General Surgery

[civilspouse]

DH is in the MD/PhD program. He will be finishing up the PhD in March and heading back to the clinics to finish his rotations and then will match the following March. Because of the way his schedule is working out (he will be finishing a year early in seven total, yeah DH!) he needs to have his electives selected in the next couple months to set up his schedule for his final year of rotations. He has been pretty set on general surgery and was planning on that, but today he had a bad experience working with a surgeon that is making him question that path. I had also been questioning his choice of surgery based on things I had read here. He has not done his surgery rotation yet, just had a few days here and there with surgeons throughout the grad school years. It will be one of the first rotations he will do after going back, but he will have to have selected his electives prior to the rotation. He says that the electives are very important because that is where he will make the connections to get letters for applying to residency programs. We have DS who is two and plan to have more in the near future and from what I've read on here surgery isn't very family friendly. My question for you is what is so terrible about surgery and why does everyone say to avoid it? What makes it so much worse than other paths? Is it just residency that is tough, or is the lifestyle after training bad too? Thanks for any information you can share.

[GrayMatterWife]

We have DS who is two and plan to have more in the near future and from what I've read on here surgery isn't very family friendly. My question for you is what is so terrible about surgery and why does everyone say to avoid it? What makes it so much worse than other paths? Is it just residency that is tough, or is the lifestyle after training bad too? Thanks for any information you can share.

Note that my DH is not a GENSURG, although he had to do a GENSURG PGY1. He is a NSG (neurosurgeon)--but the training demands and personalities are similar.

Define "Family Friendly." If you want to be married to a dermatologist, then, no, surgery is not family friendly. However, it has never been the unmitigated hell that everyone said that it would be. We had one child heading into residency and two while in residency, and I never felt like our lives weren't "family friendly."

Also, if your DH is second-thinking SURG after one experience with one surgeon, that may tell you something. Whatever happened, I assure you he will be dealing with egotistical, or dickheaded, or demanding, or irrational, or babyish surgeons for the rest of his career. Whatever he encountered--short of watching the guy commit homicide--it was nothing extraordinary.

Surgery is not "so terrible" for everyone. And most people who tell you to avoid it are either (1) surgeons/wives of who've had very bad experiences, or (2) the endless number of non-surgeon MDs who think they know how awful surgery is. Of those two groups, I would listen to the former. They actually know what they are talking about and can give you some perspective on problems with surgical life. I would never, for example, listen to a pathologist's perspective on surgery. Anymore than I would listen (seriously) to a surgeon blather on about how pathologists lead dull, slow-paced practices. What do they know? Very little, other than they probably had a bad path rotation in med school. Be sure to talk with surgeon/wives of who have NOT have a bad experience. They also can give you a perspective.

My DH was an MD-PhD and EVERYONE in his program--his mentors, professors, peers...EVERYONE (none of whom were surgeons)--criticized his decision to go into neurosurgery. One of his closest mentors sent him a scathing email, telling him that he was throwing his career away. Yeah...well...they don't have to live his life. And it turns out they were completely wrong. Neurosurgery was certainly the longer, harder choice in terms of training, but it was definitely the right choice for DH.

Residency was not bad. We had a very comfortable life, in large part because (as MD-PhD) he had no school debt and I had a good job and had long since paid off my school debt. Life was busy and hectic, but not bad. But, you as the spouse have to be very independent and kind of fearless. If you need a constant partner in everything, that's a problem. For example, do you go to Target for grocery runs in pairs? And you would feel sad and lonely going yourself? Be HONEST with yourself about what you want. If you want a completely reliable, constant, consistent Target partner [or insert whatever comparison is relevant: church partner, wedding/party partner, whatever...], don't be married a surgeon--resident or otherwise.

After residency, he is around a LOT more. It is extremely annoying. I had my life nicely paced and worked out--routines for the kids, etc., and when he shows up, he messes everything up. No, jerkoff, it is not helpful for you to waltz in at 7:00 PM and get the entire team hyped up just around bedtime. Don't you have a craniotomy you should go deal with or something??

[alison]

If you want a Target partner (I LOVE that!), then anesthesia would be a good option. .

[SuzySunshine]

Was he thinking Gen Surg as a lead into something? I think any surgery specialty is seen as not family friendly because there will always be call, there will always be unknown hours, there will always be late nights but my husband is much like GMW's in that he would have never chosen anything else.

