Hate medicine...love surgery....but I want a life? What are my options?

[DrDoogieHowser]

When I entered medical school, I was so passionate about medicine and science. However, the longer I am in medical school the more I realize I actually really don't enjoy "real" medicine (i.e. spending hours on rounds discussing electrolytes or complex medical care or patients that are on 20 medications). I don't want to do specialties like anesthesia because I don't enjoy physio or pharm and I don't want to do internal because spending all my time on rounds sounds miserable. I do however really enjoy surgery and the immediacy of being able patients acutely and I loved gross anatomy. But my problem is I am already so burned out I honestly don't feel like I have it in me to get through a surgical residency (or any residency lol) and I also want a good work/life balance after residency. A lot of people have recommended EM, but the burn out rate is still crazy. I would still like to have some interaction with patients if possible.

So... my question is, without changing careers, what are some options for me? Do I settle for a non-surgical specialty even though I will hate it every step of the way? Or do I go for surgery even with my burnout and my desire to not die during residency and have a job with good hours? For reference, I have slightly above average board scores and extracurriculars with 1 publication so far (so I won't be matching into ophthalmology lol).

(I am sorry to be another one of -those- posts, but I am trying to get some real feedback and see if anyone else has gone through something similar so please be nice haha)

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[Detective SnowBucket]

When I entered medical school, I was so passionate about medicine and science. However, the longer I am in medical school the more I realize I actually really don't enjoy "real" medicine (i.e. spending hours on rounds discussing electrolytes or complex medical care or patients that are on 20 medications). I don't want to do specialties like anesthesia because I don't enjoy physio or pharm and I don't want to do internal because spending all my time on rounds sounds miserable. I do however really enjoy surgery and the immediacy of being able patients acutely. But my problem is I am already so burned out I honestly don't feel like I have it in me to get through a surgical residency (or any residency lol) and I also want a good work/life balance after residency. A lot of people have recommended EM, but the burn out rate is still crazy.

So... my question is, without changing careers, what are some options for me? Do I settle for a non-surgical specialty even though I will hate it every step of the way? Or do I go for surgery even with my burnout and my desire to not die during residency and have a job with good hours? For reference, I have pretty average board scores and extracurriculars with 1 publication so far (so I won't be matching into ophthalmology lol).

(I am sorry to be another one of -those- posts, but I am trying to get some real feedback and see if anyone else has gone through something similar so please be nice haha)

The two things you hate sound like routine rounding and working long hours. Rads might fit the bill. With avg stats you are kinda limited though.

 

[AnatomyGrey12]

I do however really enjoy surgery and the immediacy of being able patients acutely and I loved gross anatomy.

You can't have a surgery career without a surgery residency and putting in the time and effort to learn the craft. If you like immediacy and anatomy but want more of a life then I would do rads.

 

[allantois]

PM&R

 

[Medic741]

bite the bullet and embrace psych amigo

 

[DennisReynolds]

Hospital administration.

 

[Spectreman]

Open a DO school and run the anatomy lab

 

[Ho0v-man]

Vacation. You’re too burnt out on everything to make a decision IMO. If you get some flex time for fourth year, take a week to be a human and recharge. Then do a surgical away and take it seriously to make sure it is/isn’t for you.

If not, then yeah rads/path. Path actually has an amazing lifestyle,

 

[hallowmann]

PM&R, Rads, Psych. Those are really the best options. If you are burnt out from med school, Surg is likely not for you honestly. Don't take that the wrong way, its not for me either.

 

[Neopolymath]

People like this either suck it up and do surg or go for rads or anesthesia. Looks like you are doing rads my friend. Congrats.

 

[Eilat87]

You could do PM&R.

 

[Angus Avagadro]

Opthomologist

 

[harrislakers123]

Ophtho!!! The best surgical field that exists! 2 more former DO programs just got accreditation (PCOM and St Johns-NY). A good number of traditional ACGME programs interview and rank DOs with new ones doing it every year. Obliterate Step 1 and network through conferences and away rotations.

