Disliking M3, worried about future

[AABB999]

(obvious throwaway account due to post content)

Everyone seems to get burned out during M3, and everyone has rotations they hate. But as we all fill out our paperwork for M4 and sign up for Step 2, etc, I'm secretly panicking because I haven't liked anything. I've been bored/eager to be dismissed on every required rotation thus far, and have pretty much already ruled out the two remaining required rotations left. I have friends who also dislike all the required rotations, but they're all already 100% set on what they want to do. I couldn't be farther from that. I'm doing above average overall, getting good evals and killing the NBMEs, but nothing I've done has said to me "I could see myself doing this for 30 years." I went to medical school to be surgeon, but have realized I'm not a surgeon at heart. I haven't met any doctors who I look at and think "this person is me."
I've tried to talk about this to my friends, but they just tell me "you'll figure it out" or jokingly tell me to drop out, not realizing that, if I could turn back time, I probably would. I've got plenty of debt, no other employable skills other than my brains, and hate myself for putting myself in this position. I'm also a non-trad, and while not much older than my peers, I'm feeling every tick of the clock of life. I truly want to help/heal people, but don't see a pathway to get there at this point.

My question: what do I do? I've admittedly been fully inoculated with the cultural stigma against seeing mental health professionals and am kind of scared/embarrassed to see the school counselor or psychiatrist, especially because while the psychiatrist is nice, I worked with them on psych. I don't come close to meeting the DSM criteria for depression, and I'm not sure how they could help anyway. The academic counselor we're required to meet with in M3 basically told me "you'll end up liking something" and then essentially told me to just pick something. My friends have told me to just go with something like EM/PMR and work short hours (maybe) or pathology (no).

Everyone is looking forward to M4. I'm dreading it as the deadline it is. Would love any suggestions, here or PM.

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[DO2015CA]

What about occupational medicine? It can be shaped to more of an office job than clinical. Wrote procedure for companies.

 

[Southplains]

Competitive for ortho? What did you think about anasthesia?

 

[Oso]

Surely you haven't rotated through every specialty. Maybe look into possible electives in other fields that could be interesting?

Have you looked into anesthesia, diagnostic radiology, or IR?

Also, for what it's worth, I've heard it's not unusual for surgery residents to switch fields into pathology .. for whatever reason. I know you said "no", but maybe do an elective and see what you think? I feel like now is a good time to try to keep an open mind.

 

[Anti-PD1]

What are your passions outside of medicine and First Aid. We need to know who you are to say more.

 

[AABB999]

Competitive for ortho?

Probably, with an ortho paper. Already an author on 10+ papers in surgery. More of an "I'm not an ortho type of person" deal. Would probably need a research year for derm.

What did you think about anasthesia?

Surely you haven't rotated through every specialty. Maybe look into possible electives in other fields that could be interesting? Have you looked into anesthesia, diagnostic radiology, or IR?

You're right, I haven't. Issue is I've had zero elective hours so far. Can choose one elective in May and will probably have time for one between Step 2 and away/applying.
Shadowed in reading room a bit and missed patient contact; anesthesia always seemed bored during surgeries. Don't think I have time to try all of these...

What are your passions outside of medicine and First Aid. We need to know who you are to say more.

All over the place. Outdoors/sports, art, literature, non-medical science. I am very academic and had different college professors encourage me to enter PhD fields in hard science, social science, and humanities. I've always been naturally good at pretty much everything I try, which sounds like a brag but also means I never have had to undergo any ruthless self-assessment until it was too late (now).

Would at least consider academic medicine, but don't really like wet lab work, and don't want to start a PhD now.

What about occupational medicine?

How does one even learn anything about this? Serious question.

 

[DBV]

Msk rads

 

[jcorpsmanMD]

At the end of the day it’s a job, you’re a non-trad, you know what’s it’s like. Life isn’t sunshine & rainbows. You’ll figure it out

 

[raiderette]

What about IR? Lots of procedures but different from surgery.

