Pro for lifestyle is it is largely shiftwork. Ive seen surg oncs do only ambulatory cases, and vascular guys only do clinic cases or vascular access. It's also a one year fellowship which is a plus. Great questions. On a day-to-day basis I would say that our working relationship with IR is much better than IC. I’ve had weeks where I was home by 1700 every night and one week where the earliest I got home was 2100 and even 0100 that one night. I have amazing mentors who throughout my residency never complained and just did work in front of them. Lots of clinic and elective cases, minimal call. I definitely don't want to work in a big city so there's that... Also, does Surgical Critical Care = Trauma? Really? How is their lifestyle? The Society is dedicated to recruiting medical students and general surgery residents to the specialty to ensure the best young medical professionals become vascular surgeons, as well as supporting vascular residents and fellows throughout their training. CT Surgery: Cardiac and thoracic are actually very different. Cold limb, rupture, dissection, trauma, etc. In the midwest there are some hospitals where trauma is covered by acute care surgeons , who work 12 hour shifts with a week off a month. Often, vascular conditions can be treated with medication or lifestyle changes such as exercise, and diet. You get to be a subspecialist but also maintain the general surgery breadth - i.e. If the lifestyle adjustments or medications are ineffective, surgery will most likely be considered. Additional sources to peruse if interested: Read “Taking the Gamble as Vascular Surgeons” on Page 3 by Dr. Zeltzer. Obviously not for everyone but the total hours worked for the pay is great. He has a rich professional experience of 17 years in this field. If no, there's not actually that many true colorectal specific emergencies that would happen at night. What’s not to like? Objective: Arteriovenous fistulae (AVF) are the preferred vascular access for hemodialysis, but the primary success rate of AVF remains poor. And I want to be really really good. If yes, then you'll have more nights/emergencies. You gotta look into it more, I know an attending who does this in her group, but I dont have hard data. You will either become enamored with it or you won’t. The ICs at our own institution are also very easy to work with, however, there are private practice ICs that do some renegade stuff in their own out-patient angio suite and they've learned to send their complications to another hospital so as to avoid us knowing about it. The small time hospitals love the "our general surgeons won't touch these bariatric patients" even with appendicitis... Would you say Thoracic (purely) could potentially be more lifestyle field? Small profile on Dr. Conte at UCSF explaining his outlook on being a vascular surgeon. Hahaha. Vascular surgery: Another very tough lifestyle. Go home anywhere between 1700 on a good day to 2100 on a bad day, see what cases are coming up in the week, read up on them, dinner, play with my kid, play with my wife, go to bed (not in any particular order). About Blog Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Brazilian Society for Bariatric Surgery, is an international journal devoted to the publication of peer-reviewed manuscripts of the highest quality with objective data regarding techniques for the treatment of severe obesity. Treatment for peripheral artery disease focuses on reducing the leg pain so that the patient can continue the normal physical routine. Bariatrics is variable. Acute ischemia and traumatic injury are favorite topics along with management. It all depends on what you’re going to get called for. Vascular surgery has a unique set of characteristics in the medical landscape that some practitioners will find appealing and others abhorrent. Correction(s) for this article . Cannabis use around the time of surgery may increase the intensity of post-operative perceived pain. Vascular characteristics in young women—Effect of extensive endurance training or a sedentary lifestyle N. Bjarnegård Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden Vascular and Endovascular Surgery A Comprehensive Review 9th edition Using an easy-to-read, user-friendly format and hundreds of review questions that facilitate effective studying, Vascular and Endovascular Surgery: A Comprehensive Review, 9th Edition, contains the essential information you need for exam success and daily reference. New Delhi: In a rare feat, doctors at a city hospital in New Delhi have performed a stitch-less valve replacement on a 54-year-old Fiji national. Bad patients with poor protoplasm too. Peripheral artery disease treatment is aggressive when it has advanced to the point that threatens your health. I would have thought the opposite. Surgical Oncology: Very variable lifestyle depending on whether you're a melanoma/breast surg onc type or a GI/HPB type. Can anyone comment on the lifestyle of any of the following gen surg subspecialties? I appreciate how their mindset, preparation and training has brought them to a point where they are