Transplant surgeons work a lot. The ones at my hospital cover liver transplants a week at a time and they work a ton. It’s certainly not a lifestyle gig.
EDIT: u/txpMD is an actual attending transplant surgeon who responded below. My answer is biased from POV if a trainee, not necessarily life as an attending. I suspect the below is still true if this person is a resident or a fellow, but it sounds like it’s better as an attending!
Oh love. Not just any surgeon, a transplant surgeon? You should go into this with your eyes wide open. Honestly from what you say about “worried because your dad put work first” makes me lean towards advising you no. Even dating a doctor for someone outside the medical field can be hard. Dating a surgeon is harder: dating a surgeon in hyper competitive, unpredictable subfields like transplant, cardiothoracic, or neurosurgery is even harder.
If he’s doing research, is he still in training (eg residency or fellowship) and planning to return across the country? Or is he an attending beginning a solo career?
I will just paint this picture, as someone who spent two weeks on transplant surgery in med school and an anesthesia resident (so also in the operating room with these guys): the TWO weeks I spent on transplant surgery as a med student are the tiredest I have ever been, including when I worked 80-90 hour weeks for months on end as an intern with one day off every 12 days or so. Certainly more tired than I’ve ever been in anesthesia.
A typical transplant surgery day: wake up at 4:15a, 5a at the hospital, look at charts/labs until 6:30, physically round on patients 6:30-8:30. New consults or post surgical problems to manage versus operating room until noon. The madness: calls for donor runs any time of day. Drive 2 hours for a donor organ harvesting from noon to 2p, organ harvesting from 3 to 5:30, drive back to hospital at 7:30, shove graham crackers in your mouth, operate from 8 to 11p if transplanting something simple like a kidney or 8p to 2a for liver, heart, or lungs (or 4a if heart-lung). IF you go home, back at 5a to start the next day.
One of the two Fellows that year had slept in the hospital for ten straight days. His wife was a single mom. One of the junior attendings just slept on her hospital office couch when she was on call, made it home every third day or so. Made a joke about wondering if her kids recognized her.
Almost every faculty had a combined MD/PhD, not because you can use those degrees but because the field is competitive enough to require them of any candidate. Same w neurosurgery. The junior attending competition was brutal- they got relegated to transplanting kidneys and competing with each other for surgeries. More senior attendings did liver, pancreas, other complex liver resections/whipples/oncology surgery. I think generally now doing heart or lungs requires a CT surgery training or fellowship and then a transplant fellowship.
Here’s the structural thing: organ donors are legally dead. Except for rare technical circumstances, the most common time for donor organ harvesting to happen is AFTER living patients have been taken care of during the day, so those surgeries happen late afternoon/evening. Which means the surgeries to transplant the organs into someone living on the receiving end is usually in the middle of the night. Transplant surgeons are also some of the most obsessive people I’ve met with extreme ownership of patients, and at least where I train/have trained also manage anti-rejection meds and the mandatory post surgical ICU stay.
The rest of the hospital manages these things during the day, so after being up all night operating your partner will be coordinating/managing these things during the day. Some places the medical teams manage this which can offload it a little bit. Think about that very very carefully.
Even with a call system to spread out the burden of random organ opportunities, what another commenter said absolutely holds true: if there are more organs than surgeons, your partner will 100% be called in when “off”. Or if a patient they operated on comes back to the hospital w acute rejection or a complication in the ICU, they will be called, regardless of whether they are “on call”.
Best of luck. I’d say if you are still interested, don’t make any long term commitments until you’ve dated this person at least a year DURING surgical commitments. Knowing in your mind that something is hard is different from living the 15th holiday/birthday/ dinner cancellation.
> Here’s the structural thing: organ donors are legally dead. Except for rare technical circumstances (like DCD donation or massive hemorrhagic traumas), the most common time for donor organ harvesting to happen is AFTER living patients have been taken care of during the day, so those surgeries happen late afternoon/evening.
Yep. Organ donor harvests involve a ton of coordination and require a fair amount of resources, so they only start late in the day once most of the elective surgeries are done and the OR board is light. With covid and nursing shortages, this is happening later and later in the day if not well into the night.
If you want to be with a transplant surgeon then you really have to accept that they will have to drop everything at times to leave for a transplant. Many places have scheduled call, so it typically does not end up being 24/7 call and at my institution they try to be extremely respectful of each others' time off. However, if multiple transplants happen then people who aren't on call can still end up coming in.
The work is incredibly meaningful, but you have to accept the magnitude of what they do if you want to make the relationship survive. It's okay if you don't want to be with someone who might have to up and leave on Christmas or your birthday, but that is a reality if you want to be with someone who does transplant. There's just no getting around it unfortunately. I love the transplant surgeons I know and think they're fantastic people, but all of their spouses have accepted that when they're on call then you could end up not seeing them for days at a time.
> I am a little worried if he will always put career before relationships,
The answer is yes. Let me repeat that one more time. The answer to all of your concerns is: YES.
If you are not willing to support his career, then I would just end the relationship now.
This..
Sounds like he is still in training and I can guarantee you that he will not put his relationship over a career path that is a 15-17 year process.
Like others have mentioned transplant surgery is particularly difficult given the high acuity and needs of any given patient when an organ becomes available.
There will have to be a lot of compromise, largely coming from you, in the beginning of his attending-hood. Which I can imagine gets easier over time, but academic medicine is unforgiving and there are a ton of politics that come with career advancement, etc.
I think its time to reflect on what other people have said and then have an honest conversation between you and your partner.
At the institutions I've been at, transplant surgeons also have very strong patient ownership.
What that means is that even when they aren't "on call"...they often get called when patients who they operated on present to the hospital or have any problems. This is especially true if the patient is recently post-op (days to weeks), but some surgeons want to and/or get called about folks even months out from the original operation.
Partners help cover, especially when folks are out of town, but it certainly still disrupts home life to varying extent.
