second thoughts

[ENTChap]

Hey, everyone!
Used to be an old member of SDN while in medical school, and as it was always a good resource then, I'm hoping for some help now. Any advice would be appreciated.
I'm a PGY-2 in ENT, in Los Angeles. The year is almost over and I don't know if it is the steep learning curve or overall fatigue of residency but I have to admit that I am having regrets. I was a competitive applicant in medical school, did multiple AIs in ENT, and overall liked/like the field. Still, I am in a situation where I honestly hate the people I work with (fellow residents), dont get excited about operating (would think that a surgery resident would leap at the chance to operate anytime) and have been thinking of doing something else like anesthesia. I don't have anything to prove anymore (did very well on my annual boards) in ENT and feel little loyalty to others who have harped on my every mistake and pointed them out in large groups/in front of faculty. Feels like every day that I am bullied, which is surprising because cool people usually are in ENT and the jerks usually go into general surgery.
My question is: how do you know when it is time to cut your losses and do something else? I obviously have to make that decision sooner rather than later and I understand that there are some anesthesia spots closer to my hometown. I honestly cannot imagine spending 3-4 more years with these people and the nature of the ENT game is such that there are like no openings natiowide if I were even thinking of transferring to a different program. Do you guys ever see subspecialty residents switch to gas?
Thanks, guys!

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[Narcotized]

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[aredoubleyou]

It sux working somewhere you hate, especially when you work there 80 or so hours a week. In the real world, you would find another job and quit. In this world, things are different. Residency sucks and there are people who are involved in your "education" whos only joy in life is to make others as miserable as they are. They exist in every residency, in every specialty. You may have found the mother load where you are, but there is no escaping it. If you hate ENT, then leave. If you hate your staff, suck it up and plow through (so long as their not seriously screwing with you such as putting you on probabtion and such). You can carve out a very nice life for yourself in ent when youre done.

 

[secretasianman]

Dude you're an ENT surgeon. In a few years you're going to be your own boss, see your own patients, make $$$$ and not have to put up with ppl's bs. If you went into anesthesia wouldn't you still have to cater to these very people you are not so fond of?

 

[IN2B8R]

Hey, everyone!
Used to be an old member of SDN while in medical school, and as it was always a good resource then, I'm hoping for some help now. Any advice would be appreciated.
I'm a PGY-2 in ENT, in Los Angeles. The year is almost over and I don't know if it is the steep learning curve or overall fatigue of residency but I have to admit that I am having regrets. I was a competitive applicant in medical school, did multiple AIs in ENT, and overall liked/like the field. Still, I am in a situation where I honestly hate the people I work with (fellow residents), dont get excited about operating (would think that a surgery resident would leap at the chance to operate anytime) and have been thinking of doing something else like anesthesia. I don't have anything to prove anymore (did very well on my annual boards) in ENT and feel little loyalty to others who have harped on my every mistake and pointed them out in large groups/in front of faculty. Feels like every day that I am bullied, which is surprising because cool people usually are in ENT and the jerks usually go into general surgery.
My question is: how do you know when it is time to cut your losses and do something else? I obviously have to make that decision sooner rather than later and I understand that there are some anesthesia spots closer to my hometown. I honestly cannot imagine spending 3-4 more years with these people and the nature of the ENT game is such that there are like no openings natiowide if I were even thinking of transferring to a different program. Do you guys ever see subspecialty residents switch to gas?
Thanks, guys!

So in answer to your question: if you are in heavy debt, you should not think of re-doing things. Plug away with those arse-holes and finish your damn residency (anesthesia won't be much more forgiving..). If, however, you hate ENT now and cannot stand looking at another tonsil, then switch now: odds are you don't want to do 20-30 years of anything you hate. Good luck.

 

[Taurus]

During my interviews, I met 5 former ortho residents or attendings who switched into radiology. It happens.

 

[Narcotized]

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[Impromptu]

You have been working very hard, are feeling a little burnt-out, and are now questioning whether you made the right choice. The closer you are with people and the harder you work at something, the more it hurts when you feel they are attacking or bullying you. That is why mild antagonism from family members can hurt far worse than vile insults from strangers.

I'm going out on a limb and generalizing, but you said you were a competitive applicant. I often wonder if competitive applicants choose to fight amongst each other for competitive specialties because they want to know they conquered other competitive applicants, rather than finding something they truly loved doing. They have completely brainwashed themselves, to their own detriment.

