I bet I'm thinking too much about this...but...

[anxiousnadd]

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Hello SDN colleagues!

Well, I'm in the course of planning my 4th year electives. I've got a couple set up in EM, but was considering spending one month in General Surgery at a hospital that also has an EM residency program. I'm doing this for two reasons, one because I want to make certain that EM is the field that I'll be most happy with (which I'm 90% certain right now but want to be 110%), and two, because I do enjoy surgery and would like to get a little bit more of it before residency.

In any case, my question is: will the EM program at that hospital that I do a general surgery rotation in find it suspect that I didn't spend that month in the ED with them instead of in the OR?

Thanks!

 

[GeneralVeers]

This won't help you with EM (at all). You should have taken General Surgery during your 3rd year. Did you enjoy it? Did you enjoy it MORE than EM? If so, then do surgery.

Doing another month of surgery is not going to help you in the EM world, and most residency directors won't care about it. I won't even mention that it's typically a hard rotation with insane hours. The skills you learn on that rotation that are relevant to EM you should have already learned in your 3rd year rotation.

 

[college!!]

I agree with the last post, additionally EM PDs are looking for "commitment to EM" it's on the SLORs and it comes up in a lot of interviews. Doing an away in another field can weaken your application, especially if it's early enough to show up on your transcript.

 

[Chief58]

I also agree with the above posters. Ultimately, yes, it will seem weird that you did an away in something not related to emergency medicine.

If you've taken both surgery and EM, another rotation in either won't make the career decision for you. Make the choice based on the information you gleaned from previous rotations and go forward from there.

If you really want to do another month of surgery "for the fun of it," then take it later in the year. You might be burned out by then and not want to work the hours, but that's better than adding any kind of questionable activity to your application.

 

[LadyGrey]

Respectfully diagreeing on one point -- nobody asked me about anything about rotations except "where'd you do EM?" and "anywhere else?" and occasionally "what are you doing right now?"

We can't do EM in third year, so I had it as my first rotation of fourth year, but had my other "just making sure I don't want this" stuff as my 2nd and 3rd rotations and they just never came up at all in interviews.

Surgery was NOT something I had to "rule out" personally, but would the OP be better off with something like trauma surgery? I'd think that could be spun as part of a commitment to EM, but maybe I'm wrong.

OP: have you had any EM yet, or are you in the same boat I was where you can't do it until 4th year?

 

[anxiousnadd]

Yes, I had EM way early in my third year.

As for commitment to EM, I was an EMT in my previous life, have published articles, part of the EM interest group, EMRA, ACEP, etc etc etc. Although I don't need to put my CV on this forum, believe me that when I say I have a commitment to EM, that it is there.

I am in my Gen Surg rotation right now and it's pretty fun. I definitely see myself doing it, but I'm starting to actually get bored of the same monotonous gallbladders and appendices, although I cringed today when my attending told me that EM docs are glorified FM docs...especially since I just about wanted to gouge my eye out during my FM clerkship. Not to say anything negative about FM, but just that it's not my cup of tea.

 

[The Buff]

, although I cringed today when my attending told me that EM docs are glorified FM docs...especially since I just about wanted to gouge my eye out during my FM clerkship. Not to say anything negative about FM, but just that it's not my cup of tea.

Everyone hates on EM docs in one way or another. I love EM and I have learned that whenever people say this crap to me I just laugh and secretly pity them for choosing a second-class specialty. Its all about the thick skin.

As for your original question, if you have two EM's in fourth year I don't think anyone will say anything about any other rotation. Although, I do agree that Trauma surgery would be the best to do. Plus there are no boring appys and choles there.

 

[dchristismi]

I am in my Gen Surg rotation right now and it's pretty fun. I definitely see myself doing it, but I'm starting to actually get bored of the same monotonous gallbladders and appendices...

BINGO! I liked Gen Surg up until that point too.

If you're going to do a 4th year surgery rotation, make it a cool one. I did a rotation in facial plastics as my very last month of 4th year. Laid back, random cosmetic procedures and some wicked Mohs reconstructions with this private ENT. I learned some very cool tricks of the trade and hung out with his fellow.