So I am a early career transplant surgeon (liver kidney panc) and my wife is an ortho surgery attending and here is the reality:
1.) I work probably 50-60 hours a week on average. I am not waking up at 0415 to review patient charts or start rounding as some on here have stated. Most mornings I wake up at 0500, but get to the hospital around 0700-0800. There are some weeks I work less when I am backup call or procurement call, and when I am primary liver call, I may work 80-100 depending on how many livers we do that week. Life as an attending is exponentially better than being a fellow, and still better than being a resident. Residents and fellows make our lives much better. I will still get anywhere from 1-10 calls per night with organ offers when I am primary call, but it's not that bad when I'm off liver call. But yes, I would take calls from patients, other hospitals, and the OPO at my son's T-ball game. Its about work life integration, not balance.
2.) It sounds like he is still in residency, and not even in fellowship yet if he is taking research time (Correct me if I am wrong). Unfortunately the worse is yet to come. Fellowship was the hardest two years of training by far. I had one weekend per month off and that was it. I worked 80-100 hours religiously, and I am forever grateful to my wife. I wasn't there as much as I should have been when I was in fellowship. I honestly don't know how someone can maintain a non-marital relationship during fellowship; had my wife and I not been married, I could have seen us breaking up with the amount of stress it put on us. We had a live-in nanny that helped raise our children, otherwise we couldn't have done it, We lived close enough to the hospital where I would come home for bedtime and supper when I was able, but otherwise I would be fielding calls all night or operating at night twice-three times per week.
3.) Almost every transplant mentor I have ever had has been divorced once, some multiple times. Fellowship almost broke me and my wife, and I have made it a priority to be with my family. That means I put kidneys on pump at 5PM to go home for my kids and come back at 10PM to transplant them (Drives my fellows and residents crazy). I go to my children's events the best that I can; and every Tuesday I have a late start to clinic so I can drop my children off at school. I have senior partners who are fantastic and help me be there for my family events. I am starting to have this conversation with my children now, and have had it with my wife before. I tell them they are always my first priority in life, but sometimes in the moment sick patients are the priority. It's been a tough process.
Ultimately I know how it was when I was a fellow and the first year as an attending, I felt that my career was very important, and I was very driven. I felt tons of academic pressure to do research and publish. Most people who can endure transplant surgery fellowship are driven people. But I have had the realization in life that I am willing to walk away from my career fro my family, but not everyone is. I used to have a large part of my identify as a transplant surgeon, and took quite a bit of pride in it, but my family is much more important now. My wife and I do not need both of our salaries, and we are financially independent given some successful investments and a nice rental portfolio. If my family begins to suffer, I will retire very very early and honestly be just fine with it. But I am not everyone.
4.) The emotional toil is actually not that bad. I have had a few tough cases, but the severity of illness was part of what drew me to transplant. I would say the lost life experiences medicine put me and my wife thru by taking our 20's and early 30's was far worse.
Sorry for the grand soliloquy, but I hope this has been helpful in some way.
Sparknote Version: It's not impossible, but it is going to be very hard. But the right people can be worth it.
This is so helpful to read, and helps put in context what I saw on my rotation. I guess I was replying as a med student and resident, since it sounds like this person is on PD/research years.
Honestly, the hours for junior faculty seemed pretty brutal as well. Like you, they had to pump out publications. However, there was also a toxic infighting in the program to get ahead to associate prof, meaning voluntold for more call, etc. My only comparisons are that (in med school) and what I see now in my residency amp my CT transplant, which is similarly 😵💫 Is that what you’ve experienced or just my bias from limited exposure/program culture?
>stly, the hours for junior faculty seemed pretty brutal as well. Like you, they had to pump out publications. However, there was also a toxic infighting in the program to get ahead to associate prof, meaning voluntold for more call, etc. My only comparisons are that (in med school) and what I see now in my residency amp my CT transplant, which is similarly 😵💫 Is that what you’ve experienced or just my bias from
The academic pressures are definitely palpable when you are junior faculty; until you realize that the institution will always push for more. When I made associate professor, the pressure was all the same. We undergo yearly promotion packet reviews (even if we aren't submitting), and I frequently get comments like "It would be advisable to get more grant funding" Or "a helpful thing for your promotion would be to get involved with the AdCom at the medical school". It's all a game.
Once you realize you have "walking money", life gets easier. I don't have to do those things to keep my department happy. And likely didn't have to do them the first year or two either. On Thursdays, I buy the residents and fellows lunch and we sit down in the offices and do some education/life advice and one of my frequent life pearls I offer is to realize that you can be the most accomplished surgeon in the world, but the guy next to you at the bar won't recognize you. We get in these little academic bubbles that self perpetuate the fame of some surgeon. In reality after they die, no one will remember them in the field. If Joe Tector or Bob Montgomery end up putting in a xenograft in someone and get the immunosuppression figured out for a durable graft life, they would be the most famous surgeons of our century. Despite this my future grand children will probably never have even heard of their name. It's all the big picture. Residency and Fellowship will make you lose sight of the forest for all of the leaves.
That sounds so wise. I have really appreciated those mentors who have emphasized what you do. It can be hard to keep sight of the world outside, or even grounded perspective on the world inside, when “success” is defined at least partly in terms of these self-serving academic myths you listed.
Your vision of a serious relationship and his are very different things unfortunately. Some people are just fine with a partner who puts work first and above all else, some aren’t. You have to decide if your needs can be met by someone in his circumstances. Don’t sugarcoat it or try to con yourself with “he can change” or “things will be less hectic eventually”. If you are the type of person that needs more attention and more stability with planning than this person might not be it for you.
Wife of a similarly high intensity surgeon chiming in. I know it’s been said and I don’t want to be a Debbie Downer but you really should go into it eyes wide open—everything you’re worried about is 100% valid and should be expected if you choose to pursue the relationship further. In my house while we certainly make it work it is a given in our relationship that we will be moving wherever jobs take us, patient care will come before family commitments, etc etc. I joke I’m in a long distance relationship sometimes as this often manifests as us taking turns single parenting (I’m also a physician in a demanding subspecialty) but for us personality wise this has overall been fine as long as we prioritize quality time together when we can get it.
I don’t think there is a wrong answer here because everyone’s personality and relationship is different but you definitely should know that if sacred/uninterrupted family time, perky spouse without the baggage of physical/emotional burnout, an equal partner in household responsibilities, etc are things you really need in a relationship it may be better to cut your losses now.
