Part-time academic surgeon

[ArrogantSurgeon]

Is it possible to work as an academic surgeon on a part-time basis once you become and attending? Possibly no more than 40-50 hours per week. I've heard some doctors in other non-surgical specialties who work part-time have a schedule where each month they actually work full-time for 2 weeks and then are completely off for the next 2 weeks. Is this type of schedule possible for a surgeon at an academic center?

The reason I ask is because, although I am interested in surgery, I realize that like most things in life the "thrill" of being a surgeon will eventually wear off after I've gone through years residency, fellowship, and practice. And I am the kind of person that gets real bored of *anything* that I have to do day in and day out, no matter how much I like it initially. That is why I want to do it on a part-time basis so that I have at least some time away from the profession and not be immersed in it all the time.

So...will any academic medical center hire an attending surgeon on a part-time basis? Any major logisitic problems with being a part-time surgeon?

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[womansurg]

Surgery is very technically challenging to execute and to excel at. Sort of like professional golf or something - if you are practicing a lot and 'in your game', you're going to do far better than if you are just toying around with it. That level of experience and familiarity can be all the difference between a good outcome and a bad one. The data are very clear that the quantitative experience of a particular surgeon for a procedure correlates with quality of outcome.

I'm not a big fan of the idea of a part-time surgeon. I believe that surgery is a lifelong commitment and a heavy responsiblity to bear. People choosing to go into surgery need to understand and be willing to accept the sacrifices that are involved - which are many, I assure you.

That's just my opinion.

 

[ArrogantSurgeon]

Thanks for the reply womansurg.

Would it make any difference since I am interested more in academic surgery rather than clinical surgery? In other words, I want to concentrate more on my research than actually operating. Along the 70% research, 30% clinical surgery schedule some academic surgeons maintain.

I like surgery a lot, but my future family will always be more important than my career. During residency and fellowship I'm willing to sacrifice some family life, but I just don't want to do it when I'm finally an attending. And that is why I would very much like to work part-time after completing my training. If this is at all possible, please let me know.

 

[Skylizard]

Originally posted by womansurg
Surgery is very technically challenging to execute and to excel at. Sort of like professional golf or something - if you are practicing a lot and 'in your game', you're going to do far better than if you are just toying around with it. That level of experience and familiarity can be all the difference between a good outcome and a bad one. The data are very clear that the quantitative experience of a particular surgeon for a procedure correlates with quality of outcome.

I'm not a big fan of the idea of a part-time surgeon. I believe that surgery is a lifelong commitment and a heavy responsiblity to bear. People choosing to go into surgery need to understand and be willing to accept the sacrifices that are involved - which are many, I assure you.

That's just my opinion.

I would agree with WS based on my experience and exposure to academic surgeons over a 2 year period. You may also find some answers/viewpoints in the thread :Flexibility of surgery career?

Ultimately it depends on what kind of surgeon you choose to be. Colo-rectal vs Trauma vs Critical Care vs Hepatobiliary vs Vasc vs Ct vs etc...
Ultimately, people regard individuals as being the "best in town" in part due to numbers of procedures per week or year. If you do a few parathyroids a week you are likely to be the "go to guy" instead of the community ENT doctor who does one a year. (This may be an over simplification and I am not trying to make this a Gsurgery vs ENT issue....it could be a community ENT vs Academic ENT )

So ultimately the answer to your question is in all honesty...IT DEPENDS. Some of those factors will be institutional, subspecialty, economy, demand, and what is academia in 5-10 years from now when you are completing your residency and/or fellowship.

As per you getting bored, the question is a matter of what you would get bored with quicker IM or Surgery or Neuro or Etc... It is definately important for you to have some idea of what the bread and butter is in the medical specialties and decide if one fits your interests more then the other and if it "will be enough". There will be monotony in all fields and it just depends on your personality and interests as to what field will satisfy you even in its most mundane state.

 

[womansurg]

Originally posted by ArrogantSurgeon
Would it make any difference since I am interested more in academic surgery rather than clinical surgery? In other words, I want to concentrate more on my research than actually operating. Along the 70% research, 30% clinical surgery schedule some academic surgeons maintain.