I will say that DH's schedule now is TONS better then training ever was, he's home for dinner a week night or two each week, he's only on call one week night/week and every 5th weekend. When he's off, he's REALLY off so the schedule can be more family friendly after training.

Has he done any other rotations? I know he's been disconnected being a PhD but can he do any shadowing, anything before he has to set his schedule?

[Momo]

... I think any surgery specialty is seen as not family friendly because there will always be call, there will always be unknown hours, there will always be late nights but my husband is much like GMW's in that he would have never chosen anything else...

this is also true for inteventional cardiology.

[Pollyanna]

Ummm, if one bad experience with a surgeon is making him question his path then really needs to analyze what he wants in a specialty and what he's willing to endure to get there. In ANY specialty there are jerks and in every rotation during clinicals someone WILL treat him poorly (especially if they know it bothers him). Tell him not to take things personally.
In terms of family friendly, you need to decide together what that means to you both. Dh is in a decidedly non family friendly in academic medicine but he has found a job that works beautifully with our family. Do lots of research, ask lots of questions, and talk about what you two want for your family life. Good luck!

[GrayMatterWife]

UDh is in a decidedly non family friendly in academic medicine . . .

Given his subspecialty, that really is some kind of irony!!!

[ladymoreta]

If you want a Target partner (I LOVE that!), then anesthesia would be a good option. .

Yes! I like the quote that shows up here occasionally about if he thinks he could be happy doing anything else besides surgery, he should pick that. GMW is so right. With the right attitude from the family and the doctor making the right choices for everyone (not just himself), surgery families can be really happy. I'm not one of those wives, so I know I'd be miserable if DH had chosen surgery. If he likes the OR, though, anesthesia is a great choice!

[niener]

I agree with just about everything GMW said (plus she said it better than I could have, as usual).

Our overall experience (currently a PGY2 gen surg) has been positive, and I credit most of that to (a) being extremely well-prepared (thanks in large part to the ladies here) to spend most of my day without DH, and (b) there really being nothing else he would be as happy doing with his life. I'd rather have him home for a pleasant 2 hours than a grumpy 6. We have surgery spouses here who have literally be through hell and back, mainly during training years but sometimes beyond. Those experiences unfortunately do still happen but I get the sense that they're becoming fewer and farther between (that's based on nothing more than my/my DH's personal experience with 3 training programs and the half-dozen or so other current surgery residents we know at other programs). Our current program used to have a pretty malignant reputation but they've taken big steps to turn that around and I feel like I hear that about a lot of places nowadays as the old guard is retiring or being forced out.

I'd say the guarantees are that he'll work extremely long, busy hours, take a lot of call after intern year, and will never reliably be able to do anything. Ever. If he has time to eat lunch and go to the bathroom more than once during a 12-hour period, it's a slow day. Aside from that, it's variable. Your co-residents make the biggest difference. Our residency program(s) have been very everyone's-got-everyone's-back. On some of the lighter services last year, if there were two of them on service DH could be home by noon some days because one would stay and cover while the other took the rest of the day off. DH was even able to go to two dentist appointments last year because the other residents covered his patents for a couple of hours, and of course he did the same for them. That's not true of everywhere though. One of our good friends is in a very malignant program where it's every-man-for-himself to the nth degree. She doesn't go home for days at a time and has gone almost a month without a day off. Normally you can sniff those places out during the interview trail though.

Also, if your DH is second-thinking SURG after one experience with one surgeon, that may tell you something. Whatever happened, I assure you he will be dealing with egotistical, or dickheaded, or demanding, or irrational, or babyish surgeons for the rest of his career. Whatever he encountered--short of watching the guy commit homicide--it was nothing extraordinary.

This would be a big red flag to me as well. Even at the greatest surgery program out there, he will work with the stereotypical asshole surgeon more than once. And most likely that asshole will have to write him an evaluation or a rec letter or whatever, so he'll have to suck it up and play the bitch. If you take every comment and criticism to heart, you won't make it. That's another guarantee.

[spotty_dog]

It seems to me that all the surgical specialties are pretty all-consuming. As GMW would say, you have to be hardcore to survive and thrive in a surgical environment.

