Surgeons of SDN, when did you realize you wanted to pursue surgery?

[BurntFlower]

Hi, long-time lurker here! I wanted to know when you fully realized that surgery was the career path for you. Was it before you came to med school? During first year? Or maybe M3?

Some background info: I want to shadow some surgeons during M1 to see if this is what I really want to do. I have been volunteering at a pediatric Trauma ward in my home country since I was a senior in high school (I am now almost 30 years old) and enjoy watching surgical videos in my downtime. As a painter, I love to work with my hands and pay close attention to detail. However, I will definitely keep an open mind about all specialties before rotations as per advice I have heard from current med students. Thanks in advance!

---

Members don't see this ad.

 

[TypeADissection]

I didn't know there was anything else except surgery when I went to med school. I'm being somewhat facetious, but I knew coming in there wasn't anything else I wanted to do. I spent the majority of my time trying to figure which kind of surgery I'd be pursuing. Definitely do shadow although it's hard to get a true glimpse of what being a surgeon is actually like. Do go to didactics if they're near by. But you'll get a better idea once you're on the service and seeing the daily work. Keep an open mind. Don't forget to have fun. Cheers.

 

[Winged Scapula]

Being a surgeon never crossed my mind before medical school. I’d never met one and no one in my immediate family had ever had surgery.

I did ObGyn my first 3rd year rotation and realized I liked being in the OR. GS rotation solidified the decision for me (well that and hating both my IM and FM rotations).

 

[LucidSplash]

I was all set to do EM, had aways scheduled and 4th year schedule set. I'd kinda hated anatomy lab during 1st year so I assumed I'd hate surgery. Surgery was my last rotation of 3rd year. Like WS, I had an inkling I liked the OR on ObGyn but didn't seriously consider it. I started my surgery rotation with 3 weeks at Shock Trauma (I went to Maryland) and quickly realized everything I thought I liked about EM was actually Trauma Surgery. Next on surgery I went to a community hospital for a combined general/vascular tour and fell in love. Finally made the decision to ditch EM and changed my 4th year schedule and haven't looked back since. I initially thought I wanted to do trauma but ultimately vascular was a better fit and here I am one year from finishing training, finally. If I'd done EM, I'd have been in practice for 5 years already but I realize now I'm a terrible fit for that specialty. The cacophony of the EM gives me anxiety and all I want to do is GTFO when I have to go there.

 

[TypeADissection]

The cacophony of the EM gives me anxiety and all I want to do is GTFO when I have to go there.

Willy Shakes himself could not have penned better prose

 

[BigRedBeta]

As a counterpoint to this, I recognized that I didn't want to be in the OR was during M3 surgery clerkship...

I personally had a number of surgeries growing up, had shadowed an orthopedic surgeon as a HS senior, so I felt like the OR had a lot of potential. My school required a rural medicine block in the summer between M1 and M2, and I elected to do it with a general surgeon - had a fantastic 3 weeks, got to do a lot of procedures with a undoubtedly dangerous level of autonomy for someone a year away from taking Step 1 and starting clerkships. The newness of actually seeing patients in some sense meant that everything seemed awesome and so I entered my M3 year very much considering a surgical field.

...and then it lost it's luster pretty quickly in a number of successive steps. Step 1 came back and my scores were decidedly average (as in I scored at the Median, which was roughly 220 that year), so that meant it was going to be an uphill battle for anything competitive when combined with my decidedly average preclinical grades. Then I got to my surgery clerkship (1st one of third year), and got lucky in that I got the community hospital spot with the private practice group which was the cush rotation for the residents (as they got to operate a lot more with a ton more autonomy), and infinitely more OR time for me...and it just failed to capture my passion. I basically got to hop from case to case, spend most of my time in the OR, and while I didn't dread going into cases, it was more like a chore to see my 40th lap chole. It just became so boring to stand there scrubbed in, even when I got to do something beyond hold retractors. So I was starting to waver pretty good at that point, and then I moved onto my subspecialty weeks and it went downhill fast. 2 weeks of peds ortho was remarkable mostly for watching a former D1 athlete get ripped to shreds (ended up crying...from a guy who I know took a lot of abuse from his coaches during his athletic career) in Fracture Conference when he misspoke said a PA shoulder view as an AP. I knew one of the ortho chiefs socially and liked him a lot, but he was the ring leader and it was pretty brutal. And by that point, more and more stories from my classmates about surgical culture were filtering through our ranks. I wouldn't call it abuse but it certainly is an environment that is not for everyone. While I know I can handle a lot, it's not a set of circumstances where I thrive. The culture was enough for me to take surgery out of consideration and subsequently seeing what resident life was like back at the academic mothership cemented my decision.

