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Wayyyy over hours on subinternships (100-110+)
#41
Self help books for millennials- "Work smarter not harder"

People who will actually be worth something in neurosurgery- "Work smarter AND harder"
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#42
(08-15-2019, 04:17 PM)Guest Wrote: Self help books for millennials- "Work smarter not harder"

People who will actually be worth something in neurosurgery- "Work smarter AND harder"

Yup. Sure. And those people are worth something ONLY in neurosurgery. Grow up.
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#43
(08-15-2019, 01:50 PM)Guest Wrote:
(08-15-2019, 09:57 AM)Guest Wrote:
(08-15-2019, 09:34 AM)Guest Wrote:
(08-14-2019, 02:09 AM)Guest Wrote:
(08-14-2019, 12:21 AM)Guest Wrote: Old school neurosurgeons had to be inhuman.  The field demanded it.  It also left made many of them divorced, abusive of substances, or just plain fucking crazy.  Everyone in this field has a hard-on for Cushing, but by all accounts he was an asshole of legendary proportions.

Despite what those guys (and they were mostly guys) would care to admit, there is a happy medium between getting good clinical training and losing everything important to you.  It probably takes more than 80 hours a week, and it's not easy, but there's no reason that doing this has to be unhealthy.

This is what happens when you let chicks into the field...

What's funny is how oblivious people like this are to the changing environment around them.  Patients, employers, administrators, and hospitals don't want to - and don't have to! - put up with your shit anymore.  There are way too many neurosurgeons (not to mention ortho spine folks and interventional neuroradiologists) who are just as well-trained as you are, minus the misogynistic prick personality that's going to create personnel complaints, fines, lawsuits, and other administrative headaches.  You might be able to get a job upselling 12-level fusions at some rural Midwest center where the poor patients are desperate for a warm body with "Neurosurgery" on the name tag, but the future of neurosurgery doesn't include you.  Those of us who really love our jobs will continue to find a way to actually make things better.

Kudos to the original poster, who didn't say anything about working less hard, just working smarter.  Other fields figured this out a long time ago.
“Working smarter” - the millennial solution to the dumb boomers

Synonymous with increased efficiency. Whats wrong with that?
Except used in this context “working smarter” is more often synonymous with “cutting-corners” and “deferring responsibilities”
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#44
(08-05-2019, 12:17 AM)Guest Wrote: I saw this and laughed the first time I read it but now that I'm on my SubI I see how real it is. Just remember, this is an interview and we're not good enough to know everything about our patients yet without the extra hours plus we have to show we will be willing to work hard if we are deficient in actual residency. This is a month long interview, bend over and take it.

My resident said it perfectly, "as a subI you work harder than residents and it continuously gets easier as you move up the ranks, you're working 130 hours a week right now but if you match here you'll only be at 100 not including the readings we do at home. Neurosurgery isn't a job, it's a lifestyle."

(08-05-2019, 12:17 AM)Guest Wrote: I saw this and laughed the first time I read it but now that I'm on my SubI I see how real it is. Just remember, this is an interview and we're not good enough to know everything about our patients yet without the extra hours plus we have to show we will be willing to work hard if we are deficient in actual residency. This is a month long interview, bend over and take it.

My resident said it perfectly, "as a subI you work harder than residents and it continuously gets easier as you move up the ranks, you're working 130 hours a week right now but if you match here you'll only be at 100 not including the readings we do at home. Neurosurgery isn't a job, it's a lifestyle."

I'll add, if they see you work hard they let you do stuff. After 1 week they let me expose a t10-pelvis, pit an EVD, close the entire spine and close from dura out on my own. makes you wanna work more in my opinion and keeps it fun

*uses the bovie once* .... "I EXPOSED A T10-PELVIS!"
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#45
I did a whole skull base tumor skin to skin as a premed okay.
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#46
(08-05-2019, 12:17 AM)Guest Wrote: I saw this and laughed the first time I read it but now that I'm on my SubI I see how real it is. Just remember, this is an interview and we're not good enough to know everything about our patients yet without the extra hours plus we have to show we will be willing to work hard if we are deficient in actual residency. This is a month long interview, bend over and take it.

My resident said it perfectly, "as a subI you work harder than residents and it continuously gets easier as you move up the ranks, you're working 130 hours a week right now but if you match here you'll only be at 100 not including the readings we do at home. Neurosurgery isn't a job, it's a lifestyle."

(08-05-2019, 12:17 AM)Guest Wrote: I saw this and laughed the first time I read it but now that I'm on my SubI I see how real it is. Just remember, this is an interview and we're not good enough to know everything about our patients yet without the extra hours plus we have to show we will be willing to work hard if we are deficient in actual residency. This is a month long interview, bend over and take it.

My resident said it perfectly, "as a subI you work harder than residents and it continuously gets easier as you move up the ranks, you're working 130 hours a week right now but if you match here you'll only be at 100 not including the readings we do at home. Neurosurgery isn't a job, it's a lifestyle."

I'll add, if they see you work hard they let you do stuff. After 1 week they let me expose a t10-pelvis, pit an EVD, close the entire spine and close from dura out on my own. makes you wanna work more in my opinion and keeps it fun

At what institution are they letting sub-i's in the OR play the role of a PGY2 in the latter half of their year? Aside from simple burr holes, skin closures, placing pedicle screws, or fixing bone flaps (maybe), it is unheard of for a medical student to be performing these tasks as you've described here, especially "after 1 week."
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#47
(08-18-2019, 11:09 AM)Guest Wrote:
(08-05-2019, 12:17 AM)Guest Wrote: I saw this and laughed the first time I read it but now that I'm on my SubI I see how real it is. Just remember, this is an interview and we're not good enough to know everything about our patients yet without the extra hours plus we have to show we will be willing to work hard if we are deficient in actual residency. This is a month long interview, bend over and take it.

My resident said it perfectly, "as a subI you work harder than residents and it continuously gets easier as you move up the ranks, you're working 130 hours a week right now but if you match here you'll only be at 100 not including the readings we do at home. Neurosurgery isn't a job, it's a lifestyle."

(08-05-2019, 12:17 AM)Guest Wrote: I saw this and laughed the first time I read it but now that I'm on my SubI I see how real it is. Just remember, this is an interview and we're not good enough to know everything about our patients yet without the extra hours plus we have to show we will be willing to work hard if we are deficient in actual residency. This is a month long interview, bend over and take it.

My resident said it perfectly, "as a subI you work harder than residents and it continuously gets easier as you move up the ranks, you're working 130 hours a week right now but if you match here you'll only be at 100 not including the readings we do at home. Neurosurgery isn't a job, it's a lifestyle."

I'll add, if they see you work hard they let you do stuff. After 1 week they let me expose a t10-pelvis, pit an EVD, close the entire spine and close from dura out on my own. makes you wanna work more in my opinion and keeps it fun

At what institution are they letting sub-i's in the OR play the role of a PGY2 in the latter half of their year? Aside from simple burr holes, skin closures, placing pedicle screws, or fixing bone flaps (maybe), it is unheard of for a medical student to be performing these tasks as you've described here, especially "after 1 week."

Whoever posted that he/she is doing all these procedures as a med student is obviously full of BS. As a resident at one of the busiest places in the country, I agree with above post that most of these tasks are PGY-2 level and above.
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#48
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.
Reply
#49
(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.

This is the real neurosurgery and its unfortunate you have to weed through troll posts to see it. Thank you for writing this
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