Dropping out of integrated plastics

Discussion in 'Plastic Surgery' started by BlondeDocteur, Dec 16, 2008.

  1. BlondeDocteur

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    I know / know of three people who have left integrated plastics spots, which (from my perspective as a future applicant) boggles my mind.

    One girl, who matched into quite possibly the best PRS program in the country, quit in internship to do radiology.

    Another guy left from an excellent program 1-2 months in to do psychiatry and is on track to be an analyst.

    The third girl was very interested in global health. She completed the first three years in general surgery at a fabulous Midwestern powerhouse, started her plastics years, decided she wanted to be an MSF doc and quit. She completed gen surg, a trauma fellowship and is now doing academic global health.

    Admittedly my n is both small and skewed, but I was wondering-- how common can this be? Do you guys know people who have matched and then decided the field just wasn't for them?
     
  2. Habeed

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    There's an unspoken assumption in your post. You assume that because integrated plastics takes a lot of work to get (starting from day 1 of med school) it is the best, most enjoyable medical specialty available.

    One does not follow from the other.

    Plus, cry me a river : radiology instead of plastics? That sounds like a trade up for many people.

    trauma surgery instead of plastics? I wonder which would be more exciting.

    And even psychiatry has the advantage of being free of blood and guts and is probably less stressful...
     
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  3. BlondeDocteur

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    The assumption is as follows: a specialty which takes basically killing yourself to get into is something that you actually want to do. Not that it's *objectively* the most enjoyable thing out there (different strokes for different folks, etc) but for the people who do expend the effort to rack up the qualifications, the research, the sub-is, go on the interview trail, and so forth to get in, it is.

    Radiology is a "tradeup" if you don't like the OR, don't particularly like seeing patients, and are very concerned about your hours... in which case you probably wouldn't have applied to a surgical subspecialty. Likewise for the psych peeps who don't like "blood and guts." And trauma surgery is so many lightyears removed from plastics in terms of patient base, intrinsic reward system, personality type, etc that it's unusual, I think, for the same person to be attracted to both.
     
  4. maxheadroom

    maxheadroom Rhinestone Cowboy
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    I personally know of three residents who have dropped out of integrated programs. All three were at excellent programs that have a good track record of supporting their residents. Two realized that they didn't like surgery that much and wanted something with better hours -- one went into Gas and one did Rads. One resident had to quit because of a chronic medical problem that eventually made it impossible to do surgery -- last that I heard, she was working on an MPH and trying to figure out if she would pursue further clinical training. I know lots more General Surgery dropouts -- just a quick count adds up to around 12.
     
  5. andexterouss

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    Interesting findings. It's important know what factors contributed to their attrition. According to recent research, age and non-active lifestyle(don't play sports, workout, non-outdoor activity) are major factors followed by gender(female).

    Med students that enter any surgical residency at 29 or over are more likely to quit than their younger ,more traditional, counterparts(25 yrs old). This might be due to physical demands of surgery and the realization of the poor lifestyle of the specialty which doesn't get better with age.It's one thing to anticipate the challenges you may face with residency and it's quite another to live it even for PRS residents.

    Secondly, this one is weird, but, according to research, not having an active lifestyle in sports and other outdoor activities are a major predictor of attrition.Perhaps participation in sports releases more endorphins which leads to happier surgical residents??

    Finally, gender. This one has been well researched and talked about.Lifestyle, hostile environment, pregnancy etc.

    Source:http://medgenmed.medscape.com/viewarticle/579052_print
     
  6. BlondeDocteur

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    I bet the sports connection is about endurance, pushing one's self through pain, and teamwork.
     
  7. andexterouss

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    Hmmh, I actually didn't think of it that way. But, yeah, it does make sense since surgery qualifies for all three.
     
  8. GSresident

    GSresident PGY4 on July 1, 04
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    People who worry about lifestyle during residency are missing something. Your life will get better as an attending in plastic surgery. I would bet that the people who quit were pursuing plastics for the wrong reasons - glamor, status, money etc. Or perhaps they wanted to prove something to someone, that they were worthy of matching into a competitive specialty. Stuff like that isn't enough to keep you going when you get the 3 am consult for 1cm face lac on a 108 year old. And believe me, as a resident, you will get those consults.
     
