Mid-life specialty switch

Discussion in 'General Residency Issues' started by 177983, Jun 2, 2008.

  1. 177983

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    There are a decent number of threads discussing switching specialties, but I was interested in anyone's thoughts on switching after ~15 years in a specialty. Ever heard of anyone who had a mid-life specialty change? Would there be any particular difficulties with it, other than the idea of cutting way back on money and perhaps having to move for a few years? Would programs be interested in having a 50 year old intern?
     
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  3. Winged Scapula

    Winged Scapula Cougariffic!
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    When I was a resident, one of our rads residents was a former general surgeon who came back to residency after about 10 years out. He completed the entire Rads residency as well as an IR fellowship.

    The difference in money was tough he said, but the hours (even before the 80 hr workweek) were better than as a PP general surgeon and he was happier.

    As to whether programs would be interested or not, some would be and some not. This has been done before so its worth trying and see what happens.
     
  4. DarthNeurology

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    Wow. I would think after 10 years as a surgeon he could just do a lighter case load, unless he was paying off a super big house or something. I wonder what turned him sour on general surgery after 10 years . . . I would speculate he just wanted to learn something new as after 10 years doing general surgery there is no more learning curve to ascend, although new advances etc . . . not as big a challenge.
     
  5. sunlioness

    sunlioness Fierce. Proud. Strong
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    I know of two established internists who went back and did psychiatry.
     
  6. Winged Scapula

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    His beef was that he was working his arse off for less and less reimbursement each year. He saw increased paperwork and oversight with reduced reimbursement over those 10 years. BTW, many will tell you that the learning curve is still there after 10 years; after all, many say they don't feel comfortable on their own until 5 years out of training.

    As an IR guy, I'd now estimate he makes twice his salary (if not more) as he did with general surgery, and with better hours (albeit still on call and some middle of the night procedures).
     
  7. DarthNeurology

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    I seriously doubt that finances were a big concern. Let's say that he did a 3 year radiology residency and a two year fellowship, that is hardwork! plus at only a resident's salary, however, if he lived frugally and worked as a surgeon for 5 years and invested his earnings he would be ahead so much he could work partime I would wager. How much money does one person need anyway? If he was so interested in money he could have done a fancy surgery fellowship in plastics then. I certainly hope most surgeons today don't do surgery for money reasons.
     
  8. Remember that it's not easy to work "part time" as a surgeon (that term applies more to other fields where you don't have to maintain technical skills, not to mention the difficulty in securing insurance coverage with a limited practice).

    You are correct, though, in assuming that most people don't go into surgery for the money.
     
  9. DrDre311

    DrDre311 Makaveli

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    Yes, you've figured us out. We only go into plastics for the cash; it has nothing to do with intellectual challenge, skill requirement, or personal satisfaction. Please keep it to yourself.
     
  10. DarthNeurology

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    While I'm sure plastics has all of the intellectual challenge and skill requirements for many plastics surgeons who love it for these reasons, there are many who focus mainly on physical enhancement procedures who have less than saintly aspirations. Just like there are general internal medicine doctors who choose more lucrative specialties over general medicine. Not to miss singling anyone out, but once dermatology's potential pay and lifestyle became well known medical students flocked to these residencies. I was just trying to make a point that this surgeon's career change was likely motivated for a need to learn something new as it seems far fetched that he did it for better pay. . .
     
  11. DarthNeurology

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    I had the specific scenario of academic surgery in mind where you operate maybe only 2-3 days a week, and don't do that many operations, but may also do teaching and research. After 10 years of operating I wouldn't think he would need to practice appys or something else more or less routine.
     
  12. You can do some research, but almost all surgeons only do so on a clinical research basis - labs are usually run by PhDs or MDs in other fields, as surgeons just don't have the time to devote entire days to basic science research.
     
  13. Winged Scapula

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    Since he was a friend of mine, I see no reason for him to lie to me about it. And it wasn't purely finances...it was working extremely hard with nothing to show for it. Academics is not all that easy to break into after 10 years of general surgery practice; he would have to take trauma call in addition to his clinical and research duties. Obviously if he had totally loved what he was doing he would have stayed in the field, but in central Pennsylvania there is only one academic hospital in town and working 2-3 days per week without trauma call would not have been offered to him as a faculty member. He would have worked nearly as hard for less than he was making in PP.

    Rads is 5 years plus the fellowship. And yes, it was hard work but not nearly as hard as being an attending general surgeron in his estimation.

    I'm sure he felt that earning a resident's salary was worth it. Its not like he woke up one day and decided this. Again, its not just the money but how hard you have to work for it, or quality of life. I would venture that he had a lot more understanding of his situation than either you or I do.
     
  14. DrDre311

    DrDre311 Makaveli

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    Yep, you got me again. You must know a lot of plastic surgeons. Hell, you must have done a lot of plastic surgery to know so much about it! Also, plastic surgeons are just like you see on Dr. 90210--exactly like that. All we care about is making money from "physical enhancement procedures." Quit letting our secret out.
     
  15. DarthNeurology

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    It seems like it was a respect issue, i.e. not being paid for what he thought his services were worth. I think some surgeons really need to feel that their services are highly valued. Begining medical school many medical students feel that being a surgeon is being the most specialized and skilled type of doctor there is. Then there are oohs and aaahs when students learn how highly paid competitive lifestyles specialties such as dermatology, radiation oncology, are sought after and how other specialities such as IR can do some stuff that seems much more specialized than general surgeons. I think it was a case of thinking things are greener on the other side. I think everyone in medicine is very hiearchial and is upset when they see a specialty that is more highly regarded than their own specialty that they could have gone into maybe.

    In terms of working hard with nothing to show for it, what did he expect? Surgeons are still paid more than pediatricians I would guess, plus he got to treat all those patients? Maybe he didn't like standing on his feet the whole day and couldn't see himself doing that for the rest of his life. Who knows what will happen with surgeons pay if there is universal healthcare, maybe it will be rolled back significantly, this must be hard to take if you are very competitive like many surgeons.

    The question that I think would matter most is should the general surgery residency program(s) accepted him for residency? Before I get flamed, if every surgeon quitted general surgery we would be in a bad state of affairs, he is taking up basically two residency spots i.e. radiology AND has done a surgery spot, assuming that the radiology spot would have been filled he is effectively removing one trained doctor (a surgeon) from the workforce. Was there an early sign that he didn't like surgery as much as his personal statement doubtlessly made it seem like it was what he would do forever regardless of pay?
     

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