Surgery; required grades and work hours?

[Redlan]

While I have not even been accepted to a medical school yet, I am still thinking of surgery as a profession and have two questions; Firstly, I know that in med. school the grading is pass/fail, however I have also heard that entrance into a surgery residency requires 'top' grades in med school - is this in fact true? In asking this I assume that the only way anyone would know that you had top grades was to win some awards in your medical degree...? Secondly, as a surgeon are you by and large restricted to working insane hours all the time? For the love of the job I could handle operations that went on for many hours (10-12 etc...), yet doing this four or five days a week might be too much to handle.

[Kuantum]

Try posting this in the Surgery and Surgical Subspecialty Residencies forum. You may get a response there.

[Redlan]

While I have not even been accepted to a medical school yet, I am still thinking of surgery as a profession and have two questions; Firstly, I know that in med. school the grading is pass/fail, however I have also heard that entrance into a surgery residency requires 'top' grades in med school - is this in fact true? In asking this I assume that the only way anyone would know that you had top grades was to win some awards in your medical degree...? Secondly, as a surgeon are you by and large restricted to working insane hours all the time? For the love of the job I could handle operations that went on for many hours (10-12 etc...), yet doing this four or five days a week might be too much to handle.

[quickdraw_mcgraw]

There is another thread that covers this. But if you want to do surgery, you commit to long hours and the fact that you can't leave your job at work. You will always have patients in the hospital waiting for or immediately after surgery and the nurses will page you if there is a problem. You will of course want to know. But that is what you must commit to if you want people to trust you to cut them open.

[Kyleh]

What type of surgery are you thinking about? I know surgical specialties such as plastics or urology are quite competitive with marks. Surgeons are known to have quite hectic schedules, but keep in mind that they are not in the OR every day, rather 1-2 days a week. I am really not that familiar with specifics. I am pretty sure there are some clerks or residents on this board who can comment more.

 

Best of luck with meds:)

[0nsp]

Marks don't matter at all. what matters are MAINLY the letters of evaluation you get while on different rotations in yuor clerkship years (years 3+4). As long as yuo impress the people you work with, and they have favorable things to say about you, you will fare well. what also matters is research experience (amount and type varies by subspecialty), and Extra-curriculars (refelcted on your Dean's letter). The marks you get in your pre-clinical years have NO BEARING whatsoever on your match. In your clerkshpi years you do get graded, but that is based on your performance on the wards. Again, the more important aspect is the comments section, since grading is not standardized among preceptors, so a 3/5 with great comments from a know to be tough marker will weigh more heavily than a 5/5 from someone known to be more lax. Hope this helps, but keep in mind that you're not even in yet. Worry about crossing that hurdle first, and remember that most students will change their mind about specialty several times over the course of med school.

[tuss]

As far as grades go, it's not overly important. More important is impressing the surgery attendings with a strong work ethic, sound knowledge and judgement and a genuine interest in surgery. Lots of poeple (including myself) didn't realize they even had an interest in surgery until their clerkship rotations and had no problem getting into a residency position.

 

As for work hours: Yes, they are long. Especially in residency. Expect long days (start at 6:30 am and finish after 6pm) with busy call throughout the 5 years. AFter residency the hours are still busy, but you can tailor your own practice. The average surgeon in canada probably is in the OR only 1-2 days/week, in clinic for another 1-2 days and does 1-2 calls/week. Of course there is a lot of variation.

 

Concentrate on getting into medical school first and then worry about what specialty you might be interested in. I think very few people in my med school class ended up in the specialty that they thought they would be in on the first day of med school.

[Redlan]

It is mentioned above that a surgical residency requires 6:30 am to 6:00+pm work days, 5 days per week. Five years of working hours like this would make it exceedingly difficult to do many things - like have kids or just maintain a bit of a social life and exercise outside constantly trying to catch up on sleep. However, I have also heard that much has been done to improve these excessive work requirements. Is this 60 - 80(+ call) hour work week the culmination of these efforts? I think I would make a great surgeon - I am able with my hands - but these hours might dissuade me from this side of medicine, though it is really what I am most interested in. What I am asking is if 60-80 hours really is the average work week hours for surgical residents? If so, and I ask this to anyone who is a resident in this position, is the sacrifice worth it?

Secondly, post-residency are the hours a significant improvement? All in all, can you be a surgeon and also have a family that will recognize you?

[Kirsteen]

It is mentioned above that a surgical residency requires 6:30 am to 6:00+pm work days, 5 days per week. Five years of working hours like this would make it exceedingly difficult to do many things - like have kids or just maintain a bit of a social life and exercise outside constantly trying to catch up on sleep. However, I have also heard that much has been done to improve these excessive work requirements. Is this 60 - 80(+ call) hour work week the culmination of these efforts?

