I am a third year med student and loved OB, Gen Surg, and Plastics. Anyone who could help with a pro con list, that would be great!
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OB vs. Gen Surg vs. Plastics
- Thread starter lst790
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First question: do you have the credentials to match plastics?
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What is it about each specialty that interests you? What kinds of things are important to you, professionally (and nonprofessionally as they relate to work-life balance, I suppose)
That can help us help you.
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Gen surg: Long hours, grueling 5 years of training and unless you sub specialize with an additional ~2 yrs fellowship you'll probably be stuck doing lap choles, butt cases, appendectomies, or bariatric cases. On the flip side you'll be a "jack of all trades" type of doctor --- the kind you'd want with you on a medical mission or expeditionary undertaking.
Plastics: Competitive but can be financially rewarding. Reconstructive surgery for trauma/cancer patients can also be rewarding on a personal level. Still have to do what basically amounts a gen surg residency.
OB: Surgery lite. Childbirth babies and women's health. The downside: childbirth babies and women's health.
Plastics: Competitive but can be financially rewarding. Reconstructive surgery for trauma/cancer patients can also be rewarding on a personal level. Still have to do what basically amounts a gen surg residency.
OB: Surgery lite. Childbirth babies and women's health. The downside: childbirth babies and women's health.
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General Surgery isn't all gallbladders and butt cases.
My friends here, in community private practice, do thyroids, breast cases, colon resections, gastric surgery, skin and soft tissue, melanomas, hernia repairs, and yes, gallbladders (usually SILS) and appys. It can be a lot broader than what you/we/I experienced in medical school and residency.
My friends here, in community private practice, do thyroids, breast cases, colon resections, gastric surgery, skin and soft tissue, melanomas, hernia repairs, and yes, gallbladders (usually SILS) and appys. It can be a lot broader than what you/we/I experienced in medical school and residency.
I'm female; the things that drew me to:
OB/GYN- the patient population I worked with was mostly healthy happy younger women; they were all compliant and actively participated in their care. The deliveries I saw (C-section and NSVD) were usually uncomplicated and routine. There was a lot of young twenty-year olds coming in to discuss long-term contraception methods, some STI checks, seemed pretty routine. I think I'm having trouble separating if this is the real deal everywhere or if this was just my experience seeing one extreme of the spectrum. I saw some urogyn procedures (no gynonc unfortunately) which were cool at first but became redundant after the 4th prolapsed vagina.
Gen Surg- I like medicine and I felt like I was using most of my medical knowledge while still being able to operate (more OR time than OB). There are a lot of opportunities to branch out into different fellowships. For example, I loved breast surgery and really enjoyed working with that patient population as well- I liked the interdisciplinary work and always attended tumor boards. Plus, the lifestyle of a breast surgeon isn't too shabby =)
Plastics: There is no residency program at the school I attend so it was difficult to gain a good feel, but I fell in love with what I did experience on my 2 week elective (mostly breast recon, some microsurg). I liked the creative aspect of the surgeries, the interdisciplinary work, and that it’s not limited to just one area of the body. It wasn't just about taking something out of the body, but about reshaping and reforming it.
Things that are important to me: I would like to be happy in the clinic (have to spend at least one day a week there!) I don't think I would want a crazy call schedule for the rest of my life (something people warn me about OB). I prefer a fast pace with patients leaving my care significantly healthier and happier than when they came in.
OB/GYN- the patient population I worked with was mostly healthy happy younger women; they were all compliant and actively participated in their care. The deliveries I saw (C-section and NSVD) were usually uncomplicated and routine. There was a lot of young twenty-year olds coming in to discuss long-term contraception methods, some STI checks, seemed pretty routine. I think I'm having trouble separating if this is the real deal everywhere or if this was just my experience seeing one extreme of the spectrum. I saw some urogyn procedures (no gynonc unfortunately) which were cool at first but became redundant after the 4th prolapsed vagina.
Gen Surg- I like medicine and I felt like I was using most of my medical knowledge while still being able to operate (more OR time than OB). There are a lot of opportunities to branch out into different fellowships. For example, I loved breast surgery and really enjoyed working with that patient population as well- I liked the interdisciplinary work and always attended tumor boards. Plus, the lifestyle of a breast surgeon isn't too shabby =)
Plastics: There is no residency program at the school I attend so it was difficult to gain a good feel, but I fell in love with what I did experience on my 2 week elective (mostly breast recon, some microsurg). I liked the creative aspect of the surgeries, the interdisciplinary work, and that it’s not limited to just one area of the body. It wasn't just about taking something out of the body, but about reshaping and reforming it.
Things that are important to me: I would like to be happy in the clinic (have to spend at least one day a week there!) I don't think I would want a crazy call schedule for the rest of my life (something people warn me about OB). I prefer a fast pace with patients leaving my care significantly healthier and happier than when they came in.
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Sounds like breast surgery is your best bet. People come in with tumors, you cut em out and send em to rad onc/medical onc and f/u on them. Call is manageable as there aren't a lot of 'breast surgeon to the ER/OR, stat' calls overhead, and all surgeons have clinic days. Plastic is a possibility, but the integrated residency is crazy competitive, and if you're gonna go general surgery then it keeps your options open.
That's why I enjoy being a plastic surgeon. I find that almost every case is different and requires constant thinking and innovation. I continue to learn new ways to do procedures even after many years of practice.
