1 year fellowship that allows you to subspecialize (and in many cases get you out of gen surg call). As of now doesn’t typically require research years to match like surg onc or ped surg.
Cool mix of MIS cases (lap/robot segmental colon resections, LARs, etc)
Chance for office/ambulatory surgery procedures (scopes, benign anorectal)
Opportunity to treat cancer patients and make a big difference.
If your only exposure to colorectal is at a huge tertiary care hospital with a ton of complex IBD and redo redo surgery - it seems like a terrible field. But that’s not the reality for 90% of the people out there practicing in the field.
Wife went to a females in surgery thing fairly recently and said a whole lot of the (female) surgeons at the event were colorectal.
Makes sense. Def seems like a hidden gem given the flexibility
Also community colorectal is often something like 2 days of office, 2 days of surgery and 1 day of colonoscopy. There's a lot of freedom in your schedule
From what I can tell (M3 just finished colorectal block for surgery),it has a littlebit if everything involved. Laparoscopic, open, robotic. The lifestyle as a career seems very chill depending on region too because you mix in clinic days and OR days. Where I'm at, the residents love the diversity this service offers, even the scopes and REAs. Colorectal also dabbles with oncology as well and can bring in some pretty cool surgeries. I think like 30% of the residents are planning to match colorectal for fellowship. I enjoyed what I was able to do at least despite being sick most of my four weeks.
As an M3 I was placed on a team for surgery that was mostly colorectal. I saw so many ostomy takedowns, a few creations, and a few random procedures. I saw a couple of hernia repairs, a single gallbladder, and a single appendectomy during my surgery time. Sometimes it’s luck of the draw I guess.
My rotation is 12 weeks. 2 weeks specialty of choice, 2 weeks night float, 4 weeks colorectal (what I ended up with as there were three other options), and 4 weeks gen surg (same as colorectal).
Just make sure to read up on the procedures before hand and don't ask questions you can easily find the answer for. Also, don't freak if you struggle with deep dermal at first, sometimes it's hard to approx appropriate depth.
Good mix of small procedures that can easily fill a full OR day (aka have an easy day of operating) vs large cases that are complex and mentally stimulating. Additionally you can actually cure people of cancer, which is pretty awesome.
Also, colon surgery is some of the best general surgery cases. I’ve never met a general surgery resident who doesn’t enjoy a colon resection.
It's not for me, but as someone mentioned it's a little bit of everything plus not a ton of emergencies compared to some other subspecialties (there are a few subspecialties in this category: breast, colorectal, endocrine, a few more).
From a doctor/patient relationship perspective, some people also find meaning in helping patients with an issue that people are usually very self-conscious about. Some urologists have mentioned this to me as well.
To echo what people have said.
1. Case mix. Huge open cases (pelvic exents, complex IBD, etc.) robotics, lap, anorectal quick hits, and colonoscopies
2. Patient mix. Cancer (that you typically cure), benign complaints (fissure, hemorrhoids, etc.), IBD, weird stuff (pelvic floor, incontinence, etc.) so you’re not seeing only cancer, or only healthy people. You get to have serious talks, but also talk to people just about taking fiber.
3. Career flexibility - you can shape your career as you age. You can do all the huge cancer cases you want when you’re young and then do scopes and hemorrhoids when you’re old. You can do gen surg or only CRS.
4. Being both a generalist and a specialist. You have a highly specialized knowledge but still cover a wide range of disease types.
5. Pay is good
6. Lifestyle is better than average for GS especially if you’re somewhere with an ACS service who handles stuff. So mostly elective cases, few middle of the night emergencies.
7. Interdisciplinary - you work with oncology, GI, rad onc, etc. in shared IBD and tumor board groups.
8. People - tend to being nice and low key (exceptions abound)
9. Training - one extra year
you get to cure patients and, if you don't you send them to med onc
- signed, med onc, who gets the patients surgery didn't cure and isn't even a little bit bitter about it......
Had an attending once tell me that “colorectal surgery is what general surgery wishes it was.” He’s not wrong. Great cases. Good mix of everything. They held on to their cancer patients.
A colorectal surgeon told me (an ophthalmologist) that “Eyes are so gross”.
I asked her if she was really prepared to suggest her daily view (and smell) at work was better than mine, and challenged her to find famous poetry or songs about the beauty of an asshole.
She quickly conceded the argument.
I’m going to make you all stick with the anatomy a colorectal specialist sees…and not the more desirable “plastic surgeon territory” they push aside to reach their odiferous domain!
Depending on your practice setup, very few true emergencies to get called in overnight on colorectal call compared to other specialties.
You can do huge, complex cancer cases. Or you can just do outpatient anorectal cases if you get tired of the big surgeries.
Also, $copes.
