Surgery or bust attitude

Started by Anicetus
Get help with your application

Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.

Browse articles Compare schools My application plan Read Interview Feedback
Practice for interviews Ask an Advisor
Anicetus

Anicetus

Full Member
10+ Year Member
Hey all, just looking for quick insight. So I believe almost being halfway through third year, my passion really is surgery and I honestly cannot see myself doing all the other stuff in medicine. This frightens me for a couple reasons:
Really just an average joe in medical school. No honors, slightly above average Step 1 score. Research but no publications. Clubs but nothing life changing. Lower ish tier US MD school.

This isn't so much a WAMC thread as much as a thread where I'm asking if it's okay to have an attitude that is along the lines of surgery or bust at this point in the game. I'm at the point where if I cannot do surgery i would rather not even practice medicine or do it part time at the most. Is this a calling or just a realization that I made the wrong choice to go to medical school in the first place?
I have kept an open mind and even shamed surgery before for lifestyle, but who am I kidding. Medicine in general (primary care, inpatient hospital care, clinic follow ups) just bores me to death and I have such a short attention span for it. Especially with the long complex cases in internal medicine where we mince over every electrolyte and past hospital visit blah blah. Meanwhile I just can't wait to just finally get my hands dirty (or sterile) get into the OR and cut all day, to be frank. I get it, there is clinic in surgery, I know. Am I alone on this or did I make a 6-figure mistake?
 
Anicetus said:
Hey all, just looking for quick insight. So I believe almost being halfway through third year, my passion really is surgery and I honestly cannot see myself doing all the other stuff in medicine. This frightens me for a couple reasons:
Really just an average joe in medical school. No honors, slightly above average Step 1 score. Research but no publications. Clubs but nothing life changing. Lower ish tier US MD school.

This isn't so much a WAMC thread as much as a thread where I'm asking if it's okay to have an attitude that is along the lines of surgery or bust at this point in the game. I'm at the point where if I cannot do surgery i would rather not even practice medicine or do it part time at the most. Is this a calling or just a realization that I made the wrong choice to go to medical school in the first place?
I have kept an open mind and even shamed surgery before for lifestyle, but who am I kidding. Medicine in general (primary care, inpatient hospital care, clinic follow ups) just bores me to death and I have such a short attention span for it. Especially with the long complex cases in internal medicine where we mince over every electrolyte and past hospital visit blah blah. Meanwhile I just can't wait to just finally get my hands dirty (or sterile) get into the OR and cut all day, to be frank. I get it, there is clinic in surgery, I know. Am I alone on this or did I make a 6-figure mistake?
Click to expand...
If you like the OR/acute medicine but dislike clinic and "shame surgery for lifestyle," have you considered anesthesia?
 
Carbocation1 said:
If you like the OR/acute medicine but dislike clinic and "shame surgery for lifestyle," have you considered anesthesia?
Click to expand...
Does the anesthesia forum send out an alert every time someone on this forum mentions lifestyle so they can be sure to come try to get people to switch into gas?

OP: Are you alone in what? Being surgery or bust? I think most of us that are going into surgery made up our mind during third year, largely due to liking surgery much better than anything else. I wouldn't quite call myself general surgery or bust, maybe surgical specialty or bust though.

And it seems like you would be reasonably competitive to match somewhere assuming you apply broadly and intelligently and have decent letters, so worrying about having made a six figure mistake seems unwarranted.
 
Carbocation1 said:
If you like the OR/acute medicine but dislike clinic and "shame surgery for lifestyle," have you considered anesthesia?
Click to expand...

The OP "wants to cut". You guys need to stop assuming the surgical mentality means we just like "being in the OR". The OR is where we get to do the things we enjoy; it's not the cause of our enjoyment.


OP the time to have a conversation about whether you made a mistake is if you don't match, you try a couple of cycles, and refuse to accept anything except a surgical career. There's nothing wrong with having a "surgery or bust" attitude right now; as a matter of fact I would say that it's expected of you at this point.

