Do you think General Surgery Boards are important for a Plastics Guy?

[Gr8Hands]

So things are winding down for me with just over 2 months until graduation from my general surgery program. Doing general surgery has been quite draining for me. Not in the sense of workload, hours or cases, but from an emotional standpoint. I am just not happy doing general surgery for the most part. The type of cases, sick patients, poor compliance, stool and flatus, personalities, and *freaking trauma* is not my thing. I am subsequently burned out but somehow I have persevered and have become a damn good clinician and surgeon because of it...I do thank my program and general surgery for that. My training has been great and I respect very much the people who choose general surgery as a career. Yet, I have been counting down the days for almost five years for an end to my misery and graduation cannot come soon enough. I just want to be done jumping thru the hoop that has been general surgery and cannot wait to start my Plastic Surgery Fellowship in July.

So, to those of you out there that have gone the independent route to PRS and finished a general surgery residency, I pose a question to you. If you never plan to practice general surgery again after you finish residency, what benefit would taking the general surgery boards afford you? Other than the obvious responses of sense of accomplishment, respect for your program, having general surgery to fall back on in this economic climate, healthcare reform, etc. Those things are not big factors to me at this point. It is a big time and financial investment to prepare for and take the QE/OBoards for general surgery. I especially don't want to take focus away from the first several months of my PRS fellowship preparing for this. I just want to focus on learning the broad field that is Plastic surgery...taking PRS boards and leaving general surgery behind me.

Would anyone feel very strongly that the general surgery boards would be beneficial for a private practice plastic surgeon who never wants to do general surgery again? I noticed most plastic surgeons that have been out for a while do not recertify in general surgery anyway.

Another question, does anyone think that there will come a day, if socialized medicine becomes a reality, that one may be mandated by the government to work in a boarded specialty that is in need. So say I am boarded in both general and plastics and the government decides I must do a certain amount of work in general surgery in order to keep my medical license.

Just curious on people's thoughts and opinions.

---

Members don't see this ad.

 

[Moravian]

For me, I felt like I finished the residency so I was going to get the t-shirt. Kind of a matter of pride. The GS boards are a lot easier than the plastics boards and I think do add additional credibility to your resume.

I also did some locums tenens work during my fellowship (secretly, of course) and the GS certification helped. I go on mission trips every year where I end up doing a mix of plastics and general surgery so the certification helps get credentialing in foreign countries.

Will I recert? I don't think so but I'm glad I did it (for the above reasons).

It's interesting, but the guys you always hear about (Jan Adams, Robert Rey) are not boarded in plastics or GS. Makes you wonder why.

 

[ClaudiaPipkens]

So things are winding down for me with just over 2 months until graduation from my general surgery program. Doing general surgery has been quite draining for me. Not in the sense of workload, hours or cases, but from an emotional standpoint. I am just not happy doing general surgery for the most part. The type of cases, sick patients, poor compliance, stool and flatus, personalities, and *freaking trauma* is not my thing. I am subsequently burned out but somehow I have persevered and have become a damn good clinician and surgeon because of it...I do thank my program and general surgery for that. My training has been great and I respect very much the people who choose general surgery as a career. Yet, I have been counting down the days for almost five years for an end to my misery and graduation cannot come soon enough. I just want to be done jumping thru the hoop that has been general surgery and cannot wait to start my Plastic Surgery Fellowship in July.

So, to those of you out there that have gone the independent route to PRS and finished a general surgery residency, I pose a question to you. If you never plan to practice general surgery again after you finish residency, what benefit would taking the general surgery boards afford you? Other than the obvious responses of sense of accomplishment, respect for your program, having general surgery to fall back on in this economic climate, healthcare reform, etc. Those things are not big factors to me at this point. It is a big time and financial investment to prepare for and take the QE/OBoards for general surgery. I especially don't want to take focus away from the first several months of my PRS fellowship preparing for this. I just want to focus on learning the broad field that is Plastic surgery...taking PRS boards and leaving general surgery behind me.

Would anyone feel very strongly that the general surgery boards would be beneficial for a private practice plastic surgeon who never wants to do general surgery again? I noticed most plastic surgeons that have been out for a while do not recertify in general surgery anyway.

Another question, does anyone think that there will come a day, if socialized medicine becomes a reality, that one may be mandated by the government to work in a boarded specialty that is in need. So say I am boarded in both general and plastics and the government decides I must do a certain amount of work in general surgery in order to keep my medical license.

Just curious on people's thoughts and opinions.

Hey, I really appreciate with you and the topic is informative.

