Neurosurgery Vs Interventional Radiology

[FindersFee5]

And vice versa I felt like the surgeons all needed to take a chill pill or five

Surg-onc and trauma, absolutely. Urology, ortho, plastics, ENT, I've liked almost every resident and attending I've met.

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[efle]

Surg-onc and trauma, absolutely. Urology, ortho, plastics, ENT, I've liked almost every resident and attending I've met.

I mean more their work/life balance than their personality. Our chair of neurosurg gave us a talk once and described how he used to sleep on a cot in his lab so he could run experiments overnight on top of his normal absurd workload. One of the senior docs running our general surg clerkship has the nickname "Midnight [Redacted]" because he will regularly start 5-hour cases after 4pm. Super fun sweet guy though. And the chief resident I was rotating with comes into the hospital to work on some of her days off, just like the satirical work-obsessed doc in House of God.

Great folks? A lot of them, yeah. Role models for anyone sane? Not by my definition

 

[libertyyne]

For sure, I know of a few surgeon families like that in real life. Just curious, OP, but why are you ok with the not seeing your kids part? Your initial post does seem like you'd be a little happier in neurosurg though.

A few things.
1. If i am miserable at work I am going to bring that misery home. So ending up in a job where i hate what i do could have negative impact.
2. I am a first generation immigrant from a working class family. Half my life i lived away from my father because of economic reasons. The other half both my mother and father would work 70 hours a week and would be gone before I left for school and come home around my bed time. with one day off a week or less on average. My children already have way more consistent care from my wife than any of my friends who send their kids to day care.
3. Even with neurosurgery you get 20 days of vacation and an average of 4 days off a month. This time is more time than what I had with my father on average and I turned out ok.
4. By making sacrifices by working hard I will be able to give my kids opportunities that I myself never had.

 

[libertyyne]

I just love how ophtho never gets talked about

I have no exposure to optho. besides some cataracts surgeries i saw. It seems interesting, But i never saw any of the technology at work.

And vice versa I felt like the surgeons all needed to take a chill pill or five

Some of the general surgeons were too full of themselves, others were miserable, and some were militant. The Attending Neurosurgeons I met were oddly great, humble, hardworking and extremely smart. I absolutely loved how much fun the residents were having on service.
The only other crew I oddly meshed with was urology because they were not afraid to make a dick joke or drop an F bomb.

 

[NeuResurgens]

I have no exposure to optho. besides some cataracts surgeries i saw. It seems interesting,

Some of the general surgeons were too full of themselves, others were miserable, and some were militant. The Attending Neurosurgeons I met were oddly great, humble, hardworking and extremely smart. I absolutely loved how much fun the residents were having on service.
The only other crew I oddly meshed with was urology because they were not afraid to make a dick joke or drop an F bomb.

Same for me on uro lol

 

[efle]

I oddly meshed with was urology because they were not afraid to make a dick joke or drop an F bomb.

Did you rotate ortho? If this was a highlight, you probably need to drop whatever's coming up and do that ASAP

 

[libertyyne]

Did you rotate ortho? If this was a highlight, you probably need to drop whatever's coming up and do that ASAP

not a fan of msk, and bones that are not vertebrae or the skull do not excite me.

 

[AnatomyGrey12]

A quick thought. I had a cardiology month where I did a lot of interventional cardiology stuff and as interesting as it was, I genuinely learned just how different procedures and surgery are. Procedures simply aren’t the same, and I don’t think someone who wants to do surgery things would be happy being a proceduralist.

Residency is going to be terrible pretty much no matter what you do if you are in a field where call and emergencies are a heavy component. I’ve met too many surgeons to believe that if you do a surgical field you are resigning yourself to a life of never seeing your kids or having hobbies. It’s not like you are deciding between neurosurgery and FM, where the lifestyle would be that drastically different.

My armchair analysis of our conversations over the years lead me to believe you would be an excellent fit in neurosurgery and that’s where your heart probably is, at least from my observation. I am a firm believer in trusting your gut, so wherever that is taking you is where you need to go.