 

[zero0]

Perhaps all of your concerns could be addressed with a simple reminder: this is a job, you're not supposed to be over the moon about it. Pick something that has the parts of medicine you enjoy and as little of the parts you don't like as possible. If you're really not into anything then just pick something on the low end of weekly hours. Or go balls to the wall in a high paying specialty, work your butt off for 15-20 years, retire, and say goodbye to medicine forever.

 

[Tenk]

1) Figure out what you want to do in life outside of work. Ie: how much time off do you want?

2) Figure out how much money would be the minimum yearly salary you can live with.

3) Pick the specialty you hate the least that satisfies 1 and 2.

4) Work as little as possible to enjoy your life as much as possible.

 

[libertyyne]

Find the least annoying specialty.

 

[DrYoda]

Is there anything in particular you are looking for in a career as far as what you do at work, procedures, lifestyle ect.?

My best advice is to burn a day or two (yes I know days off are precious) and try to shadow a specialty that isn't a core rotation but you at least can possibly find some interest in. I think most departments/attending wouldn't have a problem with this and it will give you at least some exposure to life outside of the core rotations. Assuming you like procedures based on the initial surgery interest; anesthesia, IR, EM, GI, critical care, interventional cards would be some ideas.

 

[DO2015CA]

Probably, with an ortho paper. Already an author on 10+ papers in surgery. More of an "I'm not an ortho type of person" deal. Would probably need a research year for derm.



You're right, I haven't. Issue is I've had zero elective hours so far. Can choose one elective in May and will probably have time for one between Step 2 and away/applying.
Shadowed in reading room a bit and missed patient contact; anesthesia always seemed bored during surgeries. Don't think I have time to try all of these...


All over the place. Outdoors/sports, art, literature, non-medical science. I am very academic and had different college professors encourage me to enter PhD fields in hard science, social science, and humanities. I've always been naturally good at pretty much everything I try, which sounds like a brag but also means I never have had to undergo any ruthless self-assessment until it was too late (now).

Would at least consider academic medicine, but don't really like wet lab work, and don't want to start a PhD now.


How does one even learn anything about this? Serious question.

Find one and shadow. Talk to them about their career and how they got there. Explain your goals in life outside medicine and see if it’s accomplishable through that specialty. Then do an elective very early 4th year.

Like others have said before, medicine is a job. Sure you have to have the passion to make it through the horrible school but you’ve done that part. Depending on the amount of money you need per year you can do anything. Hell Go family medicine and pick up part time UC shifts after you bust your bum to pay off loans quick.

 

[OtterSpace]

Didn't read all the comments so far so sorry if I regurgitate a previous reply, but I want to remind you of the industrial side of medicine OP. Perhaps you're not drawn to the clinical/typical workflow most doctors do e.g. hospitals, clinics, etc. BUT! Lucky for you there's entire industries in science and biotechnology looking to hire MDs/PhDs.

TL;DR: finish your degree & if absolutely nothing interests you in the end, consider consultant work as a physician in the business industry! Godspeed friend

 

[AMEHigh]

If you really didn't find anything that interest you then I'd do either IM or FM.
Both of those will give you broad experience and can be helpful in a bunch of non-clinical jobs if you decide to go that path in the future. You will have a wide variety of job options (or fellowships if you end up finding more of a passion). Plus, they're both only 3 years and while the hours aren't necessarily easy, you'll still be able to have a life outside of work.

I definitely wouldn't go in to anything more specialized like anesthesia or radiology if you don't have any interest in those fields.

Lastly, I didn't really love anything until starting 4th year. And what I thought I loved isn't what I matched in to. I'm very happy now, yet still don't have everything figured out. It's ok if you aren't 100% confident in exactly what you want to do.

 

[Donald Juan]

Become a hospitalist, 3 year residency and afterwards you work every other week. If you're smart with your money you can achieve financial independence in about 10 years and then leave medicine forever if you want.