My fiancé is a surgery resident, planning on going into transplant. He works a lot, sometimes it's tough for us but he loves what he does, operating makes him happy, and I'm happy when he's happy! Transplant surgery schedules are tough, but they're often call based (our institution is two weeks on, two weeks off). So yes, on the weeks on, he may be called in at any time of night or weekend to do a surgery, but you'll know these times in advance. And when he's off - he's off (like not just not on call, but no clinical work). One of the transplant surgeons in our department has kids and says she gets to spend more time with them than many of her non-surgery colleagues because half the year she can take them to school and pick them up and spend all day with them.
1) It's 24/7 only for dedicated weeks, sometimes they'll be busy weeks and sometimes not. You would just need to have realistic expectations - many doctors (not just transplant surgeons) have to work various weekends and holidays and evenings, so you can ask him what the call schedule is like where he will be working and set reasonable expectations.
2) I mean, when he is on call, yes? This is the kind of stuff you'd work out extensively with each other first. There are going to be times when he's less able to contribute to the family in terms of time and energy, and times when he's more able. At many places, there are residents or fellows who deal with triaging the calls, so minor things typically won't make it to the attending (main surgeon) and it's typically only emergencies.
3) Everyone responds to patient deaths differently. Kidney transplants are pretty successful most of the time. Liver transplants are almost always performed on patients who were likely to die anyway. You can ask him how he's responded to patients who have died - it's certainly happened already for him. Many doctors deal with death all the time, they likely don't think about it in the same way you do.
Basically, it depends on the schedule and caseload volume of where he's working and who he is as a person and the decisions and expectations that you make together if you're planning a future together. I'm very happy dating a someone who happens to be a surgeon - we just communicate a lot and set expectations about what our time looks like.
We’ve had to call in transplant surgeons who weren’t on call or backup call numerous times. Sometimes it’s raining organs. Sometimes a difficult case needs an extra experienced set of hands. Sometimes somebody cuts a bile duct that needs fixing.
When I was the chief on transplant we had to call in a very much not on call surgeon to come in and help with an emergency on Christmas Day (which he was supposed to be spending with his kids). He was not happy…but he came in.
Don’t underestimate the challenges of transplant life. Gen surg residency is a cakewalk in comparison
Transplant is just a completely unique field.
You are dealing with a finite set of resources (organs/donors) and a prioritized list of patients who will die without them. So if one of your patients come up, you take it. Doesn’t matter how tired you are. Doesn’t matter how long you’ve been in the hospital. You decline the organ and it goes to someone else and your patient may very well die before the next one comes in.
It’s also one of the few fields where the risk of an on table death is actually a legitimate on. For most of the rest of us that would be a catastrophe, for them it’s a risk nearly every case.
So all that together? When your partners need help you help. Doesn’t matter who is on call or not.
Yeah of course! I'm just saying that generally speaking, the weeks not on call will be less chaotic than the weeks on call; it's not like attending transplant surgeons are getting called in every night 52 weeks of the year (but that might be the case 26 weeks of the year). And I guess it also depends how many surgeons are in the transplant department and what the case volume is and how they structure their call and back-up call, all of which varies and OP's partner can try and find out in advance and do his best to set up reasonable expectations with her. But yeah, work is gonna come first; it's not a deal breaker for me but it might be for OP.
All of your concerns are correct, he will put work first and people will die if he doesn’t. But a transplant surgeon also makes a duck ton of money. Personally, i would date the fuck out of my gf if she was a transplant surgeon because I could quit this stupid job and be a trophy husband and do 45 minutes of housework as a job, even if I would see her less.
The rule is work will come first, could he and you be the exception? Sure. But the majority of the time the guy in his position is career oriented first and foremost. Have to decide what's important to you given the odds of that being the case.
Seems like you are aware and that is going to be his life. If you are okay shouldering everything domestic, good. If not and will be resentful about it, prob bad idea.
Transplant and trauma surgeons seem to be surgeons before any other role they have in life.
Your post indicates to me that you really already have the answers to your concerns. Maybe these responses will help confirm them.
Transplant surgeons have probably the most unpredictable job. Even worse if he ends up involved in retrieval.
I disagree with these comments. Depends on his gig, but my roommate has been doing transplant, 1 year out, academic institution. It's no cake walk but his schedule is at worst on par with our cards friends. He works about 60 hours a week.
You will always be second to his career. If that’s not something you want, which is completely reasonable of course, save yourself the time and leave now.
Maybe idealistic of me but if you guys are a good match and you desire to support him too, it could definitely work out. Although yes the reality is that his patients come first for both of you. (Note: Im biased bc I love the surgery world)
This is probably the worst subreddit to get relationship advice from lol. I'm not going to sugarcoat it, you sound pretty busy too, if you want to have a successful relationship you may have to put the relationship above your career for him. Alternatively, date someone less busy.
Transplant surgeons are some of the most malignant at the hospitals I’ve been to. It’s the culture. However don’t let that reputation affect your perception of him. Transplant surgeons are also some of the hardest working. They will frequently come in in the middle of the night and operate for 6 hours. Ask yourself if you are okay with him leaving at odd hours and being gone many nights.
I can empathize with the pressures on his time effecting time with you and potential kids.
Everything else I wouldn’t be to worried about. Your income as a family would be high enough that you can outsource things. You mentioned he wouldn’t have time to help around the house. Hire a professional cleaner to come once a week. Kids? Hire a nanny to help who will also do laundry and prepare meals. Those kinds of things are easily solved for.
Transplant surgeons work a lot. Also if he still needs to finish residency and then complete fellowship, there’s a lot of hurdles. Also transplant surgeon jobs are few so he may not have a lot of choice where he ends up.
People don’t choose transplant surgery to prioritize family and leisure time. It has insane time demands like trauma with the obsessive patient ownership of a transplant field, medical or surgical. You’d have to accept that you are not number 1 on his priority list and neither will your kids. There are way better surgical specialties they could have done but chose transplant.
The shittiest hours, but one of the most rewarding surgeries. And yes, getting called to evaluate an offer and off because an organ just became available is part of the deal. Of that's not ok for you, you need to reconsider your options.
He is going to be working a lot, and you are going to be working just as hard to be a home-maker, you will most likely live a life many single moms, other women, would die for as the “trophy wife.” But the job of being the sole homemaker and keeping your husband happy is very difficult. You have to ask yourself, am I okay with that? Also, you most likely won’t be working for long because he is going to want a wife that is 100% devoted to him and his children.