 

[Dantes]

A few things.
1. If i am miserable at work I am going to bring that misery home. So ending up in a job where i hate what i do could have negative impact.
2. I am a first generation immigrant from a working class family. Half my life i lived away from my father because of economic reasons. The other half both my mother and father would work 70 hours a week and would be gone before I left for school and come home around my bed time. with one day off a week or less on average. My children already have way more consistent care from my wife than any of my friends who send their kids to day care.
3. Even with neurosurgery you get 20 days of vacation and an average of 4 days off a month. This time is more time than what I had with my father on average and I turned out ok.
4. By making sacrifices by working hard I will be able to give my kids opportunities that I myself never had.

I can respect that, and you seem to have (rightfully) put a lot of thought into this. Just tread carefully. Your kids might not see it the same way.

 

[libertyyne]

I can respect that, and you seem to have (rightfully) put a lot of thought into this. Just tread carefully. Your kids might not see it the same way.

If that is the biggest problem in their life they have already lived a sheltered life.

 

[efle]

If that is the biggest problem in their life they have already lived a sheltered life.

I dunno man, did you have a surgeon dad? Only time I've seen my stoic Korean room mate get choked up was when I said that most dads are around daily and not just for birthdays and graduations, which is what he experienced as "being there." If your kids tell you some day they felt like you missed a decade of them growing up, are you really going to feel like that's them showing off how spoiled and sheltered they were?

 

[libertyyne]

I dunno man, did you have a surgeon dad? Only time I've seen my stoic Korean room mate get choked up was when I said that most dads are around daily and not just for birthdays and graduations, which is what he experienced as "being there." If your kids tell you some day they felt like you missed a decade of them growing up, are you really going to feel like that's them showing off how spoiled and sheltered they were?

I have already outlined my personal experience and probably the experience of a lot of families that do not have the economic resources. Not everyone has the luxury of having dad for dinner every day. Also it's fascinating that obgyns , rads docs work similar amounts of time as an attending heck IM only works 4 hours less and family medicine works 6 Less yet people never discourage people going into these fields. Yes residency is going to suck. But all residencies suck for the most part.

 

[efle]

I have already outlined my personal experience and probably the experience of a lot of families that do not have the economic resources. Not everyone has the luxury of having dad for dinner every day. Also it's fascinating that obgyns , rads docs work similar amounts of time as an attending heck IM only works 4 hours less and family medicine works 6 Less yet people never discourage people going into these fields. Yes residency is going to suck. But all residencies suck for the most part.

Whats your source for those hours comparisons? If it's the JAMA study, they literally accidentally put a negative sign on the lower bound. A typical family medicine doctor and a typical neurosurgeon aren't even comparable

 

[odyssey2]

I have already outlined my personal experience and probably the experience of a lot of families that do not have the economic resources. Not everyone has the luxury of having dad for dinner every day. Also it's fascinating that obgyns , rads docs work similar amounts of time as an attending heck IM only works 4 hours less and family medicine works 6 Less yet people never discourage people going into these fields. Yes residency is going to suck. But all residencies suck for the most part.

Radiology residency is 50-hours/week on average. You'll be hitting 80-100 regularly on neurosurgery. That's going to make a huge difference on your family life, at least during your training. Lifestyle is going to be a lot more controllable once you're an attending in those fields compared to neurosurg.

 

[Dr G Oogle]

I have already outlined my personal experience and probably the experience of a lot of families that do not have the economic resources. Not everyone has the luxury of having dad for dinner every day. Also it's fascinating that obgyns , rads docs work similar amounts of time as an attending heck IM only works 4 hours less and family medicine works 6 Less yet people never discourage people going into these fields. Yes residency is going to suck. But all residencies suck for the most part.

