Liking Surgery but not passionate?

[Medhatter]

I've read a lot of threads here and it seems the general consensus is that you shouldn't do surgery unless you can't see yourself doing anything else. I am still having a hard time accepting this notion. I am pretty committed to applying to general surgery for residency however, as I am currently rotating at an academic institution (previous rotated at a community site), I am developing a lot of doubts.

I definitely like the OR. Even when I am just retracting , I don't get bored as long as I can get a good view on the anatomy and I think about what they are trying to do each step. I look forward to the notion of finally being able to do an operation from start to finish. But I am not sure if this is a burning passion for surgery or simply my curiosity in nature and the love for taking up a challenge? I look at all the crap that the interns have to put up while they are on call and all the middle of the night surgeries that the attending have to do and I think to myself - I can get through this but I can't force myself to like this? Also, the whole time I am trying to fight back this thought that is creeping from the back of my mind telling me that this is all kind of .. boring.

I initially picked surgery because I look at these surgeons in the community who does not so complicated surgeries and get to go home at a reasonable hour each day and thinking myself that this is a pretty kick-ass job. Their patients range from healthy to really sick and you can really make a difference with what you can offer them. But now, even looking at the staff at the academic center, it seems that you pretty much have to commit your life to general surgery.

Should I look elsewhere or perhaps take another year to reconsider? Or am I just a little burnt out? I've looked at other specialties like medicine or anesthesia, while I can see myself doing them, I went for surgery ..well.. because you get to do surgery.

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[Kahreek]

i am sorry but no one but you can answer that question.

 

[cpants]

Are you premed? If so, you don't need to worry about this now. If you are a med student, you should probably look into surgical subspecialties, other procedural specialties like anesthesia, GI, even derm. The reason people say this is because surgical training and the profession in general is extremely demanding and extracts a high toll on your lifestyle. If you could be happy doing something else, you probably will be happier than you would be in surgery. Just being in the OR is cool now and will probably be cool forever. Coming in in the middle of the night to do surgery with a wife and kid at home is a lot less cool.

 

[LIDO]

I would not consider derm to be very procedural. They do very simple biopsies with suboptimal closure. Some will dabble in cystectomy, retracting the nail, and wide local excisions, but the overall depth and breadth procedurally is lacking.

 

[SLUser11]

I've read a lot of threads here and it seems the general consensus is that you shouldn't do surgery unless you can't see yourself doing anything else. I am still having a hard time accepting this notion. I am pretty committed to applying to general surgery for residency however, as I am currently rotating at an academic institution (previous rotated at a community site), I am developing a lot of doubts.

I definitely like the OR. Even when I am just retracting , I don't get bored as long as I can get a good view on the anatomy and I think about what they are trying to do each step. I look forward to the notion of finally being able to do an operation from start to finish. But I am not sure if this is a burning passion for surgery or simply my curiosity in nature and the love for taking up a challenge? I look at all the crap that the interns have to put up while they are on call and all the middle of the night surgeries that the attending have to do and I think to myself - I can get through this but I can't force myself to like this? Also, the whole time I am trying to fight back this thought that is creeping from the back of my mind telling me that this is all kind of .. boring.

I initially picked surgery because I look at these surgeons in the community who does not so complicated surgeries and get to go home at a reasonable hour each day and thinking myself that this is a pretty kick-ass job. Their patients range from healthy to really sick and you can really make a difference with what you can offer them. But now, even looking at the staff at the academic center, it seems that you pretty much have to commit your life to general surgery.

Should I look elsewhere or perhaps take another year to reconsider? Or am I just a little burnt out? I've looked at other specialties like medicine or anesthesia, while I can see myself doing them, I went for surgery ..well.. because you get to do surgery.

You don't have to have a deep, burning surgical fire in your heart to do surgery. You'll often be witness to some histrionics and outdated anecdotes that aren't very practical....e.g. "if you can see yourself doing anything other than surgery, then don't do it." Many people take a more methodical, practical approach to choosing a specialty.

Still, I'm sort of perplexed by your lack of understanding of career options in surgery. You say that you experienced practicing community surgeons doing something you like, but then you went to an academic institution where it was different, and now you're convinced that the second experience is the only way it can be? What is stopping you from making the same choices as the community surgeons you met? If you like that environment more, then apply exclusively to community programs, and rank the ones you like the highest....that's how the match works.

Still, don't let me talk you into surgery on an anonymous message board. If you're an MSIV, then you need to have a good advisor that you spoke with several months ago about this topic....otherwise you're a little late to the party.