Hi there,

 

The work hours, I found, are very program-dependent. When I completed electives in Gen Surg this past year there were two programs that worked their residents very hard. They had to be on the ward by 5:45am and the unwritten rule was that there was no going home post-call. Quite often the non-call days were 14+ hours long. One program, however, was quite great when it came to hours: UofT. Yes, we still had to be on the wards early, i.e., 6am, but the residents were allowed to leave at a reasonable hour each day and were sent home, post-call, by 10am.

 

Cheers,

Kirsteen

[quickdraw_mcgraw]

Hours used to be 100+ hours per week just a few years ago. So pretty much 60 hours of daytime work per week plus a couple or three nights of call per week is the way it goes.

 

The way I see it is that you have to operate to be a surgeon, you also have to see rare cases and operate on them. If you're not in the hospital, how can you do it?

 

Reduced work hours will mean longer surgical residencies 6-7years.

 

Oh well. I am willing to pay that price to cut.

[xylem29]

It is mentioned above that a surgical residency requires 6:30 am to 6:00+pm work days, 5 days per week. Five years of working hours like this would make it exceedingly difficult to do many things - like have kids or just maintain a bit of a social life and exercise outside constantly trying to catch up on sleep. However, I have also heard that much has been done to improve these excessive work requirements. Is this 60 - 80(+ call) hour work week the culmination of these efforts? I think I would make a great surgeon - I am able with my hands - but these hours might dissuade me from this side of medicine, though it is really what I am most interested in. What I am asking is if 60-80 hours really is the average work week hours for surgical residents? If so, and I ask this to anyone who is a resident in this position, is the sacrifice worth it?

Secondly, post-residency are the hours a significant improvement? All in all, can you be a surgeon and also have a family that will recognize you?

 

Yes - I think so. I think it really depends on you and how you allocate your time. My mother's friend's son is a neurosurg and she tells me that he loves his job and is a great father too. There's also different surgery specialties that are less time consuming than others...so if you like surgery but also value personal time too, then you could always choose a less time-taxing field.

[Ian Wong]

In residency, most surgical residents work very hard, with long hours. Probably the three worst would be Neurosurgery, General Surgery, and Orthopedic Surgery.

 

Other subspecialty residencies which are typically more benign would include Plastics, Ophthalmology, ENT, and Urology. Still, a "benign" residency may see you in the 70-80 hour a week range, after taking into account call. As well, many of these subspecialties may only take 1-3 residents a year, which means that you are going to be on frequent call.

 

After residency, you can control your hours somewhat in many ways.

 

Certain fellowships will lend themselves to worse lifestyle than others. For example, a transplant surgeon is going to have a much more painful lifestyle in practice than your average colon and rectal surgeon.

 

Living in an urban environment with a group means that you can cover for each other, whereas being the only general surgeon in a rural community obligates you to being on 24/7 call.

 

Practising in an academic institution can be favourable where you have residents to shield yourself from call.

 

Limiting your scope of practice to quick outpatient surgeries instead of more involved cases which lead to inpatient stays, means that you send your patients home soon after surgery, and don't need to round on them.

 

etc, etc...

 

The take-home message in all this is that doing surgery, of any flavour, is a huge committment, and while it's easy to think that it's a glamourous job, that luster fades for a lot of medical students once they hit their clerkships, and are pulling the 90-100 hour work weeks too.

 

It's not pretty, but it's doable to maintain a 90-100 hour work week for a month or two. Doing that chronically over a 5 year residency is another animal entirely. It's not too uncommon for surgery residents to switch into other specialties with a better lifestyle, but very uncommon to see the opposite.

 

Ian

[Redlan]

Thanks so much for all of your responses. They have given me a little more of a picture of what a surgery residency is about. Although I have this idea, I still have difficulty imagining working 60-80 hours a week(not including studying) constantly for five years. Perhaps I will one day find out! Thanks again...

[Blake]

it's easy to think that it's a glamourous job

What's the point of ''glamour'' when you're spending pretty much your life inside the hospital (which is ironically, by definition, already full of ''glamorous'' people.) ? Kinda pointless, eh ?

 

I can't say I've met any surgical residents/attendings who gave me the impression they made all those sacrifices to impress random people (and I'm soon starting my 4th straight month of surgery). I personally think people put too much emphasis on this '' oh, you want to be a heart/brain/whatever surgeon. Must be a prestige thing. ''.

 

Yea rightttt... Is it really that hard to believe these specialties are that interesting to some people, without overanalysing the situation ? I find it as annoying as hearing that people enter medicine mainly for money, which unfortunately seems to be a common theme lately.

 

Truth be told, I don't think the cafeteria lady is impressed by anyone after her 1st week at the hospital, and let's face it, surgical residents I've met don't have the time nor the interest to go to bars and play the prestige card. Or maybe I've hanged with the most low-profile, nicest and down-to-earth surgery residents ever (doubtful, but you never know). Well, at least I found great role models...

 

/Rant over. This message wasn't directed at anyone in particular, btw.