i agree with @libertyyne. I think he has a good perspective, I hardly work neurosurgery hours and am around most weekends and holidays but missed my daughters first Christmas because I had to go take care of a lady with a bleeding uterine AF fistula (which incidentally IR declined to fix, but am sure would have loved that case on December 26) and I miss a lot of family dinners and I’m sure it bothers me a lot more than it will ever bother her. I was fortunate to have my Daughter born in fellowship but in residency she would have seen me significantly less. One of my good friends is a neurosurgeon and also a very dedicated father and husband and I don’t think they are mutually exclusive. OP I think I really see your perspective and the biggest difference between NSGY and IR is patient ownership and feeing like you are“their doctor”. And I don’t think IR will ever achieve parity in this regard with surgical specialties. I disagree with the sentiment that procedures are not as satisfying as surgeries there are some very satisfying complex endovascular procedures like TIPS and complex vascular malformations, hell even taking out a mediport is satisfying because the patient will always associate you with the day they can say their chemo is over. But as far as I’m concerned the best part of being a proceduralist is the followup and seeing what a lasting impact your skills have made in their life. One of my rheumatology colleagues saw my patient a year after surgery and said “no wonder surgeons have a god complex” i don’t necessarily agree that that is a good way for a surgeon to feel but the gratitude is palpable and yes you can get that in IR but because it’s a tertiary referral specialty much of that admiration will fall to the doc who requested IR not the IR.

TLDR: do neurosurgery you have a healthy outlook and will do great; if you really can’t make up your mind to a NIR fellowship and scratch that itch

 

[libertyyne]

Whats your source for those hours comparisons? If it's the JAMA study, they literally accidentally put a negative sign on the lower bound. A typical family medicine doctor and a typical neurosurgeon aren't even comparable

That's the second source you linked earlier in this thread.

 

[efle]

That's the second source you linked earlier in this thread.

They all go back to the same dataset in the JAMA paper by Leigh (also used on the AAMC careers in medicine page), where neurosurg was grossly miscalculated by adding a negative sign (-418 to 958, versus +418 to 958).

They're out there working 65-70 hour weeks like Vascular, about as far away from family med as you can get. And that's after residency!

 

[CherryRedDracul]

+1 on IR being treated as a dumping ground. If a specialty doesn't want to do a procedure, they'll just dump on you.

Reminds me of the time a gen surg resident paged me for an abdominal fat pad biopsy to rule out amyloidosis because they were scared of doing one when this patient didn't have much subcutaneous fat, according to him.

My Skepti-Senses tingled and I took a look at the patient's imaging.

I called the gen surgery resident back: "Dude, he has at least 5 inches of subcutaneous fat in the flanks*. You don't need any imaging for this. Just push a needle into his flank. Are you seriously in general surgery? We're an IMAGE-GUIDED specialty. We're not doing this. Bye."



*PACS calipers confirmed

 

[libertyyne]

They all go back to the same dataset in the JAMA paper by Leigh (also used on the AAMC careers in medicine page), where neurosurg was grossly miscalculated by adding a negative sign (-418 to 958, versus +418 to 958).

They're out there working 65-70 hour weeks like Vascular, about as far away from family med as you can get. And that's after residency!

I am acknowledging that neurosurgeon attending will work 60-70 hours per week, when making this assessment. Thats roughly 8-18 hours more compared to a family practice attending. I am acknowledging that Neurosurgery is a lifestyle specialty where the lifestyle is neurosurgery. I have rotated/ longitudinally shadowed with three departments at this point. I know myself, and if I am not consumed by my work i get into mischief. It is just who I am and have always been.

 

[Oedipa Maas]

Ophtho doesn’t sound like a good fit for you if you like big picture things. When I did my rotation I saw how subspecialized the field was. My weeks were broken up so that I spent Monday with the glaucoma doc, Tuesday with the diabetes retinopathy doc, Wednesday with the cornea doc, Thursday with the peds doc, and Friday with the strabismus and CN palsy doc. The only day that I didn’t see the same patient presentation the whole day was the day I got to do ER follow ups with the residents. Other than that I had a really difficult time staying engaged. If you like getting really good at a very small number of things, ophtho would allow you to become a master of your craft. I didn’t see much room for a generalist. But in terms of the mystery, you would really only find that in the research side of things. Notably, it was in the same medical park that I did my family med rotation in and my hours/attending hours were about the same for both specialities although some of the family docs still had call.

