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How many hours do Neurosurgeons, and other specialised Surgeons, work in the UK? watch

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    I was wondering whether anyone could offer any insight as to the hours Consultant (and Trainee) Neurosurgeons are expected to work daily/weekly. This comes after reading into the residential programs in America, where it's widely recognised that those pursuing Neurosurgery as a career can be expected to work extremely long hours. Is it the same here in the UK? Or has legislation been implemented to monitor the hours specialised surgeons can work? I'm certainly interested in the field but I'm worried it could, more-or-less, destroy any pre-existing social life I have or any chance of me having a family in the future. Does anyone happen to know surgeons with a life outside of work? Is it difficult for them to see their family?

    Any input or experiences are much appreciated.
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    (Original post by Defensive Gnome)
    I was wondering whether anyone could offer any insight as to the hours Consultant (and Trainee) Neurosurgeons are expected to work daily/weekly. This comes after reading into the residential programs in America, where it's widely recognised that those pursuing Neurosurgery as a career can be expected to work extremely long hours. Is it the same here in the UK? Or has legislation been implemented to monitor the hours specialised surgeons can work? I'm certainly interested in the field but I'm worried it could, more-or-less, destroy any pre-existing social life I have or any chance of me having a family in the future. Does anyone happen to know surgeons with a life outside of work? Is it difficult for them to see their family?

    Any input or experiences are much appreciated.
    The European Time Directive affects the UK so doctors work 48 hours a week. They aren't supposed to work for longer than that but in reality doctors are unlikely to leave on time - I suppose it all depends on what is happening at the end of your ship.
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    Officially, not more than an average of 48 hours a week. Reality is often more than that, and as a consultant you can also take on private work if you want extra £££.
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    (Original post by Helenia)
    Officially, not more than an average of 48 hours a week. Reality is often more than that, and as a consultant you can also take on private work if you want extra £££.
    Does private work pay substantially more than NHS work?
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    (Original post by Defensive Gnome)
    Does private work pay substantially more than NHS work?
    I believe so, though the medical defence indemnity payments are much higher. The majority of consultants doing private work do it alongside NHS work, it's only a relatively small number who do purely private and I'd hazard a guess they're nearly all in London.
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    (Original post by Helenia)
    I believe so, though the medical defence indemnity payments are much higher. The majority of consultants doing private work do it alongside NHS work, it's only a relatively small number who do purely private and I'd hazard a guess they're nearly all in London.
    Surely though, in private work, you wouldn't be carrying out as many "high risk" procedures? Wouldn't it include more 'minor' operations?

    Also, which area of surgery do you think there is the greatest demand for? Cosmetic? Orthopedic? Neuro? I can't really see myself being very interested in Cosmetic Surgery but I presume there would be a greater demand for it, certainly in cities such as London.
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    (Original post by Defensive Gnome)
    Surely though, in private work, you wouldn't be carrying out as many "high risk" procedures? Wouldn't it include more 'minor' operations?

    Also, which area of surgery do you think there is the greatest demand for? Cosmetic? Orthopedic? Neuro? I can't really see myself being very interested in Cosmetic Surgery but I presume there would be a greater demand for it, certainly in cities such as London.
    The operations may be more "minor" (though you can still have open heart surgery done privately, which is pretty high risk!) but the patients are more likely to sue, and the payouts are higher, hence premiums are higher.

    I honestly have no idea what type of surgery has most demand in the private sector. It's not something I have any contact with, and it's not something you should worry yourself about at this stage! Get through medical school, foundation years and core surgical training and then think about it.
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    (Original post by Defensive Gnome)
    Surely though, in private work, you wouldn't be carrying out as many "high risk" procedures? Wouldn't it include more 'minor' operations?