 

[Entadus]

How about pathology? Psychiatry? Occupational medicine? PM&R? Radiology?

 

[DBV]

I didn't like much in third year settled on IM to keep options to subspecialize open and liked GI during my elective. Dont get me wrong it's very much a job and I won't wake up every morning pumped to go in but it'll make good money and can be relatively flexible depending on how your practice is structured.

Moral of the story is sometimes you just have to find something you can tolerate

 

[Mr.Monster]

Although I am only beginning my medical journey in the fall, I do recommend you look under the 'SDN Resources' tab, press the 'Residency Selector' button, and take the quiz on that page. It will "pair" you to specialities based on your personality type. Then, I recommend you follow the advice given on thread and shadow in the specialities where you matched personality-wise.

 

[AABB999]

Thanks all. It's just been crushing to have given up a good social life, a fairly well-paying job at a young age, and most of what made me unique/happy in order to gun for years only to realize medicine so far hasn't been what I thought it was. The attendings/residents I've met have overwhelmingly seemed unhappy, cynical, or poorly-adjusted, which hasn't helped (which might be a function of my school).

IM was my first rotation and probably my least favorite, but I guess that's an option.

My best advice is to burn a day or two (yes I know days off are precious)

I have been trying to do this, but we only get a day off every few months, and it's been tough to shadow on weekends.


I guess I'm curious whether anyone has successfully found what they want to do in the beginning of M4, and if so, how they managed to make that work. I have one elective rotation and then get 13 weeks of electives/flex time before Sept 15. However, I'm going to take some weeks for CK, and the academic adviser recommended an away rotation before applying (regardless of field), which makes things pretty tight...

 

[You shall know the Truth]

How about pathology? Psychiatry? Occupational medicine? PM&R? Radiology?

What are you looking to do come residency this year?

 

[Entadus]

What are you looking to do come residency this year?

psych

 

[You shall know the Truth]

psych

What about psych is appealing to you?

 

[treebeardette]

(obvious throwaway account due to post content)

Everyone seems to get burned out during M3, and everyone has rotations they hate. But as we all fill out our paperwork for M4 and sign up for Step 2, etc, I'm secretly panicking because I haven't liked anything. I've been bored/eager to be dismissed on every required rotation thus far, and have pretty much already ruled out the two remaining required rotations left. I have friends who also dislike all the required rotations, but they're all already 100% set on what they want to do. I couldn't be farther from that. I'm doing above average overall, getting good evals and killing the NBMEs, but nothing I've done has said to me "I could see myself doing this for 30 years." I went to medical school to be surgeon, but have realized I'm not a surgeon at heart. I haven't met any doctors who I look at and think "this person is me."
I've tried to talk about this to my friends, but they just tell me "you'll figure it out" or jokingly tell me to drop out, not realizing that, if I could turn back time, I probably would. I've got plenty of debt, no other employable skills other than my brains, and hate myself for putting myself in this position. I'm also a non-trad, and while not much older than my peers, I'm feeling every tick of the clock of life. I truly want to help/heal people, but don't see a pathway to get there at this point.

My question: what do I do? I've admittedly been fully inoculated with the cultural stigma against seeing mental health professionals and am kind of scared/embarrassed to see the school counselor or psychiatrist, especially because while the psychiatrist is nice, I worked with them on psych. I don't come close to meeting the DSM criteria for depression, and I'm not sure how they could help anyway. The academic counselor we're required to meet with in M3 basically told me "you'll end up liking something" and then essentially told me to just pick something. My friends have told me to just go with something like EM/PMR and work short hours (maybe) or pathology (no).

Everyone is looking forward to M4. I'm dreading it as the deadline it is. Would love any suggestions, here or PM.