 

[Cognovi]

They all go back to the same dataset in the JAMA paper by Leigh (also used on the AAMC careers in medicine page), where neurosurg was grossly miscalculated by adding a negative sign (-418 to 958, versus +418 to 958).

They're out there working 65-70 hour weeks like Vascular, about as far away from family med as you can get. And that's after residency!

I like how they excluded radiologists, pathologists, and anesthesiologists from that work hours study.

It would be embarassing.

 

[efle]

I like how they excluded radiologists, pathologists, and anesthesiologists from that work hours study.

It would be embarassing.

Well, it's not that they wanted to, it's just that the giant study they pulled labor hour data from (Community Tracking Study) didn't include these specialties because they're oddballs that wouldn't provide proper answers to most of the other questions.

 

[Neopolymath]

I like how they excluded radiologists, pathologists, and anesthesiologists from that work hours study.

It would be embarassing.

It's been bothering me that we don't have data on DR and anesthesiology for this chart for years.

 

[odyssey2]

According to AAMC, average hours worked for DR is 58 and anesthesia is 61. Don't know of any other data.

 

[efle]

According to AAMC, average hours worked for DR is 58 and anesthesia is 61. Don't know of any other data.

Seems weird that they have practicing rads working more hours/week than rads residents. Maybe their data is whack from having a low weeks-per-year denominator since I think most rads get 2-3 months off per year

 

[odyssey2]

Seems weird that they have practicing rads working more hours/week than rads residents. Maybe their data is whack from having a low weeks-per-year denominator since I think most rads get 2-3 months off per year

This. I think the data is also skewed by the 1-on-2-off radiologists who work 70 hrs/week but have 2/3 of the year off.

 

[Neopolymath]

Seems weird that they have practicing rads working more hours/week than rads residents. Maybe their data is whack from having a low weeks-per-year denominator since I think most rads get 2-3 months off per year

It's commonly stated in the DR forum that attending life is harder than resident life and the extra vacation is to prevent burnout. @Cognovi ?

 

[Cognovi]

It's commonly stated in the DR forum that attending life is harder than resident life and the extra vacation is to prevent burnout. @Cognovi ?

My impression (as a resident) regarding attending life is

Work intensity increases significantly. Work hours are similar to marginally higher. Vacation increases. Unconventional work schedules (eg, academic days, 1-on-2-off nighthawk) also may screw up conventional statistics.

 

[Kuratz]

I know myself, and if I am not consumed by my work i get into mischief. It is just who I am and have always been.

Hey not going to dissuade you from your dream, and we need neurosurgeons who live and breathe neurosurgery (the crazy bastards that they are). All I would say is to try to do the most taxing, rigorous sub-Is that you can before August and evaluate from there. I was the same “all-in”, ubermensch mentality throughout the whole of med school setting up to do ortho. Never once thought I would shy away from grinding. But after 12 weeks of sub-Is where it was common to work your ass from 4a to 7p AND take call without a post-call day, you just have to literally enjoy being in the OR more than anything else in life. More than your kids. More than your wife. More than enjoying exercise/hobbies/travel you name it. Maybe it was that I had kids on the horizon but just one day I realized there is so much more to life than doing another ankle ORIF in the hospital while other fantastic things pass you by. Switched into rads one month before ERAS was due and have never been happier. Maybe you’ll come to this realization, maybe you won’t. But I hope you at least entertain the idea that you won’t have the same “all-in” consuming mindset in 5-10-20 years. You can switch as late as August. So I suggest working as hard as humanely possible on your Sub-Is to get a taste of if it’s truly for you. Either way, best of luck.