    Also, which area of surgery do you think there is the greatest demand for? Cosmetic? Orthopedic? Neuro? I can't really see myself being very interested in Cosmetic Surgery but I presume there would be a greater demand for it, certainly in cities such as London.
    Plastics, especially cosmetics, is the top of the ladder in terms of pay - that's in purely NHS work as well as private. Like Helenia, though, I have no idea what demand is like. I haven't even got the faintest clue of what I want to do myself, and I doubt I'll have a clue for another few years yet.
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    I believe that orthopaedic surgeons tend to have the highest private-sector earning potential.
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    (Original post by Spencer Wells)
    I believe that orthopaedic surgeons tend to have the highest private-sector earning potential.
    10 years ago it was plastics by a fair margin, with ortho second then another fair margin to everything else. It could have changed since then though :dontknow:

    EDIT: actually this list is pretty surprising. Oncology has loads of private work? A&E docs more private income than paeds surgeons? (hopefully people can see that table)
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    (Original post by Helenia)
    Officially, not more than an average of 48 hours a week. Reality is often more than that, and as a consultant you can also take on private work if you want extra £££.
    Isn't it technically 48hrs average over 24 weeks?


    The same way people end up doing 7 nights on call, but get the week off afterwards.
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    (Original post by nexttime)
    10 years ago it was plastics by a fair margin, with ortho second then another fair margin to everything else. It could have changed since then though :dontknow:

    EDIT: actually this list is pretty surprising. Oncology has loads of private work? A&E docs more private income than paeds surgeons? (hopefully people can see that table)
    That's a great table. I'm quite surprised by how high private A&E is, and I had no idea there was even a private market for "Dental Public Health".
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    (Original post by Helenia)
    The operations may be more "minor" (though you can still have open heart surgery done privately, which is pretty high risk!) but the patients are more likely to sue, and the payouts are higher, hence premiums are higher.

    I honestly have no idea what type of surgery has most demand in the private sector. It's not something I have any contact with, and it's not something you should worry yourself about at this stage! Get through medical school, foundation years and core surgical training and then think about it.


    (Original post by Hype en Ecosse)
    Plastics, especially cosmetics, is the top of the ladder in terms of pay - that's in purely NHS work as well as private. Like Helenia, though, I have no idea what demand is like. I haven't even got the faintest clue of what I want to do myself, and I doubt I'll have a clue for another few years yet.


    (Original post by nexttime)
    10 years ago it was plastics by a fair margin, with ortho second then another fair margin to everything else. It could have changed since then though :dontknow:

    EDIT: actually this list is pretty surprising. Oncology has loads of private work? A&E docs more private income than paeds surgeons? (hopefully people can see that table)

    I'm not sure how to interpret that table. Would the majority of Consultants be receiving both the private and NHS income? That is, would the Cosmetic surgeon be able to earn around £140,000 in private work, whilst still earning around £80,000 doing NHS work? Or would they be working in either one or the other? I've heard a thing or two about the NHS clamping down on Consultants who do both private and NHS work; do you think they will implement rules any time soon?

    Also, I know this is probably just me, but don't you think a Cosmetic surgeon's salary is, in a way, dirty money. The majority of them are operating on people purely for aesthetic reasons and, most of the time, the patients don't even need surgery! I understand the use of cosmetic surgeon for the likes of burns and facial deformities, but ridding someone of their wrinkles? Really? And, after watching a few documentaries during Channel 4's "Beauty Week", I've come to realise a lot of Cosmetic Surgeons have little to no regard as to whether the patient actually needs to undergo surgery. They are happy to carry out the procedure if it means bringing in the money, irrespective of the long term implications for the patient.
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    (Original post by Defensive Gnome)
    I'm not sure how to interpret that table. Would the majority of Consultants be receiving both the private and NHS income? That is, would the Cosmetic surgeon be able to earn around £140,000 in private work, whilst still earning around £80,000 doing NHS work? Or would they be working in either one or the other? I've heard a thing or two about the NHS clamping down on Consultants who do both private and NHS work; do you think they will implement rules any time soon?
    See Helenia's post just above:
    The majority of consultants doing private work do it alongside NHS work.
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    (Original post by Hype en Ecosse)
    See Helenia's post just above:
    Yes, but surely those working normal NHS hours couldn't possibly devote "a lot" of their time to private work? So could those working perhaps, what might be described as "part-time", in private surgery expect to earn those types of salaries? Or would that be for those who work predominately in the private sector?
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    (Original post by Defensive Gnome)
    Yes, but surely those working normal NHS hours couldn't possibly devote "a lot" of their time to private work? So could those working perhaps, what might be described as "part-time", in private surgery expect to earn those types of salaries? Or would that be for those who work predominately in the private sector?
    Most of them work part time.