Sent from my iPhone using SDN mobile
 
Carbocation1 said:
If you like the OR/acute medicine but dislike clinic and "shame surgery for lifestyle," have you considered anesthesia?
Click to expand...

Maybe I wasn't clear, but I mean that I USED to look down on surgery cuz of horrible lifestyle. Now that doesn't even matter to me anymore since anything in those "lifestyle specialties" feels like stabbing my own eye out for 40 hours a week. As for anesthesia it seems incredibly boring to me unfortunately and I would just be trying to get a good look at the action.

Thanks for the responses. So would it be okay to say that I have no plan B for surgery and that I would rather be an actor than have to do something other than surgery?
 
There are many other specialties that have tons of procedures and a way superior lifestyle to general surgery

Consider all your options by looking over all possible specialties

I dont think you would have an issue matching if you have an above general surgery average step 1 even if the other parts of your cv are mediocre. there are 1000 spots in gen surg and the difference in application between the very top and bottom is huge
 
bannie22 said:
There are many other specialties that have tons of procedures and a way superior lifestyle to general surgery

Consider all your options by looking over all possible specialties

I dont think you would have an issue matching if you have an above general surgery average step 1 even if the other parts of your cv are mediocre. there are 1000 spots in gen surg and the difference in application between the very top and bottom is huge
Click to expand...
Procedures does not equal operating. Cath lab, endo suite, ir suite, those things don't interest me at all as a surgeon. I can get satisfaction out of doing a difficult line or an emergent chest tube, but those aren't surgeries to me.
 
thedrjojo said:
Procedures does not equal operating. Cath lab, endo suite, ir suite, those things don't interest me at all as a surgeon. I can get satisfaction out of doing a difficult line or an emergent chest tube, but those aren't surgeries to me.
Click to expand...
I dont disagree
op is still young and should fully explore those options before going all in though
In addition different specialties have different surgeries all necessitating a slightly different skill set and techique
Ideally anyone deciding on gen surg shud def explore the other surg subspecialties and also proxedural specialties
 
Seriously am I the only one that doesn't think my "lifestyle" or "quality of life" is bad? I LIKE what I do. I enjoy my work. I like my time off too, but it's not like I'm suffering through my worklife waiting for the weekend off. It's not like I don't know what to do with myself when I'm not at the hospital but I chose this because it's what I love to do. Bemoaning "lifestyle" isn't something that happens if you honestly enjoy your work.
 
LucidSplash said:
Bemoaning "lifestyle" isn't something that happens if you honestly enjoy your work.
Click to expand...

Completely agree. We recently started interviews for the year, and applicants always ask me if I like where I'm at. I tell them that in 6+ years, there hasn't been a day where I'm unhappy to be going to work. Sure, there are days I'm tired or disappointed I'm missing a specific event, but on balance I find it totally worth it. I certainly would not trade that for a situation where I felt my job was just something I did to facilitate my outside activities, but felt ambivalent about what I was actually doing.
 
Dr.LeoSpaceman said:
Completely agree. We recently started interviews for the year, and applicants always ask me if I like where I'm at. I tell them that in 6+ years, there hasn't been a day where I'm unhappy to be going to work. Sure, there are days I'm tired or disappointed I'm missing a specific event, but on balance I find it totally worth it. I certainly would not trade that for a situation where I felt my job was just something I did to facilitate my outside activities, but felt ambivalent about what I was actually doing.
Click to expand...

Exactly. I've definitely had days where I did not want to go to work (I'm looking at you peds surgery rotations). But EVERY job has days you're not looking forward to sometimes. I have coworkers I like less than others, I've had attendings I'd rather not scrub with. But there are equivalents in all jobs. On the whole, my job is pretty awesome.