 

[WedgeDawg]

Surgery is cool yo

 

[appalachian_man]

It’s so wild to me that there are people out there that think anything in medicine is more interesting/fun/worthwhile than being with family, enjoying a vacation, or pursuing hobbies. I’m glad there is, because otherwise we wouldn’t have any surgeons, but yikes. OP, I don’t have much advice, but I hope you find what you’re looking for. I second doing really tough sub-I’s for as long as possible, I've been recommended the same when I was considering another field. Also, thanks for being the masochists you are, so that I can make 400k+ per year with 2-3 months of vacation

this comment made by rads gang

 

[Gurby]

It’s so wild to me that there are people out there that think anything in medicine is more interesting/fun/worthwhile than being with family, enjoying a vacation, or pursuing hobbies. I’m glad there is, because otherwise we wouldn’t have any surgeons, but yikes. OP, I don’t have much advice, but I hope you find what you’re looking for. I second doing really tough sub-I’s for as long as possible, I've been recommended the same when I was considering another field. Also, thanks for being the masochists you are, so that I can make 400k+ per year with 2-3 months of vacation

this comment made by rads gang

Post I saved from Aunt Minnie:

On the surface Tuff Gong, everything you say is accurate. No one would argue with the good parts of being a radiologists. I am thankful to be in this profession, and yes I have the paid off luxury car and mansion in the gated community etc - all made possible by rads.

However, once you have the creature comforts you have desired, you start to become enlightened to the fact that they do not really bring much happiness or contentment. It is great to have financial freedom, but in reality there must be a higher meaning to your career and/or life to remain satisfied. You begin to question what motivates you in life and what you want out of your profession.

When I am sitting in front of a computer on a Sunday reading garbage cases out of the ER over and over.... it is not very satisfying, even if I do it from the comfort of my mansion.

We, as physicians, are an intellectual group, and frankly grubbing for money and material possessions is not really what drives me - it is using my brain, learning new things, exploring new avenues of thought etc. I feel gifted to have been given a strong intellect and curiosity about the world, and would like to spend my time using it. Sadly, radiology in private practice is often devoid of this need.

 

[appalachian_man]

Post I saved from Aunt Minnie:

That’s a very fair point of contention for many people to consider who are going into rads. But I would push back and say that in DR you can have a very meaningful, direct impact on patient care without all of the social work BS that doesn’t require a medical degree yet sucks up most of your time on the wards. Also, personally, my passion and meaning in life is derived from my experiences outside of medicine. Everyone is different though!

 

[efle]

Post I saved from Aunt Minnie:

That’s a very fair point of contention for many people to consider who are going into rads. But I would push back and say that in DR you can have a very meaningful, direct impact on patient care without all of the social work BS that doesn’t require a medical degree yet sucks up most of your time on the wards. Also, personally, my passion and meaning in life is derived from my experiences outside of medicine. Everyone is different though!

I'd also point out that doing your 2000th cholecystectomy or appendectomy (or knee replacement or spine or cath or free flap) is gonna become equally braindead. And at least he has the option to spend months every year traveling the world, reading the full catalog of significant philosophical and literary works, becoming a foodie, getting into artsy film, picking up instruments, playing chess competitively online, or any other intellectually stimulating hobby. Or go the FIRE route, retire in your 50s, and only work at something you love like blogging or teaching an elective at your local liberal arts college.

Grass is always greener. Short of the adrenaline junkie specialties, all jobs become routine.

 

[Dr G Oogle]

I'd also point out that doing your 2000th cholecystectomy or appendectomy (or knee replacement or spine or cath or free flap)

I used to think this and say “everything in medicine from an X-ray to a craniotomy becOmes routine” but I gotta tell you I get the same rush after doing complex pelvic reconstructions ( including most recently a young person with an ectopic ureter, obstructed hemivagina and bicornuate uterus that I reimplanted the ureter , removed the vaginal septum and reconstructed the uterus) as I do when I get called in to fix a bladder injury or detorse an ovary or an ectopic even though the latter 3 are incredibly mundane from a surgical standpoint the rush is from telling the patient and their loved ones that they are now better. I really don’t think that will get old because it’s instant gratification and those dopamine receptors are real primed. And as much as I love my off time and family and b$&5ch and moan about getting called in on the way in and maybe even during the case the end result always brightens up my day. And I’m not really one of those workaholic types, it’s just in my mind that conversation with the family at the end of surgery seems to be the only pure thing left about being a doctor

