Prelim surg match; Reconsidering specialty choice

[pomegranateblossom]

I apologize if this post is too subjective to be useful to others, but I have been thinking about this for the last couple of weeks and can't seem to come up with a good plan myself. I'd appreciate any advice.
Here's my situation. I am currently a US 4th year med student. I applied for categorical surgery and ended up matching into a prelim surgery year. I know that likely this is a result of my lower-end step scores and those won't change next year and I'm not sure applying again would make a difference. I can't seem to talk myself out of surgery. I am happy to try again and be hopeful for a categorical position; however, I am considering that perhaps I should be more realistic and consider that there are other fields I might have over-looked or never been exposed to that I would like or that the reasons I went for surgery weren't good reasons in the first place. So I have listed the reasons I like surgery below and I wonder if anyone out there in surgery or other fields can comment on whether these reasons are specific "enough" for surgery or if there are other fields that fit what I am looking for better.
#1: I like that feeling of wanting to come back to the hospital and check on my patients. I like the sense of responsibility that someone's well-being is in my hands.
#2: I like the acuity of it.
#3: I like the demand to be constantly better.
#4: I especially love the challenge of creatively designing concrete solutions that often result in a tangible improvement for the patient.
Note: If I love what I do, lifestyle isn't an issue for me at all.
Thank you for reading and thinking about responding. Please feel free to PM me.
As much as I appreciate discussing this with my medical student colleagues, I would especially be thankful for the benefit of the experience of senior residents or attendings.
If this should be posted elsewhere, please let me know.

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[vhawk]

I apologize if this post is too subjective to be useful to others, but I have been thinking about this for the last couple of weeks and can't seem to come up with a good plan myself. I'd appreciate any advice.
Here's my situation. I am currently a US 4th year med student. I applied for categorical surgery and ended up matching into a prelim surgery year. I know that likely this is a result of my lower-end step scores and those won't change next year and I'm not sure applying again would make a difference. I can't seem to talk myself out of surgery. I am happy to try again and be hopeful for a categorical position; however, I am considering that perhaps I should be more realistic and consider that there are other fields I might have over-looked or never been exposed to that I would like or that the reasons I went for surgery weren't good reasons in the first place. So I have listed the reasons I like surgery below and I wonder if anyone out there in surgery or other fields can comment on whether these reasons are specific "enough" for surgery or if there are other fields that fit what I am looking for better.
#1: I like that feeling of wanting to come back to the hospital and check on my patients. I like the sense of responsibility that someone's well-being is in my hands.
#2: I like the acuity of it.
#3: I like the demand to be constantly better.
#4: I especially love the challenge of creatively designing concrete solutions that often result in a tangible improvement for the patient.
Note: If I love what I do, lifestyle isn't an issue for me at all.
Thank you for reading and thinking about responding. Please feel free to PM me.
As much as I appreciate discussing this with my medical student colleagues, I would especially be thankful for the benefit of the experience of senior residents or attendings.
If this should be posted elsewhere, please let me know.

I'm the foremost proponent of being realistic and brutally honest with yourself when you are evaluating your options and your ability to match in certain fields and places because I got terrible advice in med school (which I ignored) and watched classmates of mine have horrible match outcomes because they weren't smart enough to ignore it. That being said, if surgery is what you truly want to do, and it sounds like that's the case, a year just isn't really that long in the grand scheme of things. I think it's worthwhile to have backup plans and start thinking about other fields you will be happy in, but it's conceivable you can still get what you want, and the rest of your career is a very long time. I just can't even imagine what my life would be like if I'd have failed to match, because I think I'd have given up and done something else, and honestly I think I would be absolutely miserable.

It is true that you can spend the year improving your application to improve your chances. And it's also true that you aren't gonna be able to improve those scores so if the rest of your app is absolutely stellar and you still didn't match, it's gonna be tough.

But there is more to it than that. You also need to apply intelligently. I don't know what kind of programs you applied to but you should broaden it and target specific programs. I don't wanna be unPC about it but there are definitely programs that you have a better chance at.

It is somewhat true that there is a negative connotation the next time around at certain programs but the flip side of that is you can sell it as a positive. None of the other applicants have demonstrated the same comitment and sacrifice that you have to truly wanting to be a surgeon. None of them have the experience you do.

But if you do it you need to do it 100%. You need to be the best resident at your entire program. Way better than the categoricals. Your best chance is at your home program usually so you need to make them regret that they didn't match you as a categorical.

I know it seems daunting. And there is a lot of anxiety and even some self doubt and shame associated with it but let me tell you that's mostly in your head. Everyone around you knows that it could have been them and how lucky we all are and they don't think less of you. The question you want them to be asking halfway through next year is "how did THIS guy not match". Focus on that. That's the goal.

