Really, What’s So Great About Surgery?

After taking a look at this thread, it really got me thinking again about why anyone would even consider a career in surgery.

I carried protein bars etc in my pockets and it came in handy. Surgery rotations were tough – I had to do 3 months, one of them over December. I had one day off – Christmas day – they paged me but I did not answer the page.

Carrying protein bars because you really don’t have time to eat and then getting paged on your only single day off — Christmas day, no less. What the fuck are people who want a lifetime of this really thinking?

I used to do my wash in shifts because I was too tired to stay up and put it in the dryer. It means having lots of easy to prepare food at home and never trying to run out of essentials: soap, TP, etc. because who wants to run out to the store when they get home after a really long day?

A career that doesn’t even allow you to complete basic day-to-day tasks such as washing clothes? I’ll pass, but thanks, anyway. Cutting on people can’t possibly be that good.

G-surg IS that bad at MANY places. I would know. Today is day 15. I broke 200 hours today. I’ve been in the hospital for no less than 10 hours of every day but one of the past 15. I got meal tickets on November 1st to cover breakfast, lunch, and dinner for the entire month of November. I should have used 31 of them. I’ve only used 20, and my team has ordered delivery for one of those missed meals. The day of my first short call I went from lunch to lunch the following day without eating anything because I was in the OR when the cafeteria closed for the night and I was back in the OR the next AM before it opened for the day. I usually get to pee, but only because there are bathrooms everywhere in this hospital.

Maybe this guy gets it. I sure as hell hope so since there are way too many idiots who seem to think surgery is God’s gift to medicine.

I get up at 4 every morning. Every fourth night I am required to work until 11, which really means working until 11, wrapping up the last few things and getting out at 11:30. Alternately it means getting pulled into the OR at 10:45 and being there until the case is finished. You are still expected back, on the floor, at 5 AM the next day no matter how late the case goes. If your fourth night falls on Friday or Saturday you stay until the following morning (usually around 10 AM). If it’s Sunday, you come in from 6 AM (yay, an extra hour of sleep!) until 11 PM.

Yep, I think he sees the light. One down, many more to go…

So Really, What’s So Great?

Finish up reading the thread and you’ll see pretty much the same — people complaining about their chosen field. It doesn’t take a rocket scientist (or even a neurosurgeon) to know what the hell you’re getting yourself into before matching into surgery.

I feel little sympathy for these guys. They rotated through surgery as a junior medical student and probably even did a Sub-I in surgery during their senior year. If that’s not enough to convince them that the lifestyle sucks, then maybe they’ll realize it when they burn out 5 years down the road and switch into Pathology.

Can’t Match Derm? Try Derm Path Instead

Dermatology is a very competitive specialty and for good reason. You’ll enjoy 9-5 clinic hours, minimal call, a nice residency lifestyle, and great pay. If you’ve lived the good life in medical school and don’t have the Step scores, grades, or AOA status to match Derm, all hope is not lost.

Dermatopathology. Another high throughput subspecialty, a “derm path” can look at up to about 100 slides per day, and charge about $75 each. Thus, revenues can approach $2 million per year per physician. What’s more, a typical overhead rate is about 30% much lower than in general dermatology.

Enter Dermatopathology. Not only do you avoid patient contact, but your salary is extremely competitive and your work hours mirror those of a dermatology clinic.

Matching into pathology is currently much easier than matching into dermatology. I honestly don’t understand it, either. I’d much rather look at slides all day versus removing skin lesions from patients in clinic. If it were me it’d be pathology over dermatology hands down. I do predict that pathology will be getting more competitive in the near future.

Keep in mind that a dermatopathology fellowship is very competitive and is desired by both dermatologists and pathologists alike. If you don’t have the numbers but still want the derm lifestyle, I suggest matching into pathology and working as hard as you can to be a stellar pathology resident and an awesome derm path fellowship candidate.

Here’s just one job posting looking for a California dermatopathologist:

Employed Position

Salary + Incentive= $300k-$500k

Comprehensive Benefit Package

NO CALL

Work Monday through Friday; No Weekends

6 Weeks Vacation

Free Standing Lab

Generous Relocation Package

Not a bad deal.

A Look Into The Deterioration of the Physician’s Financial Lifestyle

I came across this excellent article tonight while doing some reading. It’s a close look into how physicians are working more and making less these days. It’s an excellent read and I highly recommend that you all check it out.

Now, announces the New England Journal of Medicine, “many American doctors are unhappy with the quality of their professional lives.” The literature on this reads like the intake form at a depression clinic: “increasing marginalization,” “discontent,” “confused,” “angry,” “insulted.” (Is it any wonder med-school applications are down again this year?) Yes, the doctor is in, but in case you haven’t noticed, there’s a good chance he’s seething. “It’s no fun being a doctor anymore,” is the way one puts it.

At one time, most physicians were their own bosses, entrepreneurs who set up their own small businesses. That was part of the fun. “Now,” says Fox, who is just such an entrepreneur, “I’m a dinosaur.” There has been a vast, largely unnoticed change in the organization of the medical labor force. The solo practitioner, the one most of us grew up trusting, is nearly out of business. From now on, doctors will be employees like everyone else.

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