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General Surgery Residency?


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I spent most of med school thinking I would go into general surgery... What I learned at the end was the following:

 

To go into surgery you need to love surgery more than your life. This is a job which will encroach upon all other things in your life and expunge most other pleasures. 

 

I can't ever say this enough. Be very careful when assessing lifestyle. It is scary how easy it is to really screw your life up by selecting the wrong speciality for the wrong reasons. 

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Any surgical residency can be pretty tough and lots of hours. You have to enjoy it to survive and thrive.

 

When you rotate through as a clerk, it will likely be clear to you whether you like it or not. For example, if you have a long day in the OR, and you go home and think "wow, that was a great day", then yup it might be for you.

 

Don't worry too much about jobs. There will be work.

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I'm not sure what kind of vibe I was putting out there, but I'd like to make it clear that I was simply trying to clear things up about the field. I just got into med school and I am determined to ignore all things regarding salary before I make my decision. I was merely inquiring more about the specialty of general surgery.. Since I'm sure you all agree it's important to know everything about a field as you begin the med school journey. 

 

I completely understand surgery will be an obvious decision to me once I try shadowing and clerkship if I truly love it, I was looking for more answers regarding the residency and the field. 

 

I'm really sorry if I put the wrong vibe out there (jeez people lighten up a lil bit haha)

 

What the more experienced posters are trying to get at here is that answering your questions doesn't really provide meaningful information about the specialty or whether it's a good fit for you.

 

It's a hard field to train in, with long hours and a significant amount of stress. If you love surgery, you figure out how to deal with those challenges. If you don't love surgery, no degree of mental fortitude will make up for the demands of being a surgeon. Step into an OR at your earliest opportunity, ideally before clerkship, and see how you feel. That'll give you a good sense of whether it's a field worth exploring. The job prospects, the pay, the residency hours all are pretty meaningless if you don't love doing surgery. It doesn't take too long to figure out where you stand - if you're not giddy coming out of your first OR, it's probably not for you.

 

Anyway, to provide some of the answers to your questions, here goes. Gen surg residencies are moderately competitive, so you can't be idle during med school, but you don't have to gun for it from the start either. Stay active, make contacts, and follow their advice. If you end up thinking Gen surg might be for you, try to pick up a research project in the field. Otherwise, it's just a matter of impressing in clerkship and on your electives. Job security is great once you have the job - physicians don't tend to get fired. The job market, however, is fairly tight. Better in Gen surg than most other surgical specialties, but expect to have to move for employment. Pay is good, overall, but you'll be working long hours for that money and won't be crazy rich compared to other physicians. Going into any specialty for primarily monetary reasons is a bad idea, and that's doubly true for surgical specialties.

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I think that general surgery is still very competitive. The CaRMs person came to my school and made a presentation about competitivity of each program. She mentioned that general surgery is the one of the most competitive specialty in English Canada.

For example, I know a resident in General Surgery in Montreal. He mentioned for 6 spots, around 100 applicants were interviewed (for 6 spots)! So apply widely.

Do something you love, you will be happy and love your life despite the demanding lifestyle. 

What the more experienced posters are trying to get at here is that answering your questions doesn't really provide meaningful information about the specialty or whether it's a good fit for you.

 

It's a hard field to train in, with long hours and a significant amount of stress. If you love surgery, you figure out how to deal with those challenges. If you don't love surgery, no degree of mental fortitude will make up for the demands of being a surgeon. Step into an OR at your earliest opportunity, ideally before clerkship, and see how you feel. That'll give you a good sense of whether it's a field worth exploring. The job prospects, the pay, the residency hours all are pretty meaningless if you don't love doing surgery. It doesn't take too long to figure out where you stand - if you're not giddy coming out of your first OR, it's probably not for you.

 

Anyway, to provide some of the answers to your questions, here goes. Gen surg residencies are moderately competitive, so you can't be idle during med school, but you don't have to gun for it from the start either. Stay active, make contacts, and follow their advice. If you end up thinking Gen surg might be for you, try to pick up a research project in the field. Otherwise, it's just a matter of impressing in clerkship and on your electives. Job security is great once you have the job - physicians don't tend to get fired. The job market, however, is fairly tight. Better in Gen surg than most other surgical specialties, but expect to have to move for employment. Pay is good, overall, but you'll be working long hours for that money and won't be crazy rich compared to other physicians. Going into any specialty for primarily monetary reasons is a bad idea, and that's doubly true for surgical specialties.

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I think that general surgery is still very competitive. The CaRMs person came to my school and made a presentation about competitivity of each program. She mentioned that general surgery is the one of the most competitive specialty in English Canada.

For example, I know a resident in General Surgery in Montreal. He mentioned for 6 spots, around 100 applicants were interviewed (for 6 spots)! So apply widely.