just really really good. Fellowships: https://vascular.org/career-tools-training/vascular-training-programs. - Dr. John Haggie, a general and vascular surgeon from Gander, N.L., has taken over the helm of the Canadian Medical Association. A good vascular surgeon will also be hard-working, for anyone who has rotated on this service knows how demanding of one’s time this field can be. We have lots of discussions about the best lifestyle specialties, so I thought it would be interesting to see everyone's thoughts on the worst ones. Can be called anytime for organ procurement and have to fly or drive somewhere to strange places that you're not used to. Consults will come in throughout the day and the intern/junior will go see them and report back to me. The transplant surgeons I rotated with I wouldn't call cushy. Would you say that's representative of the type of surgery that you do on a daily basis? Surg critical care: Usually this is bundled with trauma/ACS. Income: If I remember correctly the starting median salary for an academic job is $382K/yr and private practice is $442K/yr (I could be completely wrong on these figures). Just 1 week after surgery, he was commuting 50 minutes twice a day, wearing business suits that restricted his movement, and eating large meals. I'm sure there are things I have forgotten. We measured upstroke time and ABI in 2313 subjects (mean age, 61.2±15.3 years). You take out organs and sew in new ones. The study cohort underwent a variety of vascular surgery … Vascular surgery is a surgical subspecialty in which diseases of the vascular system, or arteries, veins and lymphatic circulation, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. Attending Call: q3 - giving a rough approximation I’d say that 1 in about every 3-4 calls they have to come in for something in the middle of the night. “I haven’t had surgery in two years, and I’m very excited about it,” says Mary. Or Colorectal (I know you said this was a good lifestyle field too). To paraphrase Dr. John Eidt, “We are cobblers in vascular surgery, we aren’t Nike. Other bonus - it's one of the most poorly paid (on average) surgical subspecialties, actually making less than the average general surgeon. Some hospitals don’t require a critical care fellowship to take trauma call though. Anyone who is attracted to surgery will innately have a desire to not only fix a problem (because all of medicine seeks to do that) but to do so tangibly with their hands. Having gone through GS and now staring down the barrel of two more years of grueling training. Vascular can have pretty bad emergency surgeries and stressful outcomes. What is the split of open versus endovascular procedures and do you see endovascular becoming more popular/taking up a greater percentage of cases? Sadly, peripheral arterial disease (PAD) and peripheral vascular disease (PVD), cause major morbidity and mortality in the United States. But it is hard. https://www.youtube.com/watch?v=o0pJr6BiMjA, https://www.youtube.com/watch?v=Y1xS2TVL-GE. I would have thought that both "things that go clot in the night" would lead to terrible call and long hours. Contemporary vascular surgery is also heavily technology dependent, and has manifested itself in the ability to perform hybrid procedures whether that is sewing in iliac/subclavian conduits for a complex EVAR or femoral endarterectomies and stenting to create ipsilateral in-line flow to the foot. The second line of the treatment for peripheral artery disease is used to prevent the occurrence of the heart strokes. All elective. Your patients are also super sick. I have really enjoyed spending time with our IR guys because they're so eager to teach and just all around fun guys to be around. Carotid endarterectomy (one of my favorite procedures to do): https://www.youtube.com/watch?v=Oa8XV27KNAY. Inpatient vs Outpatient: Each attending does one full day of clinic a week and half day of veins. vascular surgery. When treatment is necessary vascular surgeons build long-term relationships with their patients and follow their care throughout the disease process. Division of Vascular Surgery, Department of Surgery, VU Medical Centre, Amsterdam. You will have a lot of super sick patients in the ICU all the time. It's a common phrase that "Internists apologize to their mistakes, and surgeons bury theirs." Many of these same patients are also at increased risk for coronary artery disease (CAD). If you need more work-life balance, you can focus on private practice and low-intensity procedures instead. Press question mark to learn the rest of the keyboard shortcuts. President of the Society for Vascular Surgery. Typical day from a general surgery resident standpoint:  The usual census ranges anywhere from 6-25. Was planning on doing vascular as I absolutely LOVE everything about it...it has a large variety of procedures, it’s very technical and it’s just straight up baller honestly. Some of which is due to the fact that the IR docs are younger (<5 years out of fellowship) and much more willing to have discussions in an attempt to get the best result for patients. Home / Yleinen / ucsf general surgery residency reddit. Methods and Results. Did you know if you do a amputation on someone for peripheral vascular disease, their odds of being ALIVE 3 years later are only 50%? The following procedures help restore blood flow through the artery: Angioplasty is a procedure where the doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. I heard transplant and vascular are pretty cushy. I'm applying to integrated vascular residency this coming season. Major con for this field is that there is tremendous over-saturation and too many fellows every year. R. H. H. Groenwold. Vascular & Transplant is obviously the worst as you said. mass general surgery residency reddit Home; About; Location; FAQ My father is an IM hospitalist and mentioned a colleague who shows up at 7 each day and every now and then he’ll find notes from 11:30PM from this dude. Chance to make a significant impact in a potentially curable cancer (i.e. Press J to jump to the feed. This is all I have for now. The operations are bloody because they are all coagulopathic portal hypertensives. At present, transplants happen at any hour of any day. Would you say that's representative of the type of surgery that you do on a daily basis? There is hope on the horizon for lifestyle though - with the advent of pump devices for procured organs, the window from procurement to transplant is extending. I had that surgery!". Talk to the overnight residents and get updates. Currently you will either go the traditional route (5+2) whereby you do a general surgery residency (5-7 years) and then a standard 2-year fellowship in vascular surgery. It's also a burden. Approach with extreme caution, pick a good program with staff who have an honorable work ethic and motivated, you don’t want to work 90 hours a week for assholes. Also you never know when an organ is going to become available, right? Cons - I think I mentioned them already. Depending on my familiarity with patients, I will then go by the ICU and then see the new ones on the service. Probably have to deal with Woo/CAM stuff more than any other surgeons. The problem is, they eventually find their way to our service because they're local and often don't want to be transferred somewhere else. Or you can go directly into vascular surgery and match into an integrated program right out of medical school. This isn’t a field for those who want to fix a problem and then never see it again. The vascular system is the network of blood vessels that circulate blood to and from the heart and lungs. The devil is truly in the details and the good vascular surgeon will have the big picture of what they’re trying to accomplish with a patient while being cognizant of their overall clinical picture. Other factor affecting lifestyle as a CRS surgeon is whether or not you're taking general surgery call. GI/HPB do a bunch of super difficult, high risk, poorly reimbursed cases - truly a field for the masochists among us. few to no emergencies, VERY rare to have to come into hospital at night or even on weekends). If in doubt, perform fasciotomy. You are the “mop man.”  Meaning that if an interventional cardiologist does something wrong and creates an emergency, then they’ll call you and go home while you’ll be awake into the night operating and trying to fix it. Visit our center for vascular medicine - Allen Park we have a leg doctor for your leg pain we also have a vein specialist, vein dr, vein/ Vascular surgeon contact us for more details. How is the dynamic between vascular and IR or IC? Mary applauds Dr. Thompson and the success of his targeted treatment plan on both the medical and lifestyle modification levels. much better outcomes than most cancer surgeons). After training, the average general surgeon works 50-60 hours per week (not including time available for call). Gratifying to literally change someone's life. Con is that you'll be working nights and weekends forever. 4 Exclusion criteria included same‐day procedures, surgery conducted while admitted to another service, or expected admission length of stay of less than 2 days. Welcome to /r/MedicalSchool: An international community for medical students. There is data showing you will work more as a vascular surgeon than nearly every other field. Vascular injury refers to injury to a blood vessel (artery and veins). Reddit; Mail; Embed; Permalink ; Visit our center for vascular medicine - Allen Par . - It's fairly common and although it goes in waves, we crank out 1-2 CEAs a week between all the surgeons combined. Either you are suffering from peripheral artery disease or varicose veins you need the best vascular surgeon in Hyderabad who can serve you with most effective treatment. But I do mean it when I say that this isn’t a field that you talk yourself into. That all vascular surgeons are grumpy and hate their lives. Resources provided in this section will help aspiring and current vascular surgery trainees make career decisions and This is just probably the coolest thing I would want to do but after that graph of how much people in vascular work I just can’t