 

[GSresident]

Another question, does anyone think that there will come a day, if socialized medicine becomes a reality, that one may be mandated by the government to work in a boarded specialty that is in need. So say I am boarded in both general and plastics and the government decides I must do a certain amount of work in general surgery in order to keep my medical license.

Just curious on people's thoughts and opinions.

This was my concern EXACTLY. I ended up getting certification anyway but this was a real concern. There will be people who will say that it is crazy talk, but I believe there are already states that tie 'service' in with being able to get a medical license. Read that as 'either you work for free some of the time or you don't work in this state.' I fear that as the boomers start to retire they will also need general surgeons more as they age. Hospitals will start to groan to legislatures that there aren't enough surgeons to cover the ER for trauma. The argument will be that there are plenty of surgeons, they just aren't willing and need to be coaxed. The generation in power now and for the foreseeable future is the boomers. I wouldn't put forcing others into servitude beyond them. This is, after all, the me generation.

I won't renew my boards. If your head isn't in the game of getting your boards you won't pass. The QE is very difficult. If you aren't putting all your heart into it you won't pass. You have 5 years to take it so maybe you could sit out a year and then decide to do it the next year.

 

[medfriend]

Just out of curiosity, what is it about the plastics boards that makes them so much harder than the gen surge ones?

 

[Moravian]

Just out of curiosity, what is it about the plastics boards that makes them so much harder than the gen surge ones?

The written exam is much harder. I flew through the GS written but I had serious doubts about the plastic exam until I found out that I passed. Then there is the oral exam. In the past, some examiners allegedly took delight in failing applicants. They've done some work on this recently to make the oral more straightforward and fair. But, unlike the GS boards, you don't just "show up."

There is a case collection period where you have to log cases, take photos (with consent to use the photos for boards), write daily notes, and keep close track of follow ups and complications. It doesn't sound like a big deal, but if you have privileges at different hospitals, it can be a real pain. The collection period used to be 7 months but it's going to 9 next year.

After the collection period is over, you need print out your case logs, stats and affidavits for the medical records people to notarize. This means that they need to go over your case list to make sure that your records and case log matches. In my case, two of the hospitals did not have a notary and I had to hire one. Because I waited a little too long and the medical record human in charge of doing this at one of the community hospitals was on vacation, I missed the deadline and got smacked with a $500 late fee along with the $600 dollar registration fee. Oh, and I forgot to mention that you need to send a copy of all your advertising. That means anything with your name on it: Web pages, business cards, etc.

If you forget anything (like making the appropriate number of copies) you'll get taxed with another $100 "administrative" fee.

I've not made it to the orals yet, but my partners have. The next step in the process (assuming you have enough cases) is that they will notify you of which 4 of your cases are going to be reviewed at your exam. This requires the construction of a book for each of the four cases that contains everything. And I mean everything. All notes, reports, labs, anesthesia records, photos, consents, etc. that need to be assembled in a very specified way or you'll get sent home and have to try again next year. My partners told me that depending on the complexity of the case, you might spend up to 20 hours putting together one case. And you better believe they're going to pick the ones that had complications.

And all this is before you even get to the oral part.

For the exam, they will grill you on your cases and then show you some unknowns and grill you on those. If you don't pass, you get to do it ALL over again for the next year.

Hope this answers your question.

--M

 

[asmallchild]

The written exam is much harder. I flew through the GS written but I had serious doubts about the plastic exam until I found out that I passed. Then there is the oral exam. In the past, some examiners allegedly took delight in failing applicants. They've done some work on this recently to make the oral more straightforward and fair. But, unlike the GS boards, you don't just "show up."

There is a case collection period where you have to log cases, take photos (with consent to use the photos for boards), write daily notes, and keep close track of follow ups and complications. It doesn't sound like a big deal, but if you have privileges at different hospitals, it can be a real pain. The collection period used to be 7 months but it's going to 9 next year.

After the collection period is over, you need print out your case logs, stats and affidavits for the medical records people to notarize. This means that they need to go over your case list to make sure that your records and case log matches. In my case, two of the hospitals did not have a notary and I had to hire one. Because I waited a little too long and the medical record human in charge of doing this at one of the community hospitals was on vacation, I missed the deadline and got smacked with a $500 late fee along with the $600 dollar registration fee. Oh, and I forgot to mention that you need to send a copy of all your advertising. That means anything with your name on it: Web pages, business cards, etc.

If you forget anything (like making the appropriate number of copies) you'll get taxed with another $100 "administrative" fee.