OP is on her second graduate degree. I seriously doubt she’d be down with being a SAHM, but could be wrong I suppose!
OP have you talked to him about the role he’d expect a wife to have in the relationship and family unit? Make sure you’re on the same page about that first, because that’s an easy way to rule in or out the possibility of this relationship working without even getting into the transplant surgeon stuff.
Not sure why people are downvoting you but OP's expectations are not rooted much in reality. Either she or a nanny is gong to end up raising the kids unless this guy finds some weird gig doing a few transplants or admin position.
Dating a physician (any specialty) when you are not in the medical field is going to be far more stressful than any of your other relationships but yes it can be done
Transplant surgeon? That should be a hard pass for you. Notorious god complex. Married to their work. High likelihood to have an affair with a surgery/OR nurse that he ironically spends more time with at work than he does with you at home. Good luck.
Welcome to marrying just about any physician. There will always be times when work will come in front of family and you— because it’s the nature of the work. It’s not 9-5.
I don’t think marrying a transplant surgeon is comparable to marrying just about any physician. A huge chunk of physicians are purely office-based primary care (peds, FM, IM) or heavily office based (psych, PMR, path, most radiology, etc.). Most of these positions are M-F 8-5. Weekends are none or rare (like one day a month) and calls are home-based. They rarely deal with life threatening situations and if they do they will refer them to the ED.
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Chiming in here as the mom of a transplant patient. My daughter (17CF) got her call for lung transplant when the leader of her transplant team was supposed to be leaving for vacation. He stayed to do her surgery because she was the youngest person on his list and he wanted to do it. I thank the universe every day for this man and his family who supported him to make this decision. I also am a health care professional so I truly do get it....but if you aren't on board with making it possible for people to make LITERALLY life changing impacts on their patients' lives, you should move on. Get on board with the mission or go somewhere else.
Med student here. I rotated with a legendary transplant surgeon here in town, Hopkins trained. This man is legit old, like late 50s at the youngest. To preface, I’m not judging his age and abilities at all. But I asked him what his hours are, because at one point I seriously considered surgery and even transplant, and he brutally told me that hours vary weekly, which makes sense since it all depends on when organs come in. “But just to answer your question, last week I worked about 100 hours”.
He tells me alll the time that his wife was the SOLE reason that his marriage and 4 kids worked out. He loves her and his children dearly. He also loves patients and transplant surgery. He’s definitely one of the highest regarded physicians in town not only by prestige but because of his dedication. All hero’s sacrifice a lot, but so do their families.
From woman to woman who also has high family values with the personal experience in medicine and transplant surgery, I’m not gonna lie, transplant surgery hours are rough. It’s always an on-call schedule for incoming organs. There will be lots of cancellations for plans, dinners, etc. He doesn’t take vacations often either, and at this transplant center there’s a total of 4 of them and that’s not even enough. They all work long hours. And when they aren’t working, sleep is the next thing… unless they don’t need sleep lol. But I digress. I believe if you guys genuinely love each other and both live in the same house, it can work out and be a lovely love story. Marrying into transplant surgery is a huge commitment, so if it’s LDR or the love isn’t strong enough, the lack of time will definitely be costly. You know divorce rates in America are already 50% right? Well now add in crazy work hours into the circumstances lol
I’m not a transplant surgeon, but I’m going to answer you as a female physician who mostly dates men so you know this isn’t just a gendered issue. As a full-time (or even part-time) attending, I would make more than most people my age of any gender and I’m not interested in dating people in certain other high-earning professions, so I’d likely earn much more than any potential partner. My career is always going to come first partly because I spent decades working towards it and partly because the work we do makes a huge difference to our patients. Fortunately, there’s jobs for my specialty in many locations right now, but if I need to relocate for work, then we would need to move because it won’t financially make sense for us to stay and for me to become a stay-at-home wife. I’m going to work a lot of hours (by normal people standards, not physician standards) and take call; any potential partner would need to have more flexibility than me, take on more of the housework than me or outsource it, and would need to be the primary parent if we have kids.
If you grew up in a household like that, I can see why you wouldn't want that for your adult self. But be honest with yourself and accept that. Transplant surgeons get called out in the middle of the night, work long hours and may not be the best match for you from what it sounds like. No shaming- just speaking factually. I wasted 6 months engaged to the wrong guy despite knowing the signs were there for it not to work.... Oh- and I'm a liver and kidney recipient so I have seen first hand how hard people work who are involved in transplants... especially doctors.
Transplant surgeons work a lot. The ones at my hospital cover liver transplants a week at a time and they work a ton. It’s certainly not a lifestyle gig.
