seeing the light-but is it too late???

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grizzybear

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Hi there-

I'm categorical general surgery intern, enjoying my first year at a great academic program where I feel very fortunate to have matched. I chose GS because I thought I wanted to do peds surg or maybe peds reconstructive/plastics and gs gave me the most options. However, the week of match last march I rotated in peds ENT and LOVED it, and I'm now doing an ENT rotation as an intern and am regretting not having thought seriously about ENT. To my horror I find myself seriously questioning my field and considering a switch.

I keep trying to envision my life in 10 years, and dont know if I see a general surgeon anymore. My peers are fantastic and program is very resident focused. But I am having a hard time seeing myself as the chiefs of my program and doing what they do, and while I love my faculty, I havent really found a mentor I really identify with at this new institution yet. I am doing a good job so far as an intern and do like what Im doing, but the notion of taking care of gen surg patients for the rest of my life now feels painful to me. Something just feels off, and I thought it was just my new role/hospital/city etc, but maybe its something more...

The idea of taking care of children with craniofacial malformations or tracheomalacia seems so amazing-I love the intricacy, the head/neck anatomy, and the idea of being excellent at solving very specialized clinical problems in children (which now seems so at odds with the reason I chose gen surg !!-the extensive pathophysiology and critically ill patients, the ability to operate all over the body, etc.)

I thought I was a hard core gen surgeon at heart, but now I feel like i identify more with the ent faculty/residents, thier practice, patients, personalities in the program. I know you may all be thinking why didnt I realize this before-I dont know, I guess lack of exposure to the field. But I feel like I dont even know myself anymore and I dont know what to do-what if I'm just tired, havent seen enough of gen surg form my new perspective as a resident, or what if ent isnt for me either?? I was a solid applicant with good stats, but not AOA or 260+++on my boards or anything so I dont even know if I would stand a chance at getting into ENT, much less how I could possibly go about it now (or if thats what I really want...)

So I guess I would appreciate any thoughts on why anyone out there chose ent over general surg or vv, what my options may be if I were to switch, who I could talk to about all this given i dont know anyone outside the gs dept (and they barely know me...), what I should be asking myself before I completely turn my life upsidedown. ANy thoughts would be SO appreciated for a lost intern soul :(

GB

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I pretty much chose it because of head and neck cancer: being able to do all that in such a small, complex region of the body posed a challenge to me. I love the challenge. I originally was going to be a general surgeon, but I was attracted to ENT as a college student when I saw a laryngectomy.

In terms of making a switch, there are a few options. You can drop out and work in an ENT lab for a year or two. With the right mentor, you may be able to land an ENT spot in a future match.

Alternately, you can start looking for programs that may need a PGY-2 ENT resident next year. Open PGY-2 spots are hard to find. It's usually the PGY-3 and PGY-4 spots that open up at places after people drop out of ENT or get fired.

Switching is a big deal. You may end up repeating a year or taking a year or two off. If you're really serious, talk to the program director at your hospital/school and tell him you want to switch. If they felt you were a solid intern and worked well with everyone, they may be interested in taking you on in the next match
 
I agree that switching is hard, but it is possible. I would be prepared to lose a year in transition. Another option is to finish g-surg residency and then do a H&N surgery fellowship, but that obviously leaves out sinus/peds/otology/etc.
 
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