Family life

[coquelicot]

Do you think that you can have a good family life while practising medicine? It depends on which speciality?

 

C (a worried pre-med student)

[Sheena815]

DEFINITELY depends on the specialty.

 

That's why some of the really popular ones are nicknamed "lifestyle" specialties (like Derm and Opthomology, for example). You work really good, really regular hours, with little call.

 

However, the surgeons I know (and granted I don't know a lot of them) all work at least 80 hours a week... they don't want to, but they are needed.

 

Just choose wisely which area you go into. As a warning, specialties with good lifestyles are becoming more and more popular (and as a consequence more difficult to get into) while thinks like surgery are becoming less so. Today's young people want a balanced life.. which I personally think is great.

[Kuantum]

DEFINITELY depends on the specialty.

 

That's why some of the really popular ones are nicknamed "lifestyle" specialties (like Derm and Opthomology, for example). You work really good, really regular hours, with little call.

 

However, the surgeons I know (and granted I don't know a lot of them) all work at least 80 hours a week... they don't want to, but they are needed.

 

Just choose wisely which area you go into. As a warning, specialties with good lifestyles are becoming more and more popular (and as a consequence more difficult to get into) while thinks like surgery are becoming less so. Today's young people want a balanced life.. which I personally think is great.

 

What kind of surgeons are these and where do they work? These sound more like resident hours and not so much attending hours.

[Sheena815]

What kind of surgeons are these and where do they work? These sound more like resident hours and not so much attending hours.

 

2 general surgeons, 1 orthopedic. Definitely not residents, they're in their 40's and 50's (family friends).

 

I'm not saying that's a representative sample by any means though. Take anecdotal evidence for what it is ...anecdotal. I think general surgery is one of the worst for hours as well. I believe the Orthopedic surgeon's hours are so bad because his area is low on them at the moment (somewhere up around the Niagara region).

 

I didn't mean to imply that all surgeons work god-awful hours, just that there's quite a big range and its at least somewhat specialty dependent.

[tallguy408]

Hours are relative to so many things that it is pointless to discuss them on a specialty by specialty case. I know a general surgeon who works 60 hours a week, and an internist who works 90. It depends on you, how big your call group is, where you are, what you do specifically...the list goes on. Granted, I will say that surgeons>internists>family med for scheduled hours, and family med>internal>surgery for flexibility of hours and practice. But don't think that surgery is the "busy" or "hard" field. All areas of med are working extremely hard right now with the physician shortage.

 

Word.

[Wolvenstar]

2 general surgeons, 1 orthopedic. Definitely not residents, they're in their 40's and 50's (family friends).

 

I'm not saying that's a representative sample by any means though. Take anecdotal evidence for what it is ...anecdotal. I think general surgery is one of the worst for hours as well. I believe the Orthopedic surgeon's hours are so bad because his area is low on them at the moment (somewhere up around the Niagara region).

 

I didn't mean to imply that all surgeons work god-awful hours, just that there's quite a big range and its at least somewhat specialty dependent.

 

 

 

Don't forgot that geneal surgeons (and I am sure a few other types of surgeons) tend to be on call for X number of days, so technically this counts as working even if they don't get called in, most because:

 

A) they can't leave town

they may have to up and leave for work at any time

C) can not consume alcoholic beverages (well at least I hope they aren't at the bar before being called in)

D) must always be reachable

 

 

So if you are on call for two days a week, plus the other three days of regular works it tends to make the week seem rather heavy for work. (48hrs on call plus 32hours of regular work is your 80hr work week right there)

 

Having had a chance to meet with and discuss his work with a general surgeon in my town (who showed our premed class some wonderful and interesting videos from a couple surgeries), we learned that it is not as ridiculus as it might sound when you say "80hr work week" but it is still not very pleasant none the less.

 

 

On the flip side there are many careers for doctors that have very lax hours and it is very easy to have a family. Family practictioners are one of these, I've known guys who started families while in their residency and med schools who were going in for this.

[coquelicot]

Oh I'm surprised to hear that family practitionners have good family life!!!

 

I was told that they have pretty rough conditions, specially in quebec.

 

Does you anyone know if pediatricians have good family life too?

 

thxs!

[Wolvenstar]

Really? Family practitioners or general practitioners always had the more slack job compared to surgeons, especially general or trauma surgeons I always thought. I mean sit in a office, check kids for the sniffles, check everyone's bumps, bruises, and the gross things that you really don't want to see but they bring to you anyways, and then you prescribe some drugs and go home at 5.

