The Insiders Scoop – General Surgery

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Name: Hunter Witmer, M.D.

Specialty/Interests: General Surgery

Education: Haverford College (B.S., molecular biology), Sidney Kimmel Medical College/Jefferson (M.D.)

Current Position: PGY-1 General Surgery Resident (categorical), University of Chicago Medical Center

 

1 | What drew you to general surgery?

I originally went to medical school to be an orthopedic surgeon but by my third year I realized that the clinical considerations and decision making in ortho just weren’t intellectually stimulating enough for me. My very next rotation was general surgery and the first case I saw was a 9-hour HIPEC (look it up). Seeing the entirety of abdominal anatomy and learning about the physiology and post-operative management was incredible, not to mention the finesse and alacrity with which the surgeons could handle tissue. Additionally, I identified with the toughness, efficiency, pace, and comradery of the surgery residents in a way that differed from my other rotations.

 

2 | What do you like the most about general surgery? The least?

There isn’t any single component of surgery that I can identify as a favorite. Rather, it’s the sum total of all the mental, physical, technical and emotional elements that speak to me. One of my mentors said “the best physicians in the hospital are general surgeons,” which, to me, means having a true understanding of human anatomy and physiology and being able to navigate all phases of a patient’s care from the clinic visits to level 1 trauma activations to critical care and back again. Furthermore, the surgeons I most respect are not only brilliant and technically gifted but also foster some of the deepest interpersonal and trusting relationships with their patients.

 

3 | What advice would you give to students interested in general surgery?

There are lots of great fields in medicine and you should try very hard to be open to them all. When it comes down to picking one, however, you should be very honest with your assessment of yourself and what you want out of a career. A resident once told me that if I thought I could be happy doing general surgery or literally any other specialty, I should pick the other option. I honestly did not think I would be content practicing any other kind of medicine. The challenge and reward at the end of the road were too much for me to turn down.

 

4 | Are you planning to pursue a fellowship? If so, in what and why?

Pretty much everyone in academic training programs pursues fellowship training now. I graduated from medical school thinking I wanted to do surgical oncology; however, it’s rare for interns to stick with their original plans for specialization. Now that I’m halfway through my first year, surg onc is still my leading choice but there are still so many specialties I need to try before I can totally commit.

 

5 | What was the transition like between medical school and residency?

I was fortunate to go to a med school that prepared me extremely well for clinical responsibilities. That being said, there’s nothing that prepares you for the jump into intern year. It took a couple of months before I felt like I had my responsibilities under control and could relax at work without worrying that I would miss something that would really hurt a patient. Also, as a fairly motivated individual, I was initially frustrated at the constant feeling that I didn’t know how to do X, Y or Z or that I wasn’t sure what to do next for a given patient. I know that this sentiment was shared by all my co-interns and now realize that it’s just part of the learning process.

 

6 | Has there been anything in residency that has surprised you?

In med school and on the boards there are always five potential answers but only one is the best possible answer. In real life, all bets are off. You think you know exactly how a certain disease process is managed and then a new attending comes on service and does things completely differently. I’ve come to see that clinical decision-making is equal parts experience, art and (if you’re good) data-driven based on the literature.

 

7 | Who were your most impactful mentors in your life?

My parents are both general surgeons and are without a doubt my most important role models in all domains of my life. Their career paths were very different, but I respect the utter dedication to their craft it required for them to get where they are now. More importantly, however, was growing up hearing about the hospital and tough cases over dinner and seeing just how much satisfaction and fulfillment they derived from their work no matter how difficult each day was or how little sleep they got. I think that’s what makes me confident that all the effort is worth it in the end.

 

8 | What is a typical day like for you?

Since general surgery encompasses so many different surgical domains, no rotation is exactly like another. Typically, I’m up around 4:45am and at work by 5:30 for signout from the night team. Then our team will round on each patient and formulate daily plans. Afterward, I put in orders, write progress notes and head wherever help is needed (be it the clinic or the OR if multiple rooms are running). At the end of the day, we’ll do PM rounds and signout once all the work is done (6-7pm). I have a personal goal to get a workout in every day, even if it’s only 20 mins, which generally happens right when I get home. Then it’s a quick dinner, night time dog walk and time for bed.

 

9 | How much sleep do you get each night? What is your workload like every week?

I’ve always been an early to bed/early riser and definitely not someone who functions well on minimal sleep (unfortunately). I’d guess I average 6.5-7hr a night. As for work hours, I typically log 70-80 hours per week which is significantly better than when my parents were in training. Our program takes the ACGME rules very seriously so even when you blip above the weekly limit we hear about it very quickly and our culture here is such that others are flexible and willing to cover for you when you need some time off.

 

10 | How do you maintain your work-life balance?

A mentor of mine was once asked that question and responded: “if you find someone with a work-life balance in my department let me know so I can fire them.” That was just the old school mentality, but the culture of surgery is much different now. I think there will always be debate as to how much is the “right amount” with regards to work hours or call. In the end, it’s really an individual balance that you have to find. I was an athlete in college, so I mostly decompress by breaking a sweat. Otherwise, I re-center myself after a hard day by curling up on the couch with my puppy and doing my best to always eat dinner with my fiancée. I can’t devote a lot of time to my personal life, but I make sure that that time is highly valued and a point of emphasis.

 

11 | Have you ever experienced burnout? If so, what helped you during this period?

Burnout is a serious problem in medicine, particularly in surgery. Attrition rates are somewhere around 20% and training programs are devoting a lot of thought and energy to ameliorating this issue. I’ve never felt completely burnt out, but the daily grind can easily get you down if you allow yourself to get frustrated by the quotidian and bureaucratic chores of each day. I believe that maintaining interests outside of medicine and allowing yourself a little cognitive and emotional distance from work helps keep an even keel.

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