Help!!! I want to switch into surgery

[KidDoc29]

I am 8 months into my Pediatric residency at a fairly well-repsected program, and while I love caring for and working around children, it is simply not for me. I don't know how I ended up in this situation. I did Surgery as my very first 3rd year rotation, and my lack of any clinical knowledge or skill led to a mediocre grade; my 4th year sub-I on the Peds Surg service was equally unimpressive - no OR time at all, endless afternoon consults for Broviacs so the residents could all go home post-call, and not much opportunity to interact with attendings. Although I loved the operative experiences and had considered surgery, I just didn't think that I would have good chances of matching anywhere decent, so I took my second choice...Peds. My plan had been to subspecialize in something procedural with high acuity such as cardiology, NICU, or PICU, and just kinda swallow the fact that I would never be a surgeon.
Well..... I am miserable. I dread going to work. The endless hours of writing notes and rounding with very little if any time spent giving patient care is wearing very thin. The complete refusal to allow trainees to do ANYthing the least bit invasive to a child without sedation and the presence of a fellow has left me 8 months into my year with ZERO technical ability. And I find myself longingly wishing I was in the OR correcting pathology instead of just talking about it. I still wok 80+ hours a week, except only about 12 of those are spent doing anything of any clinical or educational merit. I have been reticent to discuss this w/ any of my colleagues or PD until I have a plan in place for how to proceed.
The things I know for sure: I absolutely cannot envision myself as a pediatrician of any kind, except possibly an intensivist. I will always feel like only "half a physician" if I am unable to possess technical skills and offer my patients operative therapies. And I will not be able to keep up the charade required in order to keep on smiling each day, knowing that you are in the wrong profession.
I need serious advice about what to do. I can't very well get letters form surgeons for ERAS, it's too late to apply for this year, I will not even have the opportunity to meet any surgeons in my institution until I do my PGY-2 peds surg rotation next year, etc etc etc. My head is swimming and meanwhile I am having nighmares about RSV, constipation, and Ritalin. HELP!!!!! I MUST find a way to become a surgeon!

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[Foxxy Cleopatra]

Hmmm, tough predicament but I can think of a few options:

1. Talk to the surgery PD at your institution but make it clear that YOU want to be the one to break it to your peds program that you want to switch. I would ask them what they thought could be available for you starting this July and I'd state something along the lines that you've learned quite a bit in peds but what you really want to be able to provide for your patients is surgical care and would rather be in the OR than any place else.

If it doesn't seem like there would be a way for you to get a spot there (or if the surg PD doesn't offer to help call other places) I'd then perhaps look into doing surgical research if avaliable at your instituion with the intent of matching into surgery in 2006. This may not be a bad option, especially if you cannot see yourself doing another year in peds.

2. Check out www.apds.org (the surgery program director's website) as they have listings of open spots, sometimes an "unexpected" opening at a PGY-1 level.

3. I'd be *very* hesitant to take a prelim spot as it not infrequently leads to having to repeat your surgical intern year. In other words, I wouldn't want to be in the situation of potentially doing one peds internship and 2 surgery internships.

Good luck; surgery residency is no walk in the park but the OR is worth it.

I am 8 months into my Pediatric residency at a fairly well-repsected program, and while I love caring for and working around children, it is simply not for me. I don't know how I ended up in this situation. I did Surgery as my very first 3rd year rotation, and my lack of any clinical knowledge or skill led to a mediocre grade; my 4th year sub-I on the Peds Surg service was equally unimpressive - no OR time at all, endless afternoon consults for Broviacs so the residents could all go home post-call, and not much opportunity to interact with attendings. Although I loved the operative experiences and had considered surgery, I just didn't think that I would have good chances of matching anywhere decent, so I took my second choice...Peds. My plan had been to subspecialize in something procedural with high acuity such as cardiology, NICU, or PICU, and just kinda swallow the fact that I would never be a surgeon.
Well..... I am miserable. I dread going to work. The endless hours of writing notes and rounding with very little if any time spent giving patient care is wearing very thin. The complete refusal to allow trainees to do ANYthing the least bit invasive to a child without sedation and the presence of a fellow has left me 8 months into my year with ZERO technical ability. And I find myself longingly wishing I was in the OR correcting pathology instead of just talking about it. I still wok 80+ hours a week, except only about 12 of those are spent doing anything of any clinical or educational merit. I have been reticent to discuss this w/ any of my colleagues or PD until I have a plan in place for how to proceed.
The things I know for sure: I absolutely cannot envision myself as a pediatrician of any kind, except possibly an intensivist. I will always feel like only "half a physician" if I am unable to possess technical skills and offer my patients operative therapies. And I will not be able to keep up the charade required in order to keep on smiling each day, knowing that you are in the wrong profession.
I need serious advice about what to do. I can't very well get letters form surgeons for ERAS, it's too late to apply for this year, I will not even have the opportunity to meet any surgeons in my institution until I do my PGY-2 peds surg rotation next year, etc etc etc. My head is swimming and meanwhile I am having nighmares about RSV, constipation, and Ritalin. HELP!!!!! I MUST find a way to become a surgeon!

 

[Foxxy Cleopatra]

Oh yeah, one last thing- if you decide that you want to leave peds and sit out a year, I'd take Step 3 BEFORE you leave peds and get your state license so that you have the potential to make some $$ in the meantime.

 

[surg]

Just a couple of thoughts to add to Foxxy's which I generally agree with:

If, in your heart, you know you want to be a surgeon. Go for it. It is far better to work hard every day at something that you love doing then work hardly at all at something you can't stand.

Since it is too late to deal with this year's match (except possibly a scramble if something caught your eye), I agree that the best bet is to go meet with the PD at your institution and as a second best option, the PD of surgery at your med school.

The place that I differ is that given that it sounds like your grades might not have been the best in surgery, you may want to consider doing a prelim year in surgery. Even though it might not lead directly to a categorical spot at that place, it'll give that PD a chance to really be your advocate in finding you another spot or possibly offering you a spot there. Research may be a reasonable second alternative, but make sure to get a powerful advocate out of it, because you are going to need new LORs. Without any relevant surgical experience this year, sitting out a year before going through the match may make affect your ability to amass these letters.

Good luck to you!