Don't do surgery unless its the only specialty that you like?

[hemoccult]

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I was just curious to hear some feedback regarding the prevalent statement "...don't choose surgery unless it is the only specialty you enjoy. If you find something else that you may enjoy, do that!"

It seems like there are some surgeons who try to shun others from their profession. I loved my surgery rotation. I plan on choosing surgery as my career. I think surgery is one of the most interesting, challenging, inspiring, and rewarding specialties. I did, however, enjoy some of the other rotations also.

Why would some surgeons promote this statement/attitude regarding this specialty and warn/spurn others from choosing their own specialty. Any thoughts or comments regarding this matter would be greatly appreciated.

Thanks🙄

 

[Winged Scapula]

The conventional wisdom behind that statement is that surgery and surgical residency training in particular, have a tendency to be so painful and potentially devastating to your personal life that if you COULD or WOULD choose another specialty, you should.

Only someone who could not imagine doing something else will be able to withstand the long hours, the physical and emotional pain of residency in general (ie, you couldn't pay me enough to do an IM residency). Surgeons aren't trying to reduce the competition in the field, only to "warn" you that you must really be committed or you'll never survive the training and be a happy person.

 

[hemoccult]

Thanks for the reply. I am also of the opinion that I would rather be beaten repeatedly than to suffer through 3 years of Internal Medicine in order to reach some of the less painful fellowships that may follow.

Do you think any of the residency hour restrictions may cause a rethinking in that original statement? It seems that most every residency is going to be 80 hours which would eliminate some of the perceived painful long hours.

Personally, I find the long hours rewarding when you look at what was accomplished at the end of the day. I love surgery and have met some others who share this feeling. I guess I was just curious to uncover the foundation for the statement regarding "...choose anything else if you can."

Thanks again for your insight.

*I also look forward to applying for residency this year and may cross paths with you if I am fortunate enough to get an interview in Hershey.😛

 

[mary]

granted, I am speaking not from personal experience, but on what I have heard from friends who are surgical residents now- they say that the 80 hour work week is "created" by not counting any time not spent in direct patient contact as part of the work week. Therefore, time spent charting (which can be considerable), in conferences/lecture, or any other activity that is required but not in direct patient contact will not count. So, you will probably still be putting in much more than 80 hours per week. Sucks, but I'd rather do that for five years and be happy afterwards that endure endless IM rounds and never be in the OR.

Too bad we can't have it all!

 

[Celiac Plexus]

I heard the same "advice" when I was a 3rd year. I think that residents/attendings who say this are just trying to help you out. For example, some people loved their surgery rotation but really did not enjoy the hours, or the scut, or.... the smell of soiled ass as you debride a sacral decub ulcer.

For those people, it may have led them to pick a different field which they might love just as much and in the long run will be happier for it.

But for the die-hard surgery types, it won't deter them. They would wade through a pool of leaky colostomy bags to get to the OR... 🙂 Ok well... mb there's a better image out there but you get my point hopefully.

If you hear this "advice" enough as a third year though it might start to chafe. It wasn't until 4th year that the residents and attendings started treating me like one of the club. By then they realized that I was hopelessly committed!

Definitely consider every specialty for what you will actually be doing in that specialty. Don't sweat the hours/lifestyle/compensation issues too hard. When I was on my psych rotation I counted every minute until I could high-tail it outta there. But when I was on one of my surgery rotations, I couldn't believe how fast the time went.

Good luck!

 

[Castro Viejo]

Originally posted by pba
actually, clinical medicine is quite a tasty treat. i love it. if there was a combined medicine/surgery residency, i would be the first to sign up.

I can find internal medicine to be fascinating too sometimes, but NOTHING in the world could make me want to do an internal medicine residency. There are just too many non-medical things going on with medicine patients that the internist has to take care of because he's the "primary provider."

Now, if there were a combined Psychiatry/General Surgery residency, maybe you'll see me sign up.

Just kidding of course. 😀

Long live General Surgery.