bring myself to do so. That's how sick your patients are. I was a smoker, but no longer. You will have some emergencies (dissections and aneurysms mostly). New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. These doctors aren’t no scrubs … even if they’re in bikinis. Well I remember the JAMA article stating vascular surgeons work on average 888 hrs more per yr than the average family doctor. In surgery, the training is rigorous and the lifestyle that accompanies a busy surgical practice is taxing, but surgery is also one of the most rewarding fields of medicine. The only areas of the body that a vascular surgeon does not treat are the brain and heart. It's pretty common for trauma surgeons to be boarded in crit care, but you can also do a crit care fellowship on its own. From my rotations, I think the worst (based on call schedule, malpractice risk, and salary commensurate to workload) are OB-GYN, Vascular surgery, and General Surgery. So you basically have a rapidly evolving field that can have a large positive impact for many people while using cutting-edge technology, power tools and loupes. I've seen some of these patients at one year follow-up visits and they are near tears when talking about how much they appreciate what you've done for them. Bad outcomes in kids are brutal. The vascular surgeon who’s been in practice for more than twenty years, runs the Vascular Surgery department at RGH, which oversees a network of five area hospitals. I don't know how you do it, but cheers to you. Do you think the surgeons they produce are as competent as those who do 5+2? So what does that make me then? There’s also trauma fellowships out there that fewer people do. NAT is the worst. Depending on your practice, partners, referral patterns, you don't have to take ER call. It all depends on what you’re going to get called for. Surgeons, Physician Assistants, Nurses, front end staff and schedulers to keep the massive department running smoothly. This is compared to the traditional model where trauma is covered by general surgery or those trained in critical care. Edit: Follow-up question - how do you feel about the 0+5 programs? Bariatrics/MIS: Another lifestyle gem. Hope this helps everybody. ucsf general surgery residency reddit Or in a rural setting like my man u/nysoz. Transplant: Hands down the hardest subspecialty to train in. Despite this, PVD remains a disease with which many clinicians are unfamiliar. Plus you can also do hernia repairs and nissens and whatnot. Procedures: This is one of the best parts of vascular surgery as a field, its versatility and wide breadth of cases. He started his practice after completing Fellowship in Vascular Surgery from Nizam Institute of Medical Sciences, Hyderabad in 2005 and MS – General Surgery from St. Stephen College in 2000. Health professionals are clapping back after a study published in the Journal of Vascular Surgery suggests that women surgeons who post sexy bikini selfies online are deemed “unprofessional.” From personal experience, breast and colorectal are the best. They will be more slick with wires and catheters and those of us coming from GS will be more comfortable navigating around the abdomen, but I think at the end of our training and definitely within 3 years of practice, we're all probably the same. My call as a fellow will be q3 for the next two years, but the above written was in regards to what my attendings in residency are doing. Vascular surgery is a subspecialty that attracts future surgeons with challenging technical procedures and complex decision making. Hello reddit! Endocrine: Another low risk field with elective operations. At my hospital Crit Care does shiftwork, so hours are pretty standard, but we were always calling the attendings at night lol because our patients were so sick. How do you know if vascular surgery  is right for you? We make one shoe at a time. All are practice/setting dependent. Most patients with these ailments are not aware of the diagnosis. Search for more papers by this author. Holy shit I just watched the video of the carotid endarterectomy and wow... is that a common procedure? Often supplement your practice with an elective general surgery practice (hernias, choles, etc). Dr. Aggarwal is a senior consultant – vascular surgery with the degrees of MBBS, MCh (Vascular Surgery) and MS (general surgery). You also will be dealing with a lot of kids with severe chronic disabilities and need to have the emotional fortitude to deal with that. Basically no such thing as a breast emergency. Vascular emergency questions are asked twice as much as elective vascular reconstruction. Stijn L. Steunenberg, Jolanda de Vries, Jelle W. Raats, Nathalie Verbogt, Paul Lodder, Geert-Jan van Eijck, Eelco J. Veen, Hans G.W. The operations can be difficult, made more challenging by the fact that you are not operating on healthy veins and arteries but rather very diseased ones. NO, the field is not "dying", please stop asking. Additionally, endovascular medicines, surgical vascularization, angioplasty, and renal artery stenting appeared as major therapeutic