The Best Thing about Being a Surgeon III

Surgery is a very varied career and different people have different reasons for liking it. Here are some more things that people see as the best things about working in surgery:

“I think it’s the patients, definitely. Being able to diagnose somebody with a problem, take him to the theatre, fix it and come back and say ‘I fixed your problem’ or at least ‘I made it easier for you’ if it’s something that you can’t cure. But it’s definitely the communication with the patients.”

“On a day-to-day basis it is very varied. You never really know what you’re doing. You know your schedule but you don’t know the patients, you meet them for the first time sometimes and that is exciting.“

“It’s a fantastic job. It’s different from what people from the outside think. I don’t spend all my time operating. I operate four days a week, but often it’s only a half day rather than a full day. … I see people who are considered for an operation or who I’ve operated in the past to see how they are getting on and that sort of thing. So it’s not up to your elbows in muscles and guts all the time. It’s quite a balance and I like that.”

“It’s a very independent job. So if you don’t like to have a boss, people telling you what to do, then surgery in the UK is perfect because once you are consultant and you have the chance to work in a team that works with you rather than against you then if you need somebody to give you a hand, you can, and if you want to do things on your own and be completely independent, then you can do that, too.”

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The Tough-Minded Female Surgeon? Not Necessarily.

Similar to other areas in the workplace where women are under-represented, it is often claimed that either women don’t have what it takes to succeed or that those women who do have what it takes aren’t “proper” women (whatever that is supposed to mean). Thus, women in surgery may find themselves in a double bind situation in which they are either too feminine for a surgeon or too masculine for a woman.

But what are women interested in surgery actually like. In what ways (if in any) do they differ from women in medicine not interested in surgery and from men interested in surgery? A study by Coulston, Vollmer-Conner and Malhi gives us some answers to that. They surveyed Australian medical students, asking them about their personalities, important goals in their careers and interest in a number of medical fields, including surgery. Their findings indicate that female medical students interested in a career in surgery are not all that different from other female medical students, although they do place significantly more importance on prestige. Compared to male medical students interested in surgery, on the other hand, they care less about prestige and financial reward and more about the ability to help people – a pattern that is observed as a general difference between male and female doctors. With regards to personality factors, the study showed that women interested in surgery did not show the traits stereotypically associated with surgery (e.g. tough-mindedness).

So in the end, although this study cannot tell us anything about what it takes to succeed in surgery, it certainly suggests that the field initially attracts all kinds of women (not just those who fit the stereotype of a surgeon). It leaves the question open whether this changes over time as medical students gain more experience with surgery and surgeons.

The Best Things about Being a Surgeon II

We have already talked about some of the things that make surgery a great career in a previous post. One of the major things that people cite as being great about surgery is the impact that you have on patients. Here are some quotes about the difference that you can make as a surgeon:

“I think the most rewarding aspect of my job is seeing patients satisfied with their treatment; patients thanking you for what you have done for them. This is my job, this is what I do, but to actually get a patient say ‘thank you’, getting a thank you card or a present is something so rewarding and very touching to come from a patient because this is what we’re trained to do.”

“I think there are quite a few moments in neurosurgery when you can stand at the bedside of someone who has just woken up from a major brain tumour operation. I can remember a twelve year old boy, just recently, had gone to his grandfather’s funeral and actually become unconscious at that funeral having been unwell for a few weeks. He had a big brain tumour, lots of pressure in his head and his parents, as you might imagine, were terrified. They had been told all sorts of things that might happen. I came in and told them what I was going to do during the surgery and I told them there was a risk of death and there was a risk of major neurological damage – but I was able to stand at the bedside, not only just after he had woken up after his operation and he was fine and I could tell them that he was fine and that I got all of the tumour out, but actually a few days later I could tell them that it was a benign tumour and because I had gotten it all out on the first operation he was cured, the problem was over. So they had gone in the space of a week from thinking their child was going to die to thinking ‘oh, he’s going to go back to school in a couple of weeks and everything is going to be just fine’. And I remember the father standing next to the bed and just extending his hand to me. He didn’t even know how to really shake it because he was so overcome with emotion. … He was speechless and motionless in his gratitude.”

“One day a lad came in, nineteen, with retention of urine, which is very unusual. Usually people are sixty or seventy. And in fact he had a very rare tumour at the prostate and I found out the best person in paediatric urology surgery in England and he said ‘well, he’ll be dead in six month but this is what you do to operate’ and so on, I wrote to Philadelphia and to Toronto children’s hospitals and they wrote back and said ‘there is surgery, chemotherapy and radiotherapy. If you use one of those three or two of those three you’ll have no survivors. But if you use all three according to our protocol you’ll get a survivor’. We did quite radical surgery on him, have him chemotherapy ourselves, he had radiotherapy then – and he lived into his 40s. He married, he had two children by AID, he had a wonderful life. And in the end, when he was dying in his 40s, in our hospital, I asked him ‘was it worth it?’ and he said ‘of course it was!’“

Why Medical Students Choose Surgery – And Why They Don’t

In order to understand why women do or do not go into surgery, it is important to understand what motivates medical students to go into surgery in general. A questionnaire study by Glynn and Kerin from 2010 looked at just that.

Overall, about 20% of respondents said that they would like a career in surgery. Interestingly, this was true regardless of gender. However, when asked about whether it was likely for them to actually end up in surgery, the number dropped to 13% and was significantly higher for men than women. The most important factors that influenced planning to go into surgery were employment, career opportunities and intellectual challenge. Moreover, prestige was an important factor for those who could see themselves becoming surgeons. Medical students who highly valued their lifestyle during training, on the other hand, were less likely to indicate an interest in a future career in surgery.

But what about women in particular? Well, the authors found that on-call schedules, patient relationships and lifestyle after training were more important for female compared to male medical students. Also, for medical students with medical family backgrounds gender mattered more than for those who did not come from medical families. This is interesting, as it points to the fact that family members might not only work as positive role models who show what is possible, but can rather also strengthen existing gender stereotypes in medicine.