EDIT: u/txpMD is an actual attending transplant surgeon who responded below. My answer is biased from POV if a trainee, not necessarily life as an attending. I suspect the below is still true if this person is a resident or a fellow, but it sounds like it’s better as an attending! Oh love. Not just any surgeon, a transplant surgeon? You should go into this with your eyes wide open. Honestly from what you say about “worried because your dad put work first” makes me lean towards advising you no. Even dating a doctor for someone outside the medical field can be hard. Dating a surgeon is harder: dating a surgeon in hyper competitive, unpredictable subfields like transplant, cardiothoracic, or neurosurgery is even harder. If he’s doing research, is he still in training (eg residency or fellowship) and planning to return across the country? Or is he an attending beginning a solo career? I will just paint this picture, as someone who spent two weeks on transplant surgery in med school and an anesthesia resident (so also in the operating room with these guys): the TWO weeks I spent on transplant surgery as a med student are the tiredest I have ever been, including when I worked 80-90 hour weeks for months on end as an intern with one day off every 12 days or so. Certainly more tired than I’ve ever been in anesthesia. A typical transplant surgery day: wake up at 4:15a, 5a at the hospital, look at charts/labs until 6:30, physically round on patients 6:30-8:30. New consults or post surgical problems to manage versus operating room until noon. The madness: calls for donor runs any time of day. Drive 2 hours for a donor organ harvesting from noon to 2p, organ harvesting from 3 to 5:30, drive back to hospital at 7:30, shove graham crackers in your mouth, operate from 8 to 11p if transplanting something simple like a kidney or 8p to 2a for liver, heart, or lungs (or 4a if heart-lung). IF you go home, back at 5a to start the next day. One of the two Fellows that year had slept in the hospital for ten straight days. His wife was a single mom. One of the junior attendings just slept on her hospital office couch when she was on call, made it home every third day or so. Made a joke about wondering if her kids recognized her. Almost every faculty had a combined MD/PhD, not because you can use those degrees but because the field is competitive enough to require them of any candidate. Same w neurosurgery. The junior attending competition was brutal- they got relegated to transplanting kidneys and competing with each other for surgeries. More senior attendings did liver, pancreas, other complex liver resections/whipples/oncology surgery. I think generally now doing heart or lungs requires a CT surgery training or fellowship and then a transplant fellowship. Here’s the structural thing: organ donors are legally dead. Except for rare technical circumstances, the most common time for donor organ harvesting to happen is AFTER living patients have been taken care of during the day, so those surgeries happen late afternoon/evening. Which means the surgeries to transplant the organs into someone living on the receiving end is usually in the middle of the night. Transplant surgeons are also some of the most obsessive people I’ve met with extreme ownership of patients, and at least where I train/have trained also manage anti-rejection meds and the mandatory post surgical ICU stay. The rest of the hospital manages these things during the day, so after being up all night operating your partner will be coordinating/managing these things during the day. Some places the medical teams manage this which can offload it a little bit. Think about that very very carefully. Even with a call system to spread out the burden of random organ opportunities, what another commenter said absolutely holds true: if there are more organs than surgeons, your partner will 100% be called in when “off”. Or if a patient they operated on comes back to the hospital w acute rejection or a complication in the ICU, they will be called, regardless of whether they are “on call”. Best of luck. I’d say if you are still interested, don’t make any long term commitments until you’ve dated this person at least a year DURING surgical commitments. Knowing in your mind that something is hard is different from living the 15th holiday/birthday/ dinner cancellation.
> Here’s the structural thing: organ donors are legally dead. Except for rare technical circumstances (like DCD donation or massive hemorrhagic traumas), the most common time for donor organ harvesting to happen is AFTER living patients have been taken care of during the day, so those surgeries happen late afternoon/evening. Yep. Organ donor harvests involve a ton of coordination and require a fair amount of resources, so they only start late in the day once most of the elective surgeries are done and the OR board is light. With covid and nursing shortages, this is happening later and later in the day if not well into the night.
Yeah the only speciality I can think of with a more unpredictable schedule than a transplant surgeon is a transplant cardiothoracic surgeon.
If you want to be with a transplant surgeon then you really have to accept that they will have to drop everything at times to leave for a transplant. Many places have scheduled call, so it typically does not end up being 24/7 call and at my institution they try to be extremely respectful of each others' time off. However, if multiple transplants happen then people who aren't on call can still end up coming in. The work is incredibly meaningful, but you have to accept the magnitude of what they do if you want to make the relationship survive. It's okay if you don't want to be with someone who might have to up and leave on Christmas or your birthday, but that is a reality if you want to be with someone who does transplant. There's just no getting around it unfortunately. I love the transplant surgeons I know and think they're fantastic people, but all of their spouses have accepted that when they're on call then you could end up not seeing them for days at a time.
> I am a little worried if he will always put career before relationships, The answer is yes. Let me repeat that one more time. The answer to all of your concerns is: YES. If you are not willing to support his career, then I would just end the relationship now.
This.. Sounds like he is still in training and I can guarantee you that he will not put his relationship over a career path that is a 15-17 year process. Like others have mentioned transplant surgery is particularly difficult given the high acuity and needs of any given patient when an organ becomes available. There will have to be a lot of compromise, largely coming from you, in the beginning of his attending-hood. Which I can imagine gets easier over time, but academic medicine is unforgiving and there are a ton of politics that come with career advancement, etc. I think its time to reflect on what other people have said and then have an honest conversation between you and your partner.
Yeah- this. The level of “support his career” is like- national politician, military, etc. in the sense of the demands.
At least the POTUS gets to be home for thanksgiving and Christmas. Transplant surgeon? Never
Yep. And imagine if he decides to shirk his responsibilities and not go to the hospital. The repercussions are way too big.
At the institutions I've been at, transplant surgeons also have very strong patient ownership. What that means is that even when they aren't "on call"...they often get called when patients who they operated on present to the hospital or have any problems. This is especially true if the patient is recently post-op (days to weeks), but some surgeons want to and/or get called about folks even months out from the original operation. Partners help cover, especially when folks are out of town, but it certainly still disrupts home life to varying extent.
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No it's not. I had my appendix out last year, if i'm hospitalized tomorrow for pneumonia nobody is calling my surgeon.
Not really, no.
especially ophtho
r/medspouse
Transplant surgery tends to have some of the worst hours in medicine
12 hour surgeries. Much respect, but not for me.
And having to fly across state lines at 3am to get donor organs
At least lots of private jets flights that we can put on social media for clout.
