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Work life balance in surgery? LTFT info? Or cancel my dream

I always wanted to do surgery (I am a 4th year medic in England). I am female (besides the point).
If i dont figure out the following questions i will have to quit my dream to be a hospital doctor and just be a gp (not against gp, it is just another equal speciality and I didnt enjoy it).
I want to have a life, look after kids and have time to destress and get to attend *some* family occasions, kids school events etc.

What is the best way to have an ACTUAL social life in surgery? Please help on the following:
-best speciality in surgery for work life balance and why.
-will medicine give more balance than surgery? -excluding classic derm, I hate radiology and pathology.
-I love academia, medical education, research and would like to do this in medicine (will this make my work life balance better or worse in surgery- I got the impression better since less clinical work?)
-If I had a child after core surgical training, could I apply to work LTFT? and could I work LTFT forever for this reason or only if my child is a certain age etc.
-Can some surgical specialities deny LTFT even if you have a child... if this happens I would hve to quit medicine.
-If I work LTFT, will I only be able to do clinical work OR academics, or can i still do both?
-should I just forget about it and be a gp. Will I ever have a life as a surgeon- be realistic- the working hours in surgery are 7am-7pm no? Daily? Forever unless LTFT?
-Easiest way to do gp but be rich fast and have hospital exposure and academics.
-will I be poor as a 50% academic?

Any help for raising kids during surgery and doing a GOOD job would be beneficial or I will hve to give up and pursue something I dont enjoy but have a better life.

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I’m sure there’s other specialties other than gp that support a good work life balance
Original post by Anonymous
I always wanted to do surgery (I am a 4th year medic in England). I am female (besides the point).
If i dont figure out the following questions i will have to quit my dream to be a hospital doctor and just be a gp (not against gp, it is just another equal speciality and I didnt enjoy it).
I want to have a life, look after kids and have time to destress and get to attend *some* family occasions, kids school events etc.

What is the best way to have an ACTUAL social life in surgery? Please help on the following:
-best speciality in surgery for work life balance and why.
-will medicine give more balance than surgery? -excluding classic derm, I hate radiology and pathology.
-I love academia, medical education, research and would like to do this in medicine (will this make my work life balance better or worse in surgery- I got the impression better since less clinical work?)
-If I had a child after core surgical training, could I apply to work LTFT? and could I work LTFT forever for this reason or only if my child is a certain age etc.
-Can some surgical specialities deny LTFT even if you have a child... if this happens I would hve to quit medicine.
-If I work LTFT, will I only be able to do clinical work OR academics, or can i still do both?
-should I just forget about it and be a gp. Will I ever have a life as a surgeon- be realistic- the working hours in surgery are 7am-7pm no? Daily? Forever unless LTFT?
-Easiest way to do gp but be rich fast and have hospital exposure and academics.
-will I be poor as a 50% academic?

Any help for raising kids during surgery and doing a GOOD job would be beneficial or I will hve to give up and pursue something I dont enjoy but have a better life.


Sorry to break it to you, Social life and surgery are oxymorons. It's not compatible. I've often suggested that surgeons have some form sociopathic behaviour as they are incredible at controlling situations which the average human wouldn't be able to cope with. I honestly chose Dentistry over medicine due to the amazing work life balance it provides, along with a great salary.

There are many female surgeons out there, I'd advise that you talk to them about this issue.

GL
Surgical trainees have to sacrifice a lot in order to get the operating time required to progress. My wife will frequently stay at work 4-6 hour past her scheduled finish time (including while on nights) in order to spend time operating to build up the skills she requires, and will go in on weekends/days off. This is the norm (personally I don't think it should be, but its the way it is.)

There are surgical subspecialties with fewer out of hours commitments, but these don't really decrease until you become a consultant. As a trainee, for 8-10 years, you'll be doing a lot of out of hours work.

You can apply to work LTFT with a child, but the training program don't have to grant it (although I'm not aware of anyone who's ever been denied LTFT training, technically it doesn't have to be granted.) For a consultant job you would have to negotiate going LTFT with the clinical lead/medical director.

Outside of taking time out of program/fellowship years, the only way to split a clinic job with e.g. an academic or education commitment is when you become a consultant.

