Needing a change

[jmattwilson]

Hello if anyone has any advice what so ever I would greatly appreciate this.
I am a first year categorical surgery intern and I am about to have a melt down. First off I was allured into the field because as a student it was freaking awesome to be in the OR. Most of my surgical rotations were in sub-specialties and I just didnt get a good feel for what the whole story is. It isnt that I mind working the long hours at all. I just get so tired of the constant barage of egos in this field and being broken down. Every morning when I get up myconscious keeps saying what the F&*( are you doing. The OR is no longer fun and I find myself during even the most simple cases anxious to get out. there is so much moire I could rale on but thats enough.

I loved pathology when I was a second year and did extremely well. I truely considered it as a career and came close to changing my mind and entering the path match this year after research or something.

Which leads to my question. Is it possible to find a path spot for next year after the match is over? I mean I dont know how competitive it is this year and all. There were several vacancies last year I would have been interested in even though they weren't at the best known programs, but that doesnt matter to me I would take anything at all to be out of surgery.

Anyone who has any advice I would greatly appreciate it.

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[Pir8DeacDoc]

I'm sorry to hear about this. You've been one of the regulars around here. As a fourth year , it actually really scares me as I proceed with trepidation into a surgical career. I have already had second thoughts and residency hasn't even started. Anyway sorry for the ramble...



Do you have any vacation time coming up? Sometimes a little rest can help clear the mind and give a new perspective. If you still want to go the path route, I don't think it would be all that hard. I know at my hospital we've fairly recently had two surgery residents switch to path. I don't know if it was outside the match or not. I don't think that path is very competitive and especially not in areas a little off the beaten path. If you'd like more info on my school/hospital or the contact info of the residents here who switched from surgery, feel free to PM me. Good luck!

 

[Foxxy Cleopatra]

Hi jmattwilson,

I went through something very similar when I was in an intern- it was nothing what I thought it would be (as a matter of fact, I was miserable) and at times, I very much doubted my choice to pursue surgery.

I'm now a PGY-3 surgery resident and things actually ended up working out pretty well. I spend much more time in the OR and really enjoy taking care of patients (though still I would like to be in the OR more) and I love to operate so it helps me keep perspective.

I PM'd you- would be happy to be of help.

FC

 

[surg]

I feel for you. Know that you are not alone in feeling despair during your intern year. I would venture to say that virtually everyone thinks of quitting at some point in their residency, they just don't talk about it. Seek out some support from your friends and colleagues both here and in person. You'll be surprised how many of them have experienced the same feelings of stress and hopelessness at one time or another. Fatigue does funny things to your psyche. Some quit, but most get through it. Take some time to think about what you liked about the specialty and try not to let the bad seeds get to you. Trust me, not everyone is publishing in NEJM weekly and not everyone can do a Whipple in their sleep as an intern no matter what they tell you. Not every attending is out to get you. It just seems that way sometimes.

If you still are interested in Path, the 1st thing I would do is go down to the Path department and talk to their program director if they have one and make friends. See what his thoughts are. It is not unusual for people to make lateral moves within the same hospital or for them to have a friend somewhere who needs someone. Once you've made your decision, talk to your own PD and let him/her know. They deserve a chance to recruit someone to fill your spot once you are sure you don't want it. Depending on your relationship with other attendings or your PD, it also isn't a bad idea to talk to them sometimes if you feel like you can, even before you are sure. They can help put things in perspective sometimes and it avoids the potential for them to feel like you are working behind their backs. However, this obviously has the potential to backfire on you, so only do it when you are really ready to lay out what you are thinking.

 

[njbmd]

Hello if anyone has any advice what so ever I would greatly appreciate this.
I am a first year categorical surgery intern and I am about to have a melt down. First off I was allured into the field because as a student it was freaking awesome to be in the OR. Most of my surgical rotations were in sub-specialties and I just didnt get a good feel for what the whole story is. It isnt that I mind working the long hours at all. I just get so tired of the constant barage of egos in this field and being broken down. Every morning when I get up myconscious keeps saying what the F&*( are you doing. The OR is no longer fun and I find myself during even the most simple cases anxious to get out. there is so much moire I could rale on but thats enough.

I loved pathology when I was a second year and did extremely well. I truely considered it as a career and made several inquiries on this forum in the past. I even did two 4th year rotations in path one in january, anatomic path, and came close to changing my mind and entering the path match this year after research or something. Anyhow I just wasnt smart enough to realize my mistake at the time

Which leads to my question. Is it possible to find a path spot for next year after the match is over? I mean I dont know how competitive it is this year and all. There were several vacancies last year I would have been interested in even though they weren't at the best known programs, but that doesnt matter to me I would take anything at all to be out of surgery.

Anyone who has any advice I would greatly appreciate it.

Hi there,

I do not remember how many slots were open in path last year. You might want to make contact a few path departments like starting your medical school, to see what is out there. Pathology program directors seem to know where the openings are and what is out there. I would start with hooking up with an academic pathology center as soon as you can.

If you have a vacation coming up, I would use the time to get a CV together and make some phone calls. Start with the programs that you knew were open last year. Call some of your classmates who went into path and see if they know of any open programs. It is kind of late for the Match but some programs will be interviewing late. In any event, you definitely want to get in touch with your medical school path department and let them know that you want to make the change from surgery to pathology.

I am sorry that surgery wasn't for you but you are wise to get out at this point. If things are not getting any better, it is time to move on. This job is hard enough without being miserable. I, too, loved pathology and could easily have done path if not for loving surgery more. Transfusion medicine is pretty neat and I still spend some time in the path lab reviewing my patient's slides.