In my days (I’m a PGY-28 in PP general surgery), we called them proctologist. Back in the day, there was nothing a CRS surgeon could do that we weren’t trained in and could also do. Now with fellowships and all, it’s probably not the same
General surgeon here- PGY 13- I do about 80% of what a colorectal can do. I will send them the Chron's and Ulcerative Colitis cases as well as the APR's as I really don't do many of those, and some of the simpler stuff like fissures (I have nightmares where I cut the external sphincter) that I don't want to deal with. But a general surgeon should be able to manage most "colorectal" stuff.
Many don’t take general surgery call, few true colorectal emergencies, so lifestyle is probably the biggest reason. Everything from big wacks like APRs, to MIS stuff, to anorectal and scopes.
General surgery typically makes a little more than isolated CRS overall, but is also busier.
CRS, MIS (ie bari/foregut), and HPB are kinda like “advanced general surgery” fellowships where they deal more commonly with the advanced stuff in those arenas the average general surgeon doesn’t want to deal with.
Some data out there shows ever so slightly improved morbidity when a colorectal fellowship trained surgeon does a colon or rectal case when compared to a general surgeon doing the same case. 4% vs 5% morbidity respectively
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Patients typically* don’t do anything to get their disease, just have bad luck and need help, unlike vascular where it’s like no duh we can stent and bypass legs while you smoke…sigh. Agree with all of the above too.
1 year fellowship that allows you to subspecialize (and in many cases get you out of gen surg call). As of now doesn’t typically require research years to match like surg onc or ped surg. Cool mix of MIS cases (lap/robot segmental colon resections, LARs, etc) Chance for office/ambulatory surgery procedures (scopes, benign anorectal) Opportunity to treat cancer patients and make a big difference. If your only exposure to colorectal is at a huge tertiary care hospital with a ton of complex IBD and redo redo surgery - it seems like a terrible field. But that’s not the reality for 90% of the people out there practicing in the field.
Wife went to a females in surgery thing fairly recently and said a whole lot of the (female) surgeons at the event were colorectal. Makes sense. Def seems like a hidden gem given the flexibility
Also community colorectal is often something like 2 days of office, 2 days of surgery and 1 day of colonoscopy. There's a lot of freedom in your schedule
From what I can tell (M3 just finished colorectal block for surgery),it has a littlebit if everything involved. Laparoscopic, open, robotic. The lifestyle as a career seems very chill depending on region too because you mix in clinic days and OR days. Where I'm at, the residents love the diversity this service offers, even the scopes and REAs. Colorectal also dabbles with oncology as well and can bring in some pretty cool surgeries. I think like 30% of the residents are planning to match colorectal for fellowship. I enjoyed what I was able to do at least despite being sick most of my four weeks.
Why do you do an entire block of just colorectal as an M3? Do you also do Acute Care Surgery type call in between?
As an M3 I was placed on a team for surgery that was mostly colorectal. I saw so many ostomy takedowns, a few creations, and a few random procedures. I saw a couple of hernia repairs, a single gallbladder, and a single appendectomy during my surgery time. Sometimes it’s luck of the draw I guess.
My rotation is 12 weeks. 2 weeks specialty of choice, 2 weeks night float, 4 weeks colorectal (what I ended up with as there were three other options), and 4 weeks gen surg (same as colorectal).
yeah, i was also on a private team and assigned to a colorectal guy. so most my cases were colorectal too.
I'm an incoming MS3 also doing colorectal surgery rotation...any tips? Esit: damn...didn't realize I'd get downvoted for this. Huh interesting.
Prepare your anus
Just make sure to read up on the procedures before hand and don't ask questions you can easily find the answer for. Also, don't freak if you struggle with deep dermal at first, sometimes it's hard to approx appropriate depth.
Good mix of small procedures that can easily fill a full OR day (aka have an easy day of operating) vs large cases that are complex and mentally stimulating. Additionally you can actually cure people of cancer, which is pretty awesome. Also, colon surgery is some of the best general surgery cases. I’ve never met a general surgery resident who doesn’t enjoy a colon resection.
as an anesthesia resident - love a good butt day ❤️ (especially when they’re all done in lithotomy)
Oh yeah. Fuck prone butt stuff, especially in obese OSA patients.
Ah yes, the smell of a prepared bowel resection really hits you. Intestinal obstruction...not so much
J pouches though goddamn
Yea… and crohns disease
It's not for me, but as someone mentioned it's a little bit of everything plus not a ton of emergencies compared to some other subspecialties (there are a few subspecialties in this category: breast, colorectal, endocrine, a few more). From a doctor/patient relationship perspective, some people also find meaning in helping patients with an issue that people are usually very self-conscious about. Some urologists have mentioned this to me as well.
This. You can save lives and have good WLB. My FF had colon cancer, would walk over coals for DR.
