Surgery versus family medicine

[daffodildog]

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To get straight to the point: I wanted to be a surgeon. Statistically I should have matched. I did the sub-Is, had the letters, had the interviews, somehow I fell through the cracks. I did not match. This broke my heart. (My board scores were on the low end of surgery applicants, so I think this played a big part.) But after seeing prelims on the interview trail and how desperate they seemed, I promised myself I would not go that route. I am 30 years old, I did not want to spend a year of life for the small chance that I would actually match next year. So I SOAPed family medicine. I like preventative medicine, I am passionate about it. So I thought I could be happy with this course. Now I am struggling. And grieving that I will not be able to work in the OR. I find myself about to start a residency that actually don't know much about and not sure I want to do it. I am posting on this thread because I WANT to be excited about family medicine. Any advice about the directions a family medicine doctor can go, or in a broader sense, wisdom to help me cope with these circumstances, would be much appreciated.

 

[samac]

I’m sorry you lost your preferred specialty. Surgery can be hard for DOs and I completely understand not wanting to do prelim years.
not all procedures are lost though if you like procedures. You could have a clinic doing mainly procedural work, preventative medicine is also great. You are going to be able to have a much better work life balance. It’ll be ok. 🙂

 

[deleted407021]

Hey, sorry about the match. A lot of that process is sheer luck, or lack thereof. You'd be a great surgeon, I'm sure. You'll be an equally excellent FM doc. Samac is right about procedures. FM is renowned for its flexibility. For instance, there are FM docs who do fellowships in advanced OB and get extra training in C/S, tubals and other procedures.

 

[nofliesonme]

Dear Daffodildog,
I am sorry to hear you did not match into a surgical residency. As a mature, seasoned (old) surgeon, I would caution you about some of the above advice. Non-surgeons commonly think doing procedures substitutes for surgical decision making.. Most good surgeons do not regard themselves as technicians. In many surgical specialties almost every patient needs a different plan. It's commonly said that you can teach anyone to operate in 6months....the reason surgical residencies take 5-8 years is the need to learn surgical judgment. I think the real issue here is your need to self reflect and understand who you are and what you want. You say you are passionate about preventative medicine.....then do that. A surgical practice is completely different. This (unless there are family issues) is your choice and looks pretty clear.......and that's part of the surgical mentality making choices. Hoping it all works out for you.

 

[Splenda88]

It's hard for me to envision someone who is passionate about general surgery being happy doing FM... Of course, it can happen but I would not count on it.

 

[hallowmann]

It's hard for me to envision someone who is passionate about general surgery being happy doing FM... Of course, it can happen but I would not count on it.

I know multiple people that failed to match surgery (or even Ortho) and even did prelim surgery, then went on to do FM and they're doing fine. They have a better work-life balance than they would have and are able to spend a lot of time and enjoy other parts of their lives because of it.

OP, I even know people that were in GenSurg residencies and left them to do FM, EM, or IM. The truth is that general surgery has one of the highest attrition in residency as far as specialties go (on the order of 20%). If you can introspectively say that you could be happy anywhere other than the OR, you'll be fine. If you like clinic, then this makes it all the better.

I would recommend starting this year motivated to be the best resident you can be. You may not be spending all your time in the OR, but there really is a lot of versatility in medicine in general and Family Medicine specifically. I'd like to think most people could find a niche that would make them happy.

 

[daffodildog]

Dear Daffodildog,
I am sorry to hear you did not match into a surgical residency. As a mature, seasoned (old) surgeon, I would caution you about some of the above advice. Non-surgeons commonly think doing procedures substitutes for surgical decision making.. Most good surgeons do not regard themselves as technicians. In many surgical specialties almost every patient needs a different plan. It's commonly said that you can teach anyone to operate in 6months....the reason surgical residencies take 5-8 years is the need to learn surgical judgment. I think the real issue here is your need to self reflect and understand who you are and what you want. You say you are passionate about preventative medicine.....then do that. A surgical practice is completely different. This (unless there are family issues) is your choice and looks pretty clear.......and that's part of the surgical mentality making choices. Hoping it all works out for you.