What do you mean by "not a surgeon at heart"? If you mean you hated general surgery because you don't fit in with general surgeons, don't let that rule out the surgical subspecialties for you. I hated gen surg, I love ENT. But if you liked the OR, Ortho, ENT, Uro, Ophtho are all good options to make good money and work good hours for a surgical specialty after residency. The vast majority of ENTs I've met are happy and love what they do. The reputation is good for the others as well.

A lot of what you're describing also sounds pretty good for derm. Don't really care about anything in particular in medicine, want good hours and good money, competitive scores --> derm. I know you would have to take a research year, but it might be something worth considering anyways since you are so uncertain. Make sure you're going into the right field before you commit to it, you don't want to be trying to change residencies in a year when you figure out you chose wrong (happening to a friend right now). Consider using a research year to explore the subspecialties you wouldn't otherwise have time to explore and build up your resume for derm if you still don't know what you want. Otherwise you need to pick something soon to get away rotations set up (I don't remember the timeline).

 

[The Physician Philosopher]

I'd venture out there and say a few things.
1) no matter how excited someone gets about the specialty they choose... It ends up being a job in the end. Nothing stays exciting for twenty or thirty years.
2) with a sound investment plan in place you can easily retire in 10 to 12 years if you want. Don't have to work for thirty.
3) there are many "outside" of medicine jobs, too. Plenty of law firms, pharmaceutical companies, etc want to hire docs. Usually they want docs that have gone through residency, though not always.
4) you can make your practice as academic as you want. If you get grants that pay for your salary you don't have to do any clinical time if you don't want it. Sounds like you are already quite accomplished academically. I love this aspect of my job.

For more fodder can read my other thoughts here:

Choosing the right Medical Specialty - The Physician Philosopher

Physician Burnout: You Aren't Alone - The Physician Philosopher



Sent from my XT1710-02 using Tapatalk

 

[mistafab]

I am a lowly m2 - however based on what I know about my school’s rotations, your are basically only seeing academics or inpatient stuff. There is a lot of medicine that is private practice and more business-related where the doctors are very different than the academic types who are always fighting for grant money and working for a salary (meaning, every case they take is not giving them anything of benefit depending on their contract).

So even though you thought ortho/surgery looked bad, you probably only got exposed to academic surg which is a completely different beast. Maybe consider this before you think you don’t like everything you’ve seen. You might NOT like anything, however, how much besides academic medicine have you really seen in your rotations? VA is a completely different thing as well.

Edit: So to be clear, have you thought about a rural surgery elective? Maybe seeing a different flavor than your rotation will give you a better look at what life could be like outside of what you’ve seen.

 

[Womb Raider]

(obvious throwaway account due to post content)

Everyone seems to get burned out during M3, and everyone has rotations they hate. But as we all fill out our paperwork for M4 and sign up for Step 2, etc, I'm secretly panicking because I haven't liked anything. I've been bored/eager to be dismissed on every required rotation thus far, and have pretty much already ruled out the two remaining required rotations left. I have friends who also dislike all the required rotations, but they're all already 100% set on what they want to do. I couldn't be farther from that. I'm doing above average overall, getting good evals and killing the NBMEs, but nothing I've done has said to me "I could see myself doing this for 30 years." I went to medical school to be surgeon, but have realized I'm not a surgeon at heart. I haven't met any doctors who I look at and think "this person is me."
I've tried to talk about this to my friends, but they just tell me "you'll figure it out" or jokingly tell me to drop out, not realizing that, if I could turn back time, I probably would. I've got plenty of debt, no other employable skills other than my brains, and hate myself for putting myself in this position. I'm also a non-trad, and while not much older than my peers, I'm feeling every tick of the clock of life. I truly want to help/heal people, but don't see a pathway to get there at this point.

My question: what do I do? I've admittedly been fully inoculated with the cultural stigma against seeing mental health professionals and am kind of scared/embarrassed to see the school counselor or psychiatrist, especially because while the psychiatrist is nice, I worked with them on psych. I don't come close to meeting the DSM criteria for depression, and I'm not sure how they could help anyway. The academic counselor we're required to meet with in M3 basically told me "you'll end up liking something" and then essentially told me to just pick something. My friends have told me to just go with something like EM/PMR and work short hours (maybe) or pathology (no).

