I don't know what to do!

[anxiousnadd]

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Ok, so I have a dilemma. I'm a M3 and in the middle of trying to figure out what specialty I want to go into. I want to go into a field that will allow me to be in the OR, but also be involved with the patient's continuity of care. However, I also want to have a family. So, I used to think OB/Gyn was for me, until I saw the docs never having a life outside the practice. Surgery doesn't give me that continuity of care, but IM doesn't give me the ability to go into the OR.

I know I'm asking for a lot, and maybe I'm living a dream, but does anyone have any suggestions for me about possible career options that I can investigate?

Thanks!

 

[OncoCaP]

Ok, so I have a dilemma. I'm a M3 and in the middle of trying to figure out what specialty I want to go into. I want to go into a field that will allow me to be in the OR, but also be involved with the patient's continuity of care. However, I also want to have a family. So, I used to think OB/Gyn was for me, until I saw the docs never having a life outside the practice. Surgery doesn't give me that continuity of care, but IM doesn't give me the ability to go into the OR.

I know I'm asking for a lot, and maybe I'm living a dream, but does anyone have any suggestions for me about possible career options that I can investigate?

Thanks!

You want it all, don't you?😉 Have already considered Urology, ENT, ophthalmology?

 

[msurodeo]

Have you checked out vascular surgery? I was speaking with an attending who chose the field for that reason, OR and continuity of care. (due to type of patients, DM, etc) I am by no means an expert on vascular, but I think this area might be worth looking into for you as the surgeons that I've spoken with have been much happier with their home lives than the other specialties (OB, CT, etc).

 

[Anka]

Not a great lifestyle, but transplant also gives you 'patients for life'.

Anka

 

[ubcredfox]

I'd also suggest urology. I've heard quite a few times now that it's a good mix between procedural and clinical medicine, has great patient satisfaction (for obvious reasons), and the life style rocks.

Or you could do a sub-specialty in IM. My latest pet career choice is GI, since you get to do quite a few procedures (with cool technology), and you do get to care for patients quite a bit, in both in/out-patient settings.

 

[RugbyJC]

I'd like to second the urology. I just did my required clerk in it and it was pretty cool, as like as you don't mind sticking your fingers in rectums and mainly dealing with things below the belt. You do medicine--hypogonadism, ED, prostate cancer, BPH, IC, and even female conditions; out patient procedures like cystostopies, biopsies, catheters, and some residencies even include nephrectomies, kidney transplants and adrenal conditions.

Sometimes with FP you can do procedures, especially if you practice in a rural area. It is less likely, but still possible to get certified in C-sections or practice in an ER setting, or assist in the OR in a rural setting.

ER and anesthesia allow for some procedures and a reasonable lifestyle.

 

[medstylee]

ENT is another one you should check out. my preceptor this year is a head & neck surgeon but also does a lot of general ENT. he's got a really great mix of OR and clinic in his schedule. he's in the OR 2 days per week. his OR cases range from tonsillectomies to major facial resections that require a good deal of reconstruction (where his head/neck training comes into play). his clinic days are a good mix of medicine and procedures. he does a lot of scoping and he also runs some specialty clinics for vocal fold botox/collagen injections. occasionally he does some bronchoscopy over at the hospital as well. he has to take call for trauma, but it's pretty infrequent since it's split between ENT, oral surgery and plastics. he's obviously only on the surgical end of things like thyroid/parathyroid and cancer, but he does a lot of medical treatment for things like reflux and sinus and ear issues. i can tell the reflux stuff is a nuisance to him, but he seems to like the other medical issues he sees in clinic.

 

[anxiousnadd]

thanks everyone! i hadn't thought of any of those options.

thanks again!

 

[not me]

Ditto on vascular surgery!! There is a TON of continuity of care (sometimes too much,) most vascular surgeons are moving to be more vascular specialists, focusing on pt risk factors, managing DM, HTN, claudication medically, and you get to not only spend time in the OR but in the endosuite too which is basically like playing with toys 🙂 The lifestyle thing though is not always what it's cracked up to bve. A lot of phone calls in the middle of the night....

Nurse: Um...you know that guy you did the ABF on today
You: mmmmhhhhmmmm (yawn)
Nurse: Well, he doesn't have any pulses
You: (insert explitive of your choice here)

Not as bad in private practice. Also, you can go straight into vascular now. There are only a few programs but there will probably be more next year.

 

[PeepshowJohnny]

You really sound like you're a candidate for one of the surgical subspecialties like Urology and ENT, as others mentioned. Just be aware, these are pretty dang competitive fields there, so plan accordingly (ie, probably need to start being friendly with them now to get letters of rec and advice).