 

[Gurby]

I'd also point out that doing your 2000th cholecystectomy or appendectomy (or knee replacement or spine or cath or free flap) is gonna become equally braindead. And at least he has the option to spend months every year traveling the world, reading the full catalog of significant philosophical and literary works, becoming a foodie, getting into artsy film, picking up instruments, playing chess competitively online, or any other intellectually stimulating hobby. Or go the FIRE route, retire in your 50s, and only work at something you love like blogging or teaching an elective at your local liberal arts college.

Grass is always greener. Short of the adrenaline junkie specialties, all jobs become routine.

I don't know that doing your 2000th appy would truly be as braindead as reading your 20,000th normal CT Chest-Abdomen-Pelvis. Even after the physical surgery part becomes routine, you are still doing life/limb/lifestyle preserving interventions and being involved in weighty decisions every single day. I would think/hope that the direct interaction and relationships with patients and families help make surgical specialties a bit more resistant to the ennui I can imagine creeping in while grinding through an endlessly-growing list of studies for 12 hours at a stretch day after day.

I've met enough older working surgeons / retired surgeons to see that for many people, it never becomes mundane and they draw/drew a lot of meaning from it. It is a really special and unique thing to be trusted to operate on people. On the other hand, there are plenty of miserable and bitter young surgeons, and radiologists seem pretty darn happy across the board... Pick your sacrifice and hope for the best, I guess.

 

[odyssey2]

I don't know that doing your 2000th appy would truly be as braindead as reading your 20,000th normal CT Chest-Abdomen-Pelvis. Even after the physical surgery part becomes routine, you are still doing life/limb/lifestyle preserving interventions and being involved in weighty decisions every single day. I would think/hope that the direct interaction and relationships with patients and families help make surgical specialties a bit more resistant to the ennui I can imagine creeping in while grinding through an endlessly-growing list of studies for 12 hours at a stretch day after day.

I've met enough older working surgeons / retired surgeons to see that for many people, it never becomes mundane and they draw/drew a lot of meaning from it. It is a really special and unique thing to be trusted to operate on people. On the other hand, there are plenty of miserable and bitter young surgeons, and radiologists seem pretty darn happy across the board... Pick your sacrifice and hope for the best, I guess.

May be an unpopular opinion, but I think surgeons are born, not made, and it takes a special type of person with an insane work ethic to be happy in that field. The ones I’ve seen who end up miserable are those who went into it for ego reasons or because they thought it would be cool but weren’t prepared for the sacrifice it entails. For radiology, I think the highs aren’t as high but the lows aren’t as low, and there are a lot of people who prefer a steady state as opposed to the peaks and valleys of a surgical career.

 

[Lawpy]

May be an unpopular opinion, but I think surgeons are born, not made, and it takes a special type of person with an insane work ethic to be happy in that field. The ones I’ve seen who end up miserable are those who went into it for ego reasons or because they thought it would be cool but weren’t prepared for the sacrifice it entails. For radiology, I think the highs aren’t as high but the lows aren’t as low, and there are a lot of people who prefer a steady state as opposed to the peaks and valleys of a surgical career.

So in the end, as with everything, it depends on the person.

 

[Cognovi]

For radiology, I think the highs aren’t as high but the lows aren’t as low, and there are a lot of people who prefer a steady state as opposed to the peaks and valleys of a surgical career.

I endorse this impression as it pertains to the day-to-day life of a resident in radiology vs. surgical specialty. If you need serial emotional highs and lows to feel alive on a weekly basis, radiology won't meet your needs. But I and many others prefer even-keeled cruising.