Everyone is looking forward to M4. I'm dreading it as the deadline it is. Would love any suggestions, here or PM.

There's an MS4 who took some time off because he couldn't decide what specialty to go in to. He made a podcast where he interviewed MDs in various specialties - you might find it interesting. It's called: "The Undifferentiated Medical Student."

 

[deleted707454]

Become a part time teleradiologist and then do whatever the hell you want outside of medicine. Insight from a DR is needed, but you could likely clear 200k working 1/2 the month

 

[dpmd]

What about surgery made you initially want to do it, and what about it now makes you not want to? I want to explore whether you truly don't want it or just didn't love being a med student in surgery (which is vastly different than actually being a surgeon).

 

[ortnakas]

Everyone's giving you ideas on things you might like (which is great), but I think you also need to be a little introspective and identify what it is exactly you haven't liked so far. Do you dislike the pace of clinic? Do you dislike rounding? Do you dislike procedures? If you can't figure out what you DO like, maybe pinpointing what you don't can help figure out how to avoid it.

 

[AABB999]

What about surgery made you initially want to do it, and what about it now makes you not want to? I want to explore whether you truly don't want it or just didn't love being a med student in surgery (which is vastly different than actually being a surgeon).

I didn't like the lifestyle, and by that I mean I didn't like having absolutely no free time. I'm someone who needs time to recharge, and while I realize med school surgery perspective (retracting all day, then going home and studying) and the resident perspective is vastly different from that of an attending, I'm honestly not sure I could take 5+ years of 110-120+ hour weeks. I'm a non-trad who'll finish residency in my mid-30s, and I feel like my overall life is on pause right now; I want something outside of medicine, even if it isn't much.

Also, the unhappy residents, the many stories residents on other services told us about how half their friends in surgery switched residencies, and the fact that attendings are apparently totally happy rarely seeing their families/leaving the hospital all surprised me. Overall I've gotten the impression that surgery IS your life, and that's not what I want. Maybe that's just my personal exposure, but it's hard to say.

If you mean you hated general surgery because you don't fit in with general surgeons, don't let that rule out the surgical subspecialties for you.

You're right, of course, but as the academic counselor told me, it seems you pretty much have to go into med school knowing you want to do one of those fields. I'd love to try ENT, for example, but I don't know whether I'll have time at this point...

Everyone's giving you ideas on things you might like (which is great), but I think you also need to be a little introspective and identify what it is exactly you haven't liked so far.

I guess I'd like a mix of inpatient/outpatient (more of the latter), working in multiple settings (open to VA/prisons/etc), mostly doing shorter procedures (ideally 1-2 hrs) with some patient contact. The reason I liked ortho before med school was I had extensive exposure in an ortho mostly-outpatient clinic where the surgeons would operate a few days a week and see outpatients the other days. I never saw them round or talk about call, which was my mistake.

I haven't liked rounding for hours every day, sitting around (med school perspective) or pure med management, but I also was bored out of my mind in the OR watching the surgeons chase bleeds on the same procedures every day. For example, I thought I might really like gyn surgery, so I did 2 weeks of gyn surgery as part of OBGYN. I was in the OR for probably 120 hours and saw so many vag hysterectomies and myomectomies that I never want to see another. I'm worried I'd go crazy if I had to see that (or choles, or ORIFs, or whatever) for 5 years. On the other hand, I don't want the life of call that trauma/CT seems to be forced into. I grew up rarely seeing my father due to his work obligations, and don't want to do that to my kids.

So I guess I'd like surgery if it were "easier," which I realize is a dumb thing to say. I'm going to try to get more exposure to PMR, DR/IR, EM, etc, though in reality I likely only have time for one or two. If I were 25, things might be different, but I don't want to blink and be a 37 year old single, boring, sad attending. If medicine is just a job (which it is) I want other things in my life too, and so far, I haven't met a surgeon (resident or attending) who has that.