EDIT: You have already taken Step and are nearing end of third year then Ophtho will be extremely difficult

 

[sab3156]

Ophtho!!! The best surgical field that exists! 2 more former DO programs just got accreditation (PCOM and St Johns-NY). A good number of traditional ACGME programs interview and rank DOs with new ones doing it every year. Obliterate Step 1 and network through conferences and away rotations

Did you fail to read the original post, or what?

And telling someone nearing the completion of third year to magically become competitive for one of the most anti-DO fields is not good advice.

 

[harrislakers123]

Did you fail to read the original post, or what?

And telling someone nearing the completion of third year to magically become competitive for one of the most anti-DO fields is not good advice.

Whoops! Thanks man!

 

[paimei42]

path?

 

[Scrubs101]

Enjoy anatomy and want a life = rads

if you said you couldnt live without the OR id rec a research year and a surg sub or something. But like mentioned above take a break you sound burnt out

 

[You shall know the Truth]

being a surgical PA would give you what you want

 

[Splenda88]

Rad... 500k/year working 45-50 hrs/wk...Boom!

 

[SurgeDO]

Maybe consider ortho? I’ve never rotated through it but we have ortho residents rotating through my program. Quick rounds, the residents are usually out of the hospital by 3 or 4 pm. Most consults that come in during the middle of the night can be seen in the morning.

Perhaps some of the orthopods and ortho gunners here can provide more knowledge as mine is pretty limited.

 

[DarkHorizon]

Maybe consider ortho? I’ve never rotated through it but we have ortho residents rotating through my program. Quick rounds, the residents are usually out of the hospital by 3 or 4 pm. Most consults that come in during the middle of the night can be seen in the morning.

Perhaps some of the orthopods and ortho gunners here can provide more knowledge as mine is pretty limited.

two problems here, OP will have a very difficult time getting an ortho spot with his CV. It’ll be an absolute bloodbath to even make an impression, given his stats. With OP being so burnt out (his words) I don’t think he’s up for that kind of battle, just to get a spot.

Even if he gets spot, ortho residency is pretty hardcore. You may have encountered residents on off service, but junior residents usually start at 5 am and are there until the work is done (which is Pretty late most days). Can expect to work 60-80 hours routinely.

 

[sab3156]

Competitive residencies are off limits right now for OP, unless he wants to do a highly productive research year at a place that can get him hooked up with publications and connections. Seems like he doesn't want to do that, so the recommendations for things like Ophtho and Ortho aren't reasonable. Even doing that may not be enough due to lower than optimal Step 1 score. Is Radiology feasible for OP? He hasn't told us his actual stats, so who knows. If it's a 230, he will have trouble trying to match Radiology.

Honestly, I think OP should consider a different career if he thinks that he's going to hate going through the mental work of managing complex patients. Every specialty has complex patients and to hate your job because of that is not going to be a fun time. I also think he may just need to get over his burn out like some others are saying. Maybe do a research fellowship beween M3/M4 and re-assess your desire to practice medicine.

 

[Splenda88]

Competitive residencies are off limits right now for OP, unless he wants to do a highly productive research year at a place that can get him hooked up with publications and connections. Seems like he doesn't want to do that, so the recommendations for things like Ophtho and Ortho aren't reasonable. Is Radiology feasible for OP? He hasn't told us his actual stats, so who knows. If it's a 230, he will have trouble trying to match Radiology.

Honestly, I think OP should consider a different career if he thinks that he's going to hate going through the mental work of managing complex patients. Every specialty has complex patients and to hate your job because of that is not going to be a fun time. I think he just needs to get over his burn out like some others are saying. Maybe do a research fellowship beween M3/M4 and re-assess your desire to practice medicine.

220s with the right strategy can match easily into diagnostic rad (might not be a great program) if that person is a US MD student

 

[sab3156]

220s with the right strategy can match easily into diagnostic rad (might not be a great program) if that person is a US MD student

You're probably right, but he's a DO student I think (unless he posted in the wrong forum).

 

[Eye-eye]

Another surgical option could be uro. Not sure if the residency is as cush as ophtho can be, or what the stats required are (probably fairly competitive), but it's another surgical field with a little less brutal lifestyle.

