- Joined
- Nov 10, 2008
- Messages
- 86
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- 5
Okay, so maybe I'm trying too hard, forcing it, failing to allow it to "hit me over the head" as I was promised it eventually would. I am, however, half-way through my third year, and must admit to some recent thoughts that all of that "it's never too late to choose a specialty" talk may be a bunch of horse !@#$. Sure, you can choose it at the beginning of your fourth year, but, if it happens to be competitive, good luck getting it. Good luck competing with those wonderful, gunning chaps who've had their future specialty branded on their arse since birth, doing benchwork in highschool and barging in on the plastics chief during the first week of MSI.
It feels as though I'm making too big a deal of the decision, but, then again, it has an impact on some rather important things in my life. Will I ever see my family again? Will I be able to start a family of my own? Will I be able to pay off my whopping $160,000 debt? Will I absolutely hate what I'm stuck doing every day, for the next forty years?
Luckily, I've at least narrowed it down to a surgical field. Simply: hours of rounds + diabetes + COPD + hypertension + more diabetes + talking without doing much else = me, trying desperately to keep my eyes open, wishing the people around me would stop talking so I could feel less guilty about paying no attention.
Further than "surgical field," I've made no progress whatsoever. Oh, and I've been thinking about this for a long, long time. Unfortunately, I do value my time off: I'd been in denial about this but, try as I might, I just can't shake that good feeling you get on the night preceding a day off, knowing you're free for the next twenty-four hours. I like concerts, video games, women, and cars, in that order. Work fluctuates between the spot just after women and just before it.
In short, nothing seems quite right. It just feels like there's a glaring problem with every single option:
Neurosurgery -
I love this. There's no duty I'd rather have than to remove meningiomas, place shunts, and clip aneurysms every week. When I see somebody cut the dura I'm practically drooling in stupid fascination.
But... seven years of NO significant life outside of the hospital? Why does it have to be this way? I tried for a while to convince myself that the lifestyle was the same as it is in general surgery, in orthopedics, in ENT....but, blargh, it was nothing but a sad, sad display of denial and inept rationalization. I feel almost as if neurosurgery would be a very selfish decision, stepping out on my parents who've done everything for me, only to return after nearly a decade to find them on the early end of elderly.
I sometimes wonder whether neurosurgery is some sort of sick TRAP for people whose self-esteem took a hit secondary to some bullying in highschool. I feel the same way about jobs at MGH and other high-flying academic institutions. Something about the prestige is so great that people line up to be paid less (per hour, at least) and mistreated, just for the ability to say at the end of the day that "I work at the MGH." Similarly, how about "I'm a neurosurgeon?" How sad would it be to have those scumbag jocks in senior high take your lunch, tease you in front of the girl you always wished you were cool enough for but from whom you never even got a "Hi"...and THEN, in some abstract and pathetic way ten years down the line, to have them rob you of the rest of your life by doing such a number on your ego that you felt compelled to enter some ridiculous ego-trap of a profession just to prove them wrong. Do MGH, Hopkins, and Columbia really think that people can eat prestige to supplement the meager meal that is their academic salary? Doctors can't eat prestige. They can eat steak and lobster, and shrimp, and, on Sunday afternoons, hamburgers.
Sorry, got a bit off-topic there.
General Surgery-
This too is fascinating, but not as fascinating as neurosurgery. You know what, though? It's interesting enough to keep me from looking back over my shoulder at neuro, thinking "I should have done that, but now I'm bored." However, the salaries aren't enough to get me out of my massive debt, starting at just 180k. You'd be crazy to do this when four years of anesthesia could earn you twice this, right? That's just common sense. I'd have to do a fellowship.
Wait. I could never do a fellowship, or I'd have to murder myself to fend off the regret. Surgical oncology is awesome, as is CT surgery, as is vascular, but, since 5 + 2 = 7 = the same amount of time as a neurosurgical residency, I wouldn't be able to live with it. If I'm going to spend seven years, working 80 hours per week, I might as well work a wee bit harder and do what I'm most interested in. I'd have no regrets, except, again, that I've missed an opportunity to spend time with my parents, start a family, get married, all that stuff that starts to seem really important when you put aside the hard@ss attitude and really think about it...
Orthopedic Surgery-
Sadly, this is the obvious answer. The musculoskeletal system is the least interesting thing I've had to study since enrolling in medical school. I'd rather talk about MAST CELLS and IL-2, TNF-alpha, and PGE2. I'd rather talk about the consistency of stool. I can't stand football, stretching, huge guys with bulging biceps, or talk of fitness and exercise.
However, the field has absolutely everything else. Surgery, and lots of it. Tons of invasive operations. Money to pay off my loans and buy a frickin' Maserati with the remainder. FIVE years of residency, the same as general surgery, with a potentially lighter schedule and more control over my life upon finishing.
I must admit to myself, though, that this medicine stuff has grown on me just a bit. I don't want to forget everything I know about medications, medical management, GI disease, neurological disease, etc. etc. I like that stuff (though NOT enough to tolerate even an hour of IM rounds. No, not that much). I don't want to be the doctor who can't give his friend a decent differential when he calls to ask him why he's got purpura and a sharp pain in his left upper quadrant. After all, he's a doctor, and he should know. This takes me back to general surgery a bit, but wouldn't you have to be completely nuts to do a residency of the same length and intensity as orthopedics, to be paid $100,000k less per year while spending more time in mucky medical management with sick, angry patients? I can't love my science books THAT much, can I?
