[northern_lights]

I am nearing the end of medical school now, and I can assure you there are many surgeons who consistently work 80-90 hours/wk. I see it most often in surgeons who have subspecialized and do extremely technical work. Family, social, laundry, food, etc, all become things that you take care of whenever you get a free second. It's very, very difficult to describe the path a person takes to get to that point, but the profession can absolutely be all-consuming. It's one of the reasons surgery is less competitive as a specialty than it used to be - people see the brutal hours and make the choice to pursue options with a more attractive work-life balance.

[sp332]

Isn't that a little backwards though? The more surgeons there are, the more the work could be spread out, and the hours would be saner.

[northern_lights]

1.) It's a very time-consuming and hands-on process to train a surgeon. There aren't many other fields that I'm aware of with the same level of intense apprenticeship as surgery (and medicine in general). My first thought after entering medicine was to marvel at how much effort goes into training a single physician. There is a lot of training at between a 1:1 - 1:3 student-preceptor ratio in an effort to produce very high-quality physicians. So, the solution is not exactly as easy as, "well just make more surgeons."

2.) The federal government controls the number of residency slots each year, through Medicare funding for residency programs. I don't pretend to know the details of how it works, but my impression is that to get more residents per year, you need to convince Congress that it's necessary.

3.) Classic chicken-and-egg problem. Any medical student can go into surgery if they want to, unless their performance up till that point is seriously below par. However, there are many other specialties that offer more attractive lifestyles. So to increase the number of students who choose to do surgery, you'd need to find a way of signaling to students that the life of a surgeon isn't all back-to-back divorces, microwave dinners, and 80-90hr work weeks.

[JBlue42]

Q's re:

#2 - If Congress were convinced of that, would that help lower medical costs for patients or possibly increase it? That's assuming without some sort of tax increase to pay for it.

#3 - I guess this why I've heard that dermatology is one of the most competitive fields to get into - good hours, not as much stress, and good pay.