Maybe I have this perspective because I worked at a "regular job" for 3 years before going back to medical school. It was a good job. I worked 40-hours a week. Parts of it were mentally stimulating, others weren't. I liked the people I worked with, on the whole. It paid well and I was respected by my colleagues. The work was useful and important. There was room for advancement and growth. But I would never have wanted to do that every day for the rest of my life.
 
Last edited:
Gastrapathy said:
My General Surgery PD drinking buddy loves asking applicants about their "Plan B" if surgery doesn't work out. The right answer is a look of bafflement and then a stumbling nonsensical sentence.
Click to expand...

It has been a while, but I'm pretty sure that I told them that I'd find something else to do. Then again, when applying to medical school and they asked what I would do if I didn't go into medicine, I told them that I'd go to law school.
 
Anicetus said:
Hey all, just looking for quick insight. So I believe almost being halfway through third year, my passion really is surgery and I honestly cannot see myself doing all the other stuff in medicine. This frightens me for a couple reasons:
Really just an average joe in medical school. No honors, slightly above average Step 1 score. Research but no publications. Clubs but nothing life changing. Lower ish tier US MD school.

This isn't so much a WAMC thread as much as a thread where I'm asking if it's okay to have an attitude that is along the lines of surgery or bust at this point in the game. I'm at the point where if I cannot do surgery i would rather not even practice medicine or do it part time at the most. Is this a calling or just a realization that I made the wrong choice to go to medical school in the first place?
I have kept an open mind and even shamed surgery before for lifestyle, but who am I kidding. Medicine in general (primary care, inpatient hospital care, clinic follow ups) just bores me to death and I have such a short attention span for it. Especially with the long complex cases in internal medicine where we mince over every electrolyte and past hospital visit blah blah. Meanwhile I just can't wait to just finally get my hands dirty (or sterile) get into the OR and cut all day, to be frank. I get it, there is clinic in surgery, I know. Am I alone on this or did I make a 6-figure mistake?
Click to expand...

You literally wrote down what i've been feeling for the past 4-5 months now. I'm at the 50% point in M3 and i try so hard to get myself to enjoy other fields, but ultimately surgery keeps calling me back. I actually enjoyed showing up every day to my surgery rotation.. i can't tell if this is due to the awesome residents or the mostly cool faculty members but i genuinely had fun. Before this, my idea of fun in medical school was going home and playing video games, then grinding through whatever bs material i had to get through. I'm on a outpatient clinic rotation right now and the hours are decent but somehow 8 hours there feels like 14 vs. the 12-13 hours i had on surgery which for the most part went quickly. I too wonder if i'm choosing this for the right reasons but for now i'm following what feels right.
 
Hemorrage said:
I actually enjoyed showing up every day to my surgery rotation.. i can't tell if this is due to the awesome residents or the mostly cool faculty members but i genuinely had fun.
Click to expand...

This is one of the right reasons to choose any specialty. The fact that I "fit in" with the residents and attendings on my surgery rotations was an indication to me that I was making the right choice. Are you going to like everyone? Certainly not. But on balance, the fact that surgery attracts a certain personality type means you have a better chance of getting along with your co-workers.

The fact that you are keeping an open mind is the right thing to do. But if at the end surgery is still calling your name, don't talk yourself out of it (or let anyone else do so).
 
Dude, you need to chill out. There were over 800 gen surg spots in the 2016 match. Even the folks with board scores of 200-210 had an almost 50% chance of matching. You got a "slightly above average score" of 230-240 and you're looking at a 93% chance of matching. Over 80% were not AOA. Over 70% didn't go to a top 40 med school.

You're applying gen surg, not derm or rad onc. If you want it and are a middle of the road student, you'll get it - you might not be at The Brigham or Duke, but you can be a great general surgeon with a productive career. Lets say you're unlucky enough to be one of the 7 percent with your board scores that don't match, go do a prelim GS year and apply again. If there's one thing the surgeons I know appreciate, its hard work.

Seriously, breathe. I know med school is stressful, but you'll be fine.
 