ENT -
Hours are purportedly nice. Neck dissections are cool. Boogers and ear wax, coupled with the same suffering salary as general surgery, are not.
It's come down to a coin toss. Wait, I'd need a three-sided coin. !@#$!
Thanks for listening. Be gentle.
It feels as though I'm making too big a deal of the decision, but, then again, it has an impact on some rather important things in my life. Will I ever see my family again? Will I be able to start a family of my own? Will I be able to pay off my whopping $160,000 debt? Will I absolutely hate what I'm stuck doing every day, for the next forty years?
Luckily, I've at least narrowed it down to a surgical field. Simply: hours of rounds + diabetes + COPD + hypertension + more diabetes + talking without doing much else = me, trying desperately to keep my eyes open, wishing the people around me would stop talking so I could feel less guilty about paying no attention.
Further than "surgical field," I've made no progress whatsoever. Oh, and I've been thinking about this for a long, long time. Unfortunately, I do value my time off: I'd been in denial about this but, try as I might, I just can't shake that good feeling you get on the night preceding a day off, knowing you're free for the next twenty-four hours. I like concerts, video games, women, and cars, in that order. Work fluctuates between the spot just after women and just before it.
In short, nothing seems quite right. It just feels like there's a glaring problem with every single option:
Neurosurgery -
I love this. There's no duty I'd rather have than to remove meningiomas, place shunts, and clip aneurysms every week. When I see somebody cut the dura I'm practically drooling in stupid fascination.
But... seven years of NO significant life outside of the hospital? Why does it have to be this way? I tried for a while to convince myself that the lifestyle was the same as it is in general surgery, in orthopedics, in ENT....but, blargh, it was nothing but a sad, sad display of denial and inept rationalization. I feel almost as if neurosurgery would be a very selfish decision, stepping out on my parents who've done everything for me, only to return after nearly a decade to find them on the early end of elderly.
I sometimes wonder whether neurosurgery is some sort of sick TRAP for people whose self-esteem took a hit secondary to some bullying in highschool. I feel the same way about jobs at MGH and other high-flying academic institutions. Something about the prestige is so great that people line up to be paid less (per hour, at least) and mistreated, just for the ability to say at the end of the day that "I work at the MGH." Similarly, how about "I'm a neurosurgeon?" How sad would it be to have those scumbag jocks in senior high take your lunch, tease you in front of the girl you always wished you were cool enough for but from whom you never even got a "Hi"...and THEN, in some abstract and pathetic way ten years down the line, to have them rob you of the rest of your life by doing such a number on your ego that you felt compelled to enter some ridiculous ego-trap of a profession just to prove them wrong. Do MGH, Hopkins, and Columbia really think that people can eat prestige to supplement the meager meal that is their academic salary? Doctors can't eat prestige. They can eat steak and lobster, and shrimp, and, on Sunday afternoons, hamburgers.
Sorry, got a bit off-topic there.
General Surgery-
This too is fascinating, but not as fascinating as neurosurgery. You know what, though? It's interesting enough to keep me from looking back over my shoulder at neuro, thinking "I should have done that, but now I'm bored." However, the salaries aren't enough to get me out of my massive debt, starting at just 180k. You'd be crazy to do this when four years of anesthesia could earn you twice this, right? That's just common sense. I'd have to do a fellowship.
Wait. I could never do a fellowship, or I'd have to murder myself to fend off the regret. Surgical oncology is awesome, as is CT surgery, as is vascular, but, since 5 + 2 = 7 = the same amount of time as a neurosurgical residency, I wouldn't be able to live with it. If I'm going to spend seven years, working 80 hours per week, I might as well work a wee bit harder and do what I'm most interested in. I'd have no regrets, except, again, that I've missed an opportunity to spend time with my parents, start a family, get married, all that stuff that starts to seem really important when you put aside the hard@ss attitude and really think about it...
Orthopedic Surgery-
Sadly, this is the obvious answer. The musculoskeletal system is the least interesting thing I've had to study since enrolling in medical school. I'd rather talk about MAST CELLS and IL-2, TNF-alpha, and PGE2. I'd rather talk about the consistency of stool. I can't stand football, stretching, huge guys with bulging biceps, or talk of fitness and exercise.
However, the field has absolutely everything else. Surgery, and lots of it. Tons of invasive operations. Money to pay off my loans and buy a frickin' Maserati with the remainder. FIVE years of residency, the same as general surgery, with a potentially lighter schedule and more control over my life upon finishing.
I must admit to myself, though, that this medicine stuff has grown on me just a bit. I don't want to forget everything I know about medications, medical management, GI disease, neurological disease, etc. etc. I like that stuff (though NOT enough to tolerate even an hour of IM rounds. No, not that much). I don't want to be the doctor who can't give his friend a decent differential when he calls to ask him why he's got purpura and a sharp pain in his left upper quadrant. After all, he's a doctor, and he should know. This takes me back to general surgery a bit, but wouldn't you have to be completely nuts to do a residency of the same length and intensity as orthopedics, to be paid $100,000k less per year while spending more time in mucky medical management with sick, angry patients? I can't love my science books THAT much, can I?
ENT -
Hours are purportedly nice. Neck dissections are cool. Boogers and ear wax, coupled with the same suffering salary as general surgery, are not.
It's come down to a coin toss. Wait, I'd need a three-sided coin. !@#$!
Thanks for listening. Be gentle.
will completely understand if you say that you took a while to make a final decision on which surgical specialty you wanted (Just as long as your "But then I realized what an idiot I was to even consider any specialty but _________ is convincing)
