Neymar (not his real name) writes
Dear (Dr.) Skeptical Scalpel:
I'm writing this evening as a fourth year medical student wholly committed to pursuing a long and fulfilling life as a general surgeon. It's what I got into medicine for, and my love for the profession has only heightened in the arduous years of preparation and (nascent) training I've undergone thus far. I have had the fortune of living a very full life—travel, adventure, and a broad milieu of individuals have all shaped the form of the man I am now, and greatly influence the man—and surgeon—I hope to be in time.
Like many people in and outside of medicine, I reflect on what has been lost or what might have been lost along the path. At present, the balance sheet reflects a clear net gain. The opportunity cost, however, can be measured in the loss of time in wilderness, love and relationships and socializing that adds richness to my life. How do you advise young physicians pursuing such an ambitious and all encompassing professional course to maintain richness and fullness in their lives? How do you reconcile the personal forfeitures with the professional gains? And, most importantly, if one hopes to be a surgeon, are these questions worth considering or best left in the recesses of the mind?
Thanks for being a mentor to an entire generation of aspiring surgeons.
Thank you for writing and for the kind words.
The questions are definitely worth considering. I am not sure that my response will be applicable to your situation or anyone else's.
I chose surgery because it appealed to me more than any other specialty. Like most others of my era, I was young and had gone the traditional route—four years of college followed immediately by med school. I had experienced few adventures [in fact, none] and had not yet met my wife-to-be.
I never even considered what impact my choice would have on my personal life. The subject simply did not come up. I worked hard in medical school but had a great time. I think I had more fun in med school than I did in college.
My residency prepared me well for the rigors of a surgical career. I spent the first four years of my training taking call about half every other night and half every third night. As a chief resident, I was in call every night. Somehow I found the time to have a relationship and got married at the end of my third year.
My wife of 39 years is a saint. I have wonderful children and now grandchildren too.
I was fortunate in my career to have had the opportunity to supervise the training a number of surgeons who are helping people every day.
Although I'll never climb Everest, go an African safari, ski the Swiss Alps or do many other things that might be important to others, I've had an interesting and fulfilling life. Wilderness? Not so much. But love and relationships? I got 'em.
But it is different for the millennial generation. What I consider interesting and fulfilling might not be to you.
Surgery continues to evolve. I think it may be possible in the near future to have a career as a general surgeon and also have a manageable lifestyle. By the time you finish training, everyone will be in group or hospital-based practices. Or you could be an acute care surgeon with fixed hours.
You will have to decide what compromises to make such as deciding if leaving work at 5 pm is more important than staying late to operate on your patient who has a complication you created.
No one talks about this part—you will have to find partners you can trust with the lives of your patients. The roadside is littered with the corpses of group practices that didn't last because of productivity issues, attitudinal and/or philosophical differences among the surgeons.
For many surgeons, fulfillment is measured by the satisfaction of knowing you made a difference in someone's life.
Can you be a surgeon and have a rich and fulfilling life? You can, but it depends on how you define rich and fulfilling.
If you haven't read this post, you should.