 

[Kahreek]

I would not consider derm to be very procedural. They do very simple biopsies with suboptimal closure. Some will dabble in cystectomy, retracting the nail, and wide local excisions, but the overall depth and breadth procedurally is lacking.

mainly skin lesions excisions and minor plastic surgery stuff, there are many procedures, mostly office based, but those are very gratifying and high pay with little overhead. Go browse a pocket book about derm procedures and you will be amazed by the variety and different approaches.

 

[Dan Plainview]

You don't have to have a deep, burning surgical fire in your heart to do surgery. You'll often be witness to some histrionics and outdated anecdotes that aren't very practical....e.g. "if you can see yourself doing anything other than surgery, then don't do it." Many people take a more methodical, practical approach to choosing a specialty....

This is so true. I had a very difficult time choosing a specialty at the end of my third year. There were many things that I liked, but surgery was the one thing I could see myself doing in 20 years and still enjoying. Other specialties (EM, Anesthesia in my instance) offered better lifestyle but the same ability to intervene and actually fix people (or help surgeons fix them 😉), but I knew that as the years wore on I would gradually get frustrated with some of the nuances about each that really turned me off (constant rotating shifts and ridiculous frequent fliers in the EM, sitting around all day in anesthesia). The things that I didn't like about surgery? I could deal with those (potentially crazy lifestyle, tough training/long hours). IMO, it's almost more important to consider what you don't like about a specialty when deciding.

I was not one of those people who was "ERMAGHERD! GENERAL SURGERER" like some of your classmates you have undoubtedly already met. I liked it well enough and it suited my personality. I think you'll find most people in the field are like this. Make no mistake we love what we do, but for me at least it is not the be-all end-all.

Just my $0.02.

 

[SLUser11]

mainly skin lesions excisions and minor plastic surgery stuff, there are many procedures, mostly office based, but those are very gratifying and high pay with little overhead. Go browse a pocket book about derm procedures and you will be amazed by the variety and different approaches.

I'm not sure that I agree that ditzel excisions are "very gratifying."

Also, a pocketbook of "derm procedures" doesn't necessarily mean dermatologists are routinely performing a large variety of cases. I would guess that the procedures in most dermatology practices are relatively limited in scope and variety.

 

[Med0123]

This is so true. I had a very difficult time choosing a specialty at the end of my third year. There were many things that I liked, but surgery was the one thing I could see myself doing in 20 years and still enjoying. Other specialties (EM, Anesthesia in my instance) offered better lifestyle but the same ability to intervene and actually fix people (or help surgeons fix them 😉), but I knew that as the years wore on I would gradually get frustrated with some of the nuances about each that really turned me off (constant rotating shifts and ridiculous frequent fliers in the EM, sitting around all day in anesthesia). The things that I didn't like about surgery? I could deal with those (potentially crazy lifestyle, tough training/long hours). IMO, it's almost more important to consider what you don't like about a specialty when deciding.

I was not one of those people who was "ERMAGHERD! GENERAL SURGERER" like some of your classmates you have undoubtedly already met. I liked it well enough and it suited my personality. I think you'll find most people in the field are like this. Make no mistake we love what we do, but for me at least it is not the be-all end-all.

Just my $0.02.

post of the day! 👍 exactly my point of view

PGY-2 GS

 

[survivordo]

I'm generally of the "it's gotta be the only thing you can picture yourself" camp. Honestly, if you can picture yourself being happy rounding on patients all day then I don't think it is for you. BUT if you want something where medicine and procedures are intermixed and you can't see yourself (or don't have the stats) to get into some of the surgical subspecialties then I say go for it. There are enough different practice environments now that I think you can make it work.

Survivor DO

 

[Kahreek]

I'm not sure that I agree that ditzel excisions are "very gratifying."

Also, a pocketbook of "derm procedures" doesn't necessarily mean dermatologists are routinely performing a large variety of cases. I would guess that the procedures in most dermatology practices are relatively limited in scope and variety.

lap choles do have a large scope, i guess. (see what i did there)
In the end is all about doing what you least hate

 

[HoboCommander]

don't do it! save the spot for me =)

 

[Dral]

Lol@ suboptimal closure. 🙄

Don't go into Derm for procedures. Go into derm because you enjoy it and because yoe don't ever have to go in at 2 AM to freeze a wart. Haha.

 

[Pir8DeacDoc]

Is this dude really saying derm has a breadth of procedures? Liquid nitrogen freeze is about it. MOHs guys will swing a flap but most general dermatologists are treating acne and warts. Not swinging flaps. To speak of derm and procedures is silly. Procedures are GI and Cards.

 

[SLUser11]

lap choles do have a large scope, i guess. (see what i did there)
In the end is all about doing what you least hate

I have no specific retort, but I wanted to quote this horrible joke so you can't go back and delete it later.

