after_virtue Posted January 8, 2012 Report Share Posted January 8, 2012 Hello everyone Long time lurker first time poster. Just started Gen surg rotation right now but I've always been interested in it. I am in a community setting predominantly and so I had a few questions about this specialty since I want to start setting my electives ASAP: 1) Job prospects for working in an academic setting? how good are they if I'm willing to do a fellowship? 2) What are the hours like? I'm in a community setting now so my preceptor works around 10-12 hours a day. I don't know how accurate this is a reflection of the hours and how it varies from the type of institution you work at. I wanted to get a feel for how the hours are like for a resident as well across various institutions. I understand this can be 80-100 a week. 3) Some aspects of the speciality I loved, but others not so much. Things like perianal diseases (fissures, fistulas, pilonidal cysts) and even hemorrhoids to an extent are things I can tolerate but Ideally I'd rather tailor my practice to not have to deal with these things. How flexible can general surgery practice be? and how much of this stuff is avoidable? 4) I've heard that you can do things like ENT, Uro, Plastics through gen surg? how would this work out? Link to comment Share on other sites More sharing options...
itimebomb2 Posted January 12, 2012 Report Share Posted January 12, 2012 Sounds a little bit like you don't actually want anything to do with gen surg! Here are my experiences so far having done a few electives in it. Gen surg is a worker's job - it's not really for people who want an easy going lifestyle. There are exceptions to the rule - but unless your 65 and phasing into retirement, you're gonna be working 60-80 hour weeks for most of your life. Residencies are ubiquitously difficult - 100 wks are not uncommon if not regular. Job prospects at an academic setting in gsx in any subspecialty are not good. Not good at all... but not as bad as neuro, ortho or cardiac sx in general. Make friends in high places. If you don't like dealing with poo - general surgery probably isn't for you... I'm not sure why you'd even be interested in gen surg if you don't like the anus. Of course, if you eventually go into thoracics or oncology, you can avoid it - but again - jobs that specific are not easy to come by - and its sort of weird to go into gen surg but hate dealing with poo. It used to be that some surgical subspecialties like the things you named came out of gen surg. That may still be possible if you do a fellowship in the states. These cases would be rare exceptions in Canada and I've never met such a person myself. Hello everyone Long time lurker first time poster. Just started Gen surg rotation right now but I've always been interested in it. I am in a community setting predominantly and so I had a few questions about this specialty since I want to start setting my electives ASAP: 1) Job prospects for working in an academic setting? how good are they if I'm willing to do a fellowship? 2) What are the hours like? I'm in a community setting now so my preceptor works around 10-12 hours a day. I don't know how accurate this is a reflection of the hours and how it varies from the type of institution you work at. I wanted to get a feel for how the hours are like for a resident as well across various institutions. I understand this can be 80-100 a week. 3) Some aspects of the speciality I loved, but others not so much. Things like perianal diseases (fissures, fistulas, pilonidal cysts) and even hemorrhoids to an extent are things I can tolerate but Ideally I'd rather tailor my practice to not have to deal with these things. How flexible can general surgery practice be? and how much of this stuff is avoidable? 4) I've heard that you can do things like ENT, Uro, Plastics through gen surg? how would this work out? Link to comment Share on other sites More sharing options...
NLengr Posted January 12, 2012 Report Share Posted January 12, 2012 I am almost 100% sure you can't go into Urology, ENT or Plastics through Gen Surg in Canada anymore. They were all spun off into separate residencies. If you really want to know I suppose you could call the Royal College. Link to comment Share on other sites More sharing options...
NLengr Posted January 12, 2012 Report Share Posted January 12, 2012 Here is the info I wanted from the college (I chose plastics randomly). Royal College certification in Plastic Surgery requires all of the following: 1. Successful completion of the Royal College Surgical Foundations curriculum; 2. Successful completion of the Royal College Principles of Surgery examination; 3. Successful completion of a 5-year Royal College accredited program in Plastic Surgery or certification by the American Board of Plastic Surgery; and 4. Successful completion of the certification examination in Plastic Surgery. The 5-year program outlined above is to be regarded as the minimum training requirement. Additional training may be required by the program director to ensure that clinical competence has been achieved. You can look up the different specialties here: http://www.royalcollege.ca/public/credentials/speciality_information Link to comment Share on other sites More sharing options...
rmorelan Posted January 12, 2012 Report Share Posted January 12, 2012 I am almost 100% sure you can't go into Urology, ENT or Plastics through Gen Surg in Canada anymore. They were all spun off into separate residencies. If you really want to know I suppose you could call the Royal College. although with fellowships you can do similar work - gen surgery + fellowship and ENT both do thyroid surgeries in Canada for instance. Link to comment Share on other sites More sharing options...
NLengr Posted January 12, 2012 Report Share Posted January 12, 2012 although with fellowships you can do similar work - gen surgery + fellowship and ENT both do thyroid surgeries in Canada for instance. There is some cross over for a limited number of areas (thyroids, adrenals and soft tissue lesions come to mind). Link to comment Share on other sites More sharing options...
rmorelan Posted January 12, 2012 Report Share Posted January 12, 2012 There is some cross over for a limited number of areas (thyroids, adrenals and soft tissue lesions come to mind). Sure - there is some flexibility after all. Now how that applies to getting a job at a specific centre is a bit confusing to me (it would be odd to see I would think a community hospital ask for a gen surg with specific a crossover fellowship, and an academic centre has all the surg areas covered). Meh probably missing something Link to comment Share on other sites More sharing options...