Source: radiology resident married to a surgical resident

 

[efle]

I used to think this and say “everything in medicine from an X-ray to a craniotomy becOmes routine” but I gotta tell you I get the same rush after doing complex pelvic reconstructions ( including most recently a young person with an ectopic ureter, obstructed hemivagina and bicornuate uterus that I reimplanted the ureter , removed the vaginal septum and reconstructed the uterus) as I do when I get called in to fix a bladder injury or detorse an ovary or an ectopic even though the latter 3 are incredibly mundane from a surgical standpoint the rush is from telling the patient and their loved ones that they are now better. I really don’t think that will get old because it’s instant gratification and those dopamine receptors are real primed. And as much as I love my off time and family and b$&5ch and moan about getting called in on the way in and maybe even during the case the end result always brightens up my day. And I’m not really one of those workaholic types, it’s just in my mind that conversation with the family at the end of surgery seems to be the only pure thing left about being a doctor

I'm very envious of folks like you that felt the surgeon magic. I found the OR and patient care on my surgical rotation to be super, super underwhelming. A bummer because I think loving what you do should be #1 - anyone that feels like you needs to be a surgeon. But I'm in the camp that didn't, I could barely stay awake in half my cases. Being totally honest with myself, I had to admit the weeks where I'm happiest are the ones where I get good sleep, can reliably eat lunch, and leave the hospital at a reasonable hour with no leftover work to do at home.

I don't know that doing your 2000th appy would truly be as braindead as reading your 20,000th normal CT Chest-Abdomen-Pelvis. Even after the physical surgery part becomes routine, you are still doing life/limb/lifestyle preserving interventions and being involved in weighty decisions every single day. I would think/hope that the direct interaction and relationships with patients and families help make surgical specialties a bit more resistant to the ennui I can imagine creeping in while grinding through an endlessly-growing list of studies for 12 hours at a stretch day after day.

I've met enough older working surgeons / retired surgeons to see that for many people, it never becomes mundane and they draw/drew a lot of meaning from it. It is a really special and unique thing to be trusted to operate on people. On the other hand, there are plenty of miserable and bitter young surgeons, and radiologists seem pretty darn happy across the board... Pick your sacrifice and hope for the best, I guess.

Haha, agree to disagree about what's boring then I suppose. I was so bored I was in agony watching hysterectomy after hysterectomy within just a couple weeks, or lap chole after lap chole. Cannot imagine what it must be like after decades. Even going through normal EKGs and normal simple imaging on my medicine rotation was 100x more stimulating than that. I did meet surgeons who loved operating literally from 6am-10pm though, and while it made me miserable, more power to them. Like I said I envy having that kind of a calling in life!

 

[Dr G Oogle]

I'm very envious of folks like you that felt the surgeon magic. I found the OR and patient care on my surgical rotation to be super, super underwhelming. A bummer because I think loving what you do should be #1 - anyone that feels like you needs to be a surgeon. But I'm in the camp that didn't, I could barely stay awake in half my cases. Being totally honest with myself, I had to admit the weeks where I'm happiest are the ones where I get good sleep, can reliably eat lunch, and leave the hospital at a reasonable hour with no leftover work to do at home.


Haha, agree to disagree about what's boring then I suppose. I was so bored I was in agony watching hysterectomy after hysterectomy within just a couple weeks, or lap chole after lap chole. Cannot imagine what it must be like after decades. Even going through normal EKGs and normal simple imaging on my medicine rotation was 100x more stimulating than that. I did meet surgeons who loved operating literally from 6am-10pm though, and while it made me miserable, more power to them. Like I said I envy having that kind of a calling in life!

honestly I think it’s very hard to know as a med student from watching surgery. To this day knowing how much I love performing surgery and the nuances of surgery and being able to distinguish good from bad technique I can imagine no worse fate then watching another surgeon operate. And I felt the same way in Med school and chose a procedural rather than a surgical specialty first and only figured out well into residency that I needed more than procedures to keep me happy. I think the best way to choose a specialty is to decide whether the treated conditions are interesting, you find the patient population pleasant to take care of and the schedule is acceptable.