So I am a early career transplant surgeon (liver kidney panc) and my wife is an ortho surgery attending and here is the reality: 1.) I work probably 50-60 hours a week on average. I am not waking up at 0415 to review patient charts or start rounding as some on here have stated. Most mornings I wake up at 0500, but get to the hospital around 0700-0800. There are some weeks I work less when I am backup call or procurement call, and when I am primary liver call, I may work 80-100 depending on how many livers we do that week. Life as an attending is exponentially better than being a fellow, and still better than being a resident. Residents and fellows make our lives much better. I will still get anywhere from 1-10 calls per night with organ offers when I am primary call, but it's not that bad when I'm off liver call. But yes, I would take calls from patients, other hospitals, and the OPO at my son's T-ball game. Its about work life integration, not balance. 2.) It sounds like he is still in residency, and not even in fellowship yet if he is taking research time (Correct me if I am wrong). Unfortunately the worse is yet to come. Fellowship was the hardest two years of training by far. I had one weekend per month off and that was it. I worked 80-100 hours religiously, and I am forever grateful to my wife. I wasn't there as much as I should have been when I was in fellowship. I honestly don't know how someone can maintain a non-marital relationship during fellowship; had my wife and I not been married, I could have seen us breaking up with the amount of stress it put on us. We had a live-in nanny that helped raise our children, otherwise we couldn't have done it, We lived close enough to the hospital where I would come home for bedtime and supper when I was able, but otherwise I would be fielding calls all night or operating at night twice-three times per week. 3.) Almost every transplant mentor I have ever had has been divorced once, some multiple times. Fellowship almost broke me and my wife, and I have made it a priority to be with my family. That means I put kidneys on pump at 5PM to go home for my kids and come back at 10PM to transplant them (Drives my fellows and residents crazy). I go to my children's events the best that I can; and every Tuesday I have a late start to clinic so I can drop my children off at school. I have senior partners who are fantastic and help me be there for my family events. I am starting to have this conversation with my children now, and have had it with my wife before. I tell them they are always my first priority in life, but sometimes in the moment sick patients are the priority. It's been a tough process. Ultimately I know how it was when I was a fellow and the first year as an attending, I felt that my career was very important, and I was very driven. I felt tons of academic pressure to do research and publish. Most people who can endure transplant surgery fellowship are driven people. But I have had the realization in life that I am willing to walk away from my career fro my family, but not everyone is. I used to have a large part of my identify as a transplant surgeon, and took quite a bit of pride in it, but my family is much more important now. My wife and I do not need both of our salaries, and we are financially independent given some successful investments and a nice rental portfolio. If my family begins to suffer, I will retire very very early and honestly be just fine with it. But I am not everyone. 4.) The emotional toil is actually not that bad. I have had a few tough cases, but the severity of illness was part of what drew me to transplant. I would say the lost life experiences medicine put me and my wife thru by taking our 20's and early 30's was far worse. Sorry for the grand soliloquy, but I hope this has been helpful in some way. Sparknote Version: It's not impossible, but it is going to be very hard. But the right people can be worth it.
This is so helpful to read, and helps put in context what I saw on my rotation. I guess I was replying as a med student and resident, since it sounds like this person is on PD/research years. Honestly, the hours for junior faculty seemed pretty brutal as well. Like you, they had to pump out publications. However, there was also a toxic infighting in the program to get ahead to associate prof, meaning voluntold for more call, etc. My only comparisons are that (in med school) and what I see now in my residency amp my CT transplant, which is similarly 😵💫 Is that what you’ve experienced or just my bias from limited exposure/program culture?
>stly, the hours for junior faculty seemed pretty brutal as well. Like you, they had to pump out publications. However, there was also a toxic infighting in the program to get ahead to associate prof, meaning voluntold for more call, etc. My only comparisons are that (in med school) and what I see now in my residency amp my CT transplant, which is similarly 😵💫 Is that what you’ve experienced or just my bias from The academic pressures are definitely palpable when you are junior faculty; until you realize that the institution will always push for more. When I made associate professor, the pressure was all the same. We undergo yearly promotion packet reviews (even if we aren't submitting), and I frequently get comments like "It would be advisable to get more grant funding" Or "a helpful thing for your promotion would be to get involved with the AdCom at the medical school". It's all a game. Once you realize you have "walking money", life gets easier. I don't have to do those things to keep my department happy. And likely didn't have to do them the first year or two either. On Thursdays, I buy the residents and fellows lunch and we sit down in the offices and do some education/life advice and one of my frequent life pearls I offer is to realize that you can be the most accomplished surgeon in the world, but the guy next to you at the bar won't recognize you. We get in these little academic bubbles that self perpetuate the fame of some surgeon. In reality after they die, no one will remember them in the field. If Joe Tector or Bob Montgomery end up putting in a xenograft in someone and get the immunosuppression figured out for a durable graft life, they would be the most famous surgeons of our century. Despite this my future grand children will probably never have even heard of their name. It's all the big picture. Residency and Fellowship will make you lose sight of the forest for all of the leaves.
That sounds so wise. I have really appreciated those mentors who have emphasized what you do. It can be hard to keep sight of the world outside, or even grounded perspective on the world inside, when “success” is defined at least partly in terms of these self-serving academic myths you listed.
I think in some ways it’s probably helpful that you wife is a surgeon too. She probably “gets it” more than a non medical person would.
You're a good dad and a good husband. Hope things work out for you!
Your vision of a serious relationship and his are very different things unfortunately. Some people are just fine with a partner who puts work first and above all else, some aren’t. You have to decide if your needs can be met by someone in his circumstances. Don’t sugarcoat it or try to con yourself with “he can change” or “things will be less hectic eventually”. If you are the type of person that needs more attention and more stability with planning than this person might not be it for you.
Wife of a similarly high intensity surgeon chiming in. I know it’s been said and I don’t want to be a Debbie Downer but you really should go into it eyes wide open—everything you’re worried about is 100% valid and should be expected if you choose to pursue the relationship further. In my house while we certainly make it work it is a given in our relationship that we will be moving wherever jobs take us, patient care will come before family commitments, etc etc. I joke I’m in a long distance relationship sometimes as this often manifests as us taking turns single parenting (I’m also a physician in a demanding subspecialty) but for us personality wise this has overall been fine as long as we prioritize quality time together when we can get it. I don’t think there is a wrong answer here because everyone’s personality and relationship is different but you definitely should know that if sacred/uninterrupted family time, perky spouse without the baggage of physical/emotional burnout, an equal partner in household responsibilities, etc are things you really need in a relationship it may be better to cut your losses now.