And since that time, every time I've gone back to the OR (did a peds surgery rotation as a 3rd year peds resident, spent a week in the OR during a Peds Cardiac ICU month also as a 3rd year resident), or even on the anesthesia side (peds anesthesia month during residency, 2 separate blocks as a PICU fellow), my decision has been confirmed over and over that the OR was not the spot for me.

 

[TypeADissection]

As a counterpoint to this, I recognized that I didn't want to be in the OR was during M3 surgery clerkship...

This is also important to acknowledge. A good friend of mine during med school had a father who was a very prominent professor and chair of cardiothoracic surgery. He just assumed that he'd go into CTS himself. The way he described his M3 rotation to me was that he felt claustrophobic being scrubbed into cases because he couldn't move or scratch his balls, etc. The overall Gestalt just wasn't right. He then rotated on IM and there you go, he just loved everything about it (I know weird right?). Anyway, he is now a cardiology fellow who will go back to the institution he did his IM residency in as an attending doing general cardiology and is truly just so much happier. This isn't for everyone and that's 100% ok. Cheers.

 

[Smurfette]

I went into med school not remotely considering surgery.
As a med-3, I was absolutely miserable on my rotations and was pretty worried as everyone else seemed to enjoy third year. The first rotation I liked was OB, in March, but I only liked the OB part and hated the gyn part and the gyn surgeries. My last rotation as a med-3 was surgery, and I suddenly found that a 12-14 hour day on GS was much more enjoyable than 4 hours of pretty much anything else, and that I actually wanted to read and study. I also did two weeks of ENT (hated it) and two weeks of plastics (liked it but the residents and a couple attendings were awful and turned me off to the field) and scrambled in June to find available GS sub-i's so I could get LORs, etc.

 

[ACSurgeon]

... he felt claustrophobic being scrubbed into cases because he couldn't move or scratch his balls, etc. He then rotated on IM ..

There must be more to IM then being able to scratch your balls, right?

 

[ACSurgeon]

Hi, long-time lurker here! I wanted to know when you fully realized that surgery was the career path for you. Was it before you came to med school? During first year? Or maybe M3?

Some background info: I want to shadow some surgeons during M1 to see if this is what I really want to do. I have been volunteering at a pediatric Trauma ward in my home country since I was a senior in high school (I am now almost 30 years old) and enjoy watching surgical videos in my downtime. As a painter, I love to work with my hands and pay close attention to detail. However, I will definitely keep an open mind about all specialties before rotations as per advice I have heard from current med students. Thanks in advance!

I wanted to do something surgical early on because I wanted to learn a skill and because I was sick of the book learning and purely theoretical aspect of academia. 3rd year helped decide general surgery rather than Ortho or urology.

 

[TypeADissection]

There must be more to IM then being able to scratch your balls, right?

I dunno. Probably. I think I did a lot of ball scratching on IM. Didn’t help me come up with a ninth differential diagnosis though. I always ended up saying amyloid or sarcoid.

 

[Pir8DeacDoc]

I also did two weeks of ENT (hated it).

Aww come on. We're a good field

 

[Smurfette]

Aww come on. We're a good field

LOL. It just wasn't for me. Between nosebleeds, trach secretions (both of which gross me out and make me gag) and painful 8 hour facial reconstructions and ear surgeries where I couldn't see anything, I knew I was better off doing something else. My ENT rotation as an intern affirmed my decision, as that was probably the most miserable month of internship for me (due to residents/institution-related issues and "home call" which involved very little "home" but a lot of "call").

 

[mimelim]

It is a long story, so the cliffs...

EM --> Neurosurgery --> Trauma Surgery --> OB --> Heme/Onc --> Trauma Surgery --> Vascular surgery

To be fair, I had no idea what I was doing the entire time, probably didn't realize that vascular surgery was right for me until I was 3 years into my residency. Yay for getting lucky.

