(10-15-2019, 08:03 PM)Guest Wrote: I'm a PGY5 at a very busy program.
I remember after completing my first sub-I, I came home and essentially broke down and started crying. There was serious contemplation about getting out while the getting was good. I remember having the exact same thoughts as you. Will my life always be this? I liked medicine and surgery, and certainly enjoyed gaining more and more knowledge all while "helping people", but I also have other interests, including an at-the-time girlfriend (now a wife).
I'm glad I stuck with it and it certainly does get better. Honestly, sub-Is were the worst part of my neurosurgery experience. As some others have said, they are literally a month-long interview where you are guarding your words and personality all while trying to show you can tough it out and be there at all times of the day, performing any task asked of you without question. Additionally, you are often standing in cases that run 12+ hours, scrubbed in, while the most you will do is maybe incise the skin with the scalpel. No one enjoys that. I still hate going into long cases and eventually getting boxed out by the staff to then watch them pick at a CPA tumor. This improves as you gain autonomy and understanding. Those hours melt away when you are actually performing the surgery and doing what you imagined when you signed up for the neurosurgery gig.
A lot of this problem with sub-Is stems from the fact that you don't really have a true role. Once you are an intern, you have work to complete. This increases your satisfaction and having a role on the team gives you a little light at the end of the tunnel (when you get done with all the bullshit, you get to go home). I worked the most as a PGY2 and I feel like I probably averaged 100-120 hour weeks, but honestly it went by quickly and felt nowhere near as miserable. And as others have mentioned, as you work your way up the chain, things improve drastically. You aren't the one gathering numbers, you don't have to hold the call pager, etc etc. Most of the time spent in the hospital is spent on direct patient care (either OR or clinic), and that boosts your satisfaction greatly.
Ultimately, you have the choice to put in what you want. If you want to constantly read, perform research, and be an amazing resident, your time spent on other activities will suffer. There is a balance, it just takes time. Your career goals also influence this. Do you want to become the world's best skull-base or cerebrovascular surgeon? You're going to have to put in insane hours. But you can certainly have a rewarding practice where you do what you love and still have time for family or interests.
I would say, take a close look at the residents when you interview and/or perform sub-Is. Is it a super "blue-collar" program with no PA/NP support whatsoever? Your hours in the hospital will probably increase as a result. If you're fortunate enough to find a program that has some ancillary support, then that can seriously cut down on the amount of time spent doing bull-shit that drains your soul.
Neurosurgery takes a lot out of you. But the challenge helps you grow as a person and identify what is important to you, and at the end you have a satisfying and well-compensated career where you actually make a difference in the world.
Aren't there other jobs that don't require you to sacrifice most of your 20s and 30s (and most of your time/freedom once you're an attending) that are just as satisfying, well-compensated and impactful?
(02-14-2022, 01:06 AM)Guest Wrote: (10-15-2019, 08:03 PM)Guest Wrote: I'm a PGY5 at a very busy program.
I remember after completing my first sub-I, I came home and essentially broke down and started crying. There was serious contemplation about getting out while the getting was good. I remember having the exact same thoughts as you. Will my life always be this? I liked medicine and surgery, and certainly enjoyed gaining more and more knowledge all while "helping people", but I also have other interests, including an at-the-time girlfriend (now a wife).
I'm glad I stuck with it and it certainly does get better. Honestly, sub-Is were the worst part of my neurosurgery experience. As some others have said, they are literally a month-long interview where you are guarding your words and personality all while trying to show you can tough it out and be there at all times of the day, performing any task asked of you without question. Additionally, you are often standing in cases that run 12+ hours, scrubbed in, while the most you will do is maybe incise the skin with the scalpel. No one enjoys that. I still hate going into long cases and eventually getting boxed out by the staff to then watch them pick at a CPA tumor. This improves as you gain autonomy and understanding. Those hours melt away when you are actually performing the surgery and doing what you imagined when you signed up for the neurosurgery gig.