 

Really though I believe that it does come down to personal choice. Sure some will say they are have a duty to be their longer but really how long of hours you work is mostly up to you. No hospital will say you can't work more, but it isn't to hard to determine your work days...especially if you open a private practice (although in Canada it really isn't a true private practice).

[Satsuma]

On my gen surg rotation the staff surgeon worked ALOT.

There was not 1 call day that we did not get called for several surgical cases. He did not take any post-call days.

So we started at 6 am everyday (during the week...on weekends we would start aroun 7:00) so we could round on pts before clinic/OR. On call days when we were in the OR past midnight...we still started at 6 the next day and completed a full day of work (clinic days end at 4:00 which isn`t bad, but we did start at 6:00!). He was on call once during the week.

And I am not sure how they work out weekends. I can say that I was on call 2 weekends of my 6 week rotation. That is...from Fri through to Mon morning...on call. And I worked each and every one of those days, longer hours than most work in a regular day. Yep...9pm holding retractors for an incarcerated hernia repair...11pm holding a camera for a laparoscopic cholecytectomy...even later still holding a camera but now for appendicitis. Sleep? not so much...try to get a bit in between calls to the emerg to assess pts....next morning...8am...digging through a feces filled abdomen to repair a perforated bowel....that is just part of 1 weekend call that I remember...mostly just trying to forget it! My preceptor even went in at 1am when he WASN'T on call, just cause he knew the pt.

 

In some ways...the surgeons do choose to work those hours. I had asked why they don`t have groups like in obgyn, where whoever in the group is on call will see all the pts belonging to the doctors in the group. He said that they tried to introduce it and it didn`t go over well. Surgeons seem to think that only they know what is best for their pt and can perform the needed surgery properly. Apparently, distrusting the other surgeons to take care of their pts. At least at this hospital. So there...their opportunity for a better lifestyle out the window by choice.

 

Some of it isn`t choice though...lots of pts come in at 2am and are emergent surgical cases and someone has to do it.

 

So...there's a little glimpse into the life of at least one staff surgeon...who also wasn`t a rookie I might add.

 

Obviously a specialty like derm that doesn`t have that many emergencies is going to have a way better chance at having a more "normal" lifestyle.

[newguy?]

Any specialty can have a good time schedule and room for a family life. In the end, you choose how hard you want to work. There is just the pressure for most fields to work more, noone can force your hand in anything. If you want to work less, in a demanding field, you stipulate that before you start work, not after you have agreed to your groups conditions, or the hospital.

[Ollie]

Really? Family practitioners or general practitioners always had the more slack job compared to surgeons, especially general or trauma surgeons I always thought. I mean sit in a office, check kids for the sniffles, check everyone's bumps, bruises, and the gross things that you really don't want to see but they bring to you anyways, and then you prescribe some drugs and go home at 5.

I really hope you are being funny otherwise you just seriously insulted my future specialty and every family physician.

[newguy?]

I agree with Ollie. And "gross things that you really don't want to see," I would imagine a surgeon, a trauma surgeon, would see gross things.

And I think you wolvenstar proved yourself wrong. The fact that the family physician has to distinguish what a bump is between a tumour, or some other physical injury, and the bruise, which could be a bruise, hematoma, maybe a little trickier if it's on the head vs the trauma surgeon that knows exactly what he or she has to do.

 

And don't think I'm saying the family physician has the harder job, theres so many things for play in this, and I'm not in the position to have an opinion, but I know where your argument is flawed.

[coastalslacker]

Really? Family practitioners or general practitioners always had the more slack job compared to surgeons, especially general or trauma surgeons I always thought. I mean sit in a office, check kids for the sniffles, check everyone's bumps, bruises, and the gross things that you really don't want to see but they bring to you anyways, and then you prescribe some drugs and go home at 5.

 

 

This makes you sound like an idiot. I remember reading in another post that you aren't in med school yet. It might be a good idea not to bash the most important job in medicine.

 

On another note, I'm going into ortho and plan on spending lots of time with my family. I think the workaholic mentality is/was more prevalent in previous generations; work-life balance is much more important to many of us coming through now than it was to physicians in the past. Ideally, I'd like to work four days a week when I'm an attending (not counting call). That said, I'm going to sweat for the next five years....

[Satsuma]

Any specialty can have a good time schedule and room for a family life. In the end, you choose how hard you want to work. There is just the pressure for most fields to work more, noone can force your hand in anything. If you want to work less, in a demanding field, you stipulate that before you start work, not after you have agreed to your groups conditions, or the hospital.