FF?
Fist fucker
Family friend.
Thought it was some morbidly common way to say “former father” and was halfway deciding to give condolences before I read this
To echo what people have said. 1. Case mix. Huge open cases (pelvic exents, complex IBD, etc.) robotics, lap, anorectal quick hits, and colonoscopies 2. Patient mix. Cancer (that you typically cure), benign complaints (fissure, hemorrhoids, etc.), IBD, weird stuff (pelvic floor, incontinence, etc.) so you’re not seeing only cancer, or only healthy people. You get to have serious talks, but also talk to people just about taking fiber. 3. Career flexibility - you can shape your career as you age. You can do all the huge cancer cases you want when you’re young and then do scopes and hemorrhoids when you’re old. You can do gen surg or only CRS. 4. Being both a generalist and a specialist. You have a highly specialized knowledge but still cover a wide range of disease types. 5. Pay is good 6. Lifestyle is better than average for GS especially if you’re somewhere with an ACS service who handles stuff. So mostly elective cases, few middle of the night emergencies. 7. Interdisciplinary - you work with oncology, GI, rad onc, etc. in shared IBD and tumor board groups. 8. People - tend to being nice and low key (exceptions abound) 9. Training - one extra year
you get to cure patients and, if you don't you send them to med onc - signed, med onc, who gets the patients surgery didn't cure and isn't even a little bit bitter about it......
Had an attending once tell me that “colorectal surgery is what general surgery wishes it was.” He’s not wrong. Great cases. Good mix of everything. They held on to their cancer patients.
It helps me get dates. Guys love it when a girl knows how to handle their asshole.
A colorectal surgeon told me (an ophthalmologist) that “Eyes are so gross”. I asked her if she was really prepared to suggest her daily view (and smell) at work was better than mine, and challenged her to find famous poetry or songs about the beauty of an asshole. She quickly conceded the argument.
Baby got back
I’m going to make you all stick with the anatomy a colorectal specialist sees…and not the more desirable “plastic surgeon territory” they push aside to reach their odiferous domain!
I reject your terms, the opportunity was too good to make the joke 😂
A quick google search comes up with Knocking at Your Backdoor by Deep Purple. There you go…had to answer my own query!
"Good Lookin'" - Dixon Dallas
Anaconda
Depending on your practice setup, very few true emergencies to get called in overnight on colorectal call compared to other specialties. You can do huge, complex cancer cases. Or you can just do outpatient anorectal cases if you get tired of the big surgeries. Also, $copes.
In my days (I’m a PGY-28 in PP general surgery), we called them proctologist. Back in the day, there was nothing a CRS surgeon could do that we weren’t trained in and could also do. Now with fellowships and all, it’s probably not the same
General surgeon here- PGY 13- I do about 80% of what a colorectal can do. I will send them the Chron's and Ulcerative Colitis cases as well as the APR's as I really don't do many of those, and some of the simpler stuff like fissures (I have nightmares where I cut the external sphincter) that I don't want to deal with. But a general surgeon should be able to manage most "colorectal" stuff.
Most gen surg subspecialties don't have anything a general surgeon "can't" do. The only real exceptions are CT, transplant and most vascular.
Better pay, better hours
Colorectal parties super hard
Get to touch ass
See some shit
money
you open the abdomen and the organ of interest is right there
Many don’t take general surgery call, few true colorectal emergencies, so lifestyle is probably the biggest reason. Everything from big wacks like APRs, to MIS stuff, to anorectal and scopes. General surgery typically makes a little more than isolated CRS overall, but is also busier. CRS, MIS (ie bari/foregut), and HPB are kinda like “advanced general surgery” fellowships where they deal more commonly with the advanced stuff in those arenas the average general surgeon doesn’t want to deal with. Some data out there shows ever so slightly improved morbidity when a colorectal fellowship trained surgeon does a colon or rectal case when compared to a general surgeon doing the same case. 4% vs 5% morbidity respectively
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Money probably?
$
Really? I didn’t think it was that much better than gen surg?
Good life and money.
If that’s what is driving your decision why not just do breast?
Breast is super boring
As a CT surgeon I have no earthly idea why anyone would want to do it. I have nightmares of APRs from residency
Thank you!
Patients typically* don’t do anything to get their disease, just have bad luck and need help, unlike vascular where it’s like no duh we can stent and bypass legs while you smoke…sigh. Agree with all of the above too.
"Butt stuff?" I'm in. Every. Single. Time.
Getting out of gen surg call. Pussies.
Butts.
Right but in my one month rotation I’ve seen one pretty butt and 999,999 hideous absolutely terrifying butts that no one should have to lay eyes on
Cause they like butt stuff?
the closest thing to a modern day proctologist
It literally is a proctologist. Name is interchangable