Information about Residency Specialties

[GrayMatterWife]

People who are drawn to NSG tend to be perfectionists, assertive, comfortable being in control, completely intolerant of stupidity (not of ignorance...of stupidity...people not learning from their mistakes), competitive BUT can be team players, love a challenge, kind of adrenaline junkies (if they weren't NSGs, they'd have been fighter pilots or astronauts or Navy SEALs or something), and have a complete passion for the brain.

GMW: I read this today and just had to laugh. I would love for you to write a new one considering now you have seen the gamet of NS. I think it would be a good reflection!

The part that got me was about how it's a person who is completely intolerant of stupidity: so true! I mean wow! I feel like you were writing from my brain!: perfectionists, assertive, has to be in control, team player, but like leading in the ICU. Likes knowing that when they walk into the ICU, they have the ultimate say on their patient care.

My thought, upon re-reading my own words: Damn, was I dead-on. Times 1000. Yep, that's the typical NSG.

"People who are drawn to NSG tend to be perfectionists, assertive, comfortable being in control, completely intolerant of stupidity (not of ignorance...of stupidity...people not learning from their mistakes), competitive BUT can be team players, love a challenge, kind of adrenaline junkies (if they weren't NSGs, they'd have been fighter pilots or astronauts or Navy SEALs or something), and have a complete passion for the brain."

Amen sister...

[ides]

My turn:

1. What type of Residency:
General Surgery

2. How long is the residency (and specialty stuff afterward and the possiblilities that will make our spouses be slaves longer)
Residency is 5 - 7 years. Dh is in a community program that does not require research so his is 5. There are many subspecialities you can do a fellowship in after gen surgery. They range from 1 to 3 years in length. Dh is specilaizing in hand surgery, which is a one year fellowship.

3. How long are the work weeks during training?
Depending on the program, the service and what time of the year it is, anywhere from 80 to 100. Dh's program is pretty good at staying at 80 but often goes over. Each year the new residents get more and more adamant about putting their real hours into the system instead of doing creative math.

4. What is the in-house/out-of-house call schedule like during training?
In dh's program there is no home call. It's all in house. During the first two years there is two months of night float and weekend call about 2x a month. The third years have back up call and weekend call about 2x a month. Fourth & Fifth years have chief call which is q3 - q4. They try to average two weekends on and two off but sometimes it doesn't work out that way.

5. How much does an attending in that specialty earn(when do the big bucks start rolling in)
I'm not sure. Dh is going to subspecialize so it's pretty mute to us. I think you make much more in rural/small town areas but I think it ranges from $100k to 300k. It's the lowest paid surgical speciality.

6. how long are the hours post-training(regular hours)
Not sure. With hand it will probably be around 60 hrs/week. I'd guess around 80.

7. how much on-call is there post-training(home vs. in-house)
Not sure, but the dr's at dh's hospital have home call only.

8. What is a good time to start a family with this specialty(how helpful the spouse can be and vacation times)
General Sugery is NOT family friendly. If you can wait, I'd say do it after residency. Dh is pretty much unable to help with our son at all. I get maybe one to two hours a week off from child care and sometimes none at all. It's tough. The speciality would rather you not have a family. It's all incompasing. It never ends. After he gets home the calls/texts keep coming, then there are presentations, m&m, the yearly absite exam, etc.

9. How much vacation time do you get post-training?
Not sure. Probably about a month/year.

10. What type of people generally tend to go into the specialty (ie. peds people are more child friendly....neurosurgeons are hard to talk to....plastics spouses are superficial...)
Ha Ha - often those who can't get into other surgical specialities due to grades, letters, etc. Someone who is detail oriented & likes to work with very sick and dying patients, has a tough shell and can put their soul in their back pocket for training. General surgery has a pretty malignant culture. Dh has been given chewing outs for not being cruel enough to juniors.

[ides]

Information about Residency Specialties

I should also say that many people suffer through general surgery for another surgical speciality. A few of these are: cardio thoracic, trauma, transplant, vascular, colorectal, laproscopic, plastic & breast. Some of these specialities are starting their own integrated residencies (2yrs general & 3 or 4 of the speciality). Plastic & vascular have done this. I see more doing this in the future. I think it's a good idea.

Note: Laproscopic & colorectal are subspecialities of general surgery.

[AmeliePoulain]

This thread is great! I have a question though. DH did an oncology residency in Syria and moved here as soon as that was done. He did a short fellowship in leukemia at MD Anderson, and did a little research there during the fellowship also. He felt that all of this would affect him in getting IM residency because he is even further from IM by just working in leukemia. Now he feels that when choosing a specialty he has no choice but to try for oncology, that he is stuck with this and can't do anything else. Is it possible to go into another specialty or would they look down on this because then why did he waste time in oncology? Would this hurt his chances of doing another specialty? Has anyone else's DH done this?

[Bittersweet]

NelYH, I'm almost certain that oncology requires a three year fellowship after an IM residency. So, even if he wanted to do oncology he'd have to do an IM residency first.

[weeniegeniewife]

NelYH, I'm almost certain that oncology requires a three year fellowship after an IM residency. So, even if he wanted to do oncology he'd have to do an IM residency first.

I worked in oncology for 9 years and what Bittersweet says is true.

[MissCrabette]

Guys, her husband is already doing IM. What she's asking is if he's stuck doing oncology considering his past experience or if he can shoot for something else when it comes time to apply for fellowships. I wish I knew the answer to that.