 

[sab3156]

Another surgical option could be uro. Not sure if the residency is as cush as ophtho can be, or what the stats required are (probably fairly competitive), but it's another surgical field with a little less brutal lifestyle.

Urology is one of the most competitive specialties, so it's probably not an option for OP. But your post made me think of another specialty. Ob/Gyn.

@DrDoogieHowser have you considered doing Ob/Gyn? If you truly love surgery, you can do a fellowship in Urogynecology (aka Female Pelvic Medicine and Reconstructive Surgery) afterward. Read up on it - you may find it suitable.

 

[Dantrolene FC]

Anestheisa. It’s medicine in the OR without the clinic and rounds.

 

[jessmess]

I am sorry you're going through this. You sound really burned out and good decisions usually aren't made when you're in that headspace. I have been in your shoes. Just know that everything is going to be OK and it will all work out in the end as long as you figure out how to clear your head so that you can make a decision that is best for you.

I was burned out once and almost dropped out of med school. I switched out of surgery to something different and now I show up to work with a smile plastered on my face because I am so happy of where I am. I wanted to be a surgeon since I was a kid, and I realized later on that it didn't fit my lifestyle and I found something else that I loved even more.

Do whatever you need to do to recharge your batteries/get a clear head (if your school has you on a home quarantine, then this would be the perfect opportunity). Talk to people in the field that you trust and share your concerns... there is a reason why you feel burnt out, so you need to figure out WHY that is before you can make a life-changing decision. Idk where you are in your med school career, but the first 2 years are awful, the clinical years are great (but can be VERY stressful because of boards, shelf exams, and... having to make life-changing decisions).

Assuming you continue down the med school path... your options will be to either get excited about surgery again or consider an alternative field. Both options are great... you just gotta pick whatever rings truest to YOU.

Oh, and as a random aside....... Have you considered ER medicine (shift work, no rounds, lots of procedures)? Or how about being an ICU doc (which would be 3 yrs of IM, 1 yr of pulm crit)? ICU docs do bronchoscopies, art lines, central lines, intubations, other minor procedures, etc. but primarily do shift work, so they have lives. Perhaps ICU medicine would be something for you to consider (as long as you don't mind seeing a lot of death, which is the only thing that deterred me from that profession). There is a fair amount of 'medicine' in ICU, but maybe the occasional procedure would be enough to recharge your batteries.

Wishing you all the best. You've got this.

 

[Eye-eye]

Anestheisa. It’s medicine in the OR without the clinic and rounds.

I believe OP mentioned hating pharm, though.

 

[Dantrolene FC]

I believe OP mentioned hating pharm, though.

Yeah, probably wouldn’t be good then. Anesthesiologist are their own and it’s important to be able to practice solo because you won’t have nurses and pharmacists to help you out.

 

[Giovanotto]

I think a lot of people can relate OP, it's just the way it is. Either pick something else outside of surgery or man up. FWIW, I did the former.

 

[Peach Newport]

Urology is one of the most competitive specialties, so it's probably not an option for OP. But your post made me think of another specialty. Ob/Gyn.

@DrDoogieHowser have you considered doing Ob/Gyn? If you truly love surgery, you can do a fellowship in Urogynecology (aka Female Pelvic Medicine and Reconstructive Surgery) afterward. Read up on it - you may find it suitable.

obgyn is a brutal residency and essentially the opposite of a lifestyle specialty. definitely a specialty you do because you can’t imagine yourself doing anything else.

Im pretty sure Rads is doable in an undesirable area with average scores.

 

[Peach Newport]

I have similar feelings.

I agree with the person who suggested ICU - the guy I worked with, that really made me want to go to med school, is an intensivist. He only does nights - a week on, a week off, so every other week completely free. I hate even the idea of rounds (I’m at the end of second year, but I participated in enough rounds as a nurse to know I hate them), and the good thing about being an intensivist is that most places I’ve worked don’t do night rounds.