 

[Hotsauce21]

You have an interesting question b/c i at one time was deciding whether i wanted to do a surgical subspecialty or medicine. People thought i was crazy b/c they thought the two were so different. I think the deciding factor for you should be whether you like the OR. If you really like being in there,then i think youll be fine. For myself, i liked, but not enough. In medicine, im somewhat at fault for not paying enough attention to detail, and thats b/c im somewhat in the middle in terms of mentality. But i'll adjust, just as you'll adjust to surgery and the long hours if you like being in the OR b/c thats the meat and potatoes. my two cents

 

[njbmd]

Hi there,
If I had not become a surgeon, I would have headed straight for a residency in pathology. I loved pathology and spent the summer between my second and third year in a paid Pathology fellowship. I was able to spend time in the DC and Northern Virginia Medical Examiner's office. I also helped perform at least 100 post mortem exams from fetal autopsies to some folks whose deaths made the evening news. It was a great learning experience and profoundly affected the way I practice surgery today. I still examine most of the tissue slides on my patients and I am getting to know the pathologists well here at UVa. They are some of the most knowledgable folks that I have worked with.

Surgery and other branches of medicine are not mutually exclusive. I love working with the anesthesia folks and regularly rotate with them in SICU and on Trauma ICU rotations. I rotated with Pediatric residents and Emergency Medicine residents on my Trauma ICU rotation, Pediatric Surgery rotation and Thoracic Surgery rotation. It was amazing to see how much we all have in common.

My personal belief is that you can't really be a good competent surgeon without having a solid base in internal medicine first.

njbmd😎

 

[vuillaume]

Interesting discussion.

In the last week, I've had two girls tell me that I'm "such a surgeon". Funny, because when I started med school I wanted to do medical oncology. Not sure what that means.

The tipping point for me (as others have mentioned in this thread and others) is that I love the antiseptic smell of the OR wing, scrubbing, the camaraderie of a surgical/anesthesia team, and the concentrated effort of surgery.

At the same time, I have no patience for toxic personalities, denigrating lower level residents, other specialties or patients.

I agree that part of choosing surgery is deciding that you wouldn't want to do anything else; but I feel that a minority use that as an excuse or badge of honor for being less than polite.

hemoccult, whichever discipline you choose, choose the one that makes you the best doctor you can be for your patients. If that means being a well-rested radiologist, there is absolutely nothing wrong with that. If that means being a tired, but happy and non-toxic surgeon, welcome to the club.

 

[Skylizard]

Originally posted by vuillaume
...In the last week, I've had two girls tell me that I'm "such a surgeon"...At the same time, I have no patience for toxic personalities, denigrating lower level residents, other specialties or patients.

First, I will say, that old "surgeon personality" statement is actually one of those "polite insults". It goes with the "those people" comments people use. I doubt very much that when someone (usually ignorant or jealous) states, "your such a surgeon", they are refering to your perfectionism, intellect, or hard charging work ethic. On the contrary, most people who have used that statement are trying to perpetuate the stereotype that individuals that go into surgery have no personality, poor bedside manner, and deal best with patients when they are unconcious. I challenge you to confront anyone making that ignorant comment to you. Be blunt and directly ask them, "what is a surgeon personality?". Do not give people with any prejudice the benefit of the doubt. While in FP, I heard that statement a great deal. It was usually used by an individual in defense of their failing to follow-up on a critical lab or a 12 lead EKG!!!

A surgeon is a doctor with extensive training and skills in the most critically ill patients.

A surgeon is frequently stereotyped by nonsurgical colleagues and by advisors in the Dean's office, and may be the object of jealousy or even scorn from physicians in other specialties. When surgical patients do poorly, they frequently do very poorly, and the honest surgeon finds it easy to assume the blame for all of the patients' problems despite the fact that some surgical patients come to a bad end because of their own self-abuse.... Finally, the surgeon frequently is, at the end of an exhaustive diagnostic and therapeutic exercise, the only one who really can find the answer or solve the problem!

 

[Winged Scapula]

Originally posted by vuillaume
I agree that part of choosing surgery is deciding that you wouldn't want to do anything else; but I feel that a minority use that as an excuse or badge of honor for being less than polite.

I'm not sure I've heard others use the "I wouldn't want to do anything else" as a reason for being "less than polite." I HAVE heard others (including a couple of less than savory classmates of mine in med school) espouse the attitude that surgeons are "allowed" to be arrogant SOBS because of everything they have to deal with. I will not be shocking anyone here (or elsewhere) to state that that's a load of *&^$. Fortunately, I haven't heard anyone here make a statement close to that (not that those attitudes don't exist) but I've run into a few arrogant unpleasant medicine residents/fellows who seem to share that attitude. Its more about the person rather than the specialty.

In reference to Sky Lizard's comments re: the "polite put-down" of stating someone is "such a surgeon", I guess I should take it as a compliment when I'm told I'm "too nice to be a surgeon". I'll try and take that opportunity (as the comment comes about q weekly) to educate the misinformed about the "surgical personality". 😀