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Best surgical lifestyle?

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  • The White Coat Investor The White Coat Investor 
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    Status: Physician
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    Joined: 05/13/2011

    Specialties that are in OR 2-3 days and clinic one day….

    Trauma surgery (horrible 24 hour calls often with lots of ICU medicine, need to live in big city or near trauma hospital)

    Ortho (established ortho at my place work 1.5 days in office, 2.5 in OR… however much more clinic while you are building a practice)

    At our hospital: urology, Gyn, ENT, and Gen surgery all only have a day a week (sometimes more but not block time) in OR

    Maybe consider anesthesia? Lots of procedures, connect with patient before surgery but then don’t have to talk with them! Ha!

     

    Click to expand…

    Trauma surgeons go to the OR now? When did that start? I can’t remember the last trauma case I sent to the OR and I work in a trauma center. It’s almost all managed non-surgically outside of the inner city knife and gun clubs.

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #215418 Reply
    Liked by Tim
    Avatar Tim 
    Participant
    Status: Accountant
    Posts: 3084
    Joined: 09/18/2018

    How to pick a medical specialty – finances vs interest vs lifestyle

    Another thread to add to your reading list. One point usually not addressed is the physical requirements from a longevity standpoint.

    #215419 Reply
    Avatar Brains428 
    Participant
    Status: Physician
    Posts: 400
    Joined: 11/09/2017

    A 4 to 8 week rotation in anything says nothing of what the real job is like.

    As I’ve stated before (possibly even in the thread linked to by @tim), don’t go into something based on what you think is “cool” about a specialty. Do it based on the monotonous stuff.

    It seems like a good chunk of the surgeons I know (still early career) are not spending a ton of time in the OR right away. You also are looking at a surgical intern year where you will likely never see the OR in the scrubbed in sense (program dependent)…

    Orthopods seem the happiest, but that may be because I get along with them.

    Maybe go into anesthesia? I’m a radiologist. It’s not for everyone, but I like it. I also thought about surgery until I was doing q3 trauma call as a student (treated like the interns, 24 hour shifts and all that before work hour restrictions).

    #215424 Reply
    abds abds 
    Participant
    Status: Physician
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    Joined: 01/16/2017
    Splash Refinancing Bonus

    I’ve said it before, probably several times in threads like this: if you find the right job (often private practice), you can make most surgical specialties into whatever lifestyle you want.

    In ortho…. don’t want to be doing cases over 2 hours? Don’t do spine. Want bankers hours? Don’t do trauma and/or take a lot of level 1 trauma call. As others have said, lifestyle is often a trade-off with income for surgical specialties. Work longer hours, make more money; have more time off, make less money.

    #215425 Reply
    Liked by LizOB, Zaphod
    abds abds 
    Participant
    Status: Physician
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    2 days OR and 3 days clinic vs 3 days OR and 2 days clinic is a very reasonable expectation in my experience. Very few surgeons I know (although I do know some) are 1 day clinic and 3-4 days OR a week.

    #215428 Reply
    Avatar Peds 
    Moderator
    Status: Physician
    Posts: 4448
    Joined: 01/08/2016

    Specialties that are in OR 2-3 days and clinic one day….

    Trauma surgery (horrible 24 hour calls often with lots of ICU medicine, need to live in big city or near trauma hospital)

    Ortho (established ortho at my place work 1.5 days in office, 2.5 in OR… however much more clinic while you are building a practice)

    At our hospital: urology, Gyn, ENT, and Gen surgery all only have a day a week (sometimes more but not block time) in OR

    Maybe consider anesthesia? Lots of procedures, connect with patient before surgery but then don’t have to talk with them! Ha!

     

    Click to expand…

    Trauma surgeons go to the OR now? When did that start? I can’t remember the last trauma case I sent to the OR and I work in a trauma center. It’s almost all managed non-surgically outside of the inner city knife and gun clubs.

    Click to expand…

    welcome to utah.

    #215433 Reply
    Liked by Tim, SLC OB
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 6191
    Joined: 01/12/2016

    Don’t forget that surgeons don’t spend all their time in the OR. You’re still going to have clinic days. Clinic days are what steered me away from surgical specialties.

    Click to expand…

    Well I do like meeting people and talking to patients just not all day everyday. 2-3 OR days seems like it would be enough to break up the week and add some variety.

    Click to expand…

    Plastics fits this bill. We are in OR 3-4 days per wk clinic 1-1.5d/wk. Call can be intense depending on location. Stay away from level 1 or 2 trauma centers but still big places and its just right. Cosmetics is also similar, but you need more clinic and its much more annoying and wearing.

    I agree that the Mohs surgery one is probably best case.

