love that costs me those I care about. Everyone has priorities.

Exactly. What makes it tough is I don't know the price ahead of time. Obviously I won't have regrets if my relationships are thriving ten years from now, intact, and I'm a surgeon. If I'm divorced and/or my kid would rather talk to their uncle than me because I'm always at work... picking surgery will have been the biggest mistake I have ever made. No job is worth that contrary to what many American physicians think (emphasis on American; other countries seem to have lifestyle at least more figured out). I would rather be a proceduralist in that scenario. A lot rides on my decision.

 

[nlax30]

I'm not in surgery, but am finishing up a fellowship and about to start a sub-specialty fellowship for a total of 8 years of training. When the opportunity came up to this additional fellowship I had to have somewhat of a similar conversation with myself about being done and getting a job vs delaying "the real world" another 2 years with a family and young kids.... To be honest it wasn't easy and each situation is going to be different.

Obviously you need you spouse behind you 100% whichever way you go. I do agree that if surgery is truly what will make you happy then forget about choosing things based on the training, but rather on what's going to make you, and in turn your family happy in the long run.

Last thing you want to do is have chosen something like ER and 10 years in realize you are miserable each shift. On the flip side, if your spouse were to say, extreme example, that she'd divorce you if you did 5 years of surgery residency then that may make the decision for you.... but it doesn't seem like that's going to happen here.

 

[Ismet]

I'd rather do 40 hours a week of something I hate and keep the ones I love than 60 hours a week doing something I love that costs me those I care about. Everyone has priorities.

I get that. But it's not so black and white. Doing 40 hours a week of something you hate can make you a burned out shell of a person, and that affects much more than just your professional life. Many of us have seen that or lived it.

Not saying it's an easy decision. And certainly not one to make lightly. I think OP is doing all the right things right now in weighing all of his options. But there's a limit to how many "what if's" someone should consider; you can't predict the future.

 

[FrkyBgStok]

Didn't read the whole thread but I have 3 kids and had a similar conflict with my life (not with surgery, I hate surgery) and my wife just said "when you are happy and working a bunch, you are a better husband and father but when you are on a rotation where you aren't happy but working less, it is worse for everyone." This has always stuck with me. If I love what I do and am happy all the time, my time with my family is much better quality, even if it is ultimately less.

 

[ActinicKeratosis]

I actually really enjoyed my surgery rotation. Being in the OR being able to help out (even if it was just retracting or closing) was generally a lot of fun. The problem was during my surgery rotation I didn't have time to work out, eat healthy, or see friends/have a social life. I could totally see why people love it. However for me I simply have lots of other things in life that I want to make time for which is why I will most likely not go into surgery.


Sent from my iPhone using SDN mobile

 

[Mad Jack]

I get that. But it's not so black and white. Doing 40 hours a week of something you hate can make you a burned out shell of a person, and that affects much more than just your professional life. Many of us have seen that or lived it.

Not saying it's an easy decision. And certainly not one to make lightly. I think OP is doing all the right things right now in weighing all of his options. But there's a limit to how many "what if's" someone should consider; you can't predict the future.

I mean, I've worked plenty of jobs I didn't like- this is my third career. The vast majority of people don't enjoy their jobs, and they get by just fine. The idea of career self-actualization being absolutely necessary to one's existence is perhaps the most first world problem I've ever heard in my life. We're a very small minority of people in a very small slice of history that even have the ability to entertain that notion, the point of which being, if 98% of humanity is and has done work they didn't particularly enjoy without being husks of human beings, we certainly can to. It all just screams melodrama and self-importance when people put forth this idea that choosing a specialty you like but don't love (as in OP's case) is some road to inescapable self-loathing and eternal regret.