You mentioned OB/GYN before, but mentioned crappy lifestyle. A lot of that has to do with the unpredictability of when women drop babies. There are a few surgery focused fellowships out of OB/GYN which I'd imagine would have a more controllable lifestyle.

 

[Beau Geste]

The General Surgeon I shadowed had a really nice balance of OR and patient contact time.

He had office hours on M,W,F from 2-5 for follow-ups/consults and OR time scheduled the rest of the time during the work week. He generally worked 7a-5 or 6pm but there were days where he was done at 11 and days he worked until midnight.

I really liked that mix and made me want to explore Gen. Surg. more in my electives when I get to M3/4.

 

[smq123]

The General Surgeon I shadowed had a really nice balance of OR and patient contact time.

True, but general surgery usually doesn't have good patient continuity of care - which is what the OP wants. You see them in the office for followup, and then that's usually it. Colorectal, vascular, and surgical oncology are big exceptions to this, though.

I really liked that mix and made me want to explore Gen. Surg. more in my electives when I get to M3/4.

🙂 Fortunately, gen surg is a core, required 3rd year rotation, so you don't have much of a choice in the matter.

Ok, so I have a dilemma. I'm a M3 and in the middle of trying to figure out what specialty I want to go into. I want to go into a field that will allow me to be in the OR, but also be involved with the patient's continuity of care. However, I also want to have a family. So, I used to think OB/Gyn was for me, until I saw the docs never having a life outside the practice. Surgery doesn't give me that continuity of care, but IM doesn't give me the ability to go into the OR.

I know I'm asking for a lot, and maybe I'm living a dream, but does anyone have any suggestions for me about possible career options that I can investigate?

Ophtho is competitive, but it still might work for you. The lifestyle is pretty good (almost no such thing as an ophtho inpatient service), you get to go into the OR, and there's good continuity of care. Uro and ENT, as mentioned, are also great options.

 

[Blade28]

Er...the aforementioned Transplant, Vascular, G Surg and CT routes are known for having bad lifestyles.

I'd consider ENT, Ophtho, GU, Laparoscopic, Breast or Plastics.

Of course some of those are competitive. 🙂

 

[Beau Geste]

🙂 Fortunately, gen surg is a core, required 3rd year rotation, so you don't have much of a choice in the matter.

This I know, but if I end up liking it enough, it will also be an elective.

 

[Ashers]

Ortho also has some continuity. My dad has patients where he's treated the entire family, and some members multiple times.

If you liked that the patient population in OB/gyn is generally healthy, that's a plus with ortho too, and in ortho you get more of a variety of patients; they aren't all women.

 

[deuist]

I'll echo what some of the other people have mentioned: you should really consider subspecialties of surgery. Yes, general surgeons don't have much of a life outside the OR. However, there are many specialist who do. Dr. Cox on this board is a surgical oncologist. She recently wrote an article about her life and EOR and the continuity of care that occurs afterwards.

 

[maxnm]

I went into ENT because I wanted many of the things that the OP described. The typical ENT in private practice will have about 70/30 office to OR. Much of ENT is medical management and decision making, but at the heart of it you are a surgeon. Of course you can tailor this to what you like. Also with the way reimbursment goes these daye clinic is often more lucrative than surgery. You also have the ability to subspecialize. Head and neck oncology does not have the best lifestyle because the surgeries can be very long (some > 12 hours) and the patients stay in the hospital for a long time, but you also get contunity. After cancer surgery you will follow youe patients every month for a year or two, and then regularly for 5 years. Laryngology offers the the option of office procedures and a relatively stable lifestyle. Other subspecialties such as rhinology, plastics, and peds each have their unique aspects. If you don't do trauma, which these days the majority of ENT's don't call is usually not that bad. It can also be very exciting. You are considered an airway specialist, and together with anesthesia, you are the expert in securing the A of the ABC's.

 

[GYN DOC]

If you want to do surgery in OB/GYN you can focus your practice on gyn only without ob and do a fellowship in advanced laparoscopic gyn surgery. Its only one year. Or you can do gyn onc (3 yr fellowship) which is nothing but surgery and medicine and tons of contintinuity dealing with cancer pt. Or you can do reconstructive pelvic medicine or urogynecology - all surgery and IM and continuity with better life style - 2 -3 yr fellowship. Or you can do REI which is a lot of laparoscopic procedures and helping pt deal with infertility. All of these fellowships offer surgery without complicated lifestyle of OB. GYN ONC lifestyle can be harsh because of long surgery hours.
Even still you can always join a huge practice and decrease your call hours.