Life with a person who was a surgeon at heart, but got coerced *not* to do surgery, would probably be miserable. So that is something you do want to avoid. But life with a person who is living the surgical lifestyle but doesn't have their heart in it, is also very miserable. My husband loves working with his hands, is a very high achiever academically, and on paper is a good fit for surgery. But he hated the dawn-till-dusk no-weakness mentality of his surgery rotations. I think that surgery is a good fit for someone who lives to work, someone who ranks their career very very highly in their list of the most important things in their life, and who takes very very seriously the importance of their job and the need to excel at it. I'm not describing that very well...I think surgeons see themselves as surgeons who have families and love them, not as people/wives/husbands/fathers who just happen to do surgery, you know?

That is really, really awful that he has to pick all his electives before he's even done a core IM or Surg rotation. Boo. Good luck!

[GreyhoundsRUs]

...I think surgeons see themselves as surgeons who have families and love them, not as people/wives/husbands/fathers who just happen to do surgery, you know?

Yes. DH loves us, and puts us first, but it's a different kind of first. He doesn't come to all DD's appointments, nor to all of my OB appointments, but will text to see how things went. When my aunt passed away, he didn't travel with us to the funeral because he just couldn't get the time off (he could have pushed, but he has three grandparents in poor health - we realize he needs to save his bereavement time for them). It has required sacrifice on our part that he can't be the "typical" husband/father in many ways. I rarely ask him (as in, maybe 2x in 13 months) to watch DD while I go do something. If he's home and awake, I want to see him, and if he's tired, he should sleep, not watch DD. As one of his attendings says, "Choices and compromises".

[corn poffi]

First, can we please get rid of the "surgeons are assholes" stereotype? Academia in general is full of assholes, so like it or not, with a PhD, he'll have to deal with them all his life, so matter his speciality. Like everybody else has already said, if one bad experience is making him question his plan, that's a red flag. You don't just "become a surgeon". It's something you are because you would not be happy doing anything else.

As to whether it's family friendly, it probably depends on what kind of family you want to have. If you're okay being the main parent and having a father who is not able to be involved, than it's fine. If you want a family that goes on regular vacations and has a father who coaches little league, then you're pretty much screwed in any medical specialty.

GS residency sucks, but it's not that bad. It sucks if most of your friends are non medspouses, who don't understand why he's never around. It sucks that you can't make plans ever, and you might not get to see your SO awake for days at a time. If you're in a malignant program far from home, it could be really tough. We are also fortunate to be debt-free, in a city where we already had many friends and is close to our families, and in a program that, for the most part, has amazing residents who really support each other.

Compared to other specialities, all surgical specialties are probably more hardcore than non-surgical specialties. Longer hours, lots of call, lots of competition. When he's scrubbed into a 12-hour case, there's no talking to him. In addition, the way general surgeons function in a hospital is much different than how other surgical and non-surgical specialties work. Ortho, neurosurg, uro are much more competitive, but GS gets consults for everything under the sun. One of the most difficult things for our GS residents is having to deal with non-surgical conditions that they didn't think they'd ever have to deal with. That means the pager going off in the middle of the night for issues like pregnancy and random disease processes.

[GreyhoundsRUs]

I agree, CP - people in any field are assholes. DH has more wonderful attendings than asses, by far. Also, it's important as the resident/med student to distinguish between legitimately being an ass and not tolerating BS. Having high standards and holding people accountable - not an ass. Being petty and vindictive - an ass. It is, after all, their livelihood - as a med student, you are simply a tourist/extra body. They have to protect their own interests, too.

[spotty_dog]

It has required sacrifice on our part that he can't be the "typical" husband/father in many ways.

A lot of that is residency too though. We had a very cush residency compared to most GS, he only had to have in-house call and rotate on the floors and through surgery a few times in the first year and a half then it was all EM and shiftwork. But yeah, optional things are optional -- including events, appointments, and even respite for frazzled SAHMs. I always figured that he's working his butt off to the edges of human endurance, so I can too. He was able to step up fairly well when we had the second baby though, taking the toddler off my hands now and again during the first month after baby was born.

After residency, it's been different for us. He works his butt off so that he can earn the bucks so that he doesn't have to work so much later. When he's home, he is only the dawkter if we ask him to be (someone needs medical attention). Otherwise, he's deeply invested in projects that interest him and activities with me and the kids. If he won the lottery tomorrow, he'd still work but he'd cut back to the bare minimum to maintain his skills, and he wouldn't have any trouble defining himself or finding fulfillment without work to propel him forward.

[GrayMatterWife]

Life with a person who was a surgeon at heart, but got coerced *not* to do surgery, would probably be miserable.

Very true.