TimesNewRoman said:
Dude, you need to chill out. There were over 800 gen surg spots in the 2016 match. Even the folks with board scores of 200-210 had an almost 50% chance of matching. You got a "slightly above average score" of 230-240 and you're looking at a 93% chance of matching. Over 80% were not AOA. Over 70% didn't go to a top 40 med school.

You're applying gen surg, not derm or rad onc. If you want it and are a middle of the road student, you'll get it - you might not be at The Brigham or Duke, but you can be a great general surgeon with a productive career. Lets say you're unlucky enough to be one of the 7 percent with your board scores that don't match, go do a prelim GS year and apply again. If there's one thing the surgeons I know appreciate, its hard work.

Seriously, breathe. I know med school is stressful, but you'll be fine.
Click to expand...

Well wait a second. First, thanks for the reply, I appreciate the insight as I'm pretty new to the residency application. Second, is that 7% that go unmatched really just due to bad luck? Or is it actually due to being too mediocre with nothing to show for? Or just simply making bad decisions like being 'Harvard surgery or bust' or only ranking like 5 places and being too picky on location?
 
Anicetus said:
Well wait a second. First, thanks for the reply, I appreciate the insight as I'm pretty new to the residency application. Second, is that 7% that go unmatched really just due to bad luck? Or is it actually due to being too mediocre with nothing to show for? Or just simply making bad decisions like being 'Harvard surgery or bust' or only ranking like 5 places and being too picky on location?
Click to expand...

Can't tell you for sure, but download charting the outcomes (it's free).

What I can say after interviewing candidates, a lot of pathology comes out.
 
SouthernSurgeon said:
I actually pretty much dislike everything about the OR EXCEPT operating. I don't like transporting patients around. I don't like placing IVs, foleys, bair-huggers, etc. I don't like standing there for minutes pre-oxygenating and waiting to intubate.
Click to expand...

I've considered sticking a #10 blade in my eye as I wait 15 minutes while watching 2-3 anesthesia providers untangle lines and hookup monitors to transfer the patient to a bed and get them out of the room.
 
Anicetus said:
Hey all, just looking for quick insight. So I believe almost being halfway through third year, my passion really is surgery and I honestly cannot see myself doing all the other stuff in medicine. This frightens me for a couple reasons:
Really just an average joe in medical school. No honors, slightly above average Step 1 score. Research but no publications. Clubs but nothing life changing. Lower ish tier US MD school.

This isn't so much a WAMC thread as much as a thread where I'm asking if it's okay to have an attitude that is along the lines of surgery or bust at this point in the game. I'm at the point where if I cannot do surgery i would rather not even practice medicine or do it part time at the most. Is this a calling or just a realization that I made the wrong choice to go to medical school in the first place?
I have kept an open mind and even shamed surgery before for lifestyle, but who am I kidding. Medicine in general (primary care, inpatient hospital care, clinic follow ups) just bores me to death and I have such a short attention span for it. Especially with the long complex cases in internal medicine where we mince over every electrolyte and past hospital visit blah blah. Meanwhile I just can't wait to just finally get my hands dirty (or sterile) get into the OR and cut all day, to be frank. I get it, there is clinic in surgery, I know. Am I alone on this or did I make a 6-figure mistake?
Click to expand...
Surgery or bust totally makes sense. One thing to realize though is ... surgeons are really good medical doctors first, particularly in critical care. We may not be in the best position to diagnose that rare zebra that comes in every few months ... for that go into medicine. But surgeons can out-doctor a medical doctor any day of the week in taking care of the general population that gets hospitalized.

Sent from my SM-G900V using SDN mobile
 
Favoritefarm said:
Surgery or bust totally makes sense. One thing to realize though is ... surgeons are really good medical doctors first, particularly in critical care. We may not be in the best position to diagnose that rare zebra that comes in every few months ... for that go into medicine. But surgeons can out-doctor a medical doctor any day of the week in taking care of the general population that gets hospitalized.

Sent from my SM-G900V using SDN mobile
Click to expand...