A lot of this problem with sub-Is stems from the fact that you don't really have a true role. Once you are an intern, you have work to complete. This increases your satisfaction and having a role on the team gives you a little light at the end of the tunnel (when you get done with all the bullshit, you get to go home). I worked the most as a PGY2 and I feel like I probably averaged 100-120 hour weeks, but honestly it went by quickly and felt nowhere near as miserable. And as others have mentioned, as you work your way up the chain, things improve drastically. You aren't the one gathering numbers, you don't have to hold the call pager, etc etc. Most of the time spent in the hospital is spent on direct patient care (either OR or clinic), and that boosts your satisfaction greatly.
Ultimately, you have the choice to put in what you want. If you want to constantly read, perform research, and be an amazing resident, your time spent on other activities will suffer. There is a balance, it just takes time. Your career goals also influence this. Do you want to become the world's best skull-base or cerebrovascular surgeon? You're going to have to put in insane hours. But you can certainly have a rewarding practice where you do what you love and still have time for family or interests.
I would say, take a close look at the residents when you interview and/or perform sub-Is. Is it a super "blue-collar" program with no PA/NP support whatsoever? Your hours in the hospital will probably increase as a result. If you're fortunate enough to find a program that has some ancillary support, then that can seriously cut down on the amount of time spent doing bull-shit that drains your soul.
Neurosurgery takes a lot out of you. But the challenge helps you grow as a person and identify what is important to you, and at the end you have a satisfying and well-compensated career where you actually make a difference in the world.
Aren't there other jobs that don't require you to sacrifice most of your 20s and 30s (and most of your time/freedom once you're an attending) that are just as satisfying, well-compensated and impactful?
Like I feel like there's some Stockholm Syndrome/sunk cost fallacy in this thinking.
It’s a lot more simple than that. When the indentured servitude cost makes it not worth becoming a neurosurgeon, then people stop training for it. The system then pulls back. The programs are 7 years with required BS research time and disregard for QOL issues because good applicants keep coming in wanting to be brain surgeons at that price.
I do wonder how many applicants go for it because they’ve been trained to think doing anything else is a personal failure. For example, if someone keeps answering “I’ll apply neurosurgery again” in response to “What if you don’t match this year/next year/ten years from now?” then that person isn’t thinking rationally or is lying. Either way, undesirable as a resident.
(02-24-2022, 06:54 PM)Guest Wrote: It’s a lot more simple than that. When the indentured servitude cost makes it not worth becoming a neurosurgeon, then people stop training for it. The system then pulls back. The programs are 7 years with required BS research time and disregard for QOL issues because good applicants keep coming in wanting to be brain surgeons at that price.
I do wonder how many applicants go for it because they’ve been trained to think doing anything else is a personal failure. For example, if someone keeps answering “I’ll apply neurosurgery again” in response to “What if you don’t match this year/next year/ten years from now?” then that person isn’t thinking rationally or is lying. Either way, undesirable as a resident.
I was under the impression that everyone who goes into this field is motivated almost only by that reason?
Wrong way to think
Unregistered
(02-24-2022, 08:42 PM)Guest Wrote: (02-24-2022, 06:54 PM)Guest Wrote: It’s a lot more simple than that. When the indentured servitude cost makes it not worth becoming a neurosurgeon, then people stop training for it. The system then pulls back. The programs are 7 years with required BS research time and disregard for QOL issues because good applicants keep coming in wanting to be brain surgeons at that price.
I do wonder how many applicants go for it because they’ve been trained to think doing anything else is a personal failure. For example, if someone keeps answering “I’ll apply neurosurgery again” in response to “What if you don’t match this year/next year/ten years from now?” then that person isn’t thinking rationally or is lying. Either way, undesirable as a resident.
I was under the impression that everyone who goes into this field is motivated almost only by that reason?
“I will feel bad about myself if I don’t pick neurosurgery, so I’ll jump through any hoop to avoid that feeling.” Direct quote from too many interviews.
Have you ever met someone who goes into NS because they actually want to help others? I don't think I have.
(02-25-2022, 01:49 AM)Guest Wrote: Have you ever met someone who goes into NS because they actually want to help others? I don't think I have.
I blacklist anyone with an mba or more than one patent. I want doctors not businessmen
At my school, everyone who is doing an MBA wants to go into derm or plastic surgery or some other high-paying field. They know all the details about billing and how much the different codes pay. Business first.
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Wayyyy over hours on subinternships (100-110+)
