From ortho to... IM

[ortho_confused]

Hey everyone,

I am currently training in ortho and thinking about switching to IM. I think I don't like it anymore. I'm not depressed or burnt out. I'm a good resident and I have great relationship with everyone on the program. I just don't enjoy it anymore.

I went into it first hand for the trauma surgery. Boy I loved it when I was a med student! It was such a thrill. I also was very interested in every other aspect of the career. After 2 years of residency, not anymore. I don’t dislike it, it just feels very mildly interesting. And the more the residency progresses, the more I'm asking myself why am I working and studying this hard for something that I'm not passionate about.

I had a 2 months ICU rotation some months ago and had such passion dealing with complex medical problems, a passion that I don't think I have felt since the start of my residency. I was good at it too. And for some reason, the mental process of dealing with dying people (and sometimes saving their life) felt much more rewarding than all the surgeries I've assisted.

Since then, I can't stop thinking about switching to IM but I'm terrified at the idea of losing that passion again and later regret it. In the other hand, if I get bored again at least I would have a nicer lifestyle. I don't care (much) about the money, I love it as much as the next guy but not over my happiness.

It's pathetic that I'm 2 years into residency and I still don't know if I prefer a medical or a surgical speciality.

Has anyone insights about this?

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[anonperson]

Hey everyone,

I am currently training in ortho and thinking about switching to IM. I think I don't like it anymore. I'm not depressed or burnt out. I'm a good resident and I have great relationship with everyone on the program. I just don't enjoy it anymore.

I went into it first hand for the trauma surgery. Boy I loved it when I was a med student! It was such a thrill. I also was very interested in every other aspect of the career. After 2 years of residency, not anymore. I don’t dislike it, it just feels very mildly interesting. And the more the residency progresses, the more I'm asking myself why am I working and studying this hard for something that I'm not passionate about.

I had a 2 months ICU rotation some months ago and had such passion dealing with complex medical problems, a passion that I don't think I have felt since the start of my residency. I was good at it too. And for some reason, the mental process of dealing with dying people (and sometimes saving their life) felt much more rewarding than all the surgeries I've assisted.

Since then, I can't stop thinking about switching to IM but I'm terrified at the idea of losing that passion again and later regret it. In the other hand, if I get bored again at least I would have a nicer lifestyle. I don't care (much) about the money, I love it as much as the next guy but not over my happiness.

It's pathetic that I'm 2 years into residency and I still don't know if I prefer a medical or a surgical speciality.

Has anyone insights about this?

I would say wait it out. As a second year, you haven't been the surgeon in cases really. You've assisted which can be mentally and physically draining. You may change how you feel about operating when you are doing the bulk of the case and troubleshooting on your own.

All specialties become routine though to be honest.

Also, I wouldn't make any immediate decisions yet. You're in one of the more competitive specialties and if you leave, you won't be able to come back.

As far as money goes, I wouldn't be so quick to downplay this. Ortho salaries can get ridiculous. That is a lot of money that is left on the table.

 

[857937]

Ortho bruh, hang in there if you can handle long surgical cases.

IM is basically the dumpster of the hospital. Trust me you don't wanna do that if you can do anything else.

I'm lazy myself and I can't stand in surgeries for hours. This is why I chose IM.

ICU can be really exciting the first couple of months you do it but the excitement dies out eventually.

If you really like the ICU setting you can always do a trauma fellowship and practice in a surgical ICU.

You'll also have to be a medical intern again which trust me sucks to no end.

Don't switch!

 

[NotAProgDirector]

I personally think it's well worth making less money and enjoying what you do. Plus, it's not like internists make terrible salaries.

People switch. I agree you should make sure you've given ortho a good look. But if you want IM, apply and I'm certain you'll get good interviews.

 

[NITRAS]

I'm an Internist. I'd let it set for another year. I think another year will give you more clarity.

I used to love the ICU, but I've been a hospitalist with a closed ICU for almost three years now, and I'm happy how things turned out.

I do feel compelled to say something about how internal medicine and orthopedics are at opposite ends of the medicine vs. procedures.

 

[doc05]

If you're truly bored during surgeries, at this early stage of your career, it's a bad sign. You should be enthusiastic about operating or you'll burn out.

Don't jump to IM just because you enjoyed a month in the ICU... critical care gets old fast.

Give some thought as to what you actually want to do for your career.

 

[doc05]

I'm an Internist. I'd let it set for another year. I think another year will give you more clarity.

Another year?? How much more clarity do you want? The OP doesn't enjoy operating. Time to make a change. now.

 

[The Physician Philosopher]

Hey everyone,

I am currently training in ortho and thinking about switching to IM. I think I don't like it anymore. I'm not depressed or burnt out. I'm a good resident and I have great relationship with everyone on the program. I just don't enjoy it anymore.