As a nonsurgeon, I'll say this: that attitude scares me.

I think it was on the MarylandCC project where someone said "a surgeon is an internist who finished training." I think that mentality is important. But I've seen several surgical resident (particularly surgical sub specialties) who assume that their competence in the OR translates to other areas. Pneumonia and ARDS and AKI are more complex than initially meets the eye. I've had plenty of surgical consultants come down to the ER or come to the ICU and say "do x and send them home/to the floor/wherever" without understanding the other medical conorbidities that preclude that from happening. That's why there are critical care fellowships. I have no doubt that a surgeon who does a CCM fellowship will "out-doctor" me in a SICU in many regards, but there are just some things that they won't be better than me at - reading EKGs, intubating, recognizing zebras, etc. That's not to elevate myself or put anyone down, it's just to say that we have different roles to play, just focus on being excellent in yours.

Also, I feel like this attitude seems to go away with surgical attendings for the most part. The ENT or trauma attendings tend to be quite happy for help with organizing pneumonia or bizarre acid-base disorders.
 
SouthernSurgeon said:
You know the other thing I find funny about the constant "If you like the OR, consider anesthesia" posts?

I actually pretty much dislike everything about the OR EXCEPT operating. I don't like transporting patients around. I don't like placing IVs, foleys, bair-huggers, etc. I don't like standing there for minutes pre-oxygenating and waiting to intubate.

I like operating. I like the OR because it's where I get to operate.
Click to expand...

MAFAT - "mandatory anesthesia futzing around time"

I suppose it's better than being an IM resident sitting in front of a computer, but still makes me want to gouge my eyes out.
 
TimesNewRoman said:
As a nonsurgeon, I'll say this: that attitude scares me.
...
Also, I feel like this attitude seems to go away with surgical attendings for the most part. The ENT or trauma attendings tend to be quite happy for help with organizing pneumonia or bizarre acid-base disorders.
Click to expand...

Agreed with both you and SouthernSurgeon. I think surgeons are pretty good at managing the straightforward critical care needs of patients that are common among surgical patients. Surgeons like to rag on the MICU (including myself) because they sometimes miss what is in our minds the obvious surgical diagnosis. However if you dropped me in a MICU/NICU to treat the other 95% of patients, I have no doubts that I would be out of my depth.

Critical care trained surgeons are the exception, assuming they still are routinely on service in an ICU. We have a fairly strong surgical critical care program and associated faculty, so I think we get fairly solid training in elements of surgical critical care. Through that lens it is interesting to see how critical care has passed by some of the faculty who have subspecialized in other areas. Fortunately, they all recognize this and are happy to let the ICU staff handle the details.

VisionaryTics said:
MAFAT - "mandatory anesthesia futzing around time"

I suppose it's better than being an IM resident sitting in front of a computer, but still makes me want to gouge my eyes out.
Click to expand...

I try not to let the waiting around bother me, but it's when there is seemingly no sense of urgency that I nearly lose it. I know it's nice to have a set schedule where you know you're out at 4pm, but please recognize that I'm going to be there until all the cases are done.
 
TimesNewRoman said:
As a nonsurgeon, I'll say this: that attitude scares me.

I think it was on the MarylandCC project where someone said "a surgeon is an internist who finished training." I think that mentality is important. But I've seen several surgical resident (particularly surgical sub specialties) who assume that their competence in the OR translates to other areas. Pneumonia and ARDS and AKI are more complex than initially meets the eye. I've had plenty of surgical consultants come down to the ER or come to the ICU and say "do x and send them home/to the floor/wherever" without understanding the other medical conorbidities that preclude that from happening. That's why there are critical care fellowships. I have no doubt that a surgeon who does a CCM fellowship will "out-doctor" me in a SICU in many regards, but there are just some things that they won't be better than me at - reading EKGs, intubating, recognizing zebras, etc. That's not to elevate myself or put anyone down, it's just to say that we have different roles to play, just focus on being excellent in yours.