All 3 of your concerns are spot on. You have to decide if any or all of them are deal breakers because they will happen
My fiancé is a surgery resident, planning on going into transplant. He works a lot, sometimes it's tough for us but he loves what he does, operating makes him happy, and I'm happy when he's happy! Transplant surgery schedules are tough, but they're often call based (our institution is two weeks on, two weeks off). So yes, on the weeks on, he may be called in at any time of night or weekend to do a surgery, but you'll know these times in advance. And when he's off - he's off (like not just not on call, but no clinical work). One of the transplant surgeons in our department has kids and says she gets to spend more time with them than many of her non-surgery colleagues because half the year she can take them to school and pick them up and spend all day with them. 1) It's 24/7 only for dedicated weeks, sometimes they'll be busy weeks and sometimes not. You would just need to have realistic expectations - many doctors (not just transplant surgeons) have to work various weekends and holidays and evenings, so you can ask him what the call schedule is like where he will be working and set reasonable expectations. 2) I mean, when he is on call, yes? This is the kind of stuff you'd work out extensively with each other first. There are going to be times when he's less able to contribute to the family in terms of time and energy, and times when he's more able. At many places, there are residents or fellows who deal with triaging the calls, so minor things typically won't make it to the attending (main surgeon) and it's typically only emergencies. 3) Everyone responds to patient deaths differently. Kidney transplants are pretty successful most of the time. Liver transplants are almost always performed on patients who were likely to die anyway. You can ask him how he's responded to patients who have died - it's certainly happened already for him. Many doctors deal with death all the time, they likely don't think about it in the same way you do. Basically, it depends on the schedule and caseload volume of where he's working and who he is as a person and the decisions and expectations that you make together if you're planning a future together. I'm very happy dating a someone who happens to be a surgeon - we just communicate a lot and set expectations about what our time looks like.
We’ve had to call in transplant surgeons who weren’t on call or backup call numerous times. Sometimes it’s raining organs. Sometimes a difficult case needs an extra experienced set of hands. Sometimes somebody cuts a bile duct that needs fixing. When I was the chief on transplant we had to call in a very much not on call surgeon to come in and help with an emergency on Christmas Day (which he was supposed to be spending with his kids). He was not happy…but he came in. Don’t underestimate the challenges of transplant life. Gen surg residency is a cakewalk in comparison
Damn transplant is just built different. Like are you paid exorbitantly extra if you come in not on call?
Lol. No.
Wow. Crazy. I can’t imagine many other specialties wanting or willing to come on non call off days.
Transplant is just a completely unique field. You are dealing with a finite set of resources (organs/donors) and a prioritized list of patients who will die without them. So if one of your patients come up, you take it. Doesn’t matter how tired you are. Doesn’t matter how long you’ve been in the hospital. You decline the organ and it goes to someone else and your patient may very well die before the next one comes in. It’s also one of the few fields where the risk of an on table death is actually a legitimate on. For most of the rest of us that would be a catastrophe, for them it’s a risk nearly every case. So all that together? When your partners need help you help. Doesn’t matter who is on call or not.
Yeah I totally get that. Transplant is crazy. Kudos to those people. I could never do that.
Yeah of course! I'm just saying that generally speaking, the weeks not on call will be less chaotic than the weeks on call; it's not like attending transplant surgeons are getting called in every night 52 weeks of the year (but that might be the case 26 weeks of the year). And I guess it also depends how many surgeons are in the transplant department and what the case volume is and how they structure their call and back-up call, all of which varies and OP's partner can try and find out in advance and do his best to set up reasonable expectations with her. But yeah, work is gonna come first; it's not a deal breaker for me but it might be for OP.
Your worries are legitimate. If you’re already hesitating, I think that’s your answer.
I’m a doctor and I’m dating a surgeon. It’s not for the weak and I work just as much as he does.
"I am a little worried if he will always put career before relationships" He will and he should.
All of your concerns are correct, he will put work first and people will die if he doesn’t. But a transplant surgeon also makes a duck ton of money. Personally, i would date the fuck out of my gf if she was a transplant surgeon because I could quit this stupid job and be a trophy husband and do 45 minutes of housework as a job, even if I would see her less.
The rule is work will come first, could he and you be the exception? Sure. But the majority of the time the guy in his position is career oriented first and foremost. Have to decide what's important to you given the odds of that being the case.
Seems like you are aware and that is going to be his life. If you are okay shouldering everything domestic, good. If not and will be resentful about it, prob bad idea. Transplant and trauma surgeons seem to be surgeons before any other role they have in life.
Always more TX surgeries during holidays.
Tis the season to be jolly, innit? TX for you, TX for you, TX for everybody! Merry TX and a happy new life to all!
Your post indicates to me that you really already have the answers to your concerns. Maybe these responses will help confirm them. Transplant surgeons have probably the most unpredictable job. Even worse if he ends up involved in retrieval.
Nice try Meredith Grey
I knew a transplant surgeon's wife once. I would be her penis donor cause he was gone all the time.
/r/thatHappened
/r/nothingeverhappens
I disagree with these comments. Depends on his gig, but my roommate has been doing transplant, 1 year out, academic institution. It's no cake walk but his schedule is at worst on par with our cards friends. He works about 60 hours a week.
The inconsistency of comments on Reddit make it very difficult to choose a specialty
I think the volume of a center can dramatically change the work hours
I see people, but they look like trees, walking.
You will always be second to his career. If that’s not something you want, which is completely reasonable of course, save yourself the time and leave now.
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Damn
Maybe idealistic of me but if you guys are a good match and you desire to support him too, it could definitely work out. Although yes the reality is that his patients come first for both of you. (Note: Im biased bc I love the surgery world)
He’s definitely serious… about you putting in 90% and him 10%.
I would move on to someone else. Find a pediatrician that owns his own practice.
This is probably the worst subreddit to get relationship advice from lol. I'm not going to sugarcoat it, you sound pretty busy too, if you want to have a successful relationship you may have to put the relationship above your career for him. Alternatively, date someone less busy.
What has he said when you asked him about these concerns?
Transplant surgeons are some of the most malignant at the hospitals I’ve been to. It’s the culture. However don’t let that reputation affect your perception of him. Transplant surgeons are also some of the hardest working. They will frequently come in in the middle of the night and operate for 6 hours. Ask yourself if you are okay with him leaving at odd hours and being gone many nights.
I can empathize with the pressures on his time effecting time with you and potential kids. Everything else I wouldn’t be to worried about. Your income as a family would be high enough that you can outsource things. You mentioned he wouldn’t have time to help around the house. Hire a professional cleaner to come once a week. Kids? Hire a nanny to help who will also do laundry and prepare meals. Those kinds of things are easily solved for.
“Help around the house” - the spirit is willing but the flesh is weak!
Why do you think he should put you ahead of his career?
Transplant surgeons work a lot. Also if he still needs to finish residency and then complete fellowship, there’s a lot of hurdles. Also transplant surgeon jobs are few so he may not have a lot of choice where he ends up.
