Neuro or Emergency Med

Does anyone have a spouse or other in neuro or Emergency Medicine? My husband is currently thinking of these and I'd like to hear a bit on how the training is from the spouse standpoint!

Shella

[fluffhead]

Hi Shella,
I'm a neurospouse. My wife did an md/phd, then a year of IM, and now neuro. I'd say the neuro is almost as time-consuming as the IM year, but she's enjoying it much more, which makes our lives somewhat more bearable. We've only been at it for 6 months, so I can't give you too much insight, but she's not working as hard as some of her friends in other specialties, and she's working harder than others in some specialties.
Seems like a pretty average residency, hour-wise.
The starting salaries when they get out are not fantastic, but if he likes the field, then it's worthwhile pursuing it.
Most of her colleagues seem like pretty cerebral (no pun) folks.
Any questions, feel free to PM.

[DCJenn]

My husband is doing a peds neuro fellowship after completing a 3 year peds residency (a peds residency is not required to do peds neuro, but is obviously in order to be boarded in both)

This year is kind of wierd because he's doing 9 months of adult neuro and then ends with 3 months of peds- the next two years will be peds.

He hates adult neuro but is learning a lot. This program is experiencing some growth pains but overall it's not that much different than residency.

We have a very good friend who's doing an er residency. He likes it but his wife found the night shift incredibly annoying. They have had many months of never seeing each other because she's a general pediatrician in a clinic.

Jenn

[peggyfromwastate]

I can comment on the lifestyle of a ER doc, because my dad was an ER doc for 25 yrs. I told my husband straight up that I'd support him in any specialty except ER. ER is really disruptive to the family b/c the schedule is so shifty. One week they work days (long days after charts, my dad worked from 7 to 7, then stayed doing charts til 10 or went back to the hospital to do them before shift...) Then they work backup, then nights, etc. Anyway, from my standpoint as a child, I never knew when he was working, he rarely made it to any of my sporting events, and he wasn't usually home for dinner. Also, he was almost always on call or at the hospital for any major holiday, but that was partly by choice because he traded for those undesireable shifts to get large blocks of time off for vacations and what not. He also feels now that the field of ER looks very bleak for the future. Hospitals are out of money, and ERs typically lose lots because reimbursements are so low and they end up seeing lots of uninsured (in my dad's hospital he saw about 13% of insured paying customers, the rest were uninsured, but this is in a "poor" area). Because of all this, he predicts that the ER doc's salary will continue its downward slide so that they are paid comprable to many primary care docs. But, he was very happy in his time as an ER doc (especially in the 80s which was "the golden age of ER medicine") but wouldn't enthusiastically recommend it to new docs at this point.

I don't know a thing about neuro, except that they have a brutal call schedule... So I've heard...

Anyway, my input is HIGHLY anecdotal so take it for what it's worth!!! Good luck!

I am going to offer a different view as the wife of an EM attending. I am absolutely happy that DH choose the specialty. I did not see a huge difference in training even though it is shift work, during the months of EM they were never on call, and when your shift was over that was basically it. We had 4 years of residency as DH did a DO residency.

As an attending we are enjoying an extremely comfortable life style. DH became a partner this summer and with it a hefty pay increase. Reimbursement has actually increased this year. He works in a level 1 trauma center. PM me if you want more particulars about what the pay can range from for certain areas.

My DH works anywhere from 140-170 a month. That is 14-17 days a month. What other specialty can give you that much time off. He takes 1 call shift a month. In 2 1/2 years he has only been called in 3 times for a few hours. The schedule requests are put in 6 weeks in advance so we can always plan days off for special events for the kids. My girls see plenty of their Daddy and often have times when he is off for 4 days straight, without having to put in long stretches or funny shifts. He truly enjoys what he does and has time to be involved in his old residency at a different hospital. He also drives 50 miles each way to work and has not stressed about this too much either, except when we are buried in snow and it takes longer to get there, LOL.

Thats just my two cents worth. Email me if you need more info.

My husband is a 3rd year EM resident. He will be done with residency in 5 months and is currently interviewing for a post residency position. Residency has been tough, but I think every residency is tough. I am so thankful that he chose Emergency Medicine as his specialty. One of the main reasons is that he only had to take call his first year of residency. No more 36 hour shifts! Once he is out of residency, he will only have to work 14-15 shifts a month and the shifts will be either 8 hours or 12 hours in length. Of course there are some overnight shifts, but once we have children, he'll be able to go in to work after they are in bed and be home when they wake up.

My husband is currently interviewing for jobs and we have been impressed by the pay structure. There are so many different types of EM groups (democratic, fee for service, rvu's, independent contractor) and the pay varies by each group.

