How do I know surgery is the right fit for me?

[doctorchad88]

I'm doing internship in Europe at the moment and I'll need to pick a specialty in April.

The thing is, that I am completely lost and can't put my finger on what to pick. I find bad sides to every specialty when I think about it and because there are so many choices I have analysis paralysis.

I'm also worried because I don't think I'm prepared to make a choice of what I will do for the rest of my life. Our college is structured in a way that we have a lot of heavy theory (as in history & examination, ordering labs all the time) but not a lot of practical knowledge (procedures, suturing, placing lines, helping a surgeon etc.). Even for surgery exam we had to learn the pathology of the disease and then what kind of operations to do, in theory. In this way, I feel like this structure of college makes people like me (conservative/risk-avoidant/not liking the unknown) lean towards the specialties that are based on history & exam (IM, neuro, infections, peds, FM etc.). But I don't like specialties that have a lot of paperwork and long history, exams.

I like surgery, people tell me I have personality for it. But I'm worried I'm not fit for it. When I search for questions on how to pick surgery, the most important thing is if you like doing procedures and I already can't answer this question. I've done sad amount of procedures during college, I don't know how to suture, because I never tried. The most they allowed me to do was to hold instruments during one (!) surgery in oncology. I don't know if I have good motor and hand coordination skills because I literally never tried cutting on a human. I did play a guitar and was good at it. Our anatomy was thought in such a way that I probably wouldn't know what I'm looking at if I saw an open body (I'm exaggerating, but you get the gist). I don't know if I'm patient enough to stand for hours, because when I was just watching a surgery from behind the surgeon's back it was ****ing boring and I couldn't wait for it to end. Our clinical practice during college regarding surgery sucked. Just learn theory and answer in oral exam.

I don't think that's the way to go about practical skill such as surgery. A lot of people also say to not pick surgery if you aren't 100% sure on it as you will hate your life due to a lot amount of stress. This may be true but then there are surgical specialties that have good life-work balance such as ortho (in Europe ortho and trauma are seperate), plastic surgery, ENT, urology, ophtho etc.

My personality is structured in a way that I like to have a good base of knowledge before I pick something. When I did my IM rotation, I studied IM pathologies, labs and drugs beforehand so I could be comfortable in the rotation itself. In the surgery, I can't do it, because it's a practical field and you learn by experience but I feel like learning from the mistakes could be stressful for a person with my way of thinking. It also depends on how the practice is done, if they slide you in slowly it could be good, but if they just throw you in the middle of the procedure and tell you to do it, that would cause me immense stress. I start slowly and I'm a good worker, but with experience I get very good at the practical things. At least from the other practical everyday things, I can notice this about myself.

I now have a book called Surgical Recall, so I can read a book and be better prepared about what I need to do/know in practice. Like I said, I like to really do my research before I dos something. I'm a perfectionist, I guess.

I'm worried I can't make a good decision because I don't have enough data and experience with it. I feel I would be a good surgeon but I need to have more than a "feel" before I make a decision that will influence my life in such a way.

What would be your advice?

Thank you for your help.

---

Members don't see this ad.

 

[deleted367183]

Sorry this is so obvious, but have you done a visiting rotation/observership/external rotation in surgery? I did one in autopsy and it helped cement my interest in forensic pathology (a cousin of surgery ). We did practically zero autopsies at my home institution.

Surgical Recall is a good book! Dr. Pestana's Surgery Notes is also good. But maybe some actual surgery residents can recommend you the very best books.

 

[doctorchad88]

No, I haven't done it yet. I will be starting one next month but in the program it says that we will do rotation in more of an outpatient setting which is a pity, as there's no practical skills yet again. Maybe I can ask them if I can go to OR with them or something but I wouldn't count on it as we as interns are supposed to be in this emergency outpatient setting.

 

[guytakingboards]

No one going into surgery is that good at technique when they first start. That's part of what they learn during training. The flip side is true too. Even if someone is good at suturing to begin, there's still so much more to learn technically.

Sounds like you have a lot more shadowing and soul searching to do. That being said, a thoughtful and risk-avoidant surgeon is not the worst thing in the world.

 

[doctorchad88]

Thanks, yeah I'm a bit lost at the moment. Have no idea what to choose for my specialty, having analysis paralysis and overthinking everything. Not sure what the way out of this would be, I guess I need to shadow more.

 

[HighwayVagabond]

Good surgeons must be two things: 1-safe, 2-decisive. You seem to be an over-analyzer, which is a great quality for some specialties. Surgery is not one of them. When you're in a trauma bay and a patient is about to code, there is no time to analyze. You must make decisions swiftly and with confidence. Same thing in the OR. If you waffle people will lose confidence in you, even if you come to good conclusions in the end. It is good to be thoughtful about decisions, but your above post suggests you may like to analyze problems in a more philosophical way than you will be able to in the surgeon role.

 

[doctorchad88]

Thanks for your opinion and analysis. I'm definitely over-analyzer, I like to think of every thing that can go right or wrong and do scenarios/algorithms for every scenario possible. I do cost-benefit decisions after my lengthy analysis and try to be sensible always. That's why I say that I like to know a lot about some thing before I even start it. I like algorithm based specialties too. That's why I say jokingly that I would need to do some common surgeries myself BEFORE I even start the residency (shame there aren't any VR surgery simulations), so I can be confident in myself when I actually do start it. That's how I function the best and if I do it with this in my mind, I will do everything I put my hand on perfectly. This is how I function. Based on this, which specialty do you think would be good for me, in your opinion?

 

[HighwayVagabond]

I have very little exposure to this field, except for when they are involved with IORT, but radiation oncology strikes me as something that feels a little procedural, and requires a great deal of analyzing and over-analyzing to plan and provide the patient with the best care. It is multi-disciplinary and requires complex knowledge of many oncologic pathologies, as well as all the possible treatment algorithms for each one. Of course, I don't know you at all and am basing this on reading a couple posts in an anonymous forum, but this seems like it would at least be something to check out that may be fulfilling and rewarding for you.
There are definitely algorithms in all procedural/surgical specialties, and sometimes those algorithms get you through emergencies, but if you're someone who primarily functions on them they can really get you into trouble when you can't quickly and easily think outside the box. Some people like this completely miss that the patient has now veered far off from any straightforward pathway of care, or can become paralyzed when the prescribed algorithm is suddenly not working.

 

[j4pac]

Suturing is something you can practice without patients. All you need is suture material and a grocery store