 

I used to believe that. Then someone pointed out that if you work less, you will see less patients, people will refer to you and their pts won't get seen 'cause you aren`t working that much, and eventually they just will stop referring 'cause they figure their pts won't get seen. Then your hours end up reduced a little more than you had hoped.

 

I do think that it is up to each individual to create their lives outside of their work and know when to stop working...but I also think it is alot easier said than done. And some specialties definitely easier than others.

 

Also, if you ask a doctor if they think they have a good work-life balance...and they say yes...always dig a little deeper. You may actually find that their idea of work-life balance isn't quite the same as yours.

[supafield]

I'm surprised to hear this about the General Surgeons.... the ones I shadowed in Mississauga were very 8-4 scheduled with on call somewhere around 1 in 8....

[tallguy408]

Satsuma makes a good point about digging deeper, but also I think we need to realize what medicine means as a profession. You, by getting into med, are embracing a life of service and dedication to your patients. This does not automatically imply 100-hour weeks, but you can hardly expect the lives of those who depend on you to follow a 9-5 schedule. You have to like working hard and being dedicated to be in med.

 

Thus, when looking at "life balance", consider that in the context of a doctor. You will obviously want ample down time and family time, but you are not going to get part-time hours in a full-time profession. Besides, almost anything in meds is as cool as F*ck (including pathology).

 

Word.

[White-Tiger]

Oh I'm surprised to hear that family practitionners have good family life!!!

 

I was told that they have pretty rough conditions, specially in quebec.

 

 

 

In general, anyone who decides to practice in quebec is either crazy or somehow tied down to the province (family etc). It is one of the of the provinces that pays the least AND is the most restrictive.

 

I'm currently a McGill Med student and there is NO WAY IN H*LL that I am going to practice in Quebec. Upon graduation I plan on going straight to Ontario, settle somewhere in the 1000-islands and live a good life.

[nutritional_lee]

In general, anyone who decides to practice in quebec is either crazy or somehow tied down to the province (family etc). It is one of the of the provinces that pays the least AND is the most restrictive.

 

Heh... I can see myself as one of those tied-down folks. Out of curiosity, what do you mean by 'restrictive'?

[White-Tiger]

Heh... I can see myself as one of those tied-down folks. Out of curiosity, what do you mean by 'restrictive'?

 

Ever heard of PREMs? Essentially you need a "license" to practice in a certain area. For example, if you are a family physician and want to practice on the island of montreal, you need a specific permit to do so. Now, given the rural FP shortage, they'll only give out a certain amount of PREMs for the urban areas and the rest of the FPs will need to go practice elsewhere.

 

Compare this scheme to Ontario, where they'll essentially pay bonuses to FPs in order to settle in rural areas. The big difference between Quebec and Ontario is that ontario will give you monetary bonuses to fill in the voids, while Quebec will either force you or penalize you.

 

Another example, I heard from a practicing FP that once you receive a PREM from the Quebec goverment, you are obligated to spend a certain amount of hours per year doing geriatrics (nursing homes, etc). Well, once again, in ontario there is monetary incentives to do such work.

 

It's two way different mentalities. And Ontario appeals to me much more.

 

 

Lastly, look up salaries figures in Ontario vs Quebec. If I remember correctly, in 2002-2003, the average FP billed 150,000$ gross in Quebec while the average FP in Ontario billed 200,000$. And don't forget that Quebec is the most taxed province in the country...and yet is probably the pot-hole capital of the world. I hate this province. lol.

[nutritional_lee]

Ever heard of PREMs? Essentially you need a "license" to practice in a certain area. For example, if you are a family physician and want to practice on the island of montreal, you need a specific permit to do so. Now, given the rural FP shortage, they'll only give out a certain amount of PREMs for the urban areas and the rest of the FPs will need to go practice elsewhere.

 

The salary differences don't surprise me - I'm earning about 50% more as an RD in Ontario now than I would have in Quebec (I graduated from McGill) -- not to mention the fact that it's 10x easier to find a job here than it is in Quebec (at least for an AHP)... nor the lower taxes.

 

I'd also heard of signing bonuses in the neighbourhood of $100k in towns like Belleville and Brockville for new FPs! I guess I'd just hoped Quebec towns had similar incentives... I guess not(?).

 

I certainly hadn't heard of PREMs before, though. Wow. Good to know -- thanks!