It's hard. And you still might fail. And you may need that backup plan. Don't be a child about it, be realistic. But don't be a coward either. If you really want it you can do it, and **** it would sure suck to spend the next 30 years regretting it.

 

[pomegranateblossom]

I'm the foremost proponent of being realistic and brutally honest with yourself when you are evaluating your options and your ability to match in certain fields and places because I got terrible advice in med school (which I ignored) and watched classmates of mine have horrible match outcomes because they weren't smart enough to ignore it. That being said, if surgery is what you truly want to do, and it sounds like that's the case, a year just isn't really that long in the grand scheme of things. I think it's worthwhile to have backup plans and start thinking about other fields you will be happy in, but it's conceivable you can still get what you want, and the rest of your career is a very long time. I just can't even imagine what my life would be like if I'd have failed to match, because I think I'd have given up and done something else, and honestly I think I would be absolutely miserable.

It is true that you can spend the year improving your application to improve your chances. And it's also true that you aren't gonna be able to improve those scores so if the rest of your app is absolutely stellar and you still didn't match, it's gonna be tough.

But there is more to it than that. You also need to apply intelligently. I don't know what kind of programs you applied to but you should broaden it and target specific programs. I don't wanna be unPC about it but there are definitely programs that you have a better chance at.

It is somewhat true that there is a negative connotation the next time around at certain programs but the flip side of that is you can sell it as a positive. None of the other applicants have demonstrated the same comitment and sacrifice that you have to truly wanting to be a surgeon. None of them have the experience you do.

But if you do it you need to do it 100%. You need to be the best resident at your entire program. Way better than the categoricals. Your best chance is at your home program usually so you need to make them regret that they didn't match you as a categorical.

I know it seems daunting. And there is a lot of anxiety and even some self doubt and shame associated with it but let me tell you that's mostly in your head. Everyone around you knows that it could have been them and how lucky we all are and they don't think less of you. The question you want them to be asking halfway through next year is "how did THIS guy not match". Focus on that. That's the goal.

It's hard. And you still might fail. And you may need that backup plan. Don't be a child about it, be realistic. But don't be a coward either. If you really want it you can do it, and **** it would sure suck to spend the next 30 years regretting it.

Thank you very much for taking the time to reply. I will keep your advice in mind throughout the next year!

 

[dynx]

I apologize if this post is too subjective to be useful to others, but I have been thinking about this for the last couple of weeks and can't seem to come up with a good plan myself. I'd appreciate any advice.
Here's my situation. I am currently a US 4th year med student. I applied for categorical surgery and ended up matching into a prelim surgery year. I know that likely this is a result of my lower-end step scores and those won't change next year and I'm not sure applying again would make a difference. I can't seem to talk myself out of surgery. I am happy to try again and be hopeful for a categorical position; however, I am considering that perhaps I should be more realistic and consider that there are other fields I might have over-looked or never been exposed to that I would like or that the reasons I went for surgery weren't good reasons in the first place. So I have listed the reasons I like surgery below and I wonder if anyone out there in surgery or other fields can comment on whether these reasons are specific "enough" for surgery or if there are other fields that fit what I am looking for better.
#1: I like that feeling of wanting to come back to the hospital and check on my patients. I like the sense of responsibility that someone's well-being is in my hands.
#2: I like the acuity of it.
#3: I like the demand to be constantly better.
#4: I especially love the challenge of creatively designing concrete solutions that often result in a tangible improvement for the patient.
Note: If I love what I do, lifestyle isn't an issue for me at all.
Thank you for reading and thinking about responding. Please feel free to PM me.
As much as I appreciate discussing this with my medical student colleagues, I would especially be thankful for the benefit of the experience of senior residents or attendings.
If this should be posted elsewhere, please let me know.

Sorry but your post reads like someone convincing themselves they can do it. Look back at any surgical residents post, surgical fellows post, attendings post in this forum...I don't think you'll find them say "if I love what I do and butterflies fly out of my ass twice a day...Then lifestyle doesn't matter to me". Bottom line you're thinking of exceptions allready. Not that I'm the end all be all but it never occurred to me till I had kids there was anything outside my goals in surgery. I didn't need to like what I did. In fact most often I didn't like it. I still don't, I like the OR, if it was just the rest of the crap I'd quit, well the money is nice too. When I was a resident I just wanted to be better, same as a fellow...didn't need to do anything else, didn't really want to. That's really what you're competing against. I don't think its healthy or good I'm just saying if your predication of total commitment and outclassing your categorical competition is on "loving what you do" then forget it. Won't happen. They're many others driven by inability to fail, "can't let go" and other borderline pathological obsessive traits. So don't expect to be driven by happiness, it won't happen. Or accept you don't care about lifestyle even if for the next several years you hate what you do 80% of the time but 8 years from now it drops to 20%. Just be honest with yourself.