I've not made it to the orals yet, but my partners have. The next step in the process (assuming you have enough cases) is that they will notify you of which 4 of your cases are going to be reviewed at your exam. This requires the construction of a book for each of the four cases that contains everything. And I mean everything. All notes, reports, labs, anesthesia records, photos, consents, etc. that need to be assembled in a very specified way or you'll get sent home and have to try again next year. My partners told me that depending on the complexity of the case, you might spend up to 20 hours putting together one case. And you better believe they're going to pick the ones that had complications.

And all this is before you even get to the oral part.

For the exam, they will grill you on your cases and then show you some unknowns and grill you on those. If you don't pass, you get to do it ALL over again for the next year.

Hope this answers your question.

--M

Now I see why Dr. Rey never got board certified!

 

[2oRadio]

The written exam is much harder. I flew through the GS written but I had serious doubts about the plastic exam until I found out that I passed. Then there is the oral exam. In the past, some examiners allegedly took delight in failing applicants. They've done some work on this recently to make the oral more straightforward and fair. But, unlike the GS boards, you don't just "show up."

There is a case collection period where you have to log cases, take photos (with consent to use the photos for boards), write daily notes, and keep close track of follow ups and complications. It doesn't sound like a big deal, but if you have privileges at different hospitals, it can be a real pain. The collection period used to be 7 months but it's going to 9 next year.

After the collection period is over, you need print out your case logs, stats and affidavits for the medical records people to notarize. This means that they need to go over your case list to make sure that your records and case log matches. In my case, two of the hospitals did not have a notary and I had to hire one. Because I waited a little too long and the medical record human in charge of doing this at one of the community hospitals was on vacation, I missed the deadline and got smacked with a $500 late fee along with the $600 dollar registration fee. Oh, and I forgot to mention that you need to send a copy of all your advertising. That means anything with your name on it: Web pages, business cards, etc.

If you forget anything (like making the appropriate number of copies) you'll get taxed with another $100 "administrative" fee.

I've not made it to the orals yet, but my partners have. The next step in the process (assuming you have enough cases) is that they will notify you of which 4 of your cases are going to be reviewed at your exam. This requires the construction of a book for each of the four cases that contains everything. And I mean everything. All notes, reports, labs, anesthesia records, photos, consents, etc. that need to be assembled in a very specified way or you'll get sent home and have to try again next year. My partners told me that depending on the complexity of the case, you might spend up to 20 hours putting together one case. And you better believe they're going to pick the ones that had complications.

And all this is before you even get to the oral part.

For the exam, they will grill you on your cases and then show you some unknowns and grill you on those. If you don't pass, you get to do it ALL over again for the next year.

Hope this answers your question.

--M

thats brutal

 

[medfriend]

That was very helpful. How high does one's intellectual aptitude have to be to be a plastic surgeon(as opposed to simply studying/working hard)?Do you think that most general surgery residents, even at highly regarded programs, are not talented enough to become plastic surgeons?

 

[JackADeli]

...I just want to be done jumping thru the hoop that has been general surgery and cannot wait to start my Plastic Surgery Fellowship in July.
...I pose a question to you. If you never plan to practice general surgery again after you finish residency, what benefit would taking the general surgery boards afford you?
...Would anyone feel very strongly that the general surgery boards would be beneficial for a private practice plastic surgeon who never wants to do general surgery again?...

Very good questions. I am NOT plastics. However, I have seen a few things over the years. One thing I saw was a hospital requiring evening ED call from the new plastics attending in order to get the privileges for elective cases. I saw him in the ER numerous evenings and asked him why he was the only one. He told me that since he did not complete GenSurge ABS certification, the hospital was requiring 9 months ED call to assure something or another....
I do not know how the credentially and/or insurer reimbursement decisions will be made in the future. Does anyone else?(rhetorical).
The other thing to think about.... numerous programs are going integrated. This means many will NOT be elegible for double boarding. Your dual board certification may make the difference between you and someone else be it jobs or be it advertising.... I would say that if you have completed an accredited specialty residency (i.e. general surgery), think long and hard before allowing the opportunity for board certification to lapse. You may be leaving options and money on the table.

...You have 5 years to take it so maybe you could sit out a year and then decide to do it the next year...

It doesn't get easier with time. during that five years your focus will become: plastics residency/fellowship, passing plastics boards, job, getting a life.... when do you think you will make time for ABS gensurge examination, especially if you haven't been focused on that topic for some time? Everyone I know that has chosen to delay has regretted it. There is something to be said for just getting it over with!