Good luck!
njbmd

 

[Winged Scapula]

Echoing the others' thoughts here...

most of us have experience some frustration with various aspects of a surgical residency. Its rather classic to feel as you do about 6 months in, or right about now.

The risk of toughing it out obviously is that you finish a program with neither the desire to be a surgeon or without the skills because you've avoided the OR as much as you can. You wouldn't be the first who was told its, "only the intern blues", it will go away, it will get better, etc. and struggled through only to find themselves 5+ years later wishing they'd done something else.

As others have suggested, start asking around, get your CV in order and see if you can find a Path spot. It might not be too late to participate in this year's match - some programs are undoubtedly still interviewing. Of course, this means getting your program director's and other faculty member's LORs ASAP.

I'm not sure if anyone can tell you that switching fields is the right thing to do; there are egos in every field of medicine. Some of the most obnoxious egoists I've met have been Pediatricians (which goes against type).

Best of luck to you...

 

[jmattwilson]

Thanks for the responses
Yes I do wonder if this is the mid year blues, being winter and all without sunlight. The thing is I really like my program director and would not consider quiting midway through the year and leaving them short as I am at a small program anyhow. I just had the crappiest day yesterday and was chewed out all day for something that was out of my hands. I suppose I took it really hard as this was my first major A$% rape, of course I have been yelled at, but this was degrading. I have also had three months of trauma which could make anyone flip out. The reason I was asking about path switches is I have heard it and anesthesia are common things for surgery casualties to go into and I liked path. Jsut wondering if anyone knows someone who has done this. Who knows I may stick it out.

 

[GreatSaphenous]

So have things improved for you or have your prior doubts only intensified? Just wondering what a week of reflection has done for your outlook.

I am the Great Saphenous

 

[Celiac Plexus]

To the OP who is thinking about quitting.... I went through the same thing my intern year. There's not much I can say that the others haven't except for that intern year sucked my nuts. I got b*tch smakked by some attendings, and had a lot of horrendous days. But I just took it a day at a time, and it got better and better, and now I'm in my third year and I'm pretty happy and doing well. I am becoming a better operator all the time, and I have developed my academic credentials significantly (which is very satisfying for me).

I dunno if you are cut out for surgery. Some people aren't. It's not a big deal. The only thing is, the only person who really knows that is you. And I don't think you will be able to really know until you finish intern year and start being a proper resident. Life as a resident really is a lot different/better than life as an intern. If you suck it up, and just grin and bear it, you might find that you made the right choice (once you get intern year behind you). And if you find that as a pgy-2, you still are miserable, then you can always change fields then. I just think that giving up on surgery after 5 months of internship is a poor idea. I mean, intern year just sucks, and shouldn't be what you base your career plans on. As a surgery intern, at least at my program, I was a little scutmonkey who had to weasel my way into whatever case I could. Surgery intern year, imho, is a suboptimal educational, and social experience. You just gotta *** (keep mouth shut), and take it one day at a time. Unfortunately, that's just the way it is.

Best of luck with whatever you decide to do.

 

[SteadyEddy]

JMatt....you know I was just talking about you the other day. It's crazy to hear that you want to quit, because I've felt the same thing at times during the year. It sucks that academic surgery is so top-heavy, with the most classic chiefs refusing to do "intern work". The OR is but a make-believe place that we could only hope to see on some rotations. All I can say is hang in there man! There's gotta be light at the end of the tunnel. If you decide you want to take another career path (no pun intended)...go for it! I'll think good thoughts for ya. Take care bro.

SE

Thanks for the responses
Yes I do wonder if this is the mid year blues, being winter and all without sunlight. The thing is I really like my program director and would not consider quiting midway through the year and leaving them short as I am at a small program anyhow. I just had the crappiest day yesterday and was chewed out all day for something that was out of my hands. I suppose I took it really hard as this was my first major A$% rape, of course I have been yelled at, but this was degrading. I have also had three months of trauma which could make anyone flip out. The reason I was asking about path switches is I have heard it and anesthesia are common things for surgery casualties to go into and I liked path. Jsut wondering if anyone knows someone who has done this. Who knows I may stick it out.

 

[Roux-en-Y]

JMatt,

I remember reading many of your posts last year and meeting you when we interviewed @ UVA together; I think it sucks you're going through a tough time.

There's not much I can say that hasn't already been said. I agree that you would probably do better sticking it out this year, and that is the right thing to do for your department. Three months straight of trauma would probably make me bat-$hit crazy too.

But if you do stay on, I think you should pick yourself up by your bootstraps and decide to kick some a$$. I personally put too much stock sometimes in my superiors' opinions/criticisms (upper-levels and attendings) and this can make "a$$-rapings" that much more miserable. There will always be some amount of malignancy in surgery.

I hope life gets better.

 

[Pilot Doc]

I agree that you would probably do better sticking it out this year

This hasn't been touched on much, but it's definitely true! Quitting halfway through intern year without a really good reason is a very negative and indelible mark on your record. (As an example of a really good reason, an intern at my insitution went into autoimmune renal failure and had dialysis and plasmapheresis on alternating days.) On top of that, leaving early will alienate eveyone in your program who has to pick up your slack.

You will also be ineligible for a permanent medical license, which leaves you with essentially no employable skills. If you finish the year, you can actually hang out a shingle and practice medicine. You won't have many practical options, but there are some - and they are the difference between a decently paying job and no job.

 

[Wigginout]

Saw this thread when it was started, but never found out what JMatt decided. Has anyone heard anything?

 

[jmattwilson]

Sticking it out! Just had a temporary meltdown that day and a lot homesick for my school's program. Change is a crazy hard thing sometimes.