Friday 7 September 2012

Surgical training

Imagine for a moment a job where you are treated like a servant, you make less money than fast food workers, you get yelled at constantly for things that aren't your fault, you often work 120 hours a week (there are only 168 total), no one ever says "thank you", and this servitude is guaranteed to last for at least five years.  Oh, and at any given moment the safety of 25 or 30 people's lives rests squarely on your shoulders.  I'm sure you're just jumping out of your seat wondering how you can apply for this wonderful job, right?  Sound like something you'd be interested in?  Great!  Then train to become a surgeon.

Unfortunately, none of that is exaggerated.  Depending on where you train and what field you want to enter (cardiac, plastics, orthopaedics, urology, general, trauma, etc), surgical training takes between 5 and 8 years after 4 years of medical school.  To say it's a pressure cooker is an understatement - here was a typical day during my training.

4:30AM - Arrive at work, start pre-rounding, gathering vital signs
6:00AM - Make rounds with the team
7:00AM - Make rounds with the senior surgeon/consultant/attending
7:30AM - Surgery starts
4:00PM - Make afternoon rounds
10:00PM - Go home

And during all this time, I had to somehow create time to study.  In all specialties across medicine there are two major components to the training - A) Learn how to be a doctor and take care of patients, and B) Learn about all the stuff that can possibly go wrong with every part of the body.  In surgery, however, there is a very unique third component - C) Learn how to fix all that stuff.  The only way to learn how to operate is to see it and then do it.  But we also have to learn why we are doing the surgery, when to operate, and even more importantly when not to operate.  We then have to learn what to do when there is a complication with surgery.  If something goes wrong, it has to be fixed, and there are so many things that can go wrong it will make your head spin.  (Head spinning is not one of the complications I'm talking about.) 

In addition to working during the day, there's also the dreaded CALL.  This means staying in the hospital overnight, responding to phone calls in the middle of the night from frantic nurses about fevers, bleeding, patients falling out of bed, hiccups (seriously), and anything else that pops into their heads.  It also means seeing patients in the emergency room, assisting with surgery, and trying to steal a minute or two of sleep while praying that your pager doesn't go off again

My first year of training was by far the worst, but it only got marginally better after that.  The hours got a tiny bit better, perhaps only 100-110 hours a week, but the responsibility was much greater as the training progressed.  I had gotten married a few weeks before I started my training, and this whole process strained my marriage to its very limit. Statistics show that there is a 33% divorce rate among surgeons, and some training programs boast a 100% divorce rate, something they seem proud of as if they're saying, "Our trainees work so hard, there is NO time left for spouses!"

I somehow managed to get through my five years of training, and best thing to come out of those seemingly-endless years of torture was my beautiful daughter who was born midway through my fourth year.  The best advice I can give anyone going through this process (or even considering it) is to put family first.  A good training is very important, but nothing is more important than family.


  1. It's amazing what doctors do. But to have been able to have a family and still a marriage truly is amazing.. I'm speechless.
    (I've been up the past few days reading your blog to my sisters and family, I love your blog)

  2. Is it still so demanding? I hear there is an 80 hour limit now, call included.

  3. Very inspirational. My dream since I was around 3 was to be a doctor. My entire life, I have needed much medical attention, and when I'm older, I want to give back.

    My mom thinks I would be a good surgeon, but at this point in life, surgery scares me sooooo much; the fact that a mistake I make can kill someone... But then again, I can SAVE the person.

    I read in your other post that you planned, originally, on being a pediatrician. That's what I want to do. Did you have the same idea about being a surgeon as me? You said that you FELT it, but were you originally scared to perform surgery?

    I hope going through medical training won't ruin my future marriage. I'm almost at my 3rd year of dating my high school sweetheart, and if everything goes great, it would be amazing to marry him. But your post just reminded me that I will basically have NO life when I'm studying. How did you go through it, doc? How did you make sure your marriage stayed together?

    1. I was never afraid or intimidated by surgery. I know a lot of people who are turned off by the sight of blood, but surgery always fascinated me (and it still does).

      You can't look at it as having no life. I got through it because I MADE time to have a life. You can NOT get through it with your nose buried in a book 24/7. It also helped that my wife is an amazing person - caring, compassionate, understanding, and patient.

    2. It's not that I can't stand the sight of blood... I can't explain it well. I just feel like I can't. Maybe it's just not my calling.

      I guess I am seeing it wrong- I'm just worried that I'll be forced to keep my nose in a book. I'll try to take your advice when the time comes. Thanks :)

  4. Kudos to Mrs. Doc B, and your beautiful daughter! As well as you for beating the stastics!

  5. Its really bad to hear about your strained life as a surgeon. Its difficult to manage time and give some time to your family but try taking out little periods of time and satying with family.

  6. You have shared a very informative article here about the surgical training. After reading your article I got very much information about the surgical training and it resolved many of my doubts. Thanks for sharing this article here. GENERAL PRACTITIONER JOBS


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