[corn poffi]

I'm like 99% sure that he should be able to apply to any fellowship program he wants. Since it was a short fellowship, I see it more as a research experience than an actual fellowship. Obviously the experience would be more impressive when applying for oncology, but I don't think he's "tied down"

ETA: in my analysis,I'm not considering his fellowship in Syria as a fellowship. It's hard to say if programs would consider that to be equivalent. I could very well be wrong.

[ms.conception]

1. What type of Residency: ie internal medicine, ob, fp, er, etc.
Anesthesia

2. How long is the residency (and specialty stuff afterward and the possiblilities that will make our spouses be slaves longer)
Our program is 5yrs for Anesthesiology specifically, and the program in Canada is no longer hiring permanent positions for Anesthesiologists without Fellow training (or so i'm told) so all Anesthesiologists will require Fellowship training.

3. How long are the work weeks during training?
I believe that the work weeks are legally supposed to not exceed 80hrs per week, but this isn't reality for us. My husband works on average 100hrs of in hospital, and then additional hours for evening seminars, and study groups.

4. What is the in-house/out-of-house call schedule like during training?
On service call is 7 shifts per rotation. Call shifts are 15hrs in house, over night with an 8hr "pre-call", which is intended for them to use to sleep. Off service call is generally 7 per month and depending on the service, some of it is in house some of it is home call. Call is very demanding. In 5 years, he has worked through every night without sleep and usually sleeps in his call room until 5pm the following day.

5. How much does an attending in that specialty earn(when do the big bucks start rolling in)
Dependent on region. Where we are, Anesthesiologists without fellow training generally make about 15-18k/week. We are taxed at a 47% tax rate though, which means that take home pay isn't really that impressive. On the West Coast, Anesthesiologists generally earn about 20% less than in other regions. The program in Canada is no longer hiring permanent positions for Anesthesiologists without Fellow training (or so i'm told) so all Anesthesiologists will require Fellowship training. My husband plans on doing Critical Care Anesthesia and apparently they make 30k/week and that doesn't include call stipend.

6. how long are the hours post-training(regular hours)
Depends on the hospital/practice. From my observation, I'd say most work 80 hours a week. With 1-2 in house call shifts per week.

7. how much on-call is there post-training(home vs. in-house)
All on-service call except for Peds is in house.

8. What is a good time to start a family with this specialty(how helpful the spouse can be and vacation times)
Anesthesia has not been a family friendly program. We had our first child together (I had two from a previous relationship) in PGY2 and our second in PGY3. While my spouse took 6 weeks of parental leave, he has really not been home or able to participate in family life since PGY2. We're in PGY5 now and it's even worse. My children have gone weeks without seeing their father and have often exclaimed "Daddy what are you doing home!". Even on off-call days, he is out of the house at the University or hospital studying. The Royal College exams are brutal and require 40+hrs/week of studying for the entire year leading up to it. We have never had a holiday together and all scheduled holiday times are spent working HMO. If you can wait until after the program is done, i'd say wait until the program is done. It's not fun being a single parent.

9. How much vacation time do you get post-training?
4 weeks per year.

10. What type of people generally tend to go into the specialty (ie. peds people are more child friendly....neurosurgeons are hard to talk to....plastics spouses are superficial...)
Ha. I'd say most are pretty serious and brainy. We recently went to a faculty dinner and the joke was that no one really enjoys the company of the anesthetists. My husband is very logical and intense. He fits in well with neuro guys. We joke that anesthetists are great people persons in their specialty because their patients are all ventilated and sedated.

[ladymoreta]

Wow! We're in PGY4 of 4, and our experience has been much different. It sounds like our program is significantly more family-friendly, so I haven't had anywhere near as rough of a time during training. It is eye-opening to hear how different life could have been based on where we matched!


Laurie

[ms.conception]

Laurie, I agree. The program here is brutal, as are the Peds and Ortho programs. I also think it has to do a lot with my spouse. He's a very intense guy, very focused and goal oriented. It's a blessing when it comes to his work ethic, unfortunately, his work ethic takes precedent over the home ethic... There are few people in the program that have families. Many of them are quite young, and have little responsibility - and I think that rings true as well for the attendings who did it the same way. This is my husbands 2nd career, so he came to it late, with much more demand between home and work.

[ladymoreta]

I'm sorry. I know it's too late for you, but for future readers of this thread - that's a really good thing to look at when interviewing: how many residents are married and how many have kids. It's 100% in DH's class!

ETA - not that you always get to decide, Match being what it is...


Laurie

[spotty_dog]

My husband plans on doing Critical Care Anesthesia and apparently they make 30k/week and that doesn't include call stipend.

9. How much vacation time do you get post-training?
4 weeks per year.

So you're expecting a salary of 1.4 million dollars Canadian right out of the gate?

WOW.

[ms.conception]

With critical care as a subspecialty the average earning is 30k/week, yes, next to Interventional Radiology, it's the 2nd highest paid subspecialty. I think Neuro Surg and some ortho is up there too. But that depends on what they get hired on as, full time etc.. that also includes their call which is 1 in 5.

This is 4yrs of med, plus 5yrs of Anesthesia residency, plus 2(+)yrs of Critical Care.
Anesthesia makes between 350 and 400k out of the gate working an 80hr work week incl. call.

While it sounds very impressive (and it is, in terms of gross earnings) we also pay 47% income tax...