 

[TheVagüs]

Just wanted to pop in and comment how entertaining it is that a lot of us from last year's step 1 prep thread are torn neurosurgery vs rads/IR, myself included. I'm also nontrad and will graduate in my 30s, probably with a baby on the way.

Also considering ophtho and contending with the fact that I have yet to enjoy any inpatient management. Love the OR and surgery, but outside the OR I kinda... hate being in the hospital? I haven't warmed up to the ICU or wards like I hoped I would. Thought I would hate clinic but it turns out specialty clinic with short, focused visits is actually manageable/rewarding. It's been a wild ride so far in third year. Best of luck to all of us (and especially OP) agonizing over what to do with ourselves for the next few decades.

P.S. I can also definitely relate to wanting to take care of your parents. I struggle with the same concerns. They WILL need me sometime in the next decade, and I'm the only person in my family on track to be financially successful

 

[7331poas]

Vascular seems to be a great middle ground that I haven't seen mentioned.

 

[AnatomyGrey12]

Love the OR and surgery, but outside the OR I kinda... hate being in the hospital? I haven't warmed up to the ICU or wards like I hoped I would. Thought I would hate clinic but it turns out specialty clinic with short, focused visits is actually manageable/rewarding.

That's got ortho written all over it bro.

 

[FistLength]

I too am reading NSGY for you. One thing I would do before you take the plunge is complete informed consent with your family. i.e, spell out the horrid abominable hours you will be working, the despair you will face when families trust you and the surgery does not go as planned, and the likely strain it will cause on your and your family as you progress through your training.

It is classically known that neurosurgeons end up divorced. Perhaps this was from a different era (I recently read Dr.Henry Marsh's book Do No Harm), but I would imagine the divorce rates are still quite high.

Ultimately I agree that you must do what makes you happy, but make sure your family is as prepared as possible for the long road ahead, it is the least one can do.

 

[libertyyne]

I too am reading NSGY for you. One thing I would do before you take the plunge is complete informed consent with your family. i.e, spell out the horrid abominable hours you will be working, the despair you will face when families trust you and the surgery does not go as planned, and the likely strain it will cause on your and your family as you progress through your training.

It is classically known that neurosurgeons end up divorced. Perhaps this was from a different era (I recently read Dr.Henry Marsh's book Do No Harm), but I would imagine the divorce rates are still quite high.

Ultimately I agree that you must do what makes you happy, but make sure your family is as prepared as possible for the long road ahead, it is the least one can do.

It seems like working more is associated with lower levels of divorce among male physicians. But I will take your your advice into consideration and it is only fair that informed consent occur.

 

[longhaul3]

I'm sure the hours contribute to some nsg marriages failing, but I doubt it's a huge factor. A lot of neurosurgeons are weird and were weird before they were neurosurgeons. It's also the field where people tend to be the most singularly devoted to their work, which is kind of a personality thing. I bet that a lot of those marriages would fail if the neurosurgeon had a different profession.

 

[nimbus]

If you like to work like a dog taking care of sick ass patients, love techy gizmos, make boofoo $$$$, and don’t care about radiation, you should also consider structural interventional cardiology. TAVR, Transcaval TAVR, Mitraclip, Watchman, TMVR, etc are changing the entire cardiac landscape.

Cardiac surgery/heart failure/VAD/transplant is also a good option given your priorities and inclinations.


Both fields give you opportunities to occasionally save a life and go home a hero or spend days at the hospital taking care of 1 sick patient who drops dead despite your efforts.

 

[nimbus]

Post I saved from Aunt Minnie:

I am 28 years out of medical school. 2 close friends/classmates who ended up in diagnostic radiology. Both rich. Both agree their job feels like “factory work”.

 

[odyssey2]

I am 28 years out of medical school. 2 close friends/classmates who ended up in diagnostic radiology. Both rich. Both agree their job feels like “factory work”.

I think I’d still rather be a wealthy radiologist bored with his work than a pediatrician begging for scraps on the street.