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i don't know what to do...

Discussion in 'Neurosurgery' started by remote, 03.08.12.

  1. remote

    remote

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    so i'm currently a MS3 and i know that i definitely want to go into a surgical field. the "weird" thing is that i've narrowed it down to either neurosurgery or urology...i think i'll be happy doing either, thus making the decision very hard. what are your thoughts on these two fields? which one would you pick and why? thanks.
  2. Chakrabs

    Chakrabs

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    These are two diametrically opposed fields. Uro offers an excellent lifestyle in residency and as an attending - light call, few true emergencies, short cases, patients aren't all that sick, and lots of outpatient procedures if you'd like.

    Neurosurgery is a much longer residency, very sick patients, long grueling hours in residency (the junior neurosurgery resident on call is quite literally the busiest person in the hospital), very long cases, and not always good outcomes. However, its freaking neurosurgery - offering possibly some of the coolest procedures you'll ever see. Lots of instrumentation and gadgetry. However, it truly is a calling. Its said that if you can see yourself doing anything else, go do that instead.

    If I were you, I'd spend some time on the neurosurgery and urology services and really see what they do. Two weeks at least for each if you're truly undecided. These are fields that MS3s rarely get to see so its likely that you'll have to spend some time early in your 4th yr to explore these.

    Also remember, these are two very competitive fields - urology especially

    Tell us, what interests you about these two fields?
  3. phenylacetone

    phenylacetone

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    I cannot speak for urology, but unfortunately for neurosurgery the nature of the expected 4th year schedule (with regard to SubIs and away rotations) is such that the deadline for making a commitment to the field is maddeningly soon, depending on exactly when your particular school schedules 4th year rotations and depending on where you want to do aways. It's amazing how colossal and life-altering decisions are made with such limited information (and especially 'gut feeling').
  4. Encephalectomy

    Encephalectomy PGY-0

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    I feel you, I know that I love neurosurgery, but I definitely don't feel like I've adequately ruled out other surgical specialties. At some point you just need to bite the bullet and, like you said, go with your gut because you are going to be working with a limited amount of information no matter what. It definitely does make me a little bitter though that due to the way my school schedules things I'll be going into 4th year not having really been exposed to fields I may have liked.

    I know that my interests are neuro>general>ortho. I don't really have a good idea where ENT and Uro fall on the spectrum as I didn't get to experience them this year. On a pure interest level it is going to be below neuro, but how far and is it enough to justify the lifestyle? I agonized over this for a while and then decided f-it, I'm jumping into Neuro head first and if after 2 sub-is (which would put me at August) I feel like I've made a terrible mistake I'll try to either get an ENT application together (I'm competitive numbers wise and it doesn't require away rotations) or worst case scenario take a year off, do ENT rotations next summer and apply then.

    Uro is a harder situation. Since it is an early match you really do have to make a choice by early summer at the latest. I'm not sure about Uro, but in neurosurg it seems like doing 1 home sub-i and at least one away sub-i is expected of applicants. You'll also want to have at least one Urology rotation under your belt before applying. I would say if its truly 50-50 go with uro. uro and neurosurg are very very different fields with on average very different lifestyles, acuity of patients, office/OR balance, personalities of practitioners, outcomes etc. If you haven't experienced much of either field try to set up some time over spring break to fill in the gaps (this is what I'm doing with ENT). Good luck!
  5. remote

    remote

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    so i actually have been quite fortunate to have had an opportunity to rotate 1 week on neurosurgery and 1 week on urology which is a short amount of time but it was enough for me to realize that both fields are awesome and that i think i'd be happy in either.

    thing is that neurosurgery def. has a bigger "wow, this is awesome" feel to it but i only assume that that kind of feeling will go away very quickly after you're doing it. so i'm not too concerned about the "coolness" aspect of nsg b/c i know that it will fade very quickly if i'm doing it every day. also, i agree with the fact that nsg def. have some cool toys and gagdets...but uro also has its share including endoscopic tools, lasers, robots, etc. also i feel that uro has a little more variety in the types of procedures to it than nsg...at least that the way it seems to me.

    another big difference (as mentioned above) is obviously lifestyle during residency and beyond. I know the nsg will require a greater time commitment...which I feel would be fine for next 10-15 years or so since i'll still be young...but what about when i'm 50, 55, 60...i don't know if that time commitment would still be okay with me. i kind of feel that i'd like to spend more time with family and leisure at those ages. the thing i like about uro is that it is more flexible in that respect in that a lot of urologists can decide to taper down the amount of big procedures they do and do more office-base urology with smaller procedures....not sure if that's a viable option with nsg.

    BUT, the nervous system is the most interesting system to me and i do enjoy learning more about it...thus my liking of nsg. so yeh, i'm very confused.
  6. Chakrabs

    Chakrabs

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    Its a hard decision for sure. I was neurosurgery all the way through all of med school. Lets see if it paid off next week. However, a classmate of mine vacillated between neurosurgery, orthopedics, and urology and eventually chose uro. Hasnt expressed a single regret since matching. If you want to have some semblance of a normal family life though, go for uro.
  7. jmillski

    jmillski

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    The attendings at my institution come in at 7 and leave at 430 other than the program director. Case loads are high and this still works out for them. I've been amazed and confused. The attendings and residents are the happiest I have seen so far in 3rd year. I don't know what to make of it. I love NS but I love family more.
  8. remote

    remote

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    are you referring to the neurosurgeons or the urologists??
  9. jmillski

    jmillski

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    Sorry... Neurosurgeons
  10. remote

    remote

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    oh, that's interesting...never heard that about neurosurgery. but i have often heard and seen that urology attendings/residents are some of the happiest group of pple in the hospital. maybe it's just been my experience...
  11. jmillski

    jmillski

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    Yea thats just it for me- I can't decide if my institution Is very unique in thy respect or if any NS can tailor a family life schedule if they're willing to make monetary sacrifices
  12. YouNeverKnow22

    YouNeverKnow22

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    Wouldn't the whole time thing also depend on how involved you are in your research/ trust in your residents? Just a thought.
  13. Beta Cell

    Beta Cell

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    Where do you attend?
  14. dude1344

    dude1344

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    Go with what you love and enjoy. If it's neurosurg, so be it. :)

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