How did you know you wanted to be a surgeon?

[TheMan21]

I won't start med school until this Fall so I know I have plenty of time to make a decision, but I'm just curious as to what made you guys and gals decide to go this route. From the outside looking in, surgery seems fascinating and intimidating at the same time. Actually cutting someone open and attempting the cure/alleviate symptoms seems cool. However, the long residency, never-ending work weeks, and supposedly malignant attendings kind of turn me off.

So why do you do it?

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[Scrubbed]

 

[opr8n]

1. the idea of clinic all day, 5 days a week made me want to quit medicine
2. i like rounding on all my patients in the 2 hours prior to the OR start time of 0730, the same task which takes medicine all day to do
3. My medical lisence says "doctor of medicine and surgery" and i actually wanted to be able to practice both
4. play time = OR
5. last but not least, the ability to make significant impact of pts lives in a short period of time (heal with steel)

 

[JackADeli]

I have to agree with some of what has been said....
1. I had always thought of entering medicine. Not sure I grasped the different fields growing up... they were probably all the same blur in my head.
2. I like to think and do.
3. Most of what we do in surgery is not ~palliative but more curative.
4. Human nature what it is and me being who I am, I knew I would be frustrated and fed up giving medical guidance to be ignored. There is little issue of non-compliance with cholecystectomy.
5. Hours can be long. To me, a long (3+ hours) OR case is short compared to having to listen to some of the 15-30minutes of drivel, whining, and excuses I heard all the time from patients during medicine rotations. I enjoy talking to patients. I enjoy diagnostic challenges. But, I don't tolerate politicians that try to convince me an expired "tax cut" is not a "tax increase" nor do I tolerate a obese patient gaining wait, sitting on the couch telling me, "I am really trying to loose weight, I don't eat very much, I have really cut back" or the diabetic that has a H1c of 14 telling me, "I've really been doing a good job with my diet and exercise...". God bless the PCPs that can put up with it. I just don't have that personality.

From my perspective, heaping on more medications to counter patient non-compliance (smoking, hypertension, obesity, diabetes, dyslipidemia, etc...), is in effect prolonged palliative care.

 

[waxedapathetic]

From my perspective, heaping on more medications to counter patient non-compliance (smoking, hypertension, obesity, diabetes, dyslipidemia, etc...), is in effect prolonged palliative care.

this last statement is something i've appreciated more and more since matching to a surgery program.

it seems so frustrating to prescribe a ton of medications (much of which aren't even taken by patients--40% noncompliance rate) for a problem and not achieving much of a result. plus, recent research seems to be questioning the value of many of the arduous medication regimens used against common chronic conditions (e.g., strict glycemic control in diabetes).

i admire people who do internal medicine ... i just wouldn't be happy doing it.

 

[Semmelweis]

I did a program at NYU early in my undergraduate days when I was thinking of applying to med school. I got to round with the surgery team and observe surgery all day. It was pretty awesome and made a big impression on me. And even though I was commuting by train from Brooklyn and waking up at 4:15 to get there by 6am, the hours didn't really hit me since I was doing it for just one month. I thought it was cool and heroic to leave the surgeons at 5pm, come back the next morning and learn that they had been there all night operating on a complicated case.

Anyway, I applied to med school expressly in my personal statement saying that I wanted to be a surgeon. I had some second thoughts during my actual 3rd year surgery rotation when the hours came to hit home and the personalities were a bit rough, but I still came 'round to surgery because what surgeons do is just awesome. I gave serious consideration to a lot of other fields including ER, gas, GI, even path, but all of them ultimately felt like I was giving up on my dream. Plus, reiterating what others have already written, medicine clinic bores the tears out of me while also frustrating and annoying me. I cannot stand doing that for my whole career. Basic IM rounding for 3-4 hrs each day felt like purgatory to me. Plus, I find that I actually prefer brusque but honest personalities more than overly nice, passive aggressive ones.

I don't want to be a patient's "care coordinator;" I want to be the one fixing 'em with my own two hands. Dreaming up long differential lists interests me for a little while, but scrubbing up and going in is what keeps me at the table.

 

[JackADeli]

...i admire people who do internal medicine ... i just wouldn't be happy doing it.

Agreed. A good FP/FM/PCP is gifted in ways that I am not. They are worth their weight in gold.

 

[Rabbit Hole]

It's gonna be either General Surgery or Psychiatry for me because that's what I'd be good at. No joke.

 

[teddybear]

I don't want to be a patient's "care coordinator;" I want to be the one fixing 'em with my own two hands.

 

[Buzz Me]

It's gonna be either General Surgery or Psychiatry for me because that's what I'd be good at. No joke.

How do you know that?

 

[GoLytely]

I'll tell you why I decided NOT to become a surgeon:

1. Laparoscopy.

If I want to play video games, Modern Warfare 2 is considerably more fun and interesting than 4 hours of steering a camera around in an inflated abdomen.

The difference in enjoyment I had between a big open case (AWESOME) and a laparoscopic case (would actually dread it, beginning the night before if one were scheduled) was VAST (not to be confused with VATS, which I also hated).

Seeing the trend, and since I loved medicine as well, I opted out of surgery. I will say that the borne surgeons in my class loved the laparoscopic stuff.

 

[JackADeli]

I'll tell you why I decided NOT to become a surgeon:

1. Laparoscopy.

...Seeing the trend, and since I loved medicine as well, I opted out of surgery. I will say that the borne surgeons in my class loved the laparoscopic stuff.

It is good that you had a clear sense of what was right for you. I think too often students get hung up on zebras and choose specialties based on zebras and not the everyday practice. If you are really excited about internal medicine/FP/Pedes?etc.... primary outpt/clinical ward medicine, you should persue that.

I have met more then a few surgery residents that complained about how much they loved the diabetics/asthma/hypertension on medicine and how unhappy they were cause they thought they would be doing AAA/carotids/whipples/etc... predominately during residency. They were very unhappy with hemorrhoids and inguinal hernias during their first year.

But, as a med student, you often get to cherry pick and scrub into major cases. The attending may have you scoop the goop out of the AAA or let you feel the pancrease.... all very exciting. though, it probably is distracting from when some were happy on the medicine wards!

 

[filter07]

Much of the satisfaction I get from doing an operation is not about how much fun I get from the operation itself but that the operation I'm doing can help someone. There is a big difference, at least for me, between doing cases on the simulator (boring), and doing it on a real patient. Admittedly there are cases that are just boring no matter what (re-do re-do re-do ventral hernia repair), and no case will be as "fun" as MW2 (great game BTW). But nobody's life is improved after playing MW2, whereas I can help someone tremendously with an operation.

Although laparoscopy is less fun for me than a big whack, I like the fact that I can do an operation that will benefit the patient more with smaller scars, faster recovery time, and less pain. There is some satisfaction in doing the least damage possible for the best benefit. The same is true with the endovascular interventions I've done (very few). Not as fun but more satisfying in terms of helping the patient.

 

[Rabbit Hole]

How do you know that?

My selective OCD is perfect for repeating and mastering technical procedures.

I like the challenge of bringing people back from the fringes of reality.

You can decide which is general surgery and psychiatry.