Is neurosurgery really worth the sacrifice?

[Christa]

As an M3 trying to pick a specialty, I found what I really like: neurosurgery. From the first time I cut the dura, I knew that I could not really do anything else. I love the challenge, the epinephrine that infuses your entire body when you are in the OR, I love the 20 hour surgeries and the emergency craniotomy at 2 am. But I sadly realize that if I choose this path I will probably never see my kids or my spouse again. I will be stuck somewhere on Q4 or Q3 for the next 7 years of my life, and possible for the rest of my life. I recently saw a movie where one of the characters says to another something along the lines of “You are like the leprechaun on the cornflake box, chasing the pot of gold at the end of the rainbow - but when he gets there at the end of the day it is just cornflakes”. So I sit here and wonder, and ponder over and over about this decision: should I or should I not choose to do neurosurgery? If any of you out there have any experience please share.

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[Blake]

Can't say anything to help you, other than I'm a M3 in a similar situation. You're definitely not alone... While I haven't seen 20 hour surgeries yet, I'll admit the best moments I've ever had in med school so far were scrubbing in for neurosurgery cases (you know there's something special about this field when you come out of the OR at 4 am, with this amazed look/smile on your face, and the only thing on your mind is '' I've got to do this for a living ''.).

Add this to the fact that the NS faculty here is very supportive (chairman loves to teach, and the other attendings are actually nice people) and this career choice almost becomes a no-brainer (no pun intended)... Until you realize half of the attendings are divorced or have no kids and the residents are all single. I don't know, but having a decent family life would be nice at some point, right ? Oh well.

I guess we'll find out soon where our true passion lies with more rotations under the belt. Good luck !

 

[nimbus]

Until you realize half of the attendings are divorced or have no kids and the residents are all single. I don't know, but having a decent family life would be nice at some point, right ? Oh well.

I guess we'll find out soon where our true passion lies with more rotations under the belt. Good luck !

Half the anesthesiologists, radiologists, accountants, plumbers, and gardeners I know are also divorced. Doesn't mean a thing. After you complete your training, you can make your own decisions about the type of life you lead. If you practice in a large metropolis and have reasonable income expectations, you will have no trouble leading a reasonable lifestyle. If you go chasing $$$ in a smaller area or hyper busy practice, of course your life will suck but that was your choice.

 

[drbruce]

Half the anesthesiologists, radiologists, accountants, plumbers, and gardeners I know are also divorced. Doesn't mean a thing. QUOTE]

This is just simply not true. Having a balanced life is much harder in neurosurgery. Would a normal person really want a partner who is away almost every night and has such an erratic on call schedule that making plans to go out together is impossible?

The sad thing is that going into neurosurgery is a very selfish decision, especially if you have a family to consider. I have read that many neurosurgeons regret their decision. Seven years is a very long time to lose, especially when you are still young and in the prime of your life. It is sad to hear that so many neurosurgeons are single; this is time in ones life for relationships, having fun, travelling, exploring! The only thing that keeps them going is the stigma of quitting or the realisation that they have already come so far, they may as well complete the residency.This is certainly a trap that many surgeons fall into during their training. The British system is much better in this respect - it takes much longer to become a surgical consultant, an extra four years, I think, but the training isn't as intense and you can still lead a relatively normal life, at least compared to a US surgical resident. The salary for surgical trainees is also considerably better.

Just because you have enjoyed a few rotations doesn't necessarily mean that you will like becoming a neurosurgeon. Many medical students are draw to neurosurgery for the money, for the challengers, for the status but would you really care about the status of the job when you have to get up at 3am in the morning for the 15th time that month? I wouldn't. Having said, if you can't see yourself doing anything else in medicine apart from neurosurgery than go for it and I wish you the best of luck!

 

[StrifeM.D.]

To the OP. It's really all your preference. There are many programs to go into, all of which are extremely time consuming. However, if you like that feel of walking out of a 20 hour surgery session and after that time, still have a look of bewilderment, then by all means, do what you like. I think that there will always be sacrifices in life, especially subspecialty surgeries. I think it may be harder to find a "great" balance in life during residency, but it is attainable.

That being said, I have a very good friend who is a neurosurgeon. He completed his residency at the Barrow Neurological Institute. He and his wife both tell me stories of the immense hours and dedication it took to get through, including some nights where he would literally fall asleep at a table in a restaurant. She is a trauma nurse, so she understands the level of commitment needed. After residency he decided to go the academia route and found that there was a lot involved (mostly additional research on top of surgeries and helping to train the new residents, etc.). Not to mention tons and tons of hours. He is now 4 years out, living in SW Florida and working for one of the hospitals there. He works with 3 other docs and he has one call night per week as well as every fourth weekend and Christmas holiday on call. This job worked out beautifully because of how their system is set up. He trains for and competes in Ironman competitions, goes out for dinner all of the time, and really enjoys life.

