I've been reading the aforementioned posts and can relate to many of the thoughts stated above. I am currently an ortho resident and potentially planning to pursue a pain fellowship upon completion of my residency. Unfortunately as medical students we do not always have a clear view of what a future in a particular specialty entails until we are so submersed in it that there is essentially no turning back. I have realized that as much as I love procedures I also very much appreciate and enjoy my family, friends, and balance. I have struggled throughout my residency to find balance, and although I know residency is not the place for balance I unfortunately do no see that obtainable in my future practice. In addition, I do enjoy procedures but however do not appreciate or gain a great deal of enjoyment from procedure that require 5-6hrs in the OR. Also, the field of ortho has been hit somewhat hard as well from insurance companies and reimbursement. This in addition, to the very happy population of individuals whom are more than compelled to sue their surgeon at the drop of a hat makes the day in and out of being a surgeon not as enjoyable as it may seem. I would appreciate any and all thoughts from the members on the site. This has not been an easy decision to come to considering the long and difficult road to get to where I am today, however the decision has brought a great deal of peace to me and I am excited about the opportunity. Thank you all in advance for your thoughts.
I say go for it. What do you have to lose? One years time and a years salary. That's it. You don't have to throw away your past Ortho training.
Yes, Pain reimbursement will be cut. Other specialties will, too. If you want to avoid that, leave Medicine completely (a whole different thread). Is there added medicolegal risk prescribing opiates? Yes. So learn how to do it properly.
Do what makes you happy.
Is Pain perfect? No. The patients can be very difficult at times. I say, so what? I'm sure getting called in for an emergent open tib/fib case to the ER at 2 am when you just want to sleep can be difficult, too.
With Pain, you have the option to have a fairly normal lifestyle with very few "emergencies" compared to other specialties (as long as you stay away from IT pumps). You can essentially have your weekends and holidays off with your family.
Will patients lie to you to try and get opiates unnecessarily at times, and yell and call you names occasionally if they don't get them? Sure. I say big deal. They can do that in your ortho clinic. They'll do that to ER docs. They'll do that to family docs, internists, or anyone who takes care of Pain patients.
What you have to gain is that by sucking it up for another year, you add an entirely new specialty to your abilities. If you don't like it, you can go back to ortho. If you like it, you can do 100% pain, or even combine the two.
Do a Pain elective and see if you like it, or shadow a Pain doc for a week or two. Any one year fellowship that allows you to be boarded in a completely different specialty is definitely worth considering.
Personally, I think Ortho has great things about it, but the ER call could get old. Really, really old. Plus, if you can't get jazzed about the OR, you have to ask yourself, what the heck are you doing?
I happened to leave a specialty that left me pretty burned out. Going back to fellowship, and making a big change was tough. So far, the change has done me lots of good. I'm happy. Some of the posters here told me not to do it. I did it anyway. Will I get burned out with Pain in a few years? It could happen. But for now, the change has done me good. Sometime you just need a change.
You're coming from ortho? I say, that's cool. I'm from an "other" specialty, too. Pain is not, and should not, be run by a single specialty. The more the merrier. The toothpaste is out of that tube and can't be put back in.
That's my free opinion..