I say do a personal inventory, weigh what matters. Make a list of everything you want in life down a page, and make columns for each specialty at the top. Throw a plus under each specialty of it gives you one of your wants, or a double plus if it strongly meets that need, and a minus of it fails to or a double minus if it seriously fails to meet it. Sometimes just having a visual aid to reference can really help with evaluation of multifactorial problems, as you can really see the bonuses of one thing outweigh the other, and if there is a close matchup, you can really break it down to which set of things you want in life. That's just like, my lame little decision making table though, think about it however you want, but think carefully, and be honest with yourself, OP.

 

[Stagg737]

Didn't read the whole thread but I have 3 kids and had a similar conflict with my life (not with surgery, I hate surgery) and my wife just said "when you are happy and working a bunch, you are a better husband and father but when you are on a rotation where you aren't happy but working less, it is worse for everyone." This has always stuck with me. If I love what I do and am happy all the time, my time with my family is much better quality, even if it is ultimately less.

This is a good point, but loving what you do and being happy during your work hours doesn't help your family life if you don't actually get to spend time with your kids. Even if I was doing something I loved and it was only for residency/fellowship, I would strongly prefer not to spend the first 6-8 years of my kid's life being an absentee parent.

 

[hallowmann]

Honestly, I wouldn't do it. To be fair, this is coming from someone who couldn't imagine missing the majority of my child's early life. Sure, once you get through, your life would be more manageable, but you'll never get those years of your toddler back. If that's your top priority, which it sounds like to me in your posts and responses, I'd move on to something else. Keep in mind though, there are surgical subspecialties with very reasonable hours, even in residency, so maybe you should consider those of you really want to be in the OR.

Also, since it's neurosurg, I'm going to tell you about a friend of mine that always planned to be a neurosurgeon. After 3.5 years outside of the state he grew up in, away from his family, it was time to apply for residency. He also liked Neuro a lot, so he applied to both NS and Neuro, with most of his programs in his home state. When it came time to submit his ROL, he decided it was more important to him to be home than the difference between NS and Neuro, so he ranked NS, Neuro, NS, Neuro, etc.

In the end he matched Neuro in his home state at a program he really liked, and he managed to spend the last couple years of his father's life at home with him. Looking back, he is really glad not only that he ranked the programs the way he did, but that he matched Neuro. My point is that sometimes you have to figure out what's most important to you (and it might be NS). For most people it's not one field or bust. They can be easily happy in their job doing something else. Medicine is versatile.

You could also do what my friend did, and delay your decision until you actually go to those programs on your interviews, talk to NS residents outside of your own program, and then submit your ROL. Obviously, it's not the easiest thing applying to 2 different specialties, but people do it all the time. Maybe you just need some more time to decide.

EDIT: Just to be clear, I'm saying you need to prioritize what you want. If you can't see yourself being nearly as happy doing something else, then do NS. Obviously don't choose something else and then blame your family, that's not fair to them or you. This is your decision, and yours alone (given that your wife is on-board with what you want). Pick what you feel is most important and don't look back.

 

[SurgeDO]

I just matched neurosurgery in the DO match. Had many of the same thoughts you are currently describing at one point or another.

Ultimately, I chose neurosurgery. I knew if I did not, I would have regretted it. I would have hated to attribute even the smallest amount of this regret to my family in the future.

I also think the "neurosurgeons have no life outside the OR" stereotype is overdramatized and exaggerated. You can be the guy who works all hours of the night clipping/coiling crazy aneurysms or you could be the guy who does elective spine with the occasional crani for meningioma. I know neurosurgeons who work 4 days a week and golf on Fridays. I know neurosurgeons who couldn't pick their kid out of a line-up. There really is so much variation in how to run your future practice in this field. It's really a shame how quickly this specialty is written off by medical students based off the horror stories from the Cushing era.

Another thing to think about is this: you can always go from neurosurgery to another specialty if you and your family decide that you want more time at home. You cannot go from another specialty to neurosurgery.

Best of luck, dude. Feel free to PM me if you'd like to discuss this more.

 

[libertyyne]

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