You'll get your fill of trauma as an intern, so you really don't _have_ to do that.

 

[Chief58]

BINGO! I liked Gen Surg up until that point too.

If you're going to do a 4th year surgery rotation, make it a cool one. I did a rotation in facial plastics as my very last month of 4th year. Laid back, random cosmetic procedures and some wicked Mohs reconstructions with this private ENT. I learned some very cool tricks of the trade and hung out with his fellow.

You'll get your fill of trauma as an intern, so you really don't _have_ to do that.

Good point here. If you really want to try another surgery rotation to rule it out, then do a subspecialty. If you're still unsure because you don't like "boring" gallbladders, etc., you might find that ENT, Optho, Ortho, or Plastics is more to your liking. If you decide to do EM, anyway, then these are common off-rotations for 4th year in which you can learn valuable EM informationa and skills. For example, you can learn facial/lip lac suturing on ENT or Plastics , slit lamp exams on Ophtho, and reduction/casting on Ortho.

I really liked surgery as well, but I was given some good advice by a surgeon:

"If you can imagine going your whole life without being in the OR again, then you shouldn't do surgery. If you can't, then surgery is the life for you."

 

[anxiousnadd]

Woah! Thanks everyone!

 

[theCamel]

Everyone hates on EM docs in one way or another. I love EM and I have learned that whenever people say this crap to me I just laugh and secretly pity them for choosing a second-class specialty. Its all about the thick skin.

i wish you were joking but i doubt it. there are in fact other good fields besides EM, don't be ridiculous.

i hope you're just operating on a level of humor that i don't understand. otherwise just wow.

 

[Chief58]

i wish you were joking but i doubt it. there are in fact other good fields besides EM, don't be ridiculous.

i hope you're just operating on a level of humor that i don't understand. otherwise just wow.

Of course, he's joking! Whatever happened to giving someone the benefit of the doubt? And all this time, I thought EM docs were the masters of sarcastic, cynical humor. I guess that doesn't apply to everyone.

 

[theCamel]

Of course, he's joking! Whatever happened to giving someone the benefit of the doubt? And all this time, I thought EM docs were the masters of sarcastic, cynical humor. I guess that doesn't apply to everyone.

i'm not fluent in internet sarcasm poor me

 

[Mr. Freeze]

"If you can imagine going your whole life without being in the OR again, then you shouldn't do surgery. If you can't, then surgery is the life for you."

Is this enough? I mean, I'm really, really on the fence also about EM v. ortho; when I told my ortho mentor this, he was like, "Wow. Those are pretty different."

I love being torn between two specialties in which I haven't rotated...I guess time will tell. I have both here in a few months. Of course, after the point at which every ****ing away rotation will be full...

 

[Doctor Bob]

I love being torn between two specialties in which I haven't rotated...I guess time will tell. I have both here in a few months. Of course, after the point at which every ****ing away rotation will be full...

If you are really unsure about EM vs surgery, there's always the option of doing a surgery prelim year to help make up your mind.

I'm doing that right now (although the decision for me to go do a surgical internship before an EM residency was made for me by the military but I digress). For me it's done wonders to reinforce the feeling in my head that I want nothing to do with surgery for the rest of my life.

The nice thing about a surgical internship though is if you do it and love it, you can hopefully parlay it into a PGY2 surgery spot. If you do it and hate it, well then at least you've gotten some trauma time, ortho time, anesthesia time and so forth, putting you ahead of your classmates the following year procedure-wise when you start as an EM PGY1.

But do that only if you're truly torn and can't think of any other way to decide.

 

[ergal]

definitely never had this problem as I hate surgery with a passion. To me, surgery and EM are incredibly different. Surgery is very technical and more procedural in nature. Yes, there are procedures in EM but as many attendings have told me, they are more of an interruption in the day and they are also much more limited in number compared to our colleagues in surgery.

I would suggest you think what appeals to you about each field. Do you like hierarchy or team-based approach? Do you want autonomy as a resident? What about patient complaints and diversity?

A trauma rotation is way more interesting than another month of surgery wards and more applicable to EM. The hours completely suck though. If you have an AI requirement as a MSIV though, perhaps you can use the trauma surg to fulfill it.