The best part of my husband choosing EM is that he absolutely loves it! He loves going in to work every day and he loves the adrenaline rush that comes from saving a person's life. EM definitely is not for everyone, but we have been very happy with our choice.

Feel free to PM me if you have specific questions about residency/compensation/hours/etc...

Thanks for all the info. My husband is still far from any decision, but this helps me a lot. Its always interesting to see it from a perspective other than the student/doctor.

My dh is a second year neuro resident. The first year was'nt as bad as I thought it would be. The second year has been alot more time consuming for him. We havent seen him much this year. They say the third year is alot easier. I hope so. It would be nice to see him again.

[Flynn]

hindsight

Hello,

My husband is a General surgery PGY7 resident going into CT and since our daughter was born....I am wishing my husband chose anything but a surgery residency.

From a spouse's perspective, not the medical person's perspective, I have looked into other areas of medicine (a day late and a dollar short) and I wish my husband had chosen ER instead.

From the ER docs we know (both attendings and residents) the lifestyle is very family friendly for medicine, and the compensation for hours worked and training years is good.

A surgery residency is so difficult on a family, we have looked into starting over in another residency...it's that bad. We have two years left though and from a practical standpoint, it doesn't make a lot of sense to start over right now.

I think General Surgery is one of the hardest to get through training...but neurosurgery is right up there with the best of them. I believe most programs require at least one year of GS -- completely brutal in every way. The 80 hour work week requirement is AWESOME (a HUGE improvement from the standart 110 hour work-weeks from the past) , but don't ever expect anything less than 80 hours. It will only lead to disappointment.

Sorry to be so negetive but I wish I had been more educated (and more involved) in my husband's choices along the way. It was just as much my responsibility to know my options as it was his...I just know my TYPE A husband and thought he would be unbearable to live with if he didn't do heart surgery...

I really wish we had talked more but I wanted him to be happy and I truly thought, "how bad could it be...I can take it, I'm strong."

I can take it, I am strong BUT I HATE IT HATE IT HATE IT.
Not a good place to be.

Surgery sucks. PAY him to choose anything else.
That's my advice.

Flynn

[houseelf]

Shella,

Are you referring to neurosurgery or neurology? I hear bad, bad things about neurosurgery residencies and their lifestyles from DH's colleagues. In some ways it may possibly be even more challenging than gen surgery because their is a smaller residency pool to cover call (typically two???). Six years of residency plus possible research years and fellowship is a long time, my friend. If however, "neuro" refers to neurology, I have no idea about this specialty and do not know a single person in this field. I wish you luck either way.

Flynn,

I feel your pain, sister. (I love you, man. )

Seriosly, both DH and I have played the should-of-would-of-could-of game about 10,000 times and neither of us is entirely sure that we would do general surgery again. I can tell you FOR SURE I would have been a lot less liberal about the whole rank list because he lives at the hospital while I live in the city where he matched. You had better believe that we will have a hell-come-to-Jesus session about his fellowship ranking match list because I'm not wild about the idea of additional training to begin with. (Sing some Eagles with me..."Oh, oh, witchy woman, see how high she flies...").

We have known three people who have left gen. surgery residencies because of its gross inhumanity and dysfunction. One just quit and became a moonlighting "doc in the box" to make ends meet, one tried a urology residency, and one left medicine to pursue an MBA. Long story short, they all ended up coming back to it. It is like surgery gets in their blood or something. From what I glean about the specialty, it is wildly interesting and very gratifying. However, everyone hates what it does to the rest of their lives.

Wow, this post was great therapy for me. I need a cigarette. (Just kidding...I don't smoke.)

Sincerely,

Little Miss Sunshine

Kelly

[Flynn]

Kelly -- great post!

I can totally relate to everything Kelly said in the previous post. Second guessing "your calling" is unsettling to say the least for my DH but it has happened on more then one occasion.

The whole issue of "extended" training is also something to consider when choosing a surgery specialty. So much is "assumed" that you WILL do extra training to be the biggest, fastest, strongest damn doctor on the block. It's a weird existence.

Kudos to Kelly for also mentioning WHERE you do your training is as much or MORE important to the significant other than to the DH. The DH will rarely get to enjoy the city you choose so it's not really important if they like Seattle or Madison better -- assuming the programs are similar.

Finally, when discussing my DH's fellowship options and the choice between a 2 or a 3 year CT program, I was not budging on applying to ONLY two year programs. My DH balked initially until I had my own "Tasmanian devil" reaction and he backed off --- FAST.