I completed a general surgery residency prior to doing plastics, and I enventually found general surgery repetitive. Of course, any specialty can seem boring if you're not interested in the fine points of the field. I didn't entertain any thoughts of being a plastic surgeon until I was almost done with my general surgery residency, and I consider myself very fortunate to have stumbled on this as a career choice.
I work in a large multispecialty group, and do 100% reconstructive surgery, so my experience may not be typical for a plastic surgeon. While I have to be on call for trauma, my on call experience is much easier than that of the general and orthopedic surgeons. Those guys work very hard when they are on call. I almost never have to go in at night or on the weekends. Most facial fractures or tendon and nerve lacerations can be seen in the office later in the week. But general surgeons and orthopods seem to be up all night when they're on call. Of course, if I did replants and other microsurgery, then I would work harder at night.
I think OB /Gyn is one of those fields that you should only do if there's nothing else you want to do.
However, if I were starting over again, I would consider either orthopedic surgery, or dermatology with a Mohs fellowship. I have a hand fellowship and do a lot of hand surgery, so an ortho residency followed by a hand fellowship would put me in essentially the same practice, but with a shorter residency and a higher salary. The orthopods seem to be a very happy bunch. And, your description of whay you like about plastic surgery applies perfectly to orthopedics as well. ( I had originally considered ortho but changed my mind, for reasons that, in retrospect, were not very good ) . If you decided later that you wanted either to work harder or make even more money, you could do spine surgery.
My other major interest in recent years has been facial reconstruction following Mohs surgery, ( i.e. skin cancer resections by dermatology specialists. They usually repair the defects themselves, but if the defect is too large or complex for them, they refer to plastic surgery ). That's what I like doing most of all, and again, based on your interests, that might be a great option. That also has a shorter residency path, a much easier lifestyle, and a much higher salary than plastic surgery or ortho. And of course, you can't beat that lifestyle. However, you do have to spend a lot of time under a microscope, and the Mohs fellowships might be competitive. I don't know.
Good luck!
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Financially speaking plastics. Personally I like the diversity of general surgery cases.
Above stuff pretty much hit nail onhead. If you want to avoid call, stay away from gyn and gen surg, I call those in the most as an ED doc. I do call hand, but mostly for next day referrals. We ED docs love our hand surgeons as they are hard to come by 
I just want to give a shout out to ob/gyn since that was my alternate choice to ED. Can be hard hours, as are all surgical fields. Honestly the most impressive surgeries I saw in all med school were pelvic dissctions in ovarian Ca patients. could be repetitions, but the only thing that had me wide awake and interested in the OR. what you described was pretty accurate as far as office practice and L&D's went. What you described is your standard ob/gyn practice. office, or, and l&d. You do have a couple unique specialities such as Reproductive Medicine (high paying, cash practice) Maternal-Fetal Medicine, with some people doing surgeries on fetuses, gyn-onc has very intricate pelvic surgeries with most of those guys being quite skilled. The nice thing I found about ob/gyn is that a lot of illnesses and disease are very well-classified . Differentials are quite limited and easy to navigate. intellectually i found it nice and straightforward. Negatives are of course the hours, high malpractice, and the need to specialize if you want more interesting surgeries, less call, or higher paygrade.
I just want to give a shout out to ob/gyn since that was my alternate choice to ED. Can be hard hours, as are all surgical fields. Honestly the most impressive surgeries I saw in all med school were pelvic dissctions in ovarian Ca patients. could be repetitions, but the only thing that had me wide awake and interested in the OR. what you described was pretty accurate as far as office practice and L&D's went. What you described is your standard ob/gyn practice. office, or, and l&d. You do have a couple unique specialities such as Reproductive Medicine (high paying, cash practice) Maternal-Fetal Medicine, with some people doing surgeries on fetuses, gyn-onc has very intricate pelvic surgeries with most of those guys being quite skilled. The nice thing I found about ob/gyn is that a lot of illnesses and disease are very well-classified . Differentials are quite limited and easy to navigate. intellectually i found it nice and straightforward. Negatives are of course the hours, high malpractice, and the need to specialize if you want more interesting surgeries, less call, or higher paygrade.
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I think there are about 3 women in my med school who are interested in OB/GYN. Horrible lifestyle, malpractice, working environment, and relatively poor salary probably drives away most people.
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I'm doing urology so I don't really have a dog in this fight, but I wanted to plug for general surgery.
Currently on my gen surg subI and we do clinic once a week. 100+ patients seen from 9am and finish usually around 4pm or earlier. The variety of stuff that comes through the door blew me away. New consults for biliary cancers, melanoma excisions, choles, hernias, colectomies for tons of different reasons, fistulas, and of course butt pus. It's really amazing how much general surgery can cover.
The resident's hours are of course brutal, but the attendings are happy. They take call one day a week and rotate weekends. They have a great balance of life and work. This may not be true all areas (especially a rural region where you are the only surgeon), but the opportunity for an attending to not pull 100 hours a week is certainly there.
Currently on my gen surg subI and we do clinic once a week. 100+ patients seen from 9am and finish usually around 4pm or earlier. The variety of stuff that comes through the door blew me away. New consults for biliary cancers, melanoma excisions, choles, hernias, colectomies for tons of different reasons, fistulas, and of course butt pus. It's really amazing how much general surgery can cover.
The resident's hours are of course brutal, but the attendings are happy. They take call one day a week and rotate weekends. They have a great balance of life and work. This may not be true all areas (especially a rural region where you are the only surgeon), but the opportunity for an attending to not pull 100 hours a week is certainly there.