Saying all this you'll never be satisfied if you don't do something you're passionate about. Pursue your dreams.
Reply 4
Original post by Spencer Wells
Surgical trainees have to sacrifice a lot in order to get the operating time required to progress. My wife will frequently stay at work 4-6 hour past her scheduled finish time (including while on nights) in order to spend time operating to build up the skills she requires, and will go in on weekends/days off. This is the norm (personally I don't think it should be, but its the way it is.)

There are surgical subspecialties with fewer out of hours commitments, but these don't really decrease until you become a consultant. As a trainee, for 8-10 years, you'll be doing a lot of out of hours work.

You can apply to work LTFT with a child, but the training program don't have to grant it (although I'm not aware of anyone who's ever been denied LTFT training, technically it doesn't have to be granted.) For a consultant job you would have to negotiate going LTFT with the clinical lead/medical director.

Outside of taking time out of program/fellowship years, the only way to split a clinic job with e.g. an academic or education commitment is when you become a consultant.

Saying all this you'll never be satisfied if you don't do something you're passionate about. Pursue your dreams.

Thank you for your reply. Could I ask which field your partner is in and her weekly routine on average ie when she leaves the house and is back, on call commitments etc.
Yes it does seem very difficult which is why it is hard for me to imagine how my life could be.
I would probably look at a speciality with less on call work.
I wanted to do a medical speciality but they seem just as demanding or atleast similar to surgery. Eg the emotional stress, hard work and on call commitments are equally stressful in my opinion although yes surgery has more of a physical burden in some sense but that's it.
I guess it's easier for someone with a supporting family but I cant imagine that far as a student.
It is very hard being a doctor in any field but I dont seem to enjoy gp which is the only easier option.
Original post by Anonymous
Thank you for your reply. Could I ask which field your partner is in and her weekly routine on average ie when she leaves the house and is back, on call commitments etc.
Yes it does seem very difficult which is why it is hard for me to imagine how my life could be.
I would probably look at a speciality with less on call work.
I wanted to do a medical speciality but they seem just as demanding or atleast similar to surgery. Eg the emotional stress, hard work and on call commitments are equally stressful in my opinion although yes surgery has more of a physical burden in some sense but that's it.
I guess it's easier for someone with a supporting family but I cant imagine that far as a student.
It is very hard being a doctor in any field but I dont seem to enjoy gp which is the only easier option.

My wife is a trainee in general surgery.

On days when she operates (3 days a week) she aims to be at the hospital at 7am (official hours a 8am-5pm) - which means leaving at 6. Finish time is variable depending on whether a list overruns, and what's happening on the ward, but would normally finish by 7pm.

On-calls are around one in eight. These start at 8am and finish officially at 8:30pm, but usually she won't be in a position to leave until around 10pm (and occasionally later than this.)

I think it would be possible (most of the time) to down tools at 5pm (or 8:30pm when on-call), and people will understand if you have childcare commitments, however surgeons often have the type of personality where they like to be in control of a situation, and sometimes this means not handing something over and just doing it yourself, to make sure it's done correctly, and this will result in you staying late. This level of commitment seems to be what is required in order to succeed. At the same time you're having to do postgraduate exams, keep up with audit/QI projects, and publish or perish. It is very tough, and unfortunately this is why it is more difficult for female surgeons.
The first rule of surgeon's club: snitches get stitches.
You don't exception report if you want to be viewed favourably (my personal opinion is that this is criminal)
Close friend of mine (ophthalmology trainee) was told during induction last week by the department lead 'under no circumstances are you to exception report.' It's ****ing terrible.
Reply 8
Original post by Anonymous
I’m sure there’s other specialties other than gp that support a good work life balance

I'm not interesting in none procedural jobs and hate majority of those specialities unfortunately
Reply 9
Original post by Anonymous
Sorry to break it to you, Social life and surgery are oxymorons. It's not compatible. I've often suggested that surgeons have some form sociopathic behaviour as they are incredible at controlling situations which the average human wouldn't be able to cope with. I honestly chose Dentistry over medicine due to the amazing work life balance it provides, along with a great salary.

There are many female surgeons out there, I'd advise that you talk to them about this issue.