Do something you love, you will be happy and love your life despite the demanding lifestyle. 

 

The thing is, those same 100 applicants are going for spots all over the country, not just those 6 spots. I agree, apply broadly, but that's true for even relatively non-competitive specialties.

 

The match rate was about 85% this year for people choosing Gen Surg first, and there were a few people who successfully backed up into the field as well. That puts it fairly squarely in the "moderately competitive" range in my books - competitive enough that you have to put in an effort to match, not so competitive than you have to gun early and gun hard to really maximize your chances of matching. It's not Plastics.

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This video sums up pretty well for applying broadly for CaRMS. " It is hard to tell applicants part, if you are not one of the exceptional students who win honours or academic scholarships, or you haven't published in journals "- AFMC Ottawa.

 

yeah that bluntly is exactly the issues involved and why applying broadly is important.. Add the extra issue that going unmatched makes it extremely difficult to find your way into whatever your target discipline was subsequently you have to do everything you can to maximize your odds when applying.

 

The only reason NOT to apply to and later rank a place you interviewed at is simply this - you would rather go unmatched than to go to that centre for that program. Otherwise you rank it.

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This video sums up pretty well for applying broadly for CaRMS. " It is hard to tell applicants part, if you are not one of the exceptional students who win honours or academic scholarships, or you haven't published in journals "- AFMC Ottawa.

 

While broadly true for large programs, in smaller competative specialties (my own included) it's pretty easy to tell applicants apart because anyone we are seriously considering has done an elective rotation with us. And elective performance trumps all at application time.

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While broadly true for large programs, in smaller competative specialties (my own included) it's pretty easy to tell applicants apart because anyone we are seriously considering has done an elective rotation with us. And elective performance trumps all at application time.

 

Nlengr can I ask - I know at some schools it's impossible to do an elective at all the sites that you want (even for smaller programs, let's say 10 weeks =  2 weeks at 5 locations).  But I've heard that you can still get interviews (and acceptances) at places you don't do electives at?

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that is possible - for instance I didn't do an elective at Ottawa but matched there. I mean people know you cannot do electives everywhere - not enough time, and too many programs.

 

However doing an elective, meeting the people there, and possibly even getting a letter of reference from that site are still all pretty powerful assets.

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ALso on the pay topic, general surgeons do not make a huge amount compared to other specialties...for example, vascular surgeons and radiologists both make quite a bit more. But as others said above, pay should be the last thing on your mind when choosing a specialty because at the end of the day, the difference between possibly making $350K vs 400K is nothing compared to doing something you enjoy.

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You should also know that if you want to work in an academic centre (ie. in a major city), then you'll likely have to add a master's and a fellowship to your residency.  That makes your residency 8-9 years long.

 

It's a long and difficult program but definitely worth it if it's your passion.

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I would say it's 80-100 hour weeks.

 

For example, on a call-heavy week, you'd work 12 hour days with 26-hour call shifts.  Say you're on call Wednesday, Friday and Sunday.  So you work 12 hours on Monday and Tuesday, 26 hours Wednesday, post-call Thursday, 26 hours on Friday and 26 hours on Sunday.  12+12+26+26+26=102 hours.  We usually end up staying later than the 26 hour rule too and most residents don't sleep for 8 hours a night in General Surgery

 

However, some days are shorter than others and some call shifts you end up sleeping a bit so it's manageable.

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You should also know that if you want to work in an academic centre (ie. in a major city), then you'll likely have to add a master's and a fellowship to your residency.  That makes your residency 8-9 years long.

 

It's a long and difficult program but definitely worth it if it's your passion.

If you are lucky you can get a fellowship that integrates a masters and get away with a 2 year fellowship (and get a masters at the same time).

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Nlengr can I ask - I know at some schools it's impossible to do an elective at all the sites that you want (even for smaller programs, let's say 10 weeks =  2 weeks at 5 locations).  But I've heard that you can still get interviews (and acceptances) at places you don't do electives at?

You can, but if you haven't done an elective, the odds go down.

 

It also depends on the program. Highly competative programs where there are many more residents applying than positions are able to limit interviews only to students who did electives. In general, programs prefer ranking people they have worked with (less risk).

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Does general surgery really have 100 hour weeks? How much of it is actually spent working?

 

This comes out to 14.29 hours per day. Assuming 8 hours of sleep, there are only 1.7 hours left. You still need to eat and travel to work. How is this possible?

Most weeks on surgical rotations are between 80 and 100 hours. I've had many weeks on CV surg over 100 hours.

 

I never get 8 hours sleep. 4-6 is more common. When it's busy you get less; sometimes very little. That's part of the deal. It's worth it if you enjoy the work.

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