To be honest, this type of arrangement is not uncommon in academia. In my opinion, you cannot be a very effective and facile surgeon under these conditions, and this probably contributes to the stereotype of the academic surgeon as a bumblefud in the OR.

We had a really bright, academic minded guy here for several years, who only operated intermittently, spending the majority of his time in scholarly pursuits and surgical education. He was notoriously incompetent in the OR (although I'm certain that he never realized it). The OR personel would beg the senior residents to staff him for even simple hernias and such, because someone would need to keep him out of trouble. Super smart guy, and I'm sure he would've been an adequate technician with more practice, but that was a system which really didn't work for him. And I think this would be true for most people trying to do surgery on an infrequent basis.

Again, this is a sytem well entrenched and you would likely not be criticized (at least not to your face) for following it. It's just my own opinion.

 

[Skylizard]

Originally posted by womansurg
To be honest, this type of arrangement is not uncommon in academia. In my opinion, you cannot be a very effective and facile surgeon under these conditions, and this probably contributes to the stereotype of the academic surgeon as a bumblefud in the OR....Again, this is a sytem well entrenched and you would likely not be criticized (at least not to your face) for following it. It's just my own opinion.

I knew a thyroid/adrenal guy that only really did those operations and inguinal hernias. He did maybe 3 cases a week on a busy week. He was not fast or efficient and was definately not up to par with the chief residents or other attendings that spent more time in the trauma bay and OR. I spent my time in clinic packing his hernia patients' wound infections. However, he was extremely knowledgeable about endocrine diseases.

At another University program, I knew a surgeon that only did "simple" breast CA surgery. Definately NOT the individual to take out your gallbladder or supervise the ICU or the trauma bay. However, she was clearly very knowledgeable about the latest developments in the treatment of breast CA.

I would personally get bored limiting myself to such a small scope of practice as these two did. However, they may have had great excitement in the lab that we did not know about at the intern level.

On the other extreme, I knew an academic CT surgeon that did abdominal hernia repairs and colectomies on top of his MVRs, pneumonectomis, aortic repairs, & CABGs. I knew a community Vasc surgeon that does 70% Gsurgery & 30% vascular after completing vascular fellowship at a university program.

 

[surg]

Many years ago we had a breast surgeon that did 3-4 days a week including clinics (and given the fact that breast patients don't tend to be very sick often had her weekends off).

There are some trauma services that a 2 week on/2 week off type schedule might work since they often are patients of the "service" and not of that particular physician.

Finally, you could consider the VA. Many VA services (especially in the northern climes) are not that busy any more and would probably afford significant time for research. I doubt that our average VA surgeon is operating more than the equivalent of 2 full time weeks/month (Especially since every VA I know won't let you start an elective case after about 3:30!)

 

[MacGyver]

Originally posted by womansurg
Surgery is very technically challenging to execute and to excel at. Sort of like professional golf or something - if you are practicing a lot and 'in your game', you're going to do far better than if you are just toying around with it.

I wouldnt equate surgeons with pro golf... pro golfers work MUCH, MUCH harder on their technique and repetition than surgeons do.

At any rate, I'm not sure I would classify 40-50 weeks as "toying around" either.

Its true that the more time you spend at it, the better you will be, but its not reasonable to expect ALL surgeons to give up every semblance of life beyond work. For some surgeons thats OK, but not as a blanket for all of them.

 

[vuillaume]

The notion that an academic surgeon might lead a more relaxed life is an odd one. With exceedingly rare exceptions, academic surgeons have a pretty heavy workload partly because they are tugged in separate directions by their research, teaching, and clinical loads. I wouldn't say that their lives are worse than pure clinicians--they work hard, but it's a different kind of work. Moreover, academic programs are filled with straight operators who'd just rather be in a university-setting for one reason or another. So I'm not sure what kind of academic surgeon you're thinking of.

If one is seeking a career path more likely to provide a "better" lifestyle, I don't think General Surgery/Fellowship is not necessarily a good route to go.