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Comment by throw1234651234 | Hacker News Reader

I am way more interested in how you gave up $800,000+ a year to do software engineering.

Neurosurgery residency is very, very, very intense. Unfortunately not everyone finishes. When I was in medical school, I remember some general surgery residents quiting after falling asleep in the middle of an operation; another neurosurgery resident I rotated with was pretty miserable, I found out later he quit. I would have liked to be a neurosurgeon, but simply didn’t have the physical stamina.

I ended up becoming a radiologist. Never heard a radiology resident quiting, although have seen a few residents get kicked out for mental issues or gross incompetence.

> gross incompetence

How on Earth do you get to "resident" and have "gross incompetence"?

There are sooo many gates before getting to be a "resident" that this completely baffles me.

Undergrad/premed: live with family, have 100% 24/7 familial support of your education, living at home with all of your essential basic living needs taken care of.

Residency: move to a different location away from family, no longer living in a dormitory environment with the expectations associated with being a student but are now a real adult making your way in the world. Suddenly you have to make the whole package work on your own without laundry/cooking/mental health/financial support.

Now you can no longer put 100% of yourself into your studies, but instead can only manage the 60 or 70% that most people can muster when they have to actually maintain their physical existence while also meeting their professional expectations.

It happens. Often incompetence is specific to one specialty - neurosurgery is competitive, so you can assume that anyone who gets it has at least adequate grades/test scores. But that doesn't mean that they're clinically worth a damn.

I'm an anesthesiologist. There are people who wash out because they just don't have the temperament for it. They're not dumb, they're not even bad doctors, they just aren't mentally equipped to sit back and relax while running a code.

Obviously not OP and not in this position, but I have worked with people who left surgical training positions and their reasons were health and a realisation that they would miss every family milestone, never get a real break and have every part of their life revolve around their job with the money and god-like power not compensating for that.

Obviously that’s one side of the equation, I don’t have any surgeon friends I know well enough to give the opposing view.

Some can do it. Are they really different than the rest?? Perhaps higher tolerance to stress or even thriving in it?

OP said "did" implying finished. It's a six year residency minimum, though the first year is general surgery. It's not often people do the whole damn thing, then decide to bail. Usually it's after 2 or 3 years

Though some people are less burdened by golden handcuffs and sunk-cost fallacy

Plus, I've never met a happy (or sane) neurosurgeon

I'm in no way even close to being in the medical field, but I could see it as an unreconcilable dichotomy between the hippocratic oath and the fact you're going to be causing damage no matter what.

Sure, the hemmhorage needs to be fixed, so you're preventing further damage, but every cut may cause unknown ramifications. Anyway, I'm postulating a neurosurgeon would be aware of this, and have to carry that around with them.

Medicine as a career offers immense personal fulfillment, variety, human interaction, and prestige at the expense of dealing with difficult outcomes and ranges of personal sacrifice -- neurosurgery as a specialty just takes all of these to their extremes.

I value the former and find ways to discount the latter. So I am very happy. Though sane or not would be up to others.

$800,000 is a lot of money, even after taxes you'd only have to work a few years at that salary before you could live reasonably comfortably for the rest of your life without working at all.

Seems perfectly reasonably to switch to a lower stress career at some point.

The personalities attracted to the role aren’t really amenable to thinking that way.

There's also lifestyle inflation, and of course retiring early rarely impresses your spouse.

People do change, especially when exposed a long time to stressful environnement. Ask post-burnout fellow. Fortunately most re evaluate their life before going to burn out.

Assuming they only got as far as their residency (and didn't end up as attending physician), it's possible that they didn't see themselves spending a full 7 years as a resident doctor (making under $100k/year working 80+ hour weeks) only to spend the rest of their lives doing more of the same except with a much higher salary. If they already graduated their residency then the reasoning is the same except it's be a much harder decision because of the sunk cost.

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