NLengr Posted January 12, 2012 Report Share Posted January 12, 2012 Sure - there is some flexibility after all. Now how that applies to getting a job at a specific centre is a bit confusing to me (it would be odd to see I would think a community hospital ask for a gen surg with specific a crossover fellowship, and an academic centre has all the surg areas covered). Meh probably missing something Doing an adrenalectomy is far different than practicing urology. That's like saying the urologist who does a hysterectomy for a radical cystectomy is a gynecologist. also, a general surgeon can do any of the above mentioned procedures without specific fellowship training. It's part of the core general surgical curriculum in residency. The way I read things is the OP wants to know if you can do gen Surg, then do a ENT, uro or plastics fellowship to work as one of those specialists. The same way thoracics is set up. The answer to that is no. Link to comment Share on other sites More sharing options...
after_virtue Posted January 13, 2012 Author Report Share Posted January 13, 2012 Sounds a little bit like you don't actually want anything to do with gen surg! Here are my experiences so far having done a few electives in it. Gen surg is a worker's job - it's not really for people who want an easy going lifestyle. There are exceptions to the rule - but unless your 65 and phasing into retirement, you're gonna be working 60-80 hour weeks for most of your life. Residencies are ubiquitously difficult - 100 wks are not uncommon if not regular. Job prospects at an academic setting in gsx in any subspecialty are not good. Not good at all... but not as bad as neuro, ortho or cardiac sx in general. Make friends in high places. If you don't like dealing with poo - general surgery probably isn't for you... I'm not sure why you'd even be interested in gen surg if you don't like the anus. Of course, if you eventually go into thoracics or oncology, you can avoid it - but again - jobs that specific are not easy to come by - and its sort of weird to go into gen surg but hate dealing with poo. It used to be that some surgical subspecialties like the things you named came out of gen surg. That may still be possible if you do a fellowship in the states. These cases would be rare exceptions in Canada and I've never met such a person myself. Thanks for this reply, but you must have misread my post. I am not averse to working, there is a big difference between working 14+ hours as they do in some centers, and working 11-12 hours as an attending. I know you have to grind it out as resident regardless. I just wanted to get a feel for hours since I would want to predominantly be in an academic center, and my exposure is now more community based practice. perianal disease and 'poo' are pretty different so don't know how you confused the two. I know a lot of general surgeons who hate anal fissures/fistulas etc and tailor their practice towards other things. This is coincidentally what my preceptor does and I was wondering if there was flexibility in essentially "cherry-picking". Link to comment Share on other sites More sharing options...
A-Stark Posted January 13, 2012 Report Share Posted January 13, 2012 One of my elective preceptors (a surgical oncologist who spends about 50% of his time in research) told me that he works from about 10-11 hours, possibly a bit more on the weeks he covers the acute/trauma service. In any case, the lifestyle all depends on the type of practice. Obviously a transplant surgeon will have some of the most difficult hours, whereas someone who does mainly breast, hernias, and choles will have an easier time of it. The more inpatients you have and, I suppose, the more anastomoses you have, the more likely you'll be busy outside of "normal" hours. In the community setting, call has a lot to do with the size of the group. Link to comment Share on other sites More sharing options...
tuss Posted January 15, 2012 Report Share Posted January 15, 2012 1. Job prospects in academic centres are scarce. You will require a fellowship in the very least to qualify for an academic job and most will require at least a masters degree and preferably a PhD. 2. Hours are busy, but will depend on how much OR time you get, how frequently you need to take call and how busy the call is and other responsibilities you have (committees, teaching, research, administration, etc.). Most hospital will require you to do some sort of administrative job or committee work at some point. 3. If you do a fellowship and subspecialize then you can avoid some areas to a degree, but you'll still be taking call and picking up some of these patients. eg. i don't do any breast surgery and don't see any breast referrals, but occasionally I have to drain a breast abscess on call or see someone else's postop breast cancer patient if they have problems after hours. 4. ENT, Urology and Plastics are no longer subspecialties of general surgery. You can still do vascular and thoracic surgery as subspecialties after your general surgery training. Most other fellowship training (eg colorectal, surgical oncology, hepatobiliary, breast, trauma) will still require you to do general surgery call. Link to comment Share on other sites More sharing options...
goleafsgochris Posted January 15, 2012 Report Share Posted January 15, 2012 Many in gen surg work a lot of hours--bit not all. On my rotation in med school there were several at my academic hospital (in southern ontario) who worked in surgical oncology and worked 9-10 hrs/day on weekends with minimal (1/9) call. Residency sucks, but dont avoid gen surg if you like it just because of a few busy training years. Link to comment Share on other sites More sharing options...
after_virtue Posted January 16, 2012 Author Report Share Posted January 16, 2012 Thanks for all the input everyone has provided. What's a reasonable approach for setting up electives. I was thinking of doing 10-12 x 2 week electives across the country in gen surg or in something related like thoracics, surg onc, and trauma/icu. Is it to your advantage to mix in something like internal med like Gastro, ortho to diversify yourself or better off to maximize gen surg electives and gain exposure? Link to comment Share on other sites More sharing options...
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