Are there days and weeks of hell....sure, when aren't there? But everytime I ask, he says he would do it again in a neuron impulse!!
I think that anything that you like is worth the time. You just need to realize that there will be struggles and satifactions. Best of luck in your decision and future success!!!

-Ray

 

[FutureNeuroStud]

I agree with Ray and think that drbruce has been talking to the wrong surgeons. Many doctors will tell you not to even go into medicine nowadays. Especially those in demanding specialties. I work at a neurosurgery practice and of the 17 surgeons who work there, all but maybe one or two are incredibly happy with their jobs. Each of them has struggled to make time for family, but they do it. It just takes a little more effort when you're a neurosurgeon (or any other surgical subspecialist). Choose a residency in a field you'll enjoy and you'll figure out a way to make the rest of life work out.

 

[filter07]

I love the 20 hour surgeries and the emergency craniotomy at 2 am

You love 20 hour surgeries? Why?

 

[hans19]

Listen to yourself talking.

Standing on your feet for 20 hours skipping meals, not going to the bathroom during this 20 hours?

Crani at 2 am? How late have you stayed as an MS3 post call? All of this won't be as fun the 37th time around when you are chronically sleep deprived and generally worn out... It'll get old real fast.

Think about it. It can be done, but do you honestly think you will still love the 20 hour surgeries and 2 am crani's 20 years from now?

 

[Faebinder]

Half the anesthesiologists, radiologists, accountants, plumbers, and gardeners I know are also divorced. Doesn't mean a thing. After you complete your training, you can make your own decisions about the type of life you lead. If you practice in a large metropolis and have reasonable income expectations, you will have no trouble leading a reasonable lifestyle. If you go chasing $$$ in a smaller area or hyper busy practice, of course your life will suck but that was your choice.

whatever... what a false statement..... there is no denying that ns divorse/single rate is way higher than norm.

 

[FutureNeuroStud]

Listen to yourself talking.

Standing on your feet for 20 hours skipping meals, not going to the bathroom during this 20 hours?

Crani at 2 am? How late have you stayed as an MS3 post call? All of this won't be as fun the 37th time around when you are chronically sleep deprived and generally worn out... It'll get old real fast.

Think about it. It can be done, but do you honestly think you will still love the 20 hour surgeries and 2 am crani's 20 years from now?

Umm, 20-hr surgeries don't involve skipping meals and not going to the bathroom. You generally have other surgeons assisting you such that you can take short breaks to eat, get a drink and do your thing in the bathroom. This is not to say that you won't be incredibly exhausted or hungry when all is said and done...

 

[danielmd06]

It's wonderful that you enjoyed Neurosurgery as an MS3...I did, too. There is nothing wrong with loving this specialty and wishing to spend your life mastering it. My advice would be to speak with the residents and attendings at your home program, and scheduling appropriate fourth year electives at an early date. These electives will help you grasp a more accurate picture of what a Neurosurgery residency is like than a third year rotation.

If you change your mind, you will still have time to add different electives to your calendar. Granted, you will still be catching a mere microcosm of the residency, but at least they will allow you to make a more educated decision about your career path.

Good luck.

 

[drbruce]

Futureneurostud, your name implies that you harbour a certain biased towards neurosurgery. But I presume from your profile that you don't have any experience of neurosurgery either in the capacity of a resident or as a medical student for that matter, just as somebody who dreams of becoming neurosurgeon in the relatively near future.

My father is a brain surgeon and I can tell you from listening to his stories as a child that a significantly high proportion of neurosurgeons do regret entering this field, especially when their medical friends are working in jobs with much better lifestyles and similar salaries. You say that neurosurgeons are "incredibly happy" with their jobs. How do you know this? There was a recent discussion about the honesty of surgeons. If you have spent years training in a very demanding job, would you turn around and a tell an employee that you are unhappy with being a surgeon. These sorts of candid conversations might occur between doctors but I found it incomprehensible that you know the emotional states of most of the neurosurgeons at your practice. This is private information.

I'm not saying that all neurosurgeons dislike their job, far from it. But you have to go into this field with your eyes open. Many doctors are just not cut out for the depressing lifestyle while many others are.