 

[Eye-eye]

As a counterpoint to this, I recognized that I didn't want to be in the OR was during M3 surgery clerkship...

I personally had a number of surgeries growing up, had shadowed an orthopedic surgeon as a HS senior, so I felt like the OR had a lot of potential. My school required a rural medicine block in the summer between M1 and M2, and I elected to do it with a general surgeon - had a fantastic 3 weeks, got to do a lot of procedures with a undoubtedly dangerous level of autonomy for someone a year away from taking Step 1 and starting clerkships. The newness of actually seeing patients in some sense meant that everything seemed awesome and so I entered my M3 year very much considering a surgical field.

...and then it lost it's luster pretty quickly in a number of successive steps. Step 1 came back and my scores were decidedly average (as in I scored at the Median, which was roughly 220 that year), so that meant it was going to be an uphill battle for anything competitive when combined with my decidedly average preclinical grades. Then I got to my surgery clerkship (1st one of third year), and got lucky in that I got the community hospital spot with the private practice group which was the cush rotation for the residents (as they got to operate a lot more with a ton more autonomy), and infinitely more OR time for me...and it just failed to capture my passion. I basically got to hop from case to case, spend most of my time in the OR, and while I didn't dread going into cases, it was more like a chore to see my 40th lap chole. It just became so boring to stand there scrubbed in, even when I got to do something beyond hold retractors. So I was starting to waver pretty good at that point, and then I moved onto my subspecialty weeks and it went downhill fast. 2 weeks of peds ortho was remarkable mostly for watching a former D1 athlete get ripped to shreds (ended up crying...from a guy who I know took a lot of abuse from his coaches during his athletic career) in Fracture Conference when he misspoke said a PA shoulder view as an AP. I knew one of the ortho chiefs socially and liked him a lot, but he was the ring leader and it was pretty brutal. And by that point, more and more stories from my classmates about surgical culture were filtering through our ranks. I wouldn't call it abuse but it certainly is an environment that is not for everyone. While I know I can handle a lot, it's not a set of circumstances where I thrive. The culture was enough for me to take surgery out of consideration and subsequently seeing what resident life was like back at the academic mothership cemented my decision.

And since that time, every time I've gone back to the OR (did a peds surgery rotation as a 3rd year peds resident, spent a week in the OR during a Peds Cardiac ICU month also as a 3rd year resident), or even on the anesthesia side (peds anesthesia month during residency, 2 separate blocks as a PICU fellow), my decision has been confirmed over and over that the OR was not the spot for me.

To be fair, a lot of this can change by institution. Some places are known to be brutal or malicious and others benign and supportive. Sounds like some of the programs you were involved with as a med student may have been the former. Surgery definitely can have a little more ball busting than other fields, but with the right group, it's joking around between colleagues and helping each other grow, not being an ass because you feel superior.

 

[Iz_FtB]

It is a long story, so the cliffs...

EM --> Neurosurgery --> Trauma Surgery --> OB --> Heme/Onc --> Trauma Surgery --> Vascular surgery

To be fair, I had no idea what I was doing the entire time, probably didn't realize that vascular surgery was right for me until I was 3 years into my residency. Yay for getting lucky.

**** me, I can already tell this is the direction I'm heading. Won't be able to judge the consequence of my decision until I'm knee deep. Hoping I'm as lucky as you.

 

[mimelim]

**** me, I can already tell this is the direction I'm heading. Won't be able to judge the consequence of my decision until I'm knee deep. Hoping I'm as lucky as you.

Meh, I'd also like to think that I tend to make the best of most situations, so if you are anything like me, it should all be fine

 

[HighPriest]