    #215434 Reply
    Avatar Strider_91 
    Participant
    Status: Student
    Posts: 181
    Joined: 05/05/2017

    Mohs surgery

    No one will think you are a “real” surgeon but it’s hard to hear the jeers as you leave the office at 5pm with a wheelbarrow of cash

    Click to expand…

    ad99, I just did aspirated my coffee or snorted it out my nose or both.

    From my observation, the best surgical lifestyle is the one where you own the outpatient surgical center and don’t actually do surgery.

    beats talking to patients all day 

    Click to expand…

    I thought you were all-in for EM?  that line above is EXTREMELY important for you to process.  to type that out as an undergrad med student is very telling….  consider path, dx rads…maybe gas?

    Click to expand…

    Yeah I was all in for EM but I havent experienced surgery ever. Sucks to prove people right that said you dont know what you want to do as a 1-2nd year med student but such is life.

    I dont hate talking to patients, I like it. The better way to phrase it is that I also like not talking to patients sometimes and just completing a task with my hands. I like both. Def like being in the OR better though.

    #215438 Reply
    Liked by MPMD
    Avatar Strider_91 
    Participant
    Status: Student
    Posts: 181
    Joined: 05/05/2017

    Don’t forget that surgeons don’t spend all their time in the OR. You’re still going to have clinic days. Clinic days are what steered me away from surgical specialties.

    Click to expand…

    Well I do like meeting people and talking to patients just not all day everyday. 2-3 OR days seems like it would be enough to break up the week and add some variety.

    Click to expand…

    Plastics fits this bill. We are in OR 3-4 days per wk clinic 1-1.5d/wk. Call can be intense depending on location. Stay away from level 1 or 2 trauma centers but still big places and its just right. Cosmetics is also similar, but you need more clinic and its much more annoying and wearing.

    I agree that the Mohs surgery one is probably best case.

    Click to expand…

     

    do you need a fellowship for plastics?

    what does life look like if I dont want to do elective cosmetic procedures?

    #215439 Reply
    ACN ACN 
    Moderator
    Status: Physician
    Posts: 635
    Joined: 01/08/2016

    Ortho sports, peds, joints at a community hospital.

    If you're ever having a bad day, just remember in 1976 Ronald Wayne sold his 10% stake in Apple for $2,300.

    #215441 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 201
    Joined: 01/18/2016

    The perception of operating all night as a surgeon is not always accurate.  Do you get called about patients in the middle of the night?  sure, but the number of cases that actually need to go to the OR immediately is lower than you would think.  On top of that, the regional differences on the volume of call cases is significant.

    My bias is clear, orthopedics is a great field.  If you land in the right situation, you can have a great lifestyle and work 4-5 days a week and almost never work a weekend.  Doing that straight out of training is a little more difficult, but there are a lot of great jobs out there.

    Also, if you do a fellowship, you can select your lifestyle more easily.  Don’t want trauma call?  Go into total joint reconstruction.  Don’t like long surgeries?  Do hand fellowship.  Don’t like blood?  do sports.  You just have to pay for that choice with an extra year of training.

    I know what you mean by not having to talk with patients.  You aren’t saying you don’t want to interact with them, just that you don’t want to do 5 days of clinic a week.  Just know that to be a busy surgeon in the OR, you have to churn through a lot of patients.  I do 2 days in the OR and 2.5 in clinic and still see around 90-100 patients a week in the clinic.

    #215445 Reply
    Avatar JK 
    Participant
    Status: Physician
    Posts: 140
    Joined: 01/09/2016

    Mohs Surgery – no brainer in my opinion. Once you build your practice, you don’t have to do anything but surgery. Great hours, great pay. And if you decide later that surgery isn’t for you later on during your training…backup is general derm. Not a bad fallback 🙂

     

    Only issue is getting in. Arguably hardest residency and definitely hardest derm fellowship to get!

    #215446 Reply
    Liked by Zaphod
    Avatar Tim 
    Participant
    Status: Accountant
    Posts: 3084
    Joined: 09/18/2018

    “Ortho sports, peds, joints at a community hospital.”
    Throw in some trauma call at the “big house” and you are a rainmaker. Doors open as excess starts being referred out. You like knees and hips electives? The other docs will love the referrals of other things you send their way.

    #215459 Reply
    SerrateAndDominate SerrateAndDominate 
    Participant
    Status: Physician
    Posts: 487
    Joined: 02/01/2018

    Oh man. This is easy.

    No clinic days.
    Never talk to patients
    Do procedures on organs
    Great lifestyle

    – Pathologist

    Earn everything.

    #215472 Reply
    Avatar Eyedentist 
    Participant
    Status: Physician
    Posts: 13
    Joined: 01/09/2016

    Surprised very few votes for ophtho. Total banking hours, sit down for surgeries, fast cases, cool tech, light call, happy patients for the most part. Tougher to make bank as compared to hospital based specialities, but with the right mindset and surgery center, sky is the limit. Demand should also sky rocket as baby boomer ophthalmologists retire.

    #215473 Reply

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