How bad is a prelim year in surgery?

[X.O.]

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I have to scramble tomorrow for a prelim year and Im strongly considering doing surgery rather than medicine. For anyone doing one this year and or has done one, how bad is it? I actually enjoyed my surgery clerkship as a student but being an intern is probably completely different matter.

 

[Law2Doc]

I have to scramble tomorrow for a prelim year and Im strongly considering doing surgery rather than medicine. For anyone doing one this year and or has done one, how bad is it? I actually enjoyed my surgery clerkship as a student but being an intern is probably completely different matter.

I'm sure others can give you better details, but from the colleagues I know who are doing prelim surgery, it's not so much "bad" as "grueling". If you enjoyed your surgery clerkship, you probably will enjoy this as well. But you are going to enjoy it 80 hours/week for 12 months. Non-surgical fields, by contrast, tend to break the year up with harder and much easier electives. Surgery internship often just leaves out the easier. But you will be doing a lot of floor work, ICU work, and depending on the program a certain amount of OR time. For some, that's a fun way to spend a year, but simply too much of a good thing. For others it could be rough. It's certainly better than losing your advanced match position.

 

[exPCM]

Agree with comments of law2doc.
Where I did residency and fellowship the prelim surgery interns seemed to do predominantly floor coverage, discharges, scutwork, and spent very little time in the OR. The more senior residents got a chance to operate much more often.
I think that a prelim surg intern who is going into a non-surgical field might be scutted more than one who is trying to get a categorical position.

 

[wombatmd]

It depends on where you are. Some bad medicine programs are as bad or worse than easy surgery ones. The prelim surgery interns at my hospital have it easier and happier than the prelim medicine interns, by popular wisdom.

It's probably rare, but it happens. Ask around about specific programs, if you can.

 

[Holistic]

I matched Derm and had to scramble for a Prelim and had to take a surgery position. I took one at a Private Hospital that I had heard through the grapevine was very cush(great support staff with little scut, out by 2pm most days unless on call, not a level 1 trauma center, 4wks vacation, 50,000 salary, on call rooms in a hotel attached to hospital) this sounded better than prelim medicine in a big academic center to me. I hope the rumors I heard where true and it won't be to grueling, but I do have Derm at the end of the tunnel.....

 

[OBandWifey]

I matched Derm and had to scramble for a Prelim and had to take a surgery position. I took one at a Private Hospital that I had heard through the grapevine was very cush(great support staff with little scut, out by 2pm most days unless on call, not a level 1 trauma center, 4wks vacation, 50,000 salary, on call rooms in a hotel attached to hospital) this sounded better than prelim medicine in a big academic center to me. I hope the rumors I heard where true and it won't be to grueling, but I do have Derm at the end of the tunnel.....

Wow that's pretty awesome! I hope the rumors are true also.

 

[jalps572]

Avoid inner city prelim surgery programs or a hospital that covers a vast geographic area, they tend to be the most malignant.

 

[Law2Doc]

I matched Derm and had to scramble for a Prelim and had to take a surgery position. I took one at a Private Hospital that I had heard through the grapevine was very cush(great support staff with little scut, out by 2pm most days unless on call, not a level 1 trauma center, 4wks vacation, 50,000 salary, on call rooms in a hotel attached to hospital) this sounded better than prelim medicine in a big academic center to me. I hope the rumors I heard where true and it won't be to grueling, but I do have Derm at the end of the tunnel.....

Bear in mind that folks like to exaggerate. "out by 2pm most days" probably means it happens now and then. Less in the beginning of the year when the learning curve is steep, but moreso later in the year when folks know what they are doing and are willing to shoulder the burden to let colleagues out early in hopes they will return the favor. Plus if what they are really talking about is that you are out at 2pm on post-call days that actually is a very bad sign.

As for call rooms being in a hotel attached to the hospital, bear in mind that some folks find they rarely, if ever, see the call room while on call. So the room can be amazing but it's a meaningless perq if you are up all night most calls, as some of us seem to be. Also if it's not immediately adjacent to the wards, you probably won't bother to go there because it's a pain to walk over to a hotel, get paged, come back to see a patient, walk back to the call room, get paged again, come back to see another patient, go back to the room, and so on throughout the night. Post-op patients tend to need to be looked at due to possible complications; you can't just give orders over the phone and go back to sleep or you run huge risks. And then there are codes -- you can't be 15 minutes late because you were in another building. You need to be close. If it's in another building, like a hotel, you probably won't find it worth it to trek over there if your call is anything like a lot of ours are. You will find a couch or armchair someplace in the same building.
So don't let them fool you. Internship is internship everywhere. There are shades of gray, but it's still gray. If something sounds too good to be true, particularly for a position that stayed open for the scramble, it probably is.

 

[Buzz Me]

So many good points listed above.

If the call room is too far away, you won't ever use it. This is assuming you even have time to use the call room during a busy night.

There were some nights I barely had a chance to sit down. Literally. A couple times my feet would be so swollen by the next morning that it hurt to drive home (i.e., when I'd push down on the gas or brake pedal).