    I know of bigger plastics centres employing somewhere in 2-3 times the amount of plastic surgery consultants (compared to other specialities), but pretty much all of them are part time. One day of theatre work, one afternoon of clinics and on-call from home once in a blue moon as their NHS work, and the rest is private.
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    (Original post by Defensive Gnome)
    Yes, but surely those working normal NHS hours couldn't possibly devote "a lot" of their time to private work? So could those working perhaps, what might be described as "part-time", in private surgery expect to earn those types of salaries? Or would that be for those who work predominately in the private sector?
    As above from arcl, but it's worth noting something the JRSM study mentions:

    This finding echoes the results of earlier research. A survey conducted by the Monopolies and Mergers Commission in 1993 showed that some consultants spent substantial amounts of time each week undertaking private practice: around 60% of consultants undertook private practice alongside their NHS work; around 80% of these spent between 5 and 15 hours per week in private practice, 10% worked for 15–19 hours and 10% worked for more than 20 hours per week.
    So that gives you an idea of how many are doing private work and for how long. I unfortunately don't have a source at hand that breaks this down by specialty, so the only figures you have to work with are the mean incomes of all the consultants in this dataset.
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    (Original post by arcl)
    Most of them work part time.

    I know of bigger plastics centres employing somewhere in 2-3 times the amount of plastic surgery consultants (compared to other specialities), but pretty much all of them are part time. One day of theatre work, one afternoon of clinics and on-call from home once in a blue moon as their NHS work, and the rest is private.
    Some of them are getting £80,000+ for that?
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    (Original post by Defensive Gnome)
    Some of them are getting £80,000+ for that?
    Not necessarily. Some will have a larger commitment to NHS work than others and should be paid accordingly.

    Bare in mind that this data is around 10 years old, the table is the mean income and the article also concludes that many of the consultants in FT contracts exceed their private practice allowance.

    The data doesn't really indicate much either. I don't know what a consultant's basic was back in 2003, what the plastics consultant workforce was like then (ie was it a majority older, senior plastics consultants at the top end of the pay scale), do they have joint contracts/commitments, were there bonuses paid, what their on-call commitment was, did they do any overtime, etc. It may well have been the case that it was acceptable for to do lots of private work on top a full time NHS commitment.

    Some part timers may have got that salary for that workload,
    but I imagine the consultant with dual CCTs in OMFS and plastics may have joint appointments between a few hospitals and may earn a larger NHS wage than others, but still technically be labelled as "part-time" at that each trust (I could be wrong, I probably am wrong, but you get the idea).
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    (Original post by arcl)
    Isn't it technically 48hrs average over 24 weeks?


    The same way people end up doing 7 nights on call, but get the week off afterwards.
    Yes, it's averaged over a long period of time - I think it's 16/18 weeks rather than 24, but I could be wrong. I am well aware of this, given that 2 weeks ago I worked ~83 hours (officially) and last week I worked none. Such is the nature of 24/7 specialty rotas.
    (Original post by nexttime)
    10 years ago it was plastics by a fair margin, with ortho second then another fair margin to everything else. It could have changed since then though

    EDIT: actually this list is pretty surprising. Oncology has loads of private work? A&E docs more private income than paeds surgeons? (hopefully people can see that table)
    Oncology has lots of people who don't want to/can't let go and will spend £££ to try and get that miracle cure. Plus I think that survey was done when if you wanted to go private for one part of your treatment you then had to go private for the whole thing (remember the Herceptin row?) so maybe people were spending more on oncology then?

    Surprised A&E has that much private work, I would guess some of it comes from things like providing medical cover for public events and so on, and I think they get paid for doing police reports on assaults etc (though I think the fee for this is relatively small).
 
 
 
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