Surgery as a second residency?

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tabibintraining

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How feasible would it be to do a second residency in surgery?

I was really set on CT surgery during medical school but did not do well during either preclinicals or clinicals. I remediated two blocks in my preclinical years and straight P's in clinicals. My Step 1 score was in the high 230's after I spent 10 hours a day, every day, for 3 months studying. I ended up deciding to do psychiatry, frankly because I didn't think I could cut it any other field. Then psychiatry residency started and I started falling behind there too. Rather than put me on probation like my medical school did, my program worked with me and I had psychological testing done. Clear cut case of severe ADHD, inattentive type. My IQ tested out to the mid 140's; I had managed to compensate for my ADHD easily through grade school, with some effort through college, and then IQ just couldn't compensate for ADHD in medical school. Once I started getting treated, it was a night and day difference. I breezed through the rest of residency, scored in the 90th percentile on all of my in service training exams. Just to prove to myself I could, I applied to a top fellowship program, got in and graduated from there.

I've been working as a psychiatrist now and am established, make decent money, have a good lifestyle. But there's always that thought in the back of my head that if I had gotten help as a medical student or even in college, I would have gone down a completely different route. I was deadset on CT surgery for the longest time. I enjoy psychiatry but it's never been a passion of mine.These last few months, with Covid, have made me wonder if I really want to do this the rest of my life.

I'm wondering whether there's any chance of me going back to do a second residency in surgery. I would be in my late 30's by the time I would start. Would any program even consider my application?

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You can try. Worst they will say is no and reject you. Are you really ready to give up on what you have and go back to the bottom of the totem pole, draining anal cysts at 3am?
 
You can try. Worst they will say is no and reject you. Are you really ready to give up on what you have and go back to the bottom of the totem pole, draining anal cysts at 3am?

I've definitely gone back and forth on whether it's worth it but I'd say I'm about 70% there in terms of deciding it is. Just want to know if it's even a realistic possibility.
 
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I've definitely gone back and forth on whether it's worth it but I'd say I'm about 70% there in terms of deciding it is. Just want to know if it's even a realistic possibility.
I’m not sure anyone can tell you one way or another. My biggest fear if I was your program director would be that you quit when you realize the training sucks, go back to the sweet world of being your own boss and mess up my call schedule for 5 years. You probably could match somewhere if you apply broadly enough and have good references. CT surg is competitive though and it might be an uphill battle for you to secure that fellowship or get an integrated residency. Worst case scenario, would you be willing to be a general surgeon over a psychiatrist?
 
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I’m not sure anyone can tell you one way or another. My biggest fear if I was your program director would be that you quit when you realize the training sucks, go back to the sweet world of being your own boss and mess up my call schedule for 5 years. You probably could match somewhere if you apply broadly enough and have good references. CT surg is competitive though and it might be an uphill battle for you to secure that fellowship or get an integrated residency. Worst case scenario, would you be willing to be a general surgeon over a psychiatrist?

Honestly, if I didn't get into CT fellowship, I probably would go back to practicing psychiatry. Gen surg would be a pay cut for something I'm not passionate about.
 
Honestly, if I didn't get into CT fellowship, I probably would go back to practicing psychiatry. Gen surg would be a pay cut for something I'm not passionate about.
Then no. You should not pursue. You can apply to integrated programs and if you match then great but I have a hard time seeing that working out. I have no data on that, just a feeling. Those are wildly competitive and regardless of what you are now, you're stuck with the stats you had then.
 
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I wouldn’t do it but that’s just me.

Do you have a family or plan to have one? Surgical training is long days, long years. Then, once you start as an attending you spend the next 5-10 years solidifying your skills. If you prefer psych over general surgery then my biased opinion is that you’re not really passionate about CT surgery, it’s more of a fantasy.
 
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I still think about retraining in general or vascular surgery from time to time but honestly my gig is too good to pass up.

the way medicine, especially academic medicine is set up, makes retraining exceedingly difficult. You gotta uproot your whole life to do so.
 
Sometimes I have thoughts of wanting to be a neurosurgeon. Or an engineer. Or a musician. Or a beach bum. But these are just fantasies at the end of the day. Life is a game of choice, and you've made yours, no matter how perfect or imperfect.

I'm not saying you can't or shouldn't go back into training but you gotta be ready for the consequences of that decision.

Are you ready to pull 100-120 hour weeks consistently for 1/4 or less of your current pay?
Are you ready for possibly NOT getting into CT surgery fellowship and potentially wasting 5 yrs in gen surg residency?
Are you ready for attendings, fellows, and even your more senior residents to **** on you constantly?
Are you ready for some 27 year old know-it-all to boss you around with no regard for your previous life experience and acquired wisdom?
Are you ready for no one to give a **** that you are a board-certified, attending psychiatrist with years of real-world experience (because very little of that will matter to 99% of people you interact with)?
Are you ready for the increased cost, not just to your bank account, but to your health and body in terms of increased stress, accelerated aging, and higher risk of CV disease?
Are you ready to give up eating lunch or sometimes dinner, most days of the week?
Are you ready to go through the entirety of training and finally become a CT surgeon just to realize that you are a mediocre surgeon with mediocre outcomes?
Are you ready for the responsibility of killing people or failing to save their lives because you made a thoughtless but well-intentioned mistake?

CT surgery is no joke. You discussed your intelligence and abilities but is that backed up by passion and drive for the field? Unless you are willing to answer yes to all of these questions, you very well may find yourself wondering why you decided to leave a great, cushy job in psychiatry to do this.
 
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