5 ms·

medical school is humbling and difficult. Being a physician is difficult. I finished medical school in 1996 - didn't find it ridiculously hard, but then again,

medical school is humbling and difficult. Being a physician is difficult. I finished medical school in 1996 - didn't find it ridiculously hard, but then again, studying a lot was what I did in my youth. Now, I'm 47 years old, and work about 90 hours a week as a surgeon - I laugh when people say that we make too much. All I know is that 25 years ago, you had to be in the top 10% of your class to become a surgeon. When I applied, it was top 20%. Now, it's basically if you graduate from medical school and want to be a surgeon, you can become one. General surgeons put in long hours for not that much glory - today I waited 2 hrs to drain an abscess that took me 10 minutes, so I got home at 6:30 pm. The upside is that when I do a great job, it really is rewarding. The downside is telling families and patients I do not have much to offer, and their disease is too far gone. Anyway, don't go into medical school / surgery if you don't want to work hard. No one has a gun to your head. Physicians that pick the right profession for their personality / skill set are very happy. PS my undergraduate degree was computer science

agumonkey 10y ago
What do you think about current day surgery and potential technological change in the field (robot driven, nanotech [not smart molecules, but increasingly simple interaction at sub micron scale], large data monitoring and analysis for prevention) ?
lanius 10y ago
Interesting, I assumed that the field would become more selective over time. Or is it because just getting accepted to medical school itself is already extremely competitive?
- mahyarm 10y ago
  I have heard that getting into medical school is a lot harder than it used to be too. It might be the reason why it's easier to be a surgeon once your in. I'm not a doctor or a med student, so take that with a grain of salt.
- stephencanon 10y ago
  The specialties with better quality of life (e.g. dermatology) have become increasingly competitive, drawing some of the top students away from the more masochistic fields.
erentz 10y ago
Do you really work 90 hours? That's 13 hours a day 7 days a week. How does that even work logistically when you need to eat, sleep, commute, do laundry, shop for food, and hopefully also see family or friends on occasion.
- xanderstrike 10y ago
  I'm assuming it's 90 billable hours. He said he waited two hours to do a ten minute procedure, sounds like most of his day is spent waiting rather than working.
  - vacri 10y ago
    That's two hours that he can't be off with his family, reading a book, having a drink, learning to juggle rings, so on and so forth. It's definitely 'work', even if it is standing there twiddling your thumbs because you're waiting on colleagues.
- northern_lights 10y ago
  I am nearing the end of medical school now, and I can assure you there are many surgeons who consistently work 80-90 hours/wk. I see it most often in surgeons who have subspecialized and do extremely technical work. Family, social, laundry, food, etc, all become things that you take care of whenever you get a free second. It's very, very difficult to describe the path a person takes to get to that point, but the profession can absolutely be all-consuming. It's one of the reasons surgery is less competitive as a specialty than it used to be - people see the brutal hours and make the choice to pursue options with a more attractive work-life balance.
  - sp332 10y ago
    Isn't that a little backwards though? The more surgeons there are, the more the work could be spread out, and the hours would be saner.
    - northern_lights 10y ago
WhitneyLand 10y ago
Why do you have to work 90 hours a week? Why wouldn't your employer just offer a position with less hours for less money? In software the long hours have specific reasons. For example we can't double throughput by doubling resources, and in startups the money is limited, etc
- viraptor 10y ago
  > In software the long hours have specific reasons. Yes. Bad management and artificial marketing deadlines. You can't double the throughput in some cases by doubling the resources. (in some you can) But you don't have to work in the kind of environment that expects it. I got pulled into the environment that expected long hours once. Then the manager got replaced - throughput stayed the same, people started leaving on time and were much more happy.
  - WhitneyLand 10y ago
    You're right those are also reasons. Unfortunately they're difficult to quantify. If there were an objective way to measure quality of management things would be vastly easier. For example if a trusted management quality metric was reading "sucks", it would be easier to leverage change.
  - JBlue42 10y ago
    I work with architects (building not software) that pull similarly long hours (and not great salaries) and when I point out that it sounds like a mix of poor planning, a poor deal with the client, or project management / process issues it's always shot down as being a 'part of their culture' that they've gone through since university. My counterargument is that 'culture' isn't fixed and there's no reason not to strive for better and give people a chance to have lives outside work.
maxxxxx 10y ago
I find it hard to believe you can work 90 hrs/week and not have your performance and judgement be impacted.
- bcook 10y ago
  Maybe his performance and judgement are so impeccable that even after a 90-hour work-week he still operates better than the average.
  - maxxxxx 10y ago
    I hope you are kidding! On the other hand I wouldn't put it beyond the surgeons I have met to think that way.
mixmastamyk 10y ago
> I'm 47 years old, and work about 90 hours a week as a surgeon Sorry, you and your industry should be ashamed of themselves for putting lives at risk. Mistakes from fatigue are a real thing. Maybe you are just cutting off bunions, but there still could be complications.
Axsuul 10y ago
Can I ask if you're a surgeon in a private practice or hospital?
epmaybe 10y ago
The thing is, medical school doesn't have to be insanely difficult. I've heard courses taught extremely well that made things like neuroscience a cake walk, and poorly taught courses like dermatology become very difficult due to the mindset I had while trying to study. Why there's this dichotomy when there are clear examples of how to educate medical students 'right', I don't know. Maybe it's better for medical students like me to forget trying to go to class when there's poor quality teaching and try and learn it on my own. Or maybe in the grand scheme of things, it doesn't matter because the real education comes in residency. My undergraduate degree was also in CS, did you ever feel like you wasted four years of your undergraduate education just to go into medicine later? I'm trying to position myself in such a way that I still get to use those sorts of skills after medical school, but I forget much of what I thought I knew, and the field changes constantly. L
epmaybe 10y ago
The thing is, medical school doesn't have to be insanely difficult. I've heard courses taught extremely well that made things like neuroscience a cake walk, and poorly taught courses like dermatology become very difficult due to the mindset I had while trying to study. Why there's this dichotomy when there are clear examples of how to educate medical students 'right', I don't know. Maybe it's better for medical students like me to forget trying to go to class when there's poor quality teaching and try and learn it on my own. Or maybe in the grand scheme of things, it doesn't matter because the real education comes in residency. My undergraduate degree was also in CS, did you ever feel like you wasted four years of your undergraduate education just to go into medicine later? I'm trying to position myself in such a way that I still get to use those sorts of skills after medical school, but I forget much of what I thought I knew, and the field changes constantly. L