  9. Plastikos

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    I think i have to agree, but with one reservation...i think some of those egomaniacs find the end reward (real or imagined) of status/glamour very worth the pain of residency. Those might be the worst kind, who knows.
    Those who quit early and before have to know that this is temporary pain and quit for more than just an easy life (something to prove, no one is 100% sure, etc..) though im sure it figures into the equation.

    I think the athletic/sports take is an easy thing to see, at least anecdotally and just makes sense. Makes you competitive, teamwork, used to training/practicing to become better, coachable, have to deal with defeat and respond, and then just being in shape makes life all around easier. You have more energy, you feel better, look better, and when you look better and have more energy you feel better. Its a vicious cycle.
     
  10. dgruntledmizzou

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    Wow, interesting thread.

    With integrated plastics being the hardest field to get into, I wouldn't even think of people dropping out (aside from severe medical issues)

    Had no idea a plastic surgery residency could be so grueling
     
  11. FatPigeon

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    It's something I can understand pretty well by simply attempting to re-experience that mysterious excitement I had as a pre-med, comtemplating going to med school. Did med school turn out to be great? I guess so. As great as it was when I imagined it as a Junior in college? Absolutely not. There's a lot to be said for the effect of wear, tear, and fatigue on a person's motivation.

    Take my schedule, for instance. If you were to inquire as to what field I'm planning on going into at 4am on any given morning, or at 8pm on any given night (as I'm getting ready for BED), I'd tell you "radiation oncology." During the day, while I'm enjoying myself in the OR, I'd tell you "neurosurgery." I'd imagine that as a resident, after a year, or two, or three, as what I were doing during the day became less interesting through mere constant exposure, that 4am feeling would take over greater and greater portions of my consciousness...leaving me simply wanting to get the hell out. Let's not underestimate this...

    Sometimes I think your ego can be your absolute WORST enemy. It's had me lying to myself on several occasions. Would I like the rush of having one of the coolest jobs on the planet, doing extraordinary things every day? Yes. Would I like it after 5 or 7 years, for 90 hours per week? Not quite as much, I'm sure. And here's the thing...would I EVER like it as much as sitting in front of my bigscreen TV at night with a glass of nice wine and an attractive woman, keeping in close touch with my family and others who mean a lot to me? No.

    When it really comes down to it, I still believe most of us are looking forward to getting home at the end of the day.
     
  12. andexterouss

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    You are very right. I went to see an Ophthalmologist yesterday and I was his last patient at 5pm(very busy day for him). We finished at 5:30 and he was ready to go home. He doesn't come to work till 10am in the morning and has his cush practice in the trendy Brooklyn area of Park Slope. I was like "wow, boy would I wanna have a life like that".I bet he actually uses his bigscreen tv.:laugh:
     
    #12 andexterouss, Dec 17, 2008
    Last edited: Dec 17, 2008
  13. DrDre311

    DrDre311 Makaveli
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    Trauma sucks. And I'll take the 3 am facial lac call any day over the 3 am "Mr. [98-year old ICU patient with multiple medical problems who's septic and been trying to die for weeks]'s heart rate is 140 and his BP is 55/25...come fix it" call.

    I'd also be interested to see what Blonde thinks the best PRS program in the country is.
     
  14. ESU_MD

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    People quit residency all the time for all kinds of reasons. Its not that a big of a deal.

    A more interesting question would be how many people get kicked out of plastics residency!
     
  15. Playmakur42

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    interesting that receiving a merit scholarship made residents more likely to drop out of the residency.
     
  16. Pir8DeacDoc

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    Pittsburgh??

    When I rotated at Pitt there was an intern there who was having a tough go. He was a super nice guy and I wonder if he ever settled in and made it work.
     
  17. radslooking

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    for whatever reason, those that have higher scores, AOA status tend to drop out of residencies more. My presumption is because they have more options.
     
  18. modelslashactor

    modelslashactor Safety not guaranteed
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    there's also the possibility they only went into the field because they wanted to do the most prestigious/competitive thing and get the most out of their numbers. know a gent or two that have done this, but no dropouts so far...
     
  19. Mariah246

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    "I want to thank you for this award. This means I am the best model slash actor, and not the other way around."

    I'm pretty sure I butchered it but that was a funny movie.
     
  20. modelslashactor

    modelslashactor Safety not guaranteed
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    close, but fabio was actually voted the best actor slash model ;)
     
  21. Mariah246

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    i'm having a tough time finding a youtube clip of this. someone needs to generate one :)
     

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