I always thought of medicine as a noble profession, and still do. I grew up watching hit television shows such as ER and Grey’s Anatomy, and saw how the doctor characters performed life-saving procedures under intense pressure. I wanted to live that kind of heroism, so I decided to go to medical school and become a surgeon.
I soon found that the job is definitely not all guts, glamour, and glory. There are many downsides to it. Here are some of the worst parts:
1. It takes a long time to become a surgeon
To even start a surgical residency, you must complete 4 years of college, 4 years of medical school, and a 1-year internship. Residency training, which is a kind of apprenticeship in which you learn all there is to know about your surgical specialty, requires another 3 to 7 years. This is the minimum amount of training required before you can even take the written and oral medical board exam and receive a license.
I am a cardiothoracic surgeon. I specialize in surgery involving the heart, lungs, and other organs in the chest. My residency lasted 5 years, which means I spent a total of 14 years of my life in training.
I was one of the lucky ones. There is an exam that interns must take at the end of their year, and some people fail and must repeat it. For others, life circumstances interfere with their residency and cause it to last even longer.
As one of my colleagues says, surgery “is very technical with very little room for creativity if that’s your kind of thing.” While in training, you will spend all of your time learning from people who are more experienced than you and doing your best to meet the standards they set. This takes time, patience, humility, and dedication.
2. Being a surgeon requires working long and unpredictable hours
As a surgeon, it is hard to strike a work-life balance. It is almost impossible to have a life as an intern. Once you start your residency, things do not become much better.
There are days in which you must be on-call, which means you must be sober, lucid, and ready to work at any time. This requires you to be in the hospital and ready to treat emergency cases. An emergency surgery is not a matter of patching people up and sending them home.
Depending on the case, it can take hours to fix what has gone wrong in a human body. I have performed plenty of surgeries that were planned weeks in advance on patients whose conditions knew well. I have also had to deal with patients who were completely unknown to me, and had to spend hours trying to figure out what was wrong with them.
3. This is a very stressful job
If it is not obvious by now, I will make it plain: being a surgeon is a very stressful job. You are always under pressure to make the right decision in every situation. Medicine is not an exact science, and individual bodies respond differently to different forms of treatment.
People have allergies, pre-existing conditions, and a range of other problems that can sometimes make it hard to determine what will heal a patient and what will kill them. One of the reasons why surgeons must spend so much time in training is that we cannot afford to make a single mistake. In most other professions, an error can be corrected. In surgery, an error can cost a human life.
4. Being a surgeon is physically taxing
Added to this demand for instant and correct knowledge, are the long hours. Before you actually perform the surgery, you must deal directly with the sick and often frustrated person you are trying to help. This can be emotionally and mentally challenging, as you must sometime deal with people who have had a bad experience with doctors and are distrustful of them in general.
There is also the sheer stamina required to carry out a successful surgery. Some procedures are extremely complex. The organs targeted for repair, replacement, and extraction must be handled carefully and with expert hands.
This can take hours. I have been involved in 12-hour surgeries, and there are surgeries that have gone on for more than 24 hours. Surgery is a very physical field of medicine. As one of my colleagues puts it:
5. You are part of the health management machine
It is increasingly the case that the treatment you give a patient is dictated by the insurance company’s willingness to pay for it. I never thought of the business side of medicine until I started treating my own patients as a resident. I learned about the hard, and sometimes cruel, ways that both hospital administration and HMOs prioritize money over patient care.
The fact is that even fully employed and relatively successful people who need surgery can rarely afford it—even if they have insurance. Because I am not in private practice, I do not have the option of performing surgery for free. But in most instances, even if I were able to wave my fee the patient still could not afford the various tests and other expenses required to perform cardiovascular surgery.
6. Excessive paperwork
Another thing I was unprepared for was the paperwork. It is a legal and practical necessity for a surgeon to set down the details of each patient’s case and document their course of treatment. However, I was unprepared for the length of time it takes to actually collect and sort through the information required to create such records.
The paperwork becomes even greater if you take on a management role. Becoming a chief resident, for example, looks great on a resume. But it nearly triples your administrative workload. I speak from experience.
7. The ever-present threat of lawsuits
There are no guarantees in medicine. Like all good scientists, surgeons deal in percentages, not absolutes. Even the most routine types of surgery can lead to unforeseen complications.
This happens all the time, and the people affected by it may decide to sue.
Each year, around 85,000 medical malpractice lawsuits are filed in the United States. Only a quarter of these is actually successful. Nevertheless, having to deal with a lawsuit only adds more strain to a mind and body that are already stretched.
The only good news to report on this front is that you do get used to it after a while. For some people, filing a lawsuit is part of the grieving process. It is a way of dealing with their pain, frustration, and anger.
At the beginning of my surgical career, I was indignant whenever someone filed a suit against me. Over the years, I have learned to be sympathetic and compassionate towards people who have suffered a great loss and are struggling to make sense of it.
8. The substantial level of debt
Most people will need to take out loans to cover college and medical school. The medical school itself will be between 100 to 200 thousand dollars. You are unlikely to make much of a dent in this debt during your residency.
It is not until you receive your medical license and get an attending job or set up in private practice that you can think about retiring the debt at a much more rapid rate.