Help me pick: Gen Surg v Internal Med

[Pierat]

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Hi all - Australian medical graduate here. I'd like your input please to help me decide between general surgery or internal medicine as my specialty.

I love working with my hands and love operating and being in the OR. My main concern if I were to select gen surg is age - I'll be 40 if I were able to get on to the gen surg training program on my first try. What do you think of my age and potential impact on my surgical career? Would I be able to operate until I'm 70 then do other non-operating work before retiring at 75? The other concern is that I might miss out on medicine and advances in medicine in general, but I don't think it's a significant concern given that I could read journals to keep in touch with medicine.

If I were to select internal medicine, age is no longer a factor and I'd obviously be up to date with the relevant medical specialty that I'm in. I'm going to miss operating though. I don't think I have that deep love for internal medicine that I see in some of my friends who have always wanted to do internal med.

My med school CV revolves around surgery. I have a publication in surgery and won an achievement award in surgery as well. My scores in surgery are a lot higher than medicine (which is average amongst my cohort only).

I like helping patients with their medical/surgical problems, and I thrive on intellectual stimulation, and I like procedures and being involved some what in critical care medicine. Are there other alternatives besides surgery that could fulfill these requirements? Interventional cardiology perhaps?

Your input is much appreciated! Thanks very much!

 

[rokshana]

are you looking at doing residency in the US or Australia ?

GS as an FMG is an uphill battle...if you would be happy doing IM and are planning on trying to do residency in the US, you should think about that route...there are procedure heavier sub specialties that would still allow use your hands so to speak...not operating but...

another route is to think anesthesia...its can be more hands on and if you do pain you can be in the OR on the other side putting in stimulators and so forth...

 

[Pierat]

Sorry I should have mentioned that I'm not a FMG...just an Australian working in Australia.

 

[Law2Doc]

Sorry I should have mentioned that I'm not a FMG...just an Australian working in Australia.

Most on this board are in US training programs and we'd be guessing at how Australian nontrads in surgery are regarded in Australia. In the US, surgery would be a tough nut to crack for an older FMG, but no reason you couldn't apply to both and let the match dictate what you can get, rather than close the door yourself. No idea whether the Australian system is similar.

 

[Pierat]

Thanks for that. How about I switch up a little bit and ask what you guys think about my age and a surgical career? Still ok or too old?

 

[Mad Jack]

The only thing I can say is that you shouldn't worry about not keeping up with medicine lol- your patients will have preexisting issues, post-op infections, etc. At least in the US, the surgeon manages everything about a patient in the SICU, so you need to be up-to-date on your medical knowledge.

 

[ThoracicGuy]

Thanks for that. How about I switch up a little bit and ask what you guys think about my age and a surgical career? Still ok or too old?

If surgery training is the same in Australia as it is in the US, you would be 45 when you would start practice. That's not bad and you would have a good 20-30 years in the field, perhaps longer. People get hung up on age alot, but if you do IM (3 years in the US) compared to surgery, you're looking at 43 vs 45 years old. That's not anything worth getting worked up over. You should decide your specialty based on what YOU like to do most. Do you like surgery and surgical patients or do you like medical patients, clinic, IM subspecialties, etc?

 

[Follow the Cairns]

Thanks for that. How about I switch up a little bit and ask what you guys think about my age and a surgical career? Still ok or too old?

Certainly don't think your age is a deal breaker, but I will say, you probably will have a tougher time (physically speaking) than your younger counterparts. My husband did his Ortho residency between the ages of 30-36. Working 24 hours on and post call days were tough, but not insurmountable. Now, he's a 43 year old attending and post call, it takes him several days to get back to being himself (assuming a tough call). Fortunately, this doesn't happen often. But anyone who tells you your age doesn't factor into the equation, at least a little bit, is probably painting too rosy a picture of things.

Really, though, most residents are in the 27-32 age range. You will be 40-45. If you are a healthy individual, you can do it. I would say go for it!

 

[rokshana]

Sorry I should have mentioned that I'm not a FMG...just an Australian working in Australia.

and i take it you are planning on staying in Australia to do residency and practice?

if thats the case, you should do what you would like more...only you would know if you can keep up...

 

[Pierat]

Thanks everyone for your kind advice. Very helpful indeed!

 

[Winged Scapula]

If surgery training is the same in Australia as it is in the US, you would be 45 when you would start practice. That's not bad and you would have a good 20-30 years in the field, perhaps longer. People get hung up on age alot, but if you do IM (3 years in the US) compared to surgery, you're looking at 43 vs 45 years old. That's not anything worth getting worked up over. You should decide your specialty based on what YOU like to do most. Do you like surgery and surgical patients or do you like medical patients, clinic, IM subspecialties, etc?

Unfortunately for our 0P, surgery training is not the same in Australia.

He will be required to do 2 foundation years as a house officer before applying for surgical subspecialty training. Depending on his evaluations, marks, and the number of positions available as well as where he is applying, he may not be accepted his first year. The stories of Australian house officers spending years attempting to get in the subspecialty training positions are well known. In addition there is not a clear-cut end to the training because of what appears to be some inherent subjectivity as to when someone is ready to practice as a consultant.

That said this in and of itself is not a reason you shouldn't consider surgical training but I would suggest talking with some Australian consultants as to what the general feeling is about older applicants.