[Ian Wong]

What's the point of ''glamour'' when you're spending pretty much your life inside the hospital (which is ironically, by definition, already full of ''glamorous'' people.)

 

I meant this from the perspective of a premed student, or a preclinical med student. As a premed student, surgery sounds really cool, and it sounds even cooler during first year anatomy lab when you start cutting up cadavers.

 

However, once you move into your clinical years and realize just how much of a commitment it entails, that's enough to weed out a lot of individuals who initially were interested in surgery as a career.

 

Yea rightttt... Is it really that hard to believe these specialties are that interesting to some people, without overanalysing the situation ?

 

Nope. And in fact, I think that's about the only reason TO go into surgery. I definitely subscribe to the idea that you shouldn't do surgery unless you can't think of a single other area of medicine that you'd enjoy more. Surgery isn't for the uncommitted.

 

Ian

[tuss]

I loved my surgery residency, despite the horrible hours. It's amazing how fast the day zips by when you're doing what you love. I loved the patients, the OR, the floor, rounding, etc. It's funny that now i'm doing a year of research and the 7 hour days in the lab creep by at an excrutiating pace. It's all relative.

[Ève]

What do you people mean? It's not like Grey's Anatomy????

 

Damn! There goes my number one reason for choosing surgery!

[nowai]

Here at U of T they seem to be pushing researching academic surgeons. While I've done my share of research in undergrad, getting a PHD or having a lab of my own are not things I'm interested in.

 

Is it advisable to go into surgery with little research interest? Is it viable to later get a academic position without an interest in research? How prevalent are community surgeons?

 

Barring plastics -> cosmetic surgery, are there any other surgical fields quite seperate from academic medicine?

[Kirsteen]

Here at U of T they seem to be pushing researching academic surgeons. While I've done my share of research in undergrad, getting a PHD or having a lab of my own are not things I'm interested in.

Hi,

 

During the CaRMS interview information session at UofT for Gen Surg, they noted that the majority of the latest PGY-1s had chosen to enter the Surgical Scientist Training Program. Pretty impressive given the size of the program, i.e., ~10 PGY-1s per year.

 

Cheers,

Kirsteen

[tuss]

The current trend is that if you work in an academic hospital then you have to partake in research of some type. This could be clinical outcomes type research, lap research, clinical epidemiology, medical education, etc. It is an academic hospital and as a surgeon you have associate/assistant professor status in most cases which is why they have the research requirement.

 

That being said, there are only a few cities in this country that have a medical school and lots of cities that don't. In those places they don't have the research requirement and if you are not interested in that then those are the places for you.

[Kirsteen]

The current trend is that if you work in an academic hospital then you have to partake in research of some type. This could be clinical outcomes type research, lap research, clinical epidemiology, medical education, etc. It is an academic hospital and as a surgeon you have associate/assistant professor status in most cases which is why they have the research requirement.

Hi,

 

I'd modify the above to say that academic centre appointments require involvement in either research or education. There are plenty of academic surgeons who are not involved in research but who are quite active in education.

 

Cheers,

Kirsteen

[wildcard]

Hi all,

 

As most of you mentioned, marks don't add much weight when applying for surgical residency. However, from an IMG's point of view (who is also a Cdn citizen, but finished MD degree in Europe) would you say that marks would make a difference?

 

Just curious!

[Kirsteen]

Hi all,

 

As most of you mentioned, marks don't add much weight when applying for surgical residency. However, from an IMG's point of view (who is also a Cdn citizen, but finished MD degree in Europe) would you say that marks would make a difference?

 

Just curious!

Hi there,

 

It's difficult to say if marks would make a difference since most of us don't know the criteria which programs use to select residents from the IMG pool. However, if you do well in medical school then it certainly will look a lot better than if you fail a course here or there.

 

Cheers,

Kirsteen

[wildcard]

Hi ffp,

 

That's a great point. The plan was to try and excel academically no matter what.

 

I am actually planning on doing maximum rotations in Canada in the 3rd and 4th years. Primarily, to have that 'Cdn experience' that most hospitals will require and also to create contacts who can give favorable reference letters. Most ppl think its a long shot, but I actually know a few doctors who were going to school in Hungary and did 2 yrs worth of rotations in Canada which their medical school approved.

 

Also, ffp, you said you've interviewed IMGs. Do you have any tips/advice that could help me in the interview process as an IMG? What kind of questions are asked??

 

Kirsteen and ffp: you guys are a wealth of knowledge! Thanks for all your help!

[Kirsteen]

Hi there,

 

Just a little addendum to ffp's post above: the selection criteria for IMGs may differ from school to school and possibly, program to program. ffp (presumably) interviewed IMG candidates for her school's program(s). To obtain the most current information on IMG evaluations during the resident selection process (especially since the process changed dramatically this past year) it would be best to contact your schools of interest individually.

 

Cheers,

Kirsteen