 

[Kahreek]

thanks 😀

 

[Johnm2786]

I, too, am in the same boat as you are. I am very much interested in general surgery and will certainly apply to it. Nevertheless, seeing all the pettiness, meanness, and competitiveness of surgery at a big academic center really turned me off. Good thing is that I got to experience surgery with private practice surgeons at smaller facilities, which was a lot more relaxing and fun. So I'm just going to forge ahead, Residency will be tough but there's light at the end of the tunnel. You don't have to be a big city, big academic surgeon for all of your life. You can go to a community hospital and live a less crazy existence.

 

[SLUser11]

I, too, am in the same boat as you are. I am very much interested in general surgery and will certainly apply to it. Nevertheless, seeing all the pettiness, meanness, and competitiveness of surgery at a big academic center really turned me off. Good thing is that I got to experience surgery with private practice surgeons at smaller facilities, which was a lot more relaxing and fun. So I'm just going to forge ahead, Residency will be tough but there's light at the end of the tunnel. You don't have to be a big city, big academic surgeon for all of your life. You can go to a community hospital and live a less crazy existence.

And you can train in a reasonable environment, as well. You certainly don't want to go to a "country club" program where you won't be pushed/challenged, graduating 5 years later with marginal competence....but there are plenty of community and hybrid programs that offer a solid education without the abundance of malignancy that you dislike. Just do your research now, and it will pay off in March.

 

[Zarika]

And you can train in a reasonable environment, as well. You certainly don't want to go to a "country club" program where you won't be pushed/challenged, graduating 5 years later with marginal competence....but there are plenty of community and hybrid programs that offer a solid education without the abundance of malignancy that you dislike. Just do your research now, and it will pay off in March.

I've heard this before, and it's something that I'm interested in. I'm not sure how you "do your research" though. I'm sorry if this is a stupid question, but doesn't every program just advertise itself in the best light. What exactly kind of questions should I be asking and who should I be asking (and when). Thanks!

 

[Johnm2786]

And you can train in a reasonable environment, as well. You certainly don't want to go to a "country club" program where you won't be pushed/challenged, graduating 5 years later with marginal competence....but there are plenty of community and hybrid programs that offer a solid education without the abundance of malignancy that you dislike. Just do your research now, and it will pay off in March.

Thank you, I think that is a very good point. It's possible to have it all. 😀

 

[SLUser11]

I've heard this before, and it's something that I'm interested in. I'm not sure how you "do your research" though. I'm sorry if this is a stupid question, but doesn't every program just advertise itself in the best light. What exactly kind of questions should I be asking and who should I be asking (and when). Thanks!

Do your research here on SDN by looking at old threads and posts. Look at different websites. Read reviews. Discuss programs with other students and residents at your home program.

Thank you, I think that is a very good point. It's possible to have it all. 😀

Not exactly. There is no free lunch in surgery. You will have to work hard, regardless of where you match. You just don't have to be miserable.

 

[poorracerkid]

SLUser11 is exactly and you will do well to heed his advice. It's a lot of work. Surgery residents are, by and large, the hardest working residents in the hospital. I have many stories of us bailing IM and FM out when they are stumped by a clogged J-tube or some other issue like that and their response is "Call surgery, they'll be able to fix the problem!" It has it's frustrations but I can tell you it's extremely rewarding to work the 80 hours a week we are allowed to and really help people get better. I wouldn't trade my job for anything!

 

[Doctor Bob]

It may not be until you get to residency that you find out what you really think of a field.
I always wanted to do EM because I was an EMT, then medic, then ER tech.

But the military put me into a prelim surgery internship. And I liked being in the OR. It was fun; I liked the technical aspects, the "here is a problem, and now it's fixed" nature. For the first few months I considered going after a categorical spot... but then I noticed a trend; if the case lasted longer than an hour I just got bored and stared off into space (a very bad quality for a surgeon). Lap choles were nice and all until they became complicated and then I got bored again. If I could have structured my practice to just do central lines, chest tubes, crics/trachs, lac repairs and quick stuff like that I'd be happy.

Wait... that sounds like EM (with a critical care fellowship). So I went back to EM and never looked back.

Ok, not entirely true... from time to time I think it might have been nice to keep going with GenSurg... but then one of my colleages talks about a 3-4 hr thyroidectomy they just did and even the story makes me stare off into space.



What were we talking about again? Oh right. If you get to early 4th year and you still aren't sure of a direction, there's nothing wrong with doing an internship year to get a bit more depth of exposure to a field without the full commitment. The downside is you add an extra year to training (unless you score an advanced standing spot), but it may be worth it in the long run.