em vs surgery

[omental caKe]

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I'm a MS4 just starting the whole eras thing. I was quite happy in my surgery bubble until last night when the EM program director pulled me aside to tell me I should do EM. And he was pretty convincing. Any ideas on how to pick between 2 fields you know you'd be happy in? (I had thought about EM before doing my surgery rotations). Should I just apply to both programs and see what happens? A lot of people point out the lifestyle difference, but that isn't an issue at this point in my life. I would appreciate any advice you guys have to offer. It's super stressful not knowing 100% what specialty to pick this late in the game.

Thank you!

 

[RxnMan]

Read the EM forum FAQ. There are several entries which will help you decide if EM is for you or not.

 

[Winged Scapula]

Never let ONE person be the reason you make a life changing decision (well, outside of marriage and we know how well that often turns out).

Lifestyle may not be a consideration now, but it may be tomorrow, next year, in 10 years.

In my frame of reference, its not the lifestyle but rather if you enjoy the work. Do you want to be a surgeon? Will you be happy NOT being in the OR?

It can be hard to decide between two different fields but for most of us, there is something that pushes you one way or the other.

 

[omental caKe]

Thank you so much for your reply winged scapula.

Unfortunately it's more than one person trying to persuade me. Yes, one person would be easier to disregard.

I guess I have to decide if I can live without being in the OR. Good question. I don't know the answer. I guess I have a lot of thinking to do. I really wish I had a crystal ball. diagnose the appendix vs taking it out... hmm...

 

[gutonc]

I guess I have to decide if I can live without being in the OR.

This is definitely the key decision. If you can live without the OR, you should. If you can't, you'll ultimately be unhappy no matter how much time off you have or how "good" your lifestyle is in a non-surgical specialty.

 

[Winged Scapula]

Thank you so much for your reply winged scapula.

Unfortunately it's more than one person trying to persuade me. Yes, one person would be easier to disregard.

I guess I have to decide if I can live without being in the OR. Good question. I don't know the answer. I guess I have a lot of thinking to do. I really wish I had a crystal ball. diagnose the appendix vs taking it out... hmm...

But see, even your user name tells us you want to be a surgeon. 😀

Perhaps if you shared some of the reasons all these others are trying to persuade you to do surgery, it would be helpful.

And while a surgical residency may be painful, remember there ARE lifestyle choices in surgery. The total hours may still be more in a lifestyle friendly surgical practice than in EM but if its not many and you are doing what YOU want to do (rather than what someone else wants), maybe its the better choice. A good day for me is being in the OR; a bad day is being in the office.

 

[docB]

Always be careful when someone tells you you have an aptitude for a specialty. While they may be right it doesn't mean you would be happy in that specialty.

 

[kandrasko]

Often that type of offer is made as they are trying to find good students for the residency. That is good for the residency program but may not be so good for you.

 

[AmoryBlaine]

If 10 people are trying to convince you to do their field that might just mean that you're good. 😀

Seriously I've never understood this mentality of trying to talk someone into a specialty. If you are on a course with which you are comfortable ride it out.

The reverse is not true, I meet the odd extremely retiring, shy, slow student who wants to do a field like EM or Gen Surg --> not a good idea.

In terms of lifestyle you can go around and around about it if you want. I bet there are a few endocrine and breast surgeons who have a much better lifestyle than some ER docs in less-than-ideal community jobs.

 

[Rendar5]

Yeah, I dont' like the idea of convincing ppl to go one way or another. EM and Surg in my mind are very different fields. Majority of your EM cases are medicine, not surgical ones. Sure we do procedures, but we don't do surgeries, and don't mistake one for the other. I mean, take traumas. Sure we deal with them too like our colleagues, but our job is one of stabilization and initial resuscitation. In essence, we are a bridge, we are not the destination. Now if you like that concept, go for it. I did. I love initial diagnosis, the enormous variety of patients, the idea of being a resuscitation/stabilization specialist (in the acute setting) getting people where they need to be, and dealing with relatively minor issues that I can deal with right then and there. But if you don't like dealing with medicine diagnoses, stuff like sepsis workups, ruling out worst-case scenarios, if you love procedures more than anything in the world, if to cut is to cure, or you just love figuring out if surgery is the proper option for the patient now, don't reconsider.

In the end you gotta listen to your heart and figure out where you'll be happiest, everyone else be damned.

