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12 hours ago, F508 said:

I've always wondered what percentage of surgical staff would pick surgery again if they went back in time.. Sure, laparoscopy is super fun at first.. but once you're doing your 129th cholecystectomy at 2am, is it still fun?

I think everything loses its initial appeal. No job is going to constantly change and as you get older, your desire for change decreases and so does your ability to adapt to change. Internists will mostly prescribe the same drugs over and over again, specialists see the same diseases over and over again and family docs see those same "challenging" patients over and over again. Eventually, you need routine and eventually it becomes a job just like a meat packer in a factory probably isn't thrilled about packing meat like they were the first time they packed meat, surgeons aren't going to be as thrilled doing the same surgery for the 500th time but they can still be happy with their job.

 

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For longer-term career satisfaction, it's probably more relevant to think in terms of meaning rather than fun. It may or may not be thrilling to do that nth cholecystectomy on call , but it is meaningful and satisfying to use the skills you've trained years for in order to carry out a technically successful procedure for the patient who needs that immediate intervention. Similarly, it was probably not fun to study for the MCAT, but satisfying to receive that medical school acceptance, which made the process meaningful (and it is meaning, not fun, that is the greater contribution to happiness). Desire for change is quite person dependent, and for those who find change/improvements exciting, the medical field offers a limitless stream of new developments and ideas to influence one's practice.

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7 hours ago, Lactic Folly said:

For longer-term career satisfaction, it's probably more relevant to think in terms of meaning rather than fun. It may or may not be thrilling to do that nth cholecystectomy on call , but it is meaningful and satisfying to use the skills you've trained years for in order to carry out a technically successful procedure for the patient who needs that immediate intervention. Similarly, it was probably not fun to study for the MCAT, but satisfying to receive that medical school acceptance, which made the process meaningful (and it is meaning, not fun, that is the greater contribution to happiness). Desire for change is quite person dependent, and for those who find change/improvements exciting, the medical field offers a limitless stream of new developments and ideas to influence one's practice.

Agreed. I find relief in that what I do (even "scut" work - which is usually post-op care, albeit not necessarily fun) is meaningful to the patient care. 
Some things lose their appeal even as PGY1; that's why it's very important to reflect on who you are and what you want in the long run before committing to a surgical residency. Once you commence it, you just gotta keep remind yourself when 1) you feel miserable at 2am during your entire weekend call (home call specialties do that) 2) when you find yourself becoming mean to other people, including your own patients. 

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On 4/29/2018 at 12:03 PM, Lactic Folly said:

For longer-term career satisfaction, it's probably more relevant to think in terms of meaning rather than fun. It may or may not be thrilling to do that nth cholecystectomy on call , but it is meaningful and satisfying to use the skills you've trained years for in order to carry out a technically successful procedure for the patient who needs that immediate intervention. Similarly, it was probably not fun to study for the MCAT, but satisfying to receive that medical school acceptance, which made the process meaningful (and it is meaning, not fun, that is the greater contribution to happiness). Desire for change is quite person dependent, and for those who find change/improvements exciting, the medical field offers a limitless stream of new developments and ideas to influence one's practice.

I respectfully disagree. I think it is more relevant to think in terms of fun. Trust me, most of the older surgeons I work with continue to do so because they still have fun operating, teaching, working in the OR etc. What they do will always be meaningful, but if they lose the "fun" part they will retire.

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Thanks - perhaps we can refine the questions as "what keeps people late in their careers from wanting to retire" versus "what keeps people going for the long term when they start their training and practices". Although enjoyment and fun are similar, I also think of them slightly differently, though I'm not sure whether others make the same distinction. To me, fun is more in-the-moment excitement, while enjoyment includes a sense of satisfaction that will linger on in one's memory after the experience has ended. 

Sometimes late-career physicians are able to scale down their practice a bit and divest themselves of low-satisfaction admin duties. Even if they don't, their accumulated experience allows them to handle tasks with more ease and efficiency.

When I have the space to delve into an interesting case, or teach without other time pressures or distractions (i.e. on one's day off), it can indeed be 'fun'. When these same experiences occur during a busy clinical day, they are often very challenging to juggle and accommodate without (or even with) working around the clock. My experience on such a day has essentially no resemblance to the carefree fun I might experience on a holiday. However, when I look back on the day, I enjoy having spent that time with students, and am glad I made that space for them. It is meaningful and is why I continue to do it for the foreseeable future.

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