GL

I love medicine. It's the best thing I have discovered and really love it. Yeah I will but it's hard to judge if they mean it or if they're afraid to speak badly of a career they gave up existence for
My daughter-in-law's experience is identical. She earns, at 29 years old, a five figure income and works a sixty to seventy hour week including night shifts - and then has to study at home and go on courses that she pays for herself.
Original post by Spencer Wells
My wife is a trainee in general surgery.

On days when she operates (3 days a week) she aims to be at the hospital at 7am (official hours a 8am-5pm) - which means leaving at 6. Finish time is variable depending on whether a list overruns, and what's happening on the ward, but would normally finish by 7pm.

On-calls are around one in eight. These start at 8am and finish officially at 8:30pm, but usually she won't be in a position to leave until around 10pm (and occasionally later than this.)

I think it would be possible (most of the time) to down tools at 5pm (or 8:30pm when on-call), and people will understand if you have childcare commitments, however surgeons often have the type of personality where they like to be in control of a situation, and sometimes this means not handing something over and just doing it yourself, to make sure it's done correctly, and this will result in you staying late. This level of commitment seems to be what is required in order to succeed. At the same time you're having to do postgraduate exams, keep up with audit/QI projects, and publish or perish. It is very tough, and unfortunately this is why it is more difficult for female surgeons.

Thank you for giving me the details, your wife sounds like an incredible person who I'm sure has a lot of self discipline to do that. It is a beautiful way to spend your life and a privilege not many have but also very bittersweet. That does sound very hard but surgeons could always leave... but they dont... which does encourage me a little to find what I care about and make life fit around it. Yes it is more difficult for female surgeons and I wish it wasnt! Thank you for being so realistic and not sugar coating things
Original post by Spencer Wells
Close friend of mine (ophthalmology trainee) was told during induction last week by the department lead 'under no circumstances are you to exception report.' It's ****ing terrible.

How awful and discouraging! I have never liked surgical culture unfortunately
I agree. But surgeons are driven.
I don't condone or welcome it. I merely wanted to confirm what it can be like. In the balance, it appears to be, for a trainee surgeon, roughly work, 60; study, 20; sleep, 30; eating 10, fun 5.
Hi ecolier, could you tell me which speciality you are in and your experience from your surgical colleagues please? I've heard ent is OK but dont know if it's just ok relatively and still an awful life. I have enjoyed medicine too but the classic good life specialities (ROAD) I havent enjoyed besides derm maybe. And upon graduation feel it's too late to even have derm as a non surgical backup as everyone starts publishing from med school from my experience.
Original post by Good bloke
I agree. But surgeons are driven.


It's not a surgical thing. I kind of assumed it was until I worked similar hours to your daughter-in-law in A&E whilst doing my MRCP.

I also came in on many of my days off to find exam style patients on the wards. I don't think I would have passed if I didn't put in these extra hours, it's as simple as that. When the final part of the exam is £657 a go and the course you've gone on is >£1300, this is a serious incentive to not fail.

I don't think anyone should be coerced into staying late or giving up their time off, but unfortunately people involuntarily end up doing this to themselves as this is just what it's like in an acute specialty where the emphasis is on service provision. I was fortunate enough to have sympathetic and kind seniors who actively encouraged me to take study leave, which I'm sure isn't the case for everyone.

From the perspective of a surgical SHO/SpR, I find it entirely plausible that the surgical training programme will not deliver the experience you require within the allotted hours. So yes, it's being driven, but it's also a case of needs must.
Sorry for the silly question but in what way exactly is consultancy better? Isn't it harder from the management side and you are more senior so carry more stress of your trainees. And whaat? I did not expect that to be considered with derm tbh 😫
Original post by Anonymous
Sorry for the silly question but in what way exactly is consultancy better? Isn't it harder from the management side and you are more senior so carry more stress of your trainees. And whaat? I did not expect that to be considered with derm tbh 😫

Well for one you're less likely to be resident at night.
Whilst there are still some bosses around i don't think this consultant attitude is as rampant as is made out. In fact most of the time i'm late they're actively trying to get me home as they're worried about the comeback (i find myself having to argue to stay). I find a lot of the drive to stay late comes from trainees themselves mostly through fear of lack of experience/wanting to operate.

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