 

[FutureNeuroStud]

Futureneurostud, your name implies that you harbour a certain biased towards neurosurgery. But I presume from your profile that you don't have any experience of neurosurgery either in the capacity of a resident or as a medical student for that matter, just as somebody who dreams of becoming neurosurgeon in the relatively near future.

My father is a brain surgeon and I can tell you from listening to his stories as a child that a significantly high proportion of neurosurgeons do regret entering this field, especially when their medical friends are working in jobs with much better lifestyles and similar salaries. You say that neurosurgeons are "incredibly happy" with their jobs. How do you know this? There was a recent discussion about the honesty of surgeons. If you have spent years training in a very demanding job, would you turn around and a tell an employee that you are unhappy with being a surgeon. These sorts of candid conversations might occur between doctors but I found it incomprehensible that you know the emotional states of most of the neurosurgeons at your practice. This is private information.

I'm not saying that all neurosurgeons dislike their job, far from it. But you have to go into this field with your eyes open. Many doctors are just not cut out for the depressing lifestyle while many others are.

Due to the nature of my work, I've shadowed a lot of these guys. With some of them, I've even spent time with them away from other employees. I asked one of them, while having drinks at a Halloween block party on his street, to give me an honest opinion of how the various docs feel about their choice of neurosurgery as a profession, as I am very interested in it for myself. He said that this is something they ask each other from time to time when one of them is frustrated and looking for advice as to how he can balance home-life with work. Furthermore, he said that with the exception of one or two, all of the surgeons are "incredibly happy" with their choice of specialty, without divulging who the unhappy ones were. However, I must concede that these guys are probably in a much better situation than your average neurosurgeon. They get a lot of time off, don't have to work 80-hr weeks to get the revenue they need, and still get paid really well, all while being able to pursue varying degrees of clinical research. I guess it's a benefit of being a part of a group of 17 (quite rare in neurosurgery).

So, yes, I am a little biased...as is my anecdote. But anything you get on this post is just that. An anecdote. Thus, anyone reading this should take all of it into some consideration, but realize that no one can give you the straight truth about this and in the long run...you gotta do what makes you happy. Personally, I like working hard and find this field fascinating. I have a very understanding fiance who knows that I like to keep a busy schedule. She also knows that I'll make time for her and our family, one way or another. Thus, if I find myself with the opportunity to take a neurosurgery residency, I'll probably do it. Though I can't say for sure as I've only shadowed 5 or 6 other specialties and haven't been to medical school yet.

 

[Arista.MD]

For neurosurgery people don't have a set number of hours that they stay post call, they just stay because they have to. There is no such thing as 88 hour work week here.

If you are an M3-M4 at our institution and want a good letter, you have to stay the same amount of time as the residents. Maybe at other programs is different, but here nothing changed since the 88 hour work week was instituted; I think it actually made the attendings more upset with the residents, and increased the yelling.

just my 2 cents on how long people stay in neurosurg rotation.

 

[nimbus]

I'm an anesthesiologist at a busy Level 1 Trauma center in California. We have 8 neurosurgeons on staff and I chat with them all the time. Most of their case volume (>90%) is elective spine. Calls are infrequent for them but they can be stressful because they are often covering more than one place at a time. They all have outside interests and make time for them, whether it is family, surfing, cycling, running, movies, etc. Most seem happily married. It is different than the university hospital.

BTW, 20 hr surgeries are not a reality in private practice. In fact I never saw one even during training. I get bored after 2 hours and so do most of my surgical buds. 7-8 hrs max for a multilevel flip-flop thoracic spine with one of our slower guys.

 

[bustbones26]

Half the anesthesiologists, radiologists, accountants, plumbers, and gardeners I know are also divorced. Doesn't mean a thing. After you complete your training, you can make your own decisions about the type of life you lead. If you practice in a large metropolis and have reasonable income expectations, you will have no trouble leading a reasonable lifestyle. If you go chasing $$$ in a smaller area or hyper busy practice, of course your life will suck but that was your choice.

Academic residency training in general is a sacrifice. Let's face it, residency lifestyle sucks no matter what specialty you choose. Now, for those of you that disagree with this statement and start quoting cushy specialties, would you agree that even in those specialties that compared to an attending the resident's hours and duties are far worse?

Here is the question for you to consider. Life as a resident sucks, you will be sleep deprived, you will work long hours, you will be away from your family often. But, do you want that to be the case for 6, or even 7 years as it is for neurosurgery? Chew on that for a bit.

I for one am not discouraging you. If neurosurg is what you want to do, then go for it. And others here are right, you can choose to live a reasonable lifestyle post-residency. But keep in mind, its a long course until you get there.