Thanks for all the comments, I am reading/reflecting on them all. For the M1s/M2s out there, I'd recommend shadowing every week, which is what I wish I had done.

 

[dpmd]

I didn't like the lifestyle, and by that I mean I didn't like having absolutely no free time. I'm someone who needs time to recharge, and while I realize med school surgery perspective (retracting all day, then going home and studying) and the resident perspective is vastly different from that of an attending, I'm honestly not sure I could take 5+ years of 110-120+ hour weeks. I'm a non-trad who'll finish residency in my mid-30s, and I feel like my overall life is on pause right now; I want something outside of medicine, even if it isn't much.

Also, the unhappy residents, the many stories residents on other services told us about how half their friends in surgery switched residencies, and the fact that attendings are apparently totally happy rarely seeing their families/leaving the hospital all surprised me. Overall I've gotten the impression that surgery IS your life, and that's not what I want. Maybe that's just my personal exposure, but it's hard to say.



You're right, of course, but as the academic counselor told me, it seems you pretty much have to go into med school knowing you want to do one of those fields. I'd love to try ENT, for example, but I don't know whether I'll have time at this point...



I guess I'd like a mix of inpatient/outpatient (more of the latter), working in multiple settings (open to VA/prisons/etc), mostly doing shorter procedures (ideally 1-2 hrs) with some patient contact. The reason I liked ortho before med school was I had extensive exposure in an ortho mostly-outpatient clinic where the surgeons would operate a few days a week and see outpatients the other days. I never saw them round or talk about call, which was my mistake.

I haven't liked rounding for hours every day, sitting around (med school perspective) or pure med management, but I also was bored out of my mind in the OR watching the surgeons chase bleeds on the same procedures every day. For example, I thought I might really like gyn surgery, so I did 2 weeks of gyn surgery as part of OBGYN. I was in the OR for probably 120 hours and saw so many vag hysterectomies and myomectomies that I never want to see another. I'm worried I'd go crazy if I had to see that (or choles, or ORIFs, or whatever) for 5 years. On the other hand, I don't want the life of call that trauma/CT seems to be forced into. I grew up rarely seeing my father due to his work obligations, and don't want to do that to my kids.

So I guess I'd like surgery if it were "easier," which I realize is a dumb thing to say. I'm going to try to get more exposure to PMR, DR/IR, EM, etc, though in reality I likely only have time for one or two. If I were 25, things might be different, but I don't want to blink and be a 37 year old single, boring, sad attending. If medicine is just a job (which it is) I want other things in my life too, and so far, I haven't met a surgeon (resident or attending) who has that.


Thanks for all the comments, I am reading/reflecting on them all. For the M1s/M2s out there, I'd recommend shadowing every week, which is what I wish I had done.

It is definitely the exposure you had that is skewing things. I second the suggestion above of a rural surgery elective or even just community surgery. I was hugely turned off of general surgery in med school for the reasons you cite and others like middle of the night choles and such. But then when it became clear that I wasn't going to be able to do ortho I liked my surgical critical care rotation and figured gen surgery was something I could do as long as it wasn't at a place where the residents were as miserable as I saw at my school. So I looked for community programs and noted how the residents acted and ranked accordingly. Got into my first choice gen surg program and it was a big difference. There was only one rotation that took me past the 80 hr rules and there were others where I was actually under. There was enough down time during work hours that I didn't have to have no life outside of residency (though I did miss some special occasions, and was late to dinner here and there). And now I work part time so I can do the other things in life that are important to me. As for the boredom of watching the same surgery over and over, things are a lot different when you are the one cutting. I do probably 10 choles a week but they are quick and fun most of the time but a little different every time so it doesn't feel repetitive even when I do a bunch the same day. Plus there are other operations (mostly appys but also hernias and bowel resections plus various lumps and bumps plus pus drainage) so it isn't the same thing every day. This isn't to say that you absolutely should do surgery, but it sounds more like the things you dislike have more to do with the more observatory nature of being a student and less to do with the actual specialty (false assumptions of not having a life as a surgeon aside).