 

[Doctor Bagel]

If 10 people are trying to convince you to do their field that might just mean that you're good. 😀

Seriously I've never understood this mentality of trying to talk someone into a specialty. If you are on a course with which you are comfortable ride it out.

I agree. And just being good at something doesn't mean it's the right thing for you. What made you think you wanted to do surgery? Could you get the main stuff you liked about surgery from EM?

 

[RxnMan]

Often that type of offer is made as they are trying to find good students for the residency. That is good for the residency program but may not be so good for you.

I agree. When I said I liked specialty -blank-, I've been told by attendings and residents that I'd be "wasting my time," or "you're too good for" -blank-, and I should do their specialty instead. I've given their reccomendation thought, but not much more. It's a complimentmore than anything.

Another variant is when my attending promotes the local training program in my desired specialty. The guy's basically saying he wants you to stay in the area because you're a good worker and make a good colleague.

 

[dynx]

I'm a MS4 just starting the whole eras thing. I was quite happy in my surgery bubble until last night when the EM program director pulled me aside to tell me I should do EM. And he was pretty convincing. Any ideas on how to pick between 2 fields you know you'd be happy in? (I had thought about EM before doing my surgery rotations). Should I just apply to both programs and see what happens? A lot of people point out the lifestyle difference, but that isn't an issue at this point in my life. I would appreciate any advice you guys have to offer. It's super stressful not knowing 100% what specialty to pick this late in the game.

Thank you!

Some bonehead attending told me that I'd be a great psychiatrist when i was in medical school. Thats how little attendings really know about the aptitude/interest of the medical students on the service.
I hate most people
I hate all crazy people
I'd be the worst psych doc in the world.
It feels nice to get the compliment but let it play no part in your decision. Do what you want to do. I, for one, still can't get the smile off my face after every heart case I do (until I get 3 or 4 stupid consults that is)...you should do what makes you happy and what you like to do, thats a great lifestyle.

 

[tkim]

Some bonehead attending told me that I'd be a great psychiatrist when i was in medical school. Thats how little attendings really know about the aptitude/interest of the medical students on the service.
I hate most people
I hate all crazy people
I'd be the worst psych doc in the world.
It feels nice to get the compliment but let it play no part in your decision. Do what you want to do. I, for one, still can't get the smile off my face after every heart case I do (until I get 3 or 4 stupid consults that is)...you should do what makes you happy and what you like to do, thats a great lifestyle.

I read somewhere that when surgeons retire and do another residency, it's overwhelmingly psych. I wish I remeber where I heard/read that.

 

[Winged Scapula]

I read somewhere that when surgeons retire and do another residency, it's overwhelmingly psych. I wish I remeber where I heard/read that.

I've heard the same. As I recall, it was because if surgeons retire and go into another field, its often due to physical problems that inhibit the long hours of standing in the OR.

 

[omental caKe]

Thank you all for your comments. Your insight is greatly appreciated.

 

[tkim]

I've heard the same. As I recall, it was because if surgeons retire and go into another field, its often due to physical problems that inhibit the long hours of standing in the OR.

Ah, that makes sense.

 

[peppy]

Some bonehead attending told me that I'd be a great psychiatrist when i was in medical school. Thats how little attendings really know about the aptitude/interest of the medical students on the service.

I agree, the attendings frequently don't really know students all THAT well - especially on the emergency medicine rotation where you normally work with many different doctors who each are focusing on 10 different things at once.

I also think that sometimes attendings are more generous with praise/encouragement to the students who ARE NOT interested in the specialty, because the bar is set lower to start with.
Somehow I managed to get rave reviews on my ob/gyn rotation even though everyone there knew I aspired to psychiatry and wasn't particularly interested in delivering babies (plus I was on the rotation with someone who *did* want to be an ob/gyn and was trying hard to impress).
All I could figure is that they probably sometimes get rotators who have open contempt for the rotation and try to avoid doing the work they're assigned. Therefore when someone who isn't interested in the field at least does what's expected of them with a good attitude, perhaps that's enough to make some of them happy.

 

[kungfufishing]

The two are not all that alike. In your gut you surely like the work in one more than the other. Remember that the "better" lifestyle in EM is not all that it is cracked up to be - a lot of that time off can be spent in perpetual jet lag from schedule chaos. I think that most people in medicine work hard in one way or another and most of us have days when we feel like crap because of it. For this reason, I think you should pick the work you enjoy that will make it worthwhile. If you really like the two equally I'd say pick EM. I don't know any surgeons who have told me they liked something else just as much as the OR.