agumonkey 10y ago

What do you think about current day surgery and potential technological change in the field (robot driven, nanotech [not smart molecules, but increasingly simple interaction at sub micron scale], large data monitoring and analysis for prevention) ?

lanius 10y ago

Interesting, I assumed that the field would become more selective over time. Or is it because just getting accepted to medical school itself is already extremely competitive?

mahyarm 10y ago
I have heard that getting into medical school is a lot harder than it used to be too. It might be the reason why it's easier to be a surgeon once your in. I'm not a doctor or a med student, so take that with a grain of salt.
stephencanon 10y ago
The specialties with better quality of life (e.g. dermatology) have become increasingly competitive, drawing some of the top students away from the more masochistic fields.

erentz 10y ago

Do you really work 90 hours? That's 13 hours a day 7 days a week. How does that even work logistically when you need to eat, sleep, commute, do laundry, shop for food, and hopefully also see family or friends on occasion.

xanderstrike 10y ago
I'm assuming it's 90 billable hours. He said he waited two hours to do a ten minute procedure, sounds like most of his day is spent waiting rather than working.
- vacri 10y ago
  That's two hours that he can't be off with his family, reading a book, having a drink, learning to juggle rings, so on and so forth. It's definitely 'work', even if it is standing there twiddling your thumbs because you're waiting on colleagues.
northern_lights 10y ago
I am nearing the end of medical school now, and I can assure you there are many surgeons who consistently work 80-90 hours/wk. I see it most often in surgeons who have subspecialized and do extremely technical work. Family, social, laundry, food, etc, all become things that you take care of whenever you get a free second. It's very, very difficult to describe the path a person takes to get to that point, but the profession can absolutely be all-consuming. It's one of the reasons surgery is less competitive as a specialty than it used to be - people see the brutal hours and make the choice to pursue options with a more attractive work-life balance.
- sp332 10y ago
  Isn't that a little backwards though? The more surgeons there are, the more the work could be spread out, and the hours would be saner.
  - northern_lights 10y ago

WhitneyLand 10y ago

Why do you have to work 90 hours a week? Why wouldn't your employer just offer a position with less hours for less money? In software the long hours have specific reasons. For example we can't double throughput by doubling resources, and in startups the money is limited, etc

viraptor 10y ago
> In software the long hours have specific reasons. Yes. Bad management and artificial marketing deadlines. You can't double the throughput in some cases by doubling the resources. (in some you can) But you don't have to work in the kind of environment that expects it. I got pulled into the environment that expected long hours once. Then the manager got replaced - throughput stayed the same, people started leaving on time and were much more happy.
- WhitneyLand 10y ago
  You're right those are also reasons. Unfortunately they're difficult to quantify. If there were an objective way to measure quality of management things would be vastly easier. For example if a trusted management quality metric was reading "sucks", it would be easier to leverage change.
- JBlue42 10y ago
  I work with architects (building not software) that pull similarly long hours (and not great salaries) and when I point out that it sounds like a mix of poor planning, a poor deal with the client, or project management / process issues it's always shot down as being a 'part of their culture' that they've gone through since university. My counterargument is that 'culture' isn't fixed and there's no reason not to strive for better and give people a chance to have lives outside work.

maxxxxx 10y ago

I find it hard to believe you can work 90 hrs/week and not have your performance and judgement be impacted.

bcook 10y ago
Maybe his performance and judgement are so impeccable that even after a 90-hour work-week he still operates better than the average.
- maxxxxx 10y ago
  I hope you are kidding! On the other hand I wouldn't put it beyond the surgeons I have met to think that way.

mixmastamyk 10y ago

> I'm 47 years old, and work about 90 hours a week as a surgeon Sorry, you and your industry should be ashamed of themselves for putting lives at risk. Mistakes from fatigue are a real thing. Maybe you are just cutting off bunions, but there still could be complications.

Axsuul 10y ago

Can I ask if you're a surgeon in a private practice or hospital?

epmaybe 10y ago

The thing is, medical school doesn't have to be insanely difficult. I've heard courses taught extremely well that made things like neuroscience a cake walk, and poorly taught courses like dermatology become very difficult due to the mindset I had while trying to study. Why there's this dichotomy when there are clear examples of how to educate medical students 'right', I don't know. Maybe it's better for medical students like me to forget trying to go to class when there's poor quality teaching and try and learn it on my own. Or maybe in the grand scheme of things, it doesn't matter because the real education comes in residency. My undergraduate degree was also in CS, did you ever feel like you wasted four years of your undergraduate education just to go into medicine later? I'm trying to position myself in such a way that I still get to use those sorts of skills after medical school, but I forget much of what I thought I knew, and the field changes constantly. L

epmaybe 10y ago