I went into it first hand for the trauma surgery. Boy I loved it when I was a med student! It was such a thrill. I also was very interested in every other aspect of the career. After 2 years of residency, not anymore. I don’t dislike it, it just feels very mildly interesting. And the more the residency progresses, the more I'm asking myself why am I working and studying this hard for something that I'm not passionate about.

I had a 2 months ICU rotation some months ago and had such passion dealing with complex medical problems, a passion that I don't think I have felt since the start of my residency. I was good at it too. And for some reason, the mental process of dealing with dying people (and sometimes saving their life) felt much more rewarding than all the surgeries I've assisted.

Since then, I can't stop thinking about switching to IM but I'm terrified at the idea of losing that passion again and later regret it. In the other hand, if I get bored again at least I would have a nicer lifestyle. I don't care (much) about the money, I love it as much as the next guy but not over my happiness.

It's pathetic that I'm 2 years into residency and I still don't know if I prefer a medical or a surgical speciality.

Has anyone insights about this?

Ever considered anesthesiology? Sounds like it would be a better fit for you than IM (road to ICU, time in OR, critical thinking, but still has procedures)

 

[Gastrapathy]

Or EM +/- critical care?

 

[nlax30]

As 2nd year ortho how much actual operating are you getting to do vs the clinical scut work and/or scrubbing and not doing much of the “hands on” work.

I’m not in a surgical field but am in a very procedural oriented sub-sub-medicine specialty and at least in my case our procedures can be very very boring and mind numbing if you aren’t the primary guy doing the operating.

I guess I’m saying that I would do some more introspection and try and determine exactly what part of your current field it is that you don’t enjoy.

Every specialty has it’s exciting “cool” cases as well it’s own unique every day stuff that pays the bills so to speak.

 

[NITRAS]

Another year?? How much more clarity do you want? The OP doesn't enjoy operating. Time to make a change. now.

He's in one of the more competitive residency and wants to jump to a different end of the spectrum. It sounds brash to me. I'd want to jump to something, rather than away from something.

The PGY2's at my medical school didn't operate, they opened and closed. They did scutt work just a hair above interns. I don't claim to be an expert in surgery residencies, but it didn't look fun to me. I loved my ICU rotations, and can see the appeal. I spent more time in the ICU that most IM residents, and I didn't have to deal with any fellows, either.

 

[Sam212]

Hey everyone,

I am currently training in ortho and thinking about switching to IM. I think I don't like it anymore. I'm not depressed or burnt out. I'm a good resident and I have great relationship with everyone on the program. I just don't enjoy it anymore.

I went into it first hand for the trauma surgery. Boy I loved it when I was a med student! It was such a thrill. I also was very interested in every other aspect of the career. After 2 years of residency, not anymore. I don’t dislike it, it just feels very mildly interesting. And the more the residency progresses, the more I'm asking myself why am I working and studying this hard for something that I'm not passionate about.

I had a 2 months ICU rotation some months ago and had such passion dealing with complex medical problems, a passion that I don't think I have felt since the start of my residency. I was good at it too. And for some reason, the mental process of dealing with dying people (and sometimes saving their life) felt much more rewarding than all the surgeries I've assisted.

Since then, I can't stop thinking about switching to IM but I'm terrified at the idea of losing that passion again and later regret it. In the other hand, if I get bored again at least I would have a nicer lifestyle. I don't care (much) about the money, I love it as much as the next guy but not over my happiness.

It's pathetic that I'm 2 years into residency and I still don't know if I prefer a medical or a surgical speciality.

Has anyone insights about this?

You’re far too early in your residency to call it quits. I would stick to Ortho, things will get better. If you like more cerebral stuff, you can do a peds or tumor fellowship. If you really like managing your own ICU patients, you can potentially do that as a trauma guy but I would never recommend it. I would stick it out.

 

[Mad Jack]

The ICU isn't all it's cracked up to be. Lots of dying, not a lot of payoff.

 

[ortho_confused]

Thanks everyone for your replies.

It's true that my implication during surgery is still minimal and the fun of seeing someone else operating is not what it used to be.

I tought a lot about it the last few days (and it is hard to admit even behind an anonymous username on internet) and come to realize that a part of the problem is the more I'm getting responsabilities during surgery the more I'm getting anxious to go to the OR. It seems that I have performance anxiety in the OR and I'm looking for a way out. I will try to fix this before doing any move.

 

[OrthoTraumaMD]

Thanks everyone for your replies.

It's true that my implication during surgery is still minimal and the fun of seeing someone else operating is not what it used to be.

I tought a lot about it the last few days (and it is hard to admit even behind an anonymous username on internet) and come to realize that a part of the problem is the more I'm getting responsabilities during surgery the more I'm getting anxious to go to the OR. It seems that I have performance anxiety in the OR and I'm looking for a way out. I will try to fix this before doing any move.

There’s only one solution for anxiety in the operating room in addition to experience: Reading and preparation. Read about the case, make a plan, draw out the fracture and the implants, and go over it with your senior residents before the case. That’s it. That’s all you need.