[Wolvenstar]

This makes you sound like an idiot. I remember reading in another post that you aren't in med school yet. It might be a good idea not to bash the most important job in medicine.

 

On another note, I'm going into ortho and plan on spending lots of time with my family. I think the workaholic mentality is/was more prevalent in previous generations; work-life balance is much more important to many of us coming through now than it was to physicians in the past. Ideally, I'd like to work four days a week when I'm an attending (not counting call). That said, I'm going to sweat for the next five years....

 

 

 

First off, don't be throwing around insults, It doesn't show your smarter than me, it just tells me that I am better than you. Especially when I have used any insults. No I am not in med school yet, It would be a little hard for me to be in med school when I haven't enough credits to even apply. This does not mean i am not as smart as you. What it does mean is that you are older than I and have thus finished your undergrad before I have. So sure perhaps in courses you took in your undergrad that I have yet to take or aren't taking you will know more than I, But in context to the thread topic no.

 

 

Secondly for those who want to contradict what I said about "gross" you should realize that it is a matter of opinion. What some find gross others don't. I have no problem looking at someone whose leg is torn in half. It's not a pleasant site but it doesn't phase me. Seeing someone with some sort of foot fungus, or boils, (arbitrary examples) that I do find gross. I am not saying that were I a doctor that I would even flinch, but if I had a choice between bone stabbing out of a leg or a boils I would rather choose foot fungus.

 

 

As for insulting the profession or saying it wasn't important, you are putting words in my mouth. I would ask that you quote where I said that family physicians are not important if you are going to accuse me of such.

 

Now I wasn't insulting family physicians I was saying their jobs are more slack than a surgeon. Perhaps I should have been more specific but trauma surgeons and to a degree general surgeons, in my mind do have a tougher job to do, not because it is more important, but because of the hours the have to work.

 

Again I never mentioned anything about the importance of one specialty or another in medicine. Don't mistake me saying one is harder than the other for saying that one is more important than the other. "it's harder to climb a mountain than to plow a field, but farming is much more important to one's survival." Frankly I don't understand why one always believes that the harder job is obviously the more important one. I have not bashed family physcians, I have only made a point about which job would be more difficult, and now have explained why. The honest truth is that I rate the difficulty of a specialty by how much time it would keep my away from my family, not by which is more important.

 

That being said you have an excellent point on the workaholic mentality

[Icebox]

^

 

There's such thing as choosing your words carefully, and you continue to lack that foresight.

 

First of all, you stereotyped family medicine with "typical routine work" that they do which is simply not true. That may be a big part of what family docs do, but there's so much more to it depending on where they practice, how they practice and if they choose to pursue specialty areas within the scope of family medicine.

 

Second, to state that family medicine is not as hard as surgery is false. The difficulty of a specialty entirely depends on one's interests and skills. I have spoken to several specialists that have said they could never be family doctors - they like having their own niche where they know everything within that specialty, and wouldn't be able to go from one problem in a patient to something completely unrelated the next (ie. an ear ache in one patient to abdominal pain in the next). This is exactly how I feel - I'm interested in a specialty and feel I'd be much more comfortable knowing a lot about/being to operate on one thing than being expected to see a variety of things and differentiate them.

 

And saying, "it shows I am better than you" is an insult within itself. Giving an uninformed opinion will be reason enough to have insults thrown at you, especially from those you are offending. No one is "better" than anyone else regardless of whether they've attended med school or not, but those that have/are currently doing so definitely have more experience and more knowledge to make a better informed opinion than you until you gain that same experience; just like I would never make an assumption regarding your undergrad field if it's not the one I took, since I lack that experience that you have.

[coastalslacker]

First off, don't be throwing around insults, It doesn't show your smarter than me, it just tells me that I am better than you. Especially when I have used any insults. No I am not in med school yet, It would be a little hard for me to be in med school when I haven't enough credits to even apply. This does not mean i am not as smart as you. What it does mean is that you are older than I and have thus finished your undergrad before I have. So sure perhaps in courses you took in your undergrad that I have yet to take or aren't taking you will know more than I, But in context to the thread topic no.

 

 

Secondly for those who want to contradict what I said about "gross" you should realize that it is a matter of opinion. What some find gross others don't. I have no problem looking at someone whose leg is torn in half. It's not a pleasant site but it doesn't phase me. Seeing someone with some sort of foot fungus, or boils, (arbitrary examples) that I do find gross. I am not saying that were I a doctor that I would even flinch, but if I had a choice between bone stabbing out of a leg or a boils I would rather choose foot fungus.

