Jumping ship from surgical subspecialty

[alreadyoverit]

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Hello all,

I am a rising PGY2 in a top-20 west coast surgical subspecialty program. Finishing intern year is a time of great joy for most folks, but all I feel is dread and panic. I've done several months of my specialty now, and it seems all of the passion I had for the field is gone. The operating room is horribly stressful, the clinics make me want to gouge my eyes out, and the last thing I can bring myself to do is study when I get home.

In medical school, I was between radiology and this specialty, and very nearly did end up applying to radiology. But I was too worried that I would miss the OR and miss patient contact. After completing intern year, I now realize if I could never see the inside of an OR or a clinic again, I would be thrilled. My happiest times during medical school were my pre-clinical years where I got to just study and increase my breadth of knowledge as much as possible.

At this point, I am almost completely convinced that picking this field was a mistake and I should switch to radiology. I have good step scores, AOA, research, blah blah blah. Has anyone been through this process? Or does anyone know somebody who has? Any advice would be appreciated, even if to just tell me that I'm crazy for considering this.

 

[SeisK]

Flesh out your reasons for why radiology (being on the fence I think is a reasonable argument), start gathering LOR’s and writing a personal statement. Talk to your home institution’s PD and/or dept chair, as they’ll have better advice than anyone on this sub (other than the stickied PD thread). There may also be openings that pop up there and they may have their ear to the ground for any openings elsewhere. Check this site regularly: APDR | Association of Program Directors in Radiology

Most of all, I think as hard as it is to hear, keep your mind open to the idea of enjoying the specialty you’re in. If you do decide to jump ship for sure, by the time you end up at a DR program you’ll be nearly or over halfway done with your original specialty of choice (assuming you go the traditional route), and PGY1 and 2 are the most brutal for surgery. My suspicion is to match at your subspecialty, you had to work quite hard during your surgery clerkship and during your electives early in 4th year—you obviously didn’t hate clinic and the OR then. The brutality of surgery residency is enough to make somebody hate anything. It makes me wonder if you truly hate the things you say you do, or if the temporary hardship you’re going through makes you hate it. After you’ve established your practice, you can have as relaxed a practice as you want if you’re okay with taking the pay cut (if it’s a subspecialty, I imagine this won’t be a problem for you).

Moreover, there are some smaller costs associated with the choice to jump ship—you likely won’t end up at as prestigious a program as you are now (meaningless to some people, not meaningless to others), and while it is possible to jump from surgery to DR, going back the other way is nearly an impossibility for anything other than general surgery if you decide DR isn’t what you thought it was either.

You’re not crazy. Lots of people have made this decision before, and I think gestaltically very few have regretted it. If you decide you miss the OR you still have MSK, IR, or NIR as options down the road. If not, all the better. I love DR because even though it’s substantially specialized you can still do whatever the hell you want, you’re not committed yet after matching—if you want to research computer science, physics, and engineering you can. If you want to research cancer biology you can. If you want to work in the OR and have clinic, you can. If you want to make a buttload of money in private practice, you can. If you want a relaxed 8-5 no call, low stress with still great pay, you can.

Best.

 

[seeingthings]

I am a PGY-2 (PGY 3 in 3 days) who decided to switch from primary care to radiology this year. The process is not all that difficult if you are sure it's what you want to do. From what I could tell there are a lot of residents who switch from surgical fields to radiology. It is somewhat more difficult depending on whether or not you decide to stay in your specialty while applying because if you do you obviously still have busy rotations while going on interviews, etc. You also need to have that awkward conservation with your program, fortunately mine was very understanding. I matched into an advanced position, so I ultimately decided to just finish my primary care residency prior to starting radiology (will start July 1st 2020, right after I complete residency). You will NOT need to repeat a preliminary/intern year.

I was really worried about trying to switch and thought it would be much more challenging then it proved to be. Some residency salaries are paid by Medicare/Medicaid (can't remember which) and if they are then they may not be able to pay your salary (they only cover however many years your initially matched specialty was). Not all programs are like this. I'm happy to answer any questions, but the process was simple and essentially the same as what I did when applying for my initial primary care residency. Just more difficult in that I had less time off to go on interviews. Of note, I only applied to one program because of this. Was fortunate to match!

 

[redoitall]

just tell me that I'm crazy for considering this.

No you are not. I have plenty of examples from residents in my class to attendings who made the switch from surgery (orthor, ENT, general). So it is quite common and I am sure that plenty of folks will relate.
Just make sure you have a sound story, but again, it is so common that your story will be sound without too much effort.
Best of luck, and yes, Radiology is an amazing field. Intellectually it is extremely challenging, and I never have enough of all the crazy pathologies we see and the great calls that radiologists make.
Have fun, you will do great!

 

[Stoop Kid]

M4 here, was dead set on ortho and even had the stats for it. Even took a year off for research/clinical work to try to get myself into a top 10 program. After being in the OR and clinic (freaking hated this omg), I decided that the life of an ortho didn't match my personality and what I wanted out of my profession. One time I told myself, "man I really wish I was the only one in this OR and people would leave me alone to my work." At that point, I started looking into rads and finally made my decision.

Bottom line: Thanks for posting this. Even though my story is not exactly like yours, it's nice to know that there are people that are going through similar experiences. Hope everything goes well!