Also, I feel like this attitude seems to go away with surgical attendings for the most part. The ENT or trauma attendings tend to be quite happy for help with organizing pneumonia or bizarre acid-base disorders.
Click to expand...
We'd have some patients that got scary bad in the SICU in my old career where I was just screaming in my head "FOR THE LOVE OF GOD CALL A PULM/CC CONSULT," but the surgeons were just too into having total ownership of their patients to do so. I don't know if it was arrogance or pride or what, but it was frustrating, particularly when patients were taking that turn past surgical and into medical because they'd been kicking around the unit so long.
 
Dr.LeoSpaceman said:
I've considered sticking a #10 blade in my eye as I wait 15 minutes while watching 2-3 anesthesia providers untangle lines and hookup monitors to transfer the patient to a bed and get them out of the room.
Click to expand...
I'm a fellow at an academic center that has a policy that the resident/fellow must stay to transport the patient to the PACU and give signout and I've had no less than a dozen >1hr wakeups because of an inexperienced CRNA or Anesthesia resident this year. I spend like 12 hrs/day in the OR and am averaging like 16 hr days most of the time in fellowship....its SUPER FUN to sit there for >1hr at 8pm waiting for the patient to wake up. My frustration is not helped by 6 other anesthesiologists coming in, hanging out, and cracking jokes for the entire hour like its watercooler time. Hey its cool I didnt wanna eat today, no worries
 
VisionaryTics said:
MAFAT - "mandatory anesthesia futzing around time"

I suppose it's better than being an IM resident sitting in front of a computer, but still makes me want to gouge my eyes out.
Click to expand...

Trust me, it can't be any worse than watching a surgical resident take 4 hours to do a 30 minute procedure
 
Dr.LeoSpaceman said:
I've considered sticking a #10 blade in my eye as I wait 15 minutes while watching 2-3 anesthesia providers untangle lines and hookup monitors to transfer the patient to a bed and get them out of the room.
Click to expand...

Anesthesia here peeking from behind the curtain. Trust me we hate it more, it's obnoxious - we'd rather be out quickly too. But as you know, a professional, please refrain from asking about ridiculous things like urine output or crystalloid totals when we are moving the patient from bed to bed or extubating. Happens at least 2-3x per week.

Certain specialties (mostly gen surg) even come up to help with moving the patient over - love that. Others do absolutely nothing and watch - I'd rather these people just leave and do things in preop/PACU (and many do).

vhawk said:
its SUPER FUN to sit there for >1hr at 8pm waiting for the patient to wake up.
Click to expand...

I sympathize, thankfully it doesn't happen too often and now that we have Sugammadex it happens much less ("ZERO TWITCHES for closure ANESTHESIA!"). Also the surgeon that did that left, thankfully. But we have the same reaction when it's 8 or 10 PM and the student/intern/newbie is subcuticular closing a large wound - watching paint dry or my weeds grow is more enthralling.
 
AdmiralChz said:
Anesthesia here peeking from behind the curtain. Trust me we hate it more, it's obnoxious - we'd rather be out quickly too. But as you know, a professional, please refrain from asking about ridiculous things like urine output or crystalloid totals when we are moving the patient from bed to bed or extubating. Happens at least 2-3x per week.

Certain specialties (mostly gen surg) even come up to help with moving the patient over - love that. Others do absolutely nothing and watch - I'd rather these people just leave and do things in preop/PACU (and many do).



I sympathize, thankfully it doesn't happen too often and now that we have Sugammadex it happens much less ("ZERO TWITCHES for closure ANESTHESIA!"). Also the surgeon that did that left, thankfully. But we have the same reaction when it's 8 or 10 PM and the student/intern/newbie is subcuticular closing a large wound - watching paint dry or my weeds grow is more enthralling.
Click to expand...

That surgeon needs to learn how to sew before the patient exsanguinates from them sucking
 
You must log in or register to reply here.