 

[treebeardette]

You're right, of course, but as the academic counselor told me, it seems you pretty much have to go into med school knowing you want to do one of those fields. I'd love to try ENT, for example, but I don't know whether I'll have time at this point...

I can only speak to ENT, but I know one person who switched from ortho to ENT at the last minute, decided while doing an ortho away (summer between M3 and M4). He was only able to do the SubI at his home program and didn't do an away, still matched. Another I know applying now decided about this time in her 3rd year that she didn't like gen surg, and had liked her 2 week ENT elective, still managed to schedule a sub I and two aways, she got plenty of interviews. ENTs know that most med students don't have a lot of exposure to ENT, so it's not super surprising when people switch into it at the end of 3rd year after a random elective. I know it feels late in the game, but it's definitely not too late, especially if you have a home program. If you don't have a home program, then it becomes significantly more difficult.

I would say that what you're looking for in lifestyle can definitely be achieved in general ENT or certain ENT sub-specialties after training. Tends to be about 4 days of clinic, one day of OR. You can choose to stick with less complicated, shorter cases and refer out more complex cases. Clinic is actually tolerable with lots of scopes, biopsies, etc. However, residency will be hard, since a significant amount of our training is centered around head and neck oncology, which can be really brutally long surgeries with lots of complicated inpatients to round on.

If ENT is something you are really interested in, feel free to PM me. I'm a 4th year waiting for match day.

 

[AABB999]

Got into my first choice gen surg program and it was a big difference. There was only one rotation that took me past the 80 hr rules and there were others where I was actually under

Interesting to hear. I've had a M3 rotation that got pretty close to 80 hours/wk and still found time to exercise/chill in addition to NBME studying, I'm just worried about working significantly more than that. The surgery residents here are pretty mum about their hours but I know they work a huge amount. On my OBGYN rotation (big community program, not my home institution) no one would talk about hours, but based on schedules it looked like the PGY1s/2s were working triple digit hour weeks. You're the first person I've heard saying they worked anywhere close to 80 hours, which is encouraging.

I can do a few-week rural surgery rotation before I apply...guess I'll add that to the list.

If you don't have a home program, then it becomes significantly more difficult.

Don't have a home program. Applying ENT (vs. ortho/urology/NS) at my program is fairly rare, so much so that I don't know anyone who has/is trying. My school offers two rotations in it, one of which I can do as my M3 elective.

I liked the anatomy/pathology but never seriously considered it because my impression was that it's brutally competitive academically (I'll pass most/all cutoffs but not wow anyone) and I have no ENT research nor do I think I can get any beyond a case report or something.

If you can offer any other perspective on that, I'd appreciate a PM.

 

[moyamoya6]

Urology or IR. Urology has both clinic and surgical procedures, and the hours aren't grueling like general surgery. IR does give you patient contact, but some of the procedures can last several hours if you're okay with that.

 

[sinombre]

Interesting to hear. I've had a M3 rotation that got pretty close to 80 hours/wk and still found time to exercise/chill in addition to NBME studying, I'm just worried about working significantly more than that. The surgery residents here are pretty mum about their hours but I know they work a huge amount. On my OBGYN rotation (big community program, not my home institution) no one would talk about hours, but based on schedules it looked like the PGY1s/2s were working triple digit hour weeks. You're the first person I've heard saying they worked anywhere close to 80 hours, which is encouraging.

Keep in mind the hours are averaged over 4 weeks. I think I've only gone over 100 hours as a general surgery pgy-1 a few times but that's only because I didn't have days off on those weeks (which means I had more than one day off on other weeks that month). I probably average between 80-90 hours each week. It also varies by rotation.

