xylem29 Posted April 24, 2007 Report Share Posted April 24, 2007 Just wondering what those who fail to match to plastics (about 50% of applicants!) match into instead? What other fields would satisfy one's interest in plastics? Link to comment Share on other sites More sharing options...
Kirsteen Posted April 24, 2007 Report Share Posted April 24, 2007 Hi there, Much to the chagrin of one Gen Surg Program Director, they noted that, on one year, they happened to rank a bunch of applicants quite highly only to find that they had matched to Plastics instead. Clearly, General Surgery can be a back-up choice to Plastics. I've also heard of some other folks considering Ortho and Emerg as back-ups. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Kirsteen Posted April 25, 2007 Report Share Posted April 25, 2007 Hey again, A couple of Gen Surg programs took some additional lengths this year to filter out candidates who seemed to be turning to Gen Surg as a back-up. One program (UofT) requested a novel piece of information to be submitted with the CaRMS application: a list of all surgery rotations and electives taken during the clerkship period, presumably to screen for those who were truly keen on Gen Surg and to more easily identify those who were looking at other specialties. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
xylem29 Posted April 25, 2007 Author Report Share Posted April 25, 2007 off topic, but what I want to know is - what's up with this thing about getting OR time? Is medicine that political? If you've trained as a surgeon, do you need to have "connections" or something just to operate? I can't imagine someone spending 6 years to train as, say a neurosurg, only to not get any OR time once they're done training...what happens then? Link to comment Share on other sites More sharing options...
007 Posted April 25, 2007 Report Share Posted April 25, 2007 I know some ENT people do a lot of plastics-type work. I might not use it as a back up per se, but I'm throwing the specialty out there as something people who think they might like plastics might be interested in instead. Link to comment Share on other sites More sharing options...
xylem29 Posted April 25, 2007 Author Report Share Posted April 25, 2007 I know some ENT people do a lot of plastics-type work. I might not use it as a back up per se, but I'm throwing the specialty out there as something people who think they might like plastics might be interested in instead. i know that you can do a facial plastics and reconstruction fellowship after an ENT residency, but ENT is really competitive too. Link to comment Share on other sites More sharing options...
Kirsteen Posted April 25, 2007 Report Share Posted April 25, 2007 I know some ENT people do a lot of plastics-type work. I might not use it as a back up per se, but I'm throwing the specialty out there as something people who think they might like plastics might be interested in instead. Hey, During my last visit to TO a couple of weeks ago I ended up sitting beside an ENT guy in a hair salon who is currently doing solely Plastics work at his clinic. He's doing very well too, I might add. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Kirsteen Posted April 25, 2007 Report Share Posted April 25, 2007 off topic, but what I want to know is - what's up with this thing about getting OR time? Is medicine that political? If you've trained as a surgeon, do you need to have "connections" or something just to operate? I can't imagine someone spending 6 years to train as, say a neurosurg, only to not get any OR time once they're done training...what happens then? Hey there, This is one of the big problems with surgery in many urban centres. It's not necessarily connections that new surgical faculty need, but seniority. In most of the centres (of which I'm aware) the more senior surgeons tend to have the most OR time. The juniors tend to have the least. Take, for example, one new surgical faculty member here in Calgary with whom I had dinner last year. She came on staff and was given 1 OR day per week. One. I thought that was pretty rubbish when I heard it. Granted, she can pick up any extra OR time that other surgeons might not use on a given week, e.g., due to holidays, etc., but one day per week of surgery seems pretty meagre. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
hippie Posted April 25, 2007 Report Share Posted April 25, 2007 I don't have first hand experience with this but few months ago I remember watching something about this in montreal. They said that out of 10 residents who were done their residence, 8 left to the states because of the lack of OR time and how these doctors were scared of loosing their skills.... Link to comment Share on other sites More sharing options...