You’d skip all the crap, manage the whole ICU every night, and pretty much just respond to emergencies and do procedures. You don’t even have management breathing down your neck, and my friend wore jeans with his white coat and nobody cared. Wear what you want, eat what you want, no supervision, no rounds. You just have to be willing to work nights, which I personally am fine with because I did it for eleven years. Night shift >>>> day shift, to be honest.

Unfortunately, all of the docs I worked with were IM then pulm/crit, so you have to make it through an IM residency with their endless rounds to get there.

or you can get there through anesthesia

 

[Angus Avagadro]

I have similar feelings.

I agree with the person who suggested ICU - the guy I worked with, that really made me want to go to med school, is an intensivist. He only does nights - a week on, a week off, so every other week completely free. I hate even the idea of rounds (I’m at the end of second year, but I participated in enough rounds as a nurse to know I hate them), and the good thing about being an intensivist is that most places I’ve worked don’t do night rounds.

You’d skip all the crap, manage the whole ICU every night, and pretty much just respond to emergencies and do procedures. You don’t even have management breathing down your neck, and my friend wore jeans with his white coat and nobody cared. Wear what you want, eat what you want, no supervision, no rounds. You just have to be willing to work nights, which I personally am fine with because I did it for eleven years. Night shift >>>> day shift, to be honest.

Unfortunately, all of the docs I worked with were IM then pulm/crit, so you have to make it through an IM residency with their endless rounds to get there.

Working nights is different. You dont have your usual level of support and staff. Where is the TEE probe, ultrasound probe, sterile sleeves, diff airway cart, etc.? Staff at night are often rented or borrowed, not full time and may not know where things are stored. Very hit or miss. Working nights may be more stressful.

 

[deleted831695]

So speaking of life during residency, what's the general consensus of most brutal to least brutal non-surgical residencies (FM, IM, EM, Peds, Neuro, Rads, PM&R, Derm, etc.)?

 

[Splenda88]

IM/Neuro are the most brutal.... PM&R is arguably the least brutal

 

[Balo]

No one mentioned it, but pathology also gives you a lot of gross anatomy exposure, and I've read one case where a general surgery resident changed her mind and became a forensics pathologist; the downside is that there isn't really patient interaction unless you enjoy the deceased kind. The sub-specialty and location matter in terms of how much you could expect to earn, though (i.e. forensics pays pretty little apparently compared to surgical focused path). It has reasonable hours, so you probably won't be suffering too much in terms of lifestyle.

PM&R does give you tons of anatomic exposure, patient exposure, and the ability to do non-surgical procedures. According to one PM&R doc I've heard speak, you can tailor your practice to however you see fit.

Diagnostic radiology pays well, has tons of anatomy emphasis, and is not impossible to get into, but there wouldn't be patient exposure. It probably has a decent lifestyle unless you get tired of the same old and looking at images all day.

You probably wouldn't choose this because you don't like rounding and normal medicine things, but IM has a lot of sub-specialties that are very much like surgery (cardiology and GI are very procedure-friendly). You would have to go through 3 years of general internal medicine of course before you could go into one of those sub-specialty fellowships, and so you would have to deal with all those electrolyte considerations and complex patients.

You could choose general surgery, but if you're not willing to suffer the grueling lifestyle (or lack thereof a lifestyle at all), then, yeah, maybe you should consider these alternatives or others that people have mentioned.

 

[deleted1041468]

If you see these people giving pathology advice I’d highly recommend against it. No jobs. A field that is discombobulated. They have poor residencies even at some “top programs”. Rads is the best option for you.

 

[samac]

So speaking of life during residency, what's the general consensus of most brutal to least brutal non-surgical residencies (FM, IM, EM, Peds, Neuro, Rads, PM&R, Derm, etc.)?

IM seems overall pretty rough. My exposure is limited, but they were 12 on 2 off 12 hour days around me. Seems terrible. FM is program dependent. If it is an unopposed program from what I've seen they work hard with lots of hospital hours on top of their clinic duties.
Psych is my chosen field and overall on the interview trail, it seems to be an easier specialty. Outside of your medicine months, it would be extremely rare to hit the 80-hour cap.