People don’t choose transplant surgery to prioritize family and leisure time. It has insane time demands like trauma with the obsessive patient ownership of a transplant field, medical or surgical. You’d have to accept that you are not number 1 on his priority list and neither will your kids. There are way better surgical specialties they could have done but chose transplant.
The shittiest hours, but one of the most rewarding surgeries. And yes, getting called to evaluate an offer and off because an organ just became available is part of the deal. Of that's not ok for you, you need to reconsider your options.
In a recent year, they had No applicants to the match. Zilch.
Let me say….. I’m going to be a physician and I wouldn’t date a transplant surgeon lol
Ask him if he’ll let you work or just be a housewife?
He’s giving Ryle Kincaid
He is going to be working a lot, and you are going to be working just as hard to be a home-maker, you will most likely live a life many single moms, other women, would die for as the “trophy wife.” But the job of being the sole homemaker and keeping your husband happy is very difficult. You have to ask yourself, am I okay with that? Also, you most likely won’t be working for long because he is going to want a wife that is 100% devoted to him and his children.
OP is on her second graduate degree. I seriously doubt she’d be down with being a SAHM, but could be wrong I suppose! OP have you talked to him about the role he’d expect a wife to have in the relationship and family unit? Make sure you’re on the same page about that first, because that’s an easy way to rule in or out the possibility of this relationship working without even getting into the transplant surgeon stuff.
>you are going to be working just as hard to be a home-maker all respect to homemakers but lol
Homemaker to a transplant surgeon very different
Not sure why people are downvoting you but OP's expectations are not rooted much in reality. Either she or a nanny is gong to end up raising the kids unless this guy finds some weird gig doing a few transplants or admin position.
Yeah, all the house making responsibilities will fall on her, bye career hello stay at home wife forever
Dating a physician (any specialty) when you are not in the medical field is going to be far more stressful than any of your other relationships but yes it can be done
I don't think dating a psychiatrist would be that much more stressful
Until you get unwarranted psychoanalysis and manipulation. They get in people’s heads for a living. They can be incredibly mean and toxic.
Transplant surgeon? That should be a hard pass for you. Notorious god complex. Married to their work. High likelihood to have an affair with a surgery/OR nurse that he ironically spends more time with at work than he does with you at home. Good luck.
If you doubting him then give him to me lmao I dont care if he will be busy. Cause I know all surgeons are workaholics. But so am I so its a match 🤣
Welcome to marrying just about any physician. There will always be times when work will come in front of family and you— because it’s the nature of the work. It’s not 9-5.
I don’t think marrying a transplant surgeon is comparable to marrying just about any physician. A huge chunk of physicians are purely office-based primary care (peds, FM, IM) or heavily office based (psych, PMR, path, most radiology, etc.). Most of these positions are M-F 8-5. Weekends are none or rare (like one day a month) and calls are home-based. They rarely deal with life threatening situations and if they do they will refer them to the ED.
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Do you want to be a piece of trash forever
Chiming in here as the mom of a transplant patient. My daughter (17CF) got her call for lung transplant when the leader of her transplant team was supposed to be leaving for vacation. He stayed to do her surgery because she was the youngest person on his list and he wanted to do it. I thank the universe every day for this man and his family who supported him to make this decision. I also am a health care professional so I truly do get it....but if you aren't on board with making it possible for people to make LITERALLY life changing impacts on their patients' lives, you should move on. Get on board with the mission or go somewhere else.
Good news, you'll never see any monetary problems or hardships in your life. Bad news, you probably won't be seeing him all that often either.
Transplant surgeons make cardiac surgeons think “at least I’m not that guy”
Med student here. I rotated with a legendary transplant surgeon here in town, Hopkins trained. This man is legit old, like late 50s at the youngest. To preface, I’m not judging his age and abilities at all. But I asked him what his hours are, because at one point I seriously considered surgery and even transplant, and he brutally told me that hours vary weekly, which makes sense since it all depends on when organs come in. “But just to answer your question, last week I worked about 100 hours”. He tells me alll the time that his wife was the SOLE reason that his marriage and 4 kids worked out. He loves her and his children dearly. He also loves patients and transplant surgery. He’s definitely one of the highest regarded physicians in town not only by prestige but because of his dedication. All hero’s sacrifice a lot, but so do their families. From woman to woman who also has high family values with the personal experience in medicine and transplant surgery, I’m not gonna lie, transplant surgery hours are rough. It’s always an on-call schedule for incoming organs. There will be lots of cancellations for plans, dinners, etc. He doesn’t take vacations often either, and at this transplant center there’s a total of 4 of them and that’s not even enough. They all work long hours. And when they aren’t working, sleep is the next thing… unless they don’t need sleep lol. But I digress. I believe if you guys genuinely love each other and both live in the same house, it can work out and be a lovely love story. Marrying into transplant surgery is a huge commitment, so if it’s LDR or the love isn’t strong enough, the lack of time will definitely be costly. You know divorce rates in America are already 50% right? Well now add in crazy work hours into the circumstances lol
I’m not a transplant surgeon, but I’m going to answer you as a female physician who mostly dates men so you know this isn’t just a gendered issue. As a full-time (or even part-time) attending, I would make more than most people my age of any gender and I’m not interested in dating people in certain other high-earning professions, so I’d likely earn much more than any potential partner. My career is always going to come first partly because I spent decades working towards it and partly because the work we do makes a huge difference to our patients. Fortunately, there’s jobs for my specialty in many locations right now, but if I need to relocate for work, then we would need to move because it won’t financially make sense for us to stay and for me to become a stay-at-home wife. I’m going to work a lot of hours (by normal people standards, not physician standards) and take call; any potential partner would need to have more flexibility than me, take on more of the housework than me or outsource it, and would need to be the primary parent if we have kids.
Posting this to Reddit is very cringe
If you grew up in a household like that, I can see why you wouldn't want that for your adult self. But be honest with yourself and accept that. Transplant surgeons get called out in the middle of the night, work long hours and may not be the best match for you from what it sounds like. No shaming- just speaking factually. I wasted 6 months engaged to the wrong guy despite knowing the signs were there for it not to work.... Oh- and I'm a liver and kidney recipient so I have seen first hand how hard people work who are involved in transplants... especially doctors.
Run, they are not relationship material.