 

[bannie22]

Keep fighting for your dreams. But always be prepared for the worst

 

[doc05]

I apologize if this post is too subjective to be useful to others, but I have been thinking about this for the last couple of weeks and can't seem to come up with a good plan myself. I'd appreciate any advice.
Here's my situation. I am currently a US 4th year med student. I applied for categorical surgery and ended up matching into a prelim surgery year. I know that likely this is a result of my lower-end step scores and those won't change next year and I'm not sure applying again would make a difference. I can't seem to talk myself out of surgery. I am happy to try again and be hopeful for a categorical position; however, I am considering that perhaps I should be more realistic and consider that there are other fields I might have over-looked or never been exposed to that I would like or that the reasons I went for surgery weren't good reasons in the first place. So I have listed the reasons I like surgery below and I wonder if anyone out there in surgery or other fields can comment on whether these reasons are specific "enough" for surgery or if there are other fields that fit what I am looking for better.
#1: I like that feeling of wanting to come back to the hospital and check on my patients. I like the sense of responsibility that someone's well-being is in my hands.
#2: I like the acuity of it.
#3: I like the demand to be constantly better.
#4: I especially love the challenge of creatively designing concrete solutions that often result in a tangible improvement for the patient.
Note: If I love what I do, lifestyle isn't an issue for me at all.
Thank you for reading and thinking about responding. Please feel free to PM me.
As much as I appreciate discussing this with my medical student colleagues, I would especially be thankful for the benefit of the experience of senior residents or attendings.
If this should be posted elsewhere, please let me know.

sorry, but none of your reasons are good enough. the work is miserable, and it will only get worse. most of the "reasons" you've listed will get really old, really fast.

and please don't pretend that "lifestyle isn't an issue"... you're either lying to yourself or you're not human.

 

[Kazaki]

Radiology isn't as competitive as surgery from what I hear. Try radiology, then an interventional fellowship. IR guys are going to be given admitting privileges in hospitals starting 2020 I believe, so there's going to be more patient contact involved in the field than there is today.
You can work in acute settings and actually see your patients get better right before your eyes, whilst constantly developing your catheter skills.
Some say (this sounds like Jeremy Clarkson from Top Gear haha) that interventional/catheter based procedures are going to be a big part of medicine in the future. Even in surgery, minimally invasive procedures are preferred as long as they'll have the same outcome as the not-so-minimmaly-invasive procedures. That's not to say that interventional/endovascular therapies will replace surgery, I don't think that'll happen in our lifetime (maybe never), but it's a relatively new field (compared to surgery), with many advancements in treating many conditions, it ticks all the boxes of why you want to do surgery, it has a much much much better lifestyle than surgery, and I think a bit more money as well (compared to general surgery).
That's just my 2 cents.
Hope all works out for you!

P.S. the reasons behind you choosing to do surgery are in no way, shape or form restricted to surgery, and given your low step scores, it was a bad call to restrict yourself to a competitive field.

 

[dynx]

Radiology isn't as competitive as surgery from what I hear.

Is this true? I have no recent information but sounds suspect.

Try radiology, then an interventional fellowship. IR guys are going to be given admitting privileges in hospitals starting 2020 I believe, so there's going to be more patient contact involved in the field than there is today.

Are you trying to talk him into going for radiology or talk him out of it?

 

[vhawk]

i dont know the match data but rads has certainly become much less competitive recently while gen surg has stayed the same or become slightly more competitive

 

[Kazaki]

Is this true? I have no recent information but sounds suspect.



Are you trying to talk him into going for radiology or talk him out of it?

Haha suggesting an option

 

[Moose A Moose]

OP, if it's what you really want then go for it.

However, from your list of reasons, it sounds like just about any medical field could work out for you in the end.

Best of luck.

 

[Psai]

Is this true? I have no recent information but sounds suspect.



Are you trying to talk him into going for radiology or talk him out of it?

I think radiology is still competitive but it is on the downslope while general surgery is on the upslope for whatever reasons. People that wouldn't have matched a few years ago to radiology are going to decent programs and people have been matching lower than expected on their general surgery match lists. This is all anecdotal though, charting the outcomes from 2014 says that radiology was noticeably more competitive than general surgery. We won't know until the next update.

I'm thinking that it's the extra year of training is turning people away as well as the increased workload due to decreased compensation led to a decreased interest in radiology. Surgery seems to be safer as you own your patients and it seems to be more robust against the effects of hospital consolidation and the deterioration of physician autonomy

 

[Slack3r]

IR sounded cool, but I didn't want to irradiate myself all day every day for a living. To each their own tho.