OP, seriously consider psych. For some reason, I have met a lot of folks who loved surgery but shifted to psych and loved it equally. One mentioned it was because they loved helping people when they were most vulnerable, they're just different kinds of vulnerable. It's definitely a lifestyle specialty.

 

[DNC127]

Do family med OP.

Often work 8-5, 4 days a week, and you can make 300k in the midwest. Pretty dope gig. And you don't have to deal with medicine rounding and that BS.

Family med is super underrated.

 

[deleted1041468]

Do family med OP.

Often work 8-5, 4 days a week, and you can make 300k in the midwest. Pretty dope gig. And you don't have to deal with medicine rounding and that BS.

Family med is super underrated.

I agree. Not doing family med but I think it’s a great lifestyle as long as mid levels don’t take over completely and you lose your job. It’s very underrated.

 

[Splenda88]

Do family med OP.

Often work 8-5, 4 days a week, and you can make 300k in the midwest. Pretty dope gig. And you don't have to deal with medicine rounding and that BS.

Family med is super underrated.

It's amazing that FM is not competitive... Salary and lifestyle are great. You can make 200k+ working M-Th in some big cities or nice suburbs.

 

[slowthai]

OP, seriously consider psych. For some reason, I have met a lot of folks who loved surgery but shifted to psych and loved it equally. One mentioned it was because they loved helping people when they were most vulnerable, they're just different kinds of vulnerable. It's definitely a lifestyle specialty.

I still don't really understand this. I've heard other claims of it being "invasive", just like surgery but focused on the mind instead of the body. I'm still not seeing how it's a natural switch honestly.

 

[Neopolymath]

I still don't really understand this. I've heard other claims of it being "invasive", just like surgery but focused on the mind instead of the body. I'm still not seeing how it's a natural switch honestly.

I didn't either until I heard tons of people saying it about themselves. I can see it personally having greatly enjoyed both rotations. Two awesome fields.

 

[FindersFee5]

I still don't really understand this. I've heard other claims of it being "invasive", just like surgery but focused on the mind instead of the body. I'm still not seeing how it's a natural switch honestly.

So I've heard this a bunch too - but only from psychiatrists. Never heard a surgeons say "I was originally planning to do psychiatry but then I fell in love with surgery." My pet theory is that it's some weird compensatory mechanism for psychiatrists not feeling entirely like real doctors.

 

[slowthai]

So I've heard this a bunch too - but only from psychiatrists. Never heard a surgeons say "I was originally planning to do psychiatry but then I fell in love with surgery." My pet theory is that it's some weird compensatory mechanism for psychiatrists not feeling entirely like real doctors.

Lol. So I did some reading in the psych forums and one parallel that came up is the ability to more or less focus on just one problem and have a major impact on the outcome. But honestly, I'm still not really seeing it, because you're still pushing pills like 90% of the time, lol. And most of the time, it's doesn't appear to be an immediate gratification specialty unless you're doing consult psych.

 

[libertyyne]

Working nights is different. You dont have your usual level of support and staff. Where is the TEE probe, ultrasound probe, sterile sleeves, diff airway cart, etc.? Staff at night are often rented or borrowed, not full time and may not know where things are stored. Very hit or miss. Working nights may be more stressful.

not to mention circadian rythm troubles. When you are young you think its easy , but try being 55 and switching circadian from your on and off weeks.

 

[sunshinefl]

I didn't either until I heard tons of people saying it about themselves. I can see it personally having greatly enjoyed both rotations. Two awesome fields.

So I've heard this a bunch too - but only from psychiatrists. Never heard a surgeons say "I was originally planning to do psychiatry but then I fell in love with surgery." My pet theory is that it's some weird compensatory mechanism for psychiatrists not feeling entirely like real doctors.

Multiple surgery residents have told me that psych was their 2nd favorite field.

 

[libertyyne]

Multiple surgery residents have told me that psych was their 2nd favorite field.

Gen surgery? Surprising, the crowds are very different.

 

[samac]

Gen surgery? Surprising, the crowds are very different.

I honestly find it strange because I hated gen surg with the intensity of 1000 suns and went psych, but I've heard it from so many people on both sides now there must be something to it.