I also was shocked to find out that many fellowships, in CT anyway, require you to live in essentially student housing and you cannot bring your pets. If my dogs don't go, I don't go so that was something we had to research quite a bit too. I don't think we did the best job but we did end up matching near my family which was the best possible option from my perspective so their is a happy ending there I guess if you can be happy about two more additional years!!!

There is a BIG difference between neurosurgery and neurology -- it's like apples and oranges sister so find out what he is thinking of -- then talk him out of neurosurgery if at all possible!!!!!!

Research Shella -- we all think our DH has our interests at heart but unfortunately, all too often, we are factored into the choice AFTER the top 5 programs are of course the natural choices to consider!!!! Why choose anything but the best??? (Sarcasm)

Anyway, I am done blathering. I LOVED Kelly's post so much I had to write some more.

Flynn

[houseelf]

Flynn, it is a mutual love fest here for our mutual distaste of surgery! ( snicker, snicker) Anytime you want to mutually vent, let me know, I'm your girl.

Still, I feel compelled to inject a little diplomacy here. I feel bad about whining about the pain of a surgery residency here because the truth is that everyone here has there own substantial burdens to deal with: multiple moves, several kids, near poverty, illness, serious marital issues, in laws, long term military commitment with the prospect of deployment, etc. I think that badmouthing surgery is my coping mechanism that helps me lick my wounds and temporarily makes me feel better. (It has become some sort of bad habit that I can't kick.)

Truth is, however, some of the situations that members here currently are in here would make me curl up like a baby and cry. I hope that my "woe-is-me" attitude about surgery doesn't offend anyone. I do realize that my attitude could use a slight improvement. Don't get me wrong, I'll never recruit for the profession, but I don't want my whining to make you all feel invalidated. Please know that I realize that I'm flattering myself with all of this talk, but it sure feels good.

So please come and vent away, one and all, I will validate you to the end!

Kelly

[SueC]

I personally did not feel "invalidated". My hats off to you both, the surgery lifestyle sounds like it sucks to me. When we were engaged, my husband was seriously considering trauma surgery, and that scared me to death! I was relieved when he went the med/peds route, and didn't have a clue what I was in for when he announced he would be doing a fellowship. I also wasn't smart enough to do any homework about it so going into it, I really thought life was going to get better. I think those of you that are asking questions beforehand are very wise. I guess we all have our own battles with our spouse's respective professions, but its nice that we can all come here and whine without anyone saying, well if you think you have it bad...

[Flynn]

introspection

Let me clarify that there are many more difficult challenges to deal with than being married to a surgery resident! I am so lucky on so many levels it makes my eyes puddle up. I DO realize this.

Perhaps the reason I am so passionate about how challenging being married to a surgery resident can be is we CHOSE this life!!!!

I am angry at myself for not being more educated and not thinking of the big picture when making career decisions with my DH. I tried to be the "supportive spouse" and go with the flow. Big mistake from my perspective now. My situation can be avoided!!!! Many challenges that are discussed within this support system cannot be avoided. Somehow I think I could have avoided where I am now if I had done something once upon a time...

This lifestyle has caused me to rethink my marriage and how many children we wanted to have. Origionally three was the target family but the way things are now, I can't see having more than two. I resent this but am not quite sure how to deal with it just yet. This is all due to my husband's job...it's hard to admit something seemingly so simple can affect every area of your life. Not in a good way either.

All things considered I have GREAT life.

I wish I had been more involved and I blame myself equally with my DH. I think that is my greatest frustration. I contributed to this situation by being passive. I hate myself for it.

Flynn

[houseelf]

Flynn,

I didn't mean to invalidate you by saying that we all have our burdens either! I know that we have some shy members who are really going through some rough times who may need some encouragement, so I'm fumbling at trying to make everyone feel o.k. about everyone. Still, I'll be the first to get your back when you "rage the against the machine" of surgery.

I feel the exact same way as the post that you just wrote. Part of me wonders, what the heck is wrong with me? Why can't I just play nice and suck it up? I have a fantastic hubby who adores me, a great kid, a family friendly job, fantastic girlfriends, a loving extended family, and a million other blessings....so what is my problem?

On the other hand, this way of life is so hard day in and day out.. I was joking with my girlfriends the other day about how my "positive attitude" about DH's career really helps us get through the day. (NOT!!!) I need to just realize that things are the way they are and make the best of them. Still, the other part of me desperately seeks validation because this is such a damn hard way to go. Can you say "wants cake and wants to eat it to?". Do I sound like Sybil yet? Don't answer that. I'm in a rare psychotic pregnant state right now. It could be dangerous.

Where were we???? What was the original question???? Can somebody pass the Halydol?

Kelly