approaches in vascular patients. Vascular surgery: Another very tough lifestyle. Open in app; Facebook; Tweet; Reddit; Mail; Embed; Permalink ; The VenaSeal Closure System in Singapore - Permanent treatment for varicose veins. Hey, great write up. Dealing with sick transplant patients before and after transplants as well. Lifestyle: This is highly variable, but vascular surgeons tend to work a fair bit more than other specialties. Photo: Courtesy photo But someone has to do it, might as well be us vascular surgeons... Stupid sexy ortho can't always take the credit. Lot of new technology and endovascular techniques have revolutionized the field. Treating kids is cool - they have a remarkable ability to handle and bounce back from what you do to them. Program lengths vary from 5-7 years, depending on research requirements. + + Stop Hemorrhage + + Stop active bleeding from arterial or venous hemorrhage by gentle manual compression. Whipples are an ego balm for the surgeon though so many pursue it. The transplant fellow is the hardest working person in the hospital. A reason for me pursuing vascular surgery is just how good my mentors are. The typical critical care fellowship is mainly non operative 1 year rounding in various ICU. My attendings are averaging probably around 65 hours a week, but this can vary from as short as 40 some weeks to 80-90 other weeks. https://www.mdedge.com/sites/default/files/Document/April-2018/webvas18_1_digital.pdf. Also can do endoscopies and minor anorectal procedures which are quick and bill reasonably and have few complications. Although a healthy lifestyle can reduce the risk of vascular disease, there are some conditions that unequivocally require a diagnosis and treatment by a vascular specialist. Breast surgery: Largely elective (i.e. It is rewarding to have the ability to tailor each operation to achieve the best outcomes for individual patients in the goal of improving quality of life, limb salvage, or risk reduction for stroke or aneurysm rupture. What did you end up going into? Bottom line - none of us are going to be hurting for money, and we will sure as hell work for it. The trauma fellowship adds an additional trauma operative year. [ads2] Peripheral Vascular Disease 1st Edition Peripheral vascular disease (PVD) affects more than 30 million people worldwide, most often individuals over age 65. If the hours were better I would have gone into vascular 100%... do not go into this field unless you want work to dominate your life. The studies reinforced that lifestyle and dietary patterns influenced susceptibility of circulatory system diseases. Apr 4th, 2017. Those figures are especially alarming considering the growing, aging population in the United States. So in the future you could very realistically procure a liver one afternoon, then schedule the transplant for the following morning. I've personally seen within a ~36 hour period 3 liver transplants and 6 kidney transplants (plus associated procurements) all performed by our small transplant team. Masochist squared? Either anecdotes or actual data - whatever you have. The Department of Surgery offers an elective every fall quarter (SURG 160.10 – Introduction to Vascular and Cardiovascular Interventions) that introduces students to vascular surgery. I’ve decided not to because I don’t want to get locked into something that is 2 years away and lot can happen in that time. The specialty evolved from general and cardiac surgery, and includes treatment of the body's other major and essential veins and arteries. Moreover, increase in R&D activities for the development of small size vascular grafts to treat small vascular diseases augment the market in the region. Anyone who is already a practicing attending or fellow would be able to lend more insight. (Range was like 450-1300 more). There’s very little middle ground and I don’t think this specialty was ever meant to be any other way. Even if you do general surgery, if you have enough backup and your call is fairly spread out, your life improves massively. More Articles. Abstract Surgical site infections (SSI) substantially increase costs for healthcare providers because of additional treatments and extended patient recovery. 1-4 Compared with nonsmokers, smokers who undergo surgery have longer hospital stays, higher risk of readmission, are more likely to be admitted to an intensive care unit, and have an increased risk of in-hospital mortality. And aneurysms mostly ) what you ’ re seeing and make plans for the surgeon so! George 's vascular Institute, st George 's Healthcare NHS Trust, London UK... Perceived pain t general surgery breadth - i.e which many clinicians are unfamiliar Article content the usual ranges... T had surgery in two years, depending on research requirements crazy IBD/fistula!, especially transplant, CC, and we will sure as hell work for it on patients... Unfortunate because it is vital to leave the smoking habit to reduce the risk peripheral. To leave the smoking habit to reduce the risk of thromboembolism ( blood clots the... 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