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[anonperson]

Thanks everyone for your replies.

It's true that my implication during surgery is still minimal and the fun of seeing someone else operating is not what it used to be.

I tought a lot about it the last few days (and it is hard to admit even behind an anonymous username on internet) and come to realize that a part of the problem is the more I'm getting responsabilities during surgery the more I'm getting anxious to go to the OR. It seems that I have performance anxiety in the OR and I'm looking for a way out. I will try to fix this before doing any move.

The 5 Ps.
Proper preparation prevents poor performance.

The advice from OrthoTraumaMD is great

No one is born a great surgeon or knowing the steps of each specific procedure. This comes with hours and years of preparation and study. So when you see someone in the OR who is great at what they do, know it comes from laying a strong foundation.

Sure, some people are gifted and have extra ability and not everyone is going to be a Debakey, but if you put in the time and effort, one can become a safe and reasonably adequate surgeon.

 

[deleted547631]

Stay in Ortho! It's worth the years of frustration you'd endure in residency. Ortho surgeons are the happiest group of surgeons I've worked with. Stay in that upper bracket!

 

[DOFOSHO]

Hey everyone,

I am currently training in ortho and thinking about switching to IM. I think I don't like it anymore. I'm not depressed or burnt out. I'm a good resident and I have great relationship with everyone on the program. I just don't enjoy it anymore.

I went into it first hand for the trauma surgery. Boy I loved it when I was a med student! It was such a thrill. I also was very interested in every other aspect of the career. After 2 years of residency, not anymore. I don’t dislike it, it just feels very mildly interesting. And the more the residency progresses, the more I'm asking myself why am I working and studying this hard for something that I'm not passionate about.

I had a 2 months ICU rotation some months ago and had such passion dealing with complex medical problems, a passion that I don't think I have felt since the start of my residency. I was good at it too. And for some reason, the mental process of dealing with dying people (and sometimes saving their life) felt much more rewarding than all the surgeries I've assisted.

Since then, I can't stop thinking about switching to IM but I'm terrified at the idea of losing that passion again and later regret it. In the other hand, if I get bored again at least I would have a nicer lifestyle. I don't care (much) about the money, I love it as much as the next guy but not over my happiness.

It's pathetic that I'm 2 years into residency and I still don't know if I prefer a medical or a surgical speciality.

Has anyone insights about this?

ICU is only a piece of IM training. Most of your time will be spent on the floors dealing with BS, on the phone dealing with BS, in clinic dealing with BS....there is a recurring theme. Your "it just feels very mildly interesting" sounds much better than wanting to go into the stairwell and bang your head against the concrete wall.

 

[ASDIC]

I would go ahead and transfer out to IM.

Why waste your time training in something you are not passionate about? This is going to be your entire life.

I transferred out of anesthesiology to IM a few years ago and do not regret it. I remember those days in the 4th year of medical school where you had deadlines to decide with a specialty for the match. I was undecided at the time. So, I had a career advisor who steered me into anesthesiology due to the lifestyle and money. I followed his advice and chose anesthesiology.

However, after doing my prelim year in IM, I loved clinical internal medicine. The team based approach in coming up with diagnosis and treatment plans, opportunities to further specialize, having that patient interaction and working in a wide variety of IM areas such as clinic, wards and ICU made me question my decision about anesthesiology.

So when I started anesthesiology the next year, I was no longer enthusiastic or passionate about the field. I hated waking up at 4:30 every morning, prepping for the OR, wearing a mask and sitting in the OR all day. At the end of my first month, I approached my PD and requested that I be allowed to transfer back to IM. My PD encouraged me to stay and complete the field. But I was stressed about staying there because I didn't want to waste my time doing something I didn't like. I was able to secure a PGY2 categorical IM position and completed my PGY3 year as well.

I have an excellent lifestyle now as an internist and make enough to keep me and my family happy.

 

[Limvostov]

I'd stick with ortho. Tumor is a lot like medicine, those guys are great surgeons and medicine physicians. Being a scope jockey doing one chondroplasty after the next is great too when you step back and think about it. GI and cardiology have a lot in common with ortho from a pay/lifestyle standpoint so if you switch maybe that's a good route. I liked ortho and cardiology. Ended up in cardiology after three long years of wondering what I would do if I got stuck in medicine. I think ortho has enough diversity that you'll find your niche. I wouldn't risk going into medicine. There is some satisfaction to be had in medicine, but they are also the team everyone (even non-physicians) dump on so think I'd twice about signing up for that. Also, I know people say that money isn't everything and it's not, but it is something and it should not be disregarded. I don't want or need fancy things, but being done at 55 sounds sweet and ortho is a specialty that can get you there comfortably if you live simple.

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[turnupthegas]

ANESTHESIA


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[zanzizic]

Don’t make a decision you’ll regret at this point. Finish ortho and you’ll find a direction in the specialty that you will enjoy.