I left a PhD tract research program for medical school predominantly because I'm a weak person who needs instant gratification rather than weeks of long, fruitless hours leading up to a single breakthrough. So when I was looking at specialties, surgical tracts made the most sense. More often than not you go to the OR and come out with a patient who's better off, so it's much more gratifying. I thought about EM for a long time, but then I realized I didn't want to be running a triage station most of the time and waiting for the excitement to come through the door. I liked the idea of being either the last stop or near-to-last stop for a patient with a problem. It came down to general surgery or ENT, and it was very, very close. I liked that the general surgeons could handle a little of everything, and I actually liked the critical care aspect (as a med student with more interest in cool medicine than lifestyle). But I also really liked ENT and the surprising breadth of surgical techniques necessary to do that job. And contrary to what's already been said here, snot is gross but still better than anything that comes from the anus. I mean, be honest, if someone put a guy to your head and told you you had to either put either a stranger's runny nose or their runny anus in their mouth, you'd choose the nose 100% of the time.
I agree that watching a lot of the ear/sinus cases is boring as a med student or junior resident, but those cases are fun to do, and especially for ear cases they're very technique-driven. Plus, ENT has a pretty good lifestyle that doesn't involve the bum or regularly having to shake hands with another man's D&B. Finally, the Army would have made me do a research year in general surgery, which would have meant an additional year of commitment, and which would have meant deploying every five minutes. That by itself wasn't enough to change my interest, but it certainly added to the decision.

Plus, I like working with my hands, and who wants to spend all of their time in clinic?

 

[Psai]

I left a PhD tract research program for medical school predominantly because I'm a weak person who needs instant gratification rather than weeks of long, fruitless hours leading up to a single breakthrough. So when I was looking at specialties, surgical tracts made the most sense. More often than not you go to the OR and come out with a patient who's better off, so it's much more gratifying. I thought about EM for a long time, but then I realized I didn't want to be running a triage station most of the time and waiting for the excitement to come through the door. I liked the idea of being either the last stop or near-to-last stop for a patient with a problem. It came down to general surgery or ENT, and it was very, very close. I liked that the general surgeons could handle a little of everything, and I actually liked the critical care aspect (as a med student with more interest in cool medicine than lifestyle). But I also really liked ENT and the surprising breadth of surgical techniques necessary to do that job. And contrary to what's already been said here, snot is gross but still better than anything that comes from the anus. I mean, be honest, if someone put a guy to your head and told you you had to either put either a stranger's runny nose or their runny anus in their mouth, you'd choose the nose 100% of the time.
I agree that watching a lot of the ear/sinus cases is boring as a med student or junior resident, but those cases are fun to do, and especially for ear cases they're very technique-driven. Plus, ENT has a pretty good lifestyle that doesn't involve the bum or regularly having to shake hands with another man's D&B. Finally, the Army would have made me do a research year in general surgery, which would have meant an additional year of commitment, and which would have meant deploying every five minutes. That by itself wasn't enough to change my interest, but it certainly added to the decision.

Plus, I like working with my hands, and who wants to spend all of their time in clinic?

Speak for yourself

 

[HighPriest]

Speak for yourself

If you pick the anus, that’s cool. But you’re either in a weird minority or lying to yourself.

 

[BigRedBeta]

To be fair, a lot of this can change by institution. Some places are known to be brutal or malicious and others benign and supportive. Sounds like some of the programs you were involved with as a med student may have been the former. Surgery definitely can have a little more ball busting than other fields, but with the right group, it's joking around between colleagues and helping each other grow, not being an ass because you feel superior.

The culture aspect was simply the straw that broke the camel's back.

I got more OR time with more autonomy than almost anyone in my medical school class by the time 3rd year was done because of the combination of my rural surgery weeks (most people did family med rotations), and getting the community private practice group as opposed to the academic mothership (combined with the fact that my single solitary resident went on vacation during my month meant I got to do even more than most other students) and I still was a hard lean away from surgery after 4 weeks of gen surg because I just didn't love being in the OR. I promise, I really did give it a lot of consideration. Just not where I needed to be.

 

[OrthoTraumaMD]

I only have this to say:

http://gomerblog.com/2014/09/bones/


Sent from my iPhone using SDN mobile

 

[Eye-eye]

The culture aspect was simply the straw that broke the camel's back.

I got more OR time with more autonomy than almost anyone in my medical school class by the time 3rd year was done because of the combination of my rural surgery weeks (most people did family med rotations), and getting the community private practice group as opposed to the academic mothership (combined with the fact that my single solitary resident went on vacation during my month meant I got to do even more than most other students) and I still was a hard lean away from surgery after 4 weeks of gen surg because I just didn't love being in the OR. I promise, I really did give it a lot of consideration. Just not where I needed to be.

I think that's the most common and reasonable reason not to do surgery. If you don't love the OR, I can't see it being the best fit.

 

[dienekes88]

As an MS1. Watched some heart surgery. That was that.