I think anesthesiology proves this rule. It pays highly, it is a very enjoyable specialty...yet it isn't nearly as competitive as other high paying specialties, ones that are less enjoyable and don't quite pay as much. Why? A self-perpetuating cycle. I'm fine with that. It left anesthesiology wide-open to me, someone who rather enjoyed doing it, but didn't have the highest Step 1 board score.

So, you now have this nagging feeling that ENT isn't for you. You dislike working with competitive people (people similar to you). You dislike the field because you may have brainwashed yourself and chosen it for the wrong reason.

Should you stop? Absolutely not. We are humans. We can get a sense of satisfaction from accomplishing any honest work. Just like there is no one and only soul mate waiting somewhere in the world, there is no one and only specialty that is going to make all your dreams come true. Learn to get that sense of accomplishment back, reconnect with your humanity. Learn how to deal with people you don't like being with. (Read some family help books). Find the systemic flaws in your system of life and fix the system.

 

[ENTChap]

Thanks a lot, everyone, for your kind words. I think that I am likely burned out, but its so hard to not be when you have other residents (the guys who are supposed to be in the trenches with) criticizing how you handled a consult (which you ran over with an attending, mind you) or loving berating you (i.e. personal attacks-height, I am 5'6''). I mean, I have never done anything clinically/surgically dangerous or dumb, its all about the politics/how you filled out this paperwork, scheduled this patient's follow-up. I absolutely know surgery is typically more difficult in residency than say IM or psych (and anticipated this), but when most of the crap comes from fellow residents, its hard to fathom staying somewhere like that. Residents are supposed to be able to complain to one another about stuff, but how can you chat with people when they are the source of that very crap? As a result, I just put my head down and plow through. Am I alone or is this generally the rule in residency out there?
I guess I am just venting, and appreciate this outlet. Will just have to accept it and hope residency speeds along quickly.

 

[IN2B8R]

You have been working very hard, are feeling a little burnt-out, and are now questioning whether you made the right choice. The closer you are with people and the harder you work at something, the more it hurts when you feel they are attacking or bullying you. That is why mild antagonism from family members can hurt far worse than vile insults from strangers.

I'm going out on a limb and generalizing, but you said you were a competitive applicant. I often wonder if competitive applicants choose to fight amongst each other for competitive specialties because they want to know they conquered other competitive applicants, rather than finding something they truly loved doing. They have completely brainwashed themselves, to their own detriment.

I think anesthesiology proves this rule. It pays highly, it is a very enjoyable specialty...yet it isn't nearly as competitive as other high paying specialties, ones that are less enjoyable and don't quite pay as much. Why? A self-perpetuating cycle. I'm fine with that. It left anesthesiology wide-open to me, someone who rather enjoyed doing it, but didn't have the highest Step 1 board score.

So, you now have this nagging feeling that ENT isn't for you. You dislike working with competitive people (people similar to you). You dislike the field because you may have brainwashed yourself and chosen it for the wrong reason.

Should you stop? Absolutely not. We are humans. We can get a sense of satisfaction from accomplishing any honest work. Just like there is no one and only soul mate waiting somewhere in the world, there is no one and only specialty that is going to make all your dreams come true. Learn to get that sense of accomplishment back, reconnect with your humanity. Learn how to deal with people you don't like being with. (Read some family help books). Find the systemic flaws in your system of life and fix the system.

Any relation to that guy who used to do SNL's "Deep thoughts, by Jack Handy"?

 

[IN2B8R]

Thanks a lot, everyone, for your kind words. I think that I am likely burned out, but its so hard to not be when you have other residents (the guys who are supposed to be in the trenches with) criticizing how you handled a consult (which you ran over with an attending, mind you) or loving berating you (i.e. personal attacks-height, I am 5'6''). I mean, I have never done anything clinically/surgically dangerous or dumb, its all about the politics/how you filled out this paperwork, scheduled this patient's follow-up. I absolutely know surgery is typically more difficult in residency than say IM or psych (and anticipated this), but when most of the crap comes from fellow residents, its hard to fathom staying somewhere like that. Residents are supposed to be able to complain to one another about stuff, but how can you chat with people when they are the source of that very crap? As a result, I just put my head down and plow through. Am I alone or is this generally the rule in residency out there?
I guess I am just venting, and appreciate this outlet. Will just have to accept it and hope residency speeds along quickly.