I really doubt residents are regularly working more than 100 hours a week where you are. If they are it's a pretty huge acgme violation.

That's not to say that residency isn't difficult and time-consuming. But it's probably not as bad as you think it is.

 

[Autopsy101]

Advice I give to students who aren't sure between two specialties - if you really are not sure about which to match - pick the longest residency to match in. When you match surgery, you are allocated 5 years of pgy GME funding from medicare (called your initial residency period (IRP) - if you choose to switch to a shorter one like IM or FM - it's not a problem. If you match in IM or FM and decide to change to a longer residency such as surgery, you won't have the funding, so the hospital will have to fund any additional time that you are training which can make it much more difficult to find a program that will accept you.

https://members.aamc.org/eweb/upload/Medicare Payments for Graduate Medical Education 2013.pdf

See item 8.

 

[funtertaining15]

I feel ya... M3 + I'm still thinking about what to do. Think I have an idea of what I might do bc I know that I don't want my life to be centered around medicine...anyways.. Actually I am on a pathology elective now..one resident is a neuro resident wanting to switch to path; another is a path resident who actually was in surgery before switching to path..realized it after interviews and rank while doing an elective. Definitely don't knock it until you try it...not as many procedures but some other stuff you can do.. as long as you don't mind looking at cells thru a microscope and trying to figure out where you are in the body and if it's neoplasia or not, then maybe think about path ^^

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[AABB999]

pick the longest residency to match in.

Noted. Would really rather not have to switch, but I know it's somewhat common...

as long as you don't mind looking at cells thru a microscope and trying to figure out where you are in the body and if it's neoplasia or not, then maybe think about path ^^

Actually really like histology and grossing. Based off of M2 alone, I'd seriously consider it.

Based on the actual job (poor employment prospects according to both here and pathologists I've talked to, almost no patient interaction, haven't met a pathologist under 45 who isn't painfully socially awkward IMO) I've pretty much ruled it out. It's something I'll definitely do multiple electives in, but as others have said on this thread, I'm ultimately looking for not just a field but a job I can stand.

I know a guy who has an absolute passion for path, knows exactly what he wants to do in it, and is the perfect path personality type. He'd also be willing to work in rural North Dakota in order to do it. I am not.

 

[Durty-Trixxx]

Based on everything you wrote I'd say FM or PMR would be your best choices. It's pretty obvious you arent obsessed with a mega salary lifestyle with no free time.

Neither choice would be too demanding during residency unless you specifically chose programs that are grueling. Obviously they would be cakewalks compared to a gen. surgery residency. There are some FM residencies where you do no in-house call after PGY-1. You could even do a 1-year urgent care fellowship after your FM residency and have a very normal 9-6 kinda life working urgi-centers and still making a nice six-figure salary in just about any city in America. Sounds pretty sweet to me.

 

[funtertaining15]

Noted. Would really rather not have to switch, but I know it's somewhat common...


Actually really like histology and grossing. Based off of M2 alone, I'd seriously consider it.

Based on the actual job (poor employment prospects according to both here and pathologists I've talked to, almost no patient interaction, haven't met a pathologist under 45 who isn't painfully socially awkward IMO) I've pretty much ruled it out. It's something I'll definitely do multiple electives in, but as others have said on this thread, I'm ultimately looking for not just a field but a job I can stand.

I know a guy who has an absolute passion for path, knows exactly what he wants to do in it, and is the perfect path personality type. He'd also be willing to work in rural North Dakota in order to do it. I am not.

Yeah, there's less pt interaction, but they also work in blood bank and apheresis center so there's definitely patient interaction there. But yeah, the hospital I'm rotating at is in a busy city area so location is definitely something to consider. The people/residents/etc I've worked with so far are actually the opposite of the stereotypical socially awkward that's heard. A few are more like that but mostly everyone I've met are definitely friendly and outgoing.

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