agregson Posted April 25, 2007 Report Share Posted April 25, 2007 the other difficulty that the new staff run into is waiting lists for surgeries. If they are seeing patients 3 or 4 days a week in clinic, you can imagine that they end up being really "behind" in the OR scheduling. The newest urogynecologist here told me that it only takes about 2-3 weeks to get into see her for a new consult, but you'll have to wait up to 9 months for surgery (for non-urgent things like incontinence). That's outrageous. Link to comment Share on other sites More sharing options...
tuss Posted April 25, 2007 Report Share Posted April 25, 2007 Actually 1 day/week for a general surgeon is quite good. 1.5 days is about perfect. Any more OR time than that you become way too busy. If you figure you have to see 2 days of clinic patietns for each OR day (follow ups, consults, etc.), plus scoping time (most general surgeons do some endoscopy) and then teaching and research time on top of that... you quickly run out of days in the week. Plus, the more you operate, the more inpatients you have and things just spiral out of control. The olden days of operating 3 days/week and then working 120 hours a week to keep up are gone - thank goodness. 1 - 1.5 days/week is perfect. Many new surgeons are being offered 1 day every other week which isn't really enough. Link to comment Share on other sites More sharing options...
Kirsteen Posted April 25, 2007 Report Share Posted April 25, 2007 Hey there, Actually, here in Calgary, the majority of General Surgeons do not perform endoscopy. At most, there are a couple who do, but they are the colorectal guys. Similar scenario at UBC and McGill. The more senior surgeons I worked with at each centre had 2-3 OR days per week and didn't seem to be working 120+ hour weeks. (The guys who did were in hepatobiliary and only worked those types of hours when there was a large supply of organs.) What centre are you at? Cheers, Kirsteen Link to comment Share on other sites More sharing options...
xylem29 Posted April 25, 2007 Author Report Share Posted April 25, 2007 So how can people expect to pay back their loans if they are only doing one operation per week? Do surgeons get paid "fee for service" for the procedure, and then also get a salary from the hospital for the non-OR work? Link to comment Share on other sites More sharing options...
tuss Posted April 25, 2007 Report Share Posted April 25, 2007 Fee for service includes billling for every clinic visit, every inpatient you have in hospital and every procedure (not just ORs). The situation in Calgary Kirsteen (i too am in Calgary) is that most surgeons only have 1-1.5 days/week - even the senior surgeons. Emergency cases, call, and scramble time is on top of that. Link to comment Share on other sites More sharing options...
Kirsteen Posted April 25, 2007 Report Share Posted April 25, 2007 The situation in Calgary Kirsteen (i too am in Calgary) is that most surgeons only have 1-1.5 days/week - even the senior surgeons. Emergency cases, call, and scramble time is on top of that. Hey there, Interesting. Just goes to show you that sample size is pretty important. The surgeons I've worked with here (which is not the majority) have had 2 or 2.5 OR days, except for the junior faculty member who only had 1. Based on what you've noted for other surgeons (1-1.5 days) in conjunction with my experiences here and with faculty at the other centres mentioned above, it seems that the surgical faculty here may have less OR time than those at other centres. Again, this is anecdotal, but I wonder if CAGS has done any research into these sorts of numbers, cross-country? Cheers, Kirsteen Link to comment Share on other sites More sharing options...
tuss Posted April 26, 2007 Report Share Posted April 26, 2007 You must also consider that at academic centres there is an expectation to spend time doing research and teaching, and surgeon do receive payment for the university to this time. There are many different funding arrangements that you can have as faculty at a university centre. Surgeons in the community (ie non-academic centre) have much more OR time and probably make more money than academic surgeons. Also lower cost of living. Definetly something to be said for community surgery. Link to comment Share on other sites More sharing options...
xylem29 Posted April 26, 2007 Author Report Share Posted April 26, 2007 You must also consider that at academic centres there is an expectation to spend time doing research and teaching, and surgeon do receive payment for the university to this time. There are many different funding arrangements that you can have as faculty at a university centre. Surgeons in the community (ie non-academic centre) have much more OR time and probably make more money than academic surgeons. Also lower cost of living. Definetly something to be said for community surgery. true, but if you like research then you like research right! Link to comment Share on other sites More sharing options...
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