Just plow through that ****. If other residents in the program are giving you **** about your height, pull ur weenie out and tell'em to suck on it. You won't have to deal w/those fuggers your entire career. Get used to the politics, though, 'cause that crap ain't going anywhere--ever! And when it is all said and done, remember that the guy behind the ether screen is always a friendly shoulder to cry on: be that in a hospital setting when you are actively killing a patient, or some other social setting. Regards and all the best.

 

[Masseter Spasm]

I think that every resident at one time or another during training doubts his/her choice of specialty. I think one red flag in your case is that you admit that you do not enjoy operating. If that is the case, I would switch to a non-surgical field.

Performing an operation may be the only thing that many surgeons enjoy about practicing medicine. If you dislike operating, the other aspects of your field will only get worse (long clinic days, patients you dislike, pages interupting your sleep, annoying consults, taking call, etc.)

 

[monchi]

Thanks a lot, everyone, for your kind words. I think that I am likely burned out, but its so hard to not be when you have other residents (the guys who are supposed to be in the trenches with) criticizing how you handled a consult (which you ran over with an attending, mind you) or loving berating you (i.e. personal attacks-height, I am 5'6''). I mean, I have never done anything clinically/surgically dangerous or dumb, its all about the politics/how you filled out this paperwork, scheduled this patient's follow-up. I absolutely know surgery is typically more difficult in residency than say IM or psych (and anticipated this), but when most of the crap comes from fellow residents, its hard to fathom staying somewhere like that. Residents are supposed to be able to complain to one another about stuff, but how can you chat with people when they are the source of that very crap? As a result, I just put my head down and plow through. Am I alone or is this generally the rule in residency out there?
I guess I am just venting, and appreciate this outlet. Will just have to accept it and hope residency speeds along quickly.

I've read through the posts and there's a ton of great advice here (but you didn't need me to tell you that). I'll try not to repeat stuff. My thoughts, for whatever it's worth:

ANY residency is going to be a lot tougher when you feel alone, and that's what you sound like right now. In my anesthesia residency, there are >40 total, but in the ENT res at my hospital there are only 1-2 for each year. Sounds like you're probably in the same boat. That's a hard situation - you might not have anyone else in your year to vent to, or even if you do, you might not like them. So yes, an anes res in that respect would be nicer, but that wouldn't be a reason to switch, IMHO. With anything that's difficult, support from people who care about you is paramount. Switching residencies is hard, but possible. I know of two people in ENT who have. If you're far from your family, you might want to consider moving closer to them.

About not liking to operate - is it because that's when you're stuck working with the people you don't like? If that's the case, someone already pointed out that as an attending you'll be "The Man", or you can change jobs. Or if it truly is not liking to operate, then you have serious soul searching to do. You won't be retracting forever.

Well, good luck to you. The surgery specialties at my hospital have lost a bunch of great residents to anes and rad this year. So you're definitely not alone in re-thinking your choices.

 

[Pilot Doc]

My standard advice to these posts - SSRI for 2-3 months then reassess.

 

[sevoflurane]

ENT docs I work with are the happiest among the surgeons I know. They all drive nice cars and have plenty of time outside of the OR. Just had one come back from a 2 week motorcycle trip in Patagonia. If you don't like to operate that is a different story as mentioned above. We all have rough times in our life for one reason or another. It is because of these trials of life that we are able to grow and fully taste the fruits of our labor. Hang in there and try to focus on the good in your life (your family, patients, the fact that you are a physician, the beautiful california weather, etc, etc.) Things will get better Home-E.

 

[Sergio99]

You make a great point talked about previously by myself, mil, and others in different posts. As an ENT surgeon you will be "The Man." As an anesthesiologist you will be working for "The Man." Being The Man has a lot of drawbacks that anesthesia doesn't have (wearing your beeper after you leave work, running a practice, etc), but of all "The Man" subspecialties out there, ENT is about as good as it gets.

Great posting, Narc, it sums up a vast amount of truth.

Again, ENTChap, repeating what others have said, if you don't hate the specialty per se, sticking to it in spite of these circumstantial drawbacks will pay handsome dividends. Later you will look back and smile satisfied that you did it.