 

 

As for insulting the profession or saying it wasn't important, you are putting words in my mouth. I would ask that you quote where I said that family physicians are not important if you are going to accuse me of such.

 

Now I wasn't insulting family physicians I was saying their jobs are more slack than a surgeon. Perhaps I should have been more specific but trauma surgeons and to a degree general surgeons, in my mind do have a tougher job to do, not because it is more important, but because of the hours the have to work.

 

Again I never mentioned anything about the importance of one specialty or another in medicine. Don't mistake me saying one is harder than the other for saying that one is more important than the other. "it's harder to climb a mountain than to plow a field, but farming is much more important to one's survival." Frankly I don't understand why one always believes that the harder job is obviously the more important one. I have not bashed family physcians, I have only made a point about which job would be more difficult, and now have explained why. The honest truth is that I rate the difficulty of a specialty by how much time it would keep my away from my family, not by which is more important.

 

That being said you have an excellent point on the workaholic mentality

 

 

Son, I call it how I see it. Good luck in whatever you end up doing.

[Ollie]

Now I wasn't insulting family physicians I was saying their jobs are more slack than a surgeon. Perhaps I should have been more specific but trauma surgeons and to a degree general surgeons, in my mind do have a tougher job to do, not because it is more important, but because of the hours the have to work.

 

The honest truth is that I rate the difficulty of a specialty by how much time it would keep my away from my family, not by which is more important.

 

You should really refrain from commenting on things that you clearly know little about. A lot of family docs, especially in rural areas do office practice, inpatient care, ER, OB, surgical assist, etc, etc, etc. They can easily work the same hours as a surgeon.

[Wolvenstar]

^

 

There's such thing as choosing your words carefully, and you continue to lack that foresight.

 

First of all, you stereotyped family medicine with "typical routine work" that they do which is simply not true. That may be a big part of what family docs do, but there's so much more to it depending on where they practice, how they practice and if they choose to pursue specialty areas within the scope of family medicine.

 

Second, to state that family medicine is not as hard as surgery is false. The difficulty of a specialty entirely depends on one's interests and skills. I have spoken to several specialists that have said they could never be family doctors - they like having their own niche where they know everything within that specialty, and wouldn't be able to go from one problem in a patient to something completely unrelated the next (ie. an ear ache in one patient to abdominal pain in the next). This is exactly how I feel - I'm interested in a specialty and feel I'd be much more comfortable knowing a lot about/being to operate on one thing than being expected to see a variety of things and differentiate them.

 

And saying, "it shows I am better than you" is an insult within itself. Giving an uninformed opinion will be reason enough to have insults thrown at you, especially from those you are offending. No one is "better" than anyone else regardless of whether they've attended med school or not, but those that have/are currently doing so definitely have more experience and more knowledge to make a better informed opinion than you until you gain that same experience; just like I would never make an assumption regarding your undergrad field if it's not the one I took, since I lack that experience that you have.

 

 

 

My statement of "routine work" may have been an overgeneralization but you, yourself admitted that it is a big part of what they do, so my point is upheld.

 

Now I did say that being a general surgeon or trauma surgeon is more difficult or hard than being a FP, but had you read my entire post I told you that I rate difficulty in how much time the profession/specialty keeps one away form their family.

 

By your meaning of difficulty this is not so. However I am not using your deffinition of difficulty, I am using mine and stated what that is. Perhaps if you had taken the time to read it all you could have disputed my claim like Ollie did by argueing that FPs work the same hours as Surgeons, rather than just go on a rant about what he believes difficulty means.

 

 

Now I can understand your point that he would (hopefully) be more knowledgable than me when it comes to this but what I was saying was that just because I am still an undergrad doesn't mean i am not competent enough to be participating in this discussion. You don't learn everything just by going to school, there are many ways to learn about the medical field.

 

 

 

Now Ollie, I actually do know several FPs who do practice; ER, OB, surgical assist, or are certified surgeons themselves that decided they would prefer to live in a rural area and do more work as a FP. I do understand that many FPs choose to work as much as other doctors, but the fact being that they choose to do extra. Granted they should be given credit for it, and I do completely understand that the common FP will do more than what is needed. However, are you telling me that the average FP works the same hours as the average trauma or general surgeon?

 

 

 

CoastalSlacker;

 

I will give you respect for not being afraid to state your beliefs, boy, I wish you well in life.