Thank you. I think a lot of self-reflection is needed. I am struggling because I was 100% convinced that the sacrifices needed to be a surgeon, were worth it. I loved being in the OR, even into the early morning. And enjoyed spending time with surgeons, the way they think and their decision making process. One of the biggest reasons that I love surgery is that the doctor steps in to fix the problem, instead of trying to convince the patient to make the best decision for themself. So I am having to somehow completely change my thinking and my identity.
On the other hand I also like preventative medicine and nutrition. I do not like working in the clinic but maybe this will change as I take more of the doctor role instead of the medical student role. I like procedures but minor clinic procedures pale in comparison the beautiful anatomy on display in the OR. So like you were saying I am not sure that increasing the clinic procedures will help me. However I am thinking about going the OB route. Being able to C/s would be incredible.
So much to think about.

 

[Sardonix]

What Hallowmann said.

You mentioned that you don't know much about your residency. First step is to change that.

What electives are available?
What procedures will you be trained in on?
Where do program graduates end up? Cities? Small towns?
What do graduates end up doing? Any fellowships or tendency to focus on one niche over others?
Is it an unopposed or opposed program?

FM is so vast and versatile, answering these questions will hopefully show you various paths you could take. I know you're grieving from the match--understandably so. But all is not lost!

 

[Sardonix]

Thank you. I think a lot of self-reflection is needed. I am struggling because I was 100% convinced that the sacrifices needed to be a surgeon, were worth it. I loved being in the OR, even into the early morning. And enjoyed spending time with surgeons, the way they think and their decision making process. One of the biggest reasons that I love surgery is that the doctor steps in to fix the problem, instead of trying to convince the patient to make the best decision for themself. So I am having to somehow completely change my thinking and my identity.
On the other hand I also like preventative medicine and nutrition. I do not like working in the clinic but maybe this will change as I take more of the doctor role instead of the medical student role. I like procedures but minor clinic procedures pale in comparison the beautiful anatomy on display in the OR. So like you were saying I am not sure that increasing the clinic procedures will help me. However I am thinking about going the OB route. Being able to C/s would be incredible.
So much to think about.

Literally just posted this on another thread, but I feel it's appropriate here too. Sorry for the information overload:

The List

September 2019 – advancedfamilymedicine

1 post published by sstringfield during September 2019

advancedfamilymedicine.wordpress.com

 

[daffodildog]

I know multiple people that failed to match surgery (or even Ortho) and even did prelim surgery, then went on to do FM and they're doing fine. They have a better work-life balance than they would have and are able to spend a lot of time and enjoy other parts of their lives because of it.

OP, I even know people that were in GenSurg residencies and left them to do FM, EM, or IM. The truth is that general surgery has one of the highest attrition in residency as far as specialties go (on the order of 20%). If you can introspectively say that you could be happy anywhere other than the OR, you'll be fine. If you like clinic, then this makes it all the better.

I would recommend starting this year motivated to be the best resident you can be. You may not be spending all your time in the OR, but there really is a lot of versatility in medicine in general and Family Medicine specifically. I'd like to think most people could find a niche that would make them happy.

Thank you! That is my goal. I want to be a sponge and learn as much as I can, so I can go whatever direction I want to in this speciality. I need to focus on the positives, that I will have a better work-life balance. I am married and my husband, who has been completely supportive, is relieved in the sense that I will have more time to spend with the family.

 

[daffodildog]

Literally just posted this on another thread, but I feel it's appropriate here too. Sorry for the information overload:

The List

September 2019 – advancedfamilymedicine

1 post published by sstringfield during September 2019

advancedfamilymedicine.wordpress.com

Thank you! This is exactly what I am looking for!

 

[You shall know the Truth]

I’m sorry to hear.
How is the location you soaped into? Is there any other benefit about the program, people, curriculum that you can be excited about?

 

[deleted831695]

Meh, screw those residencies. They lost out on a great physician. Channel that passion to now building relationships and impacting the lives of your patients over-long term.

You'll have a shorter residency with (likely) better hours. You may not make a surgeon's salary, but you can easily earn $200k+ with great work-life balance, so you'll live comfortably and have time for your family and for life outside medicine.

 

[daffodildog]

I’m sorry to hear.
How is the location you soaped into? Is there any other benefit about the program, people, curriculum that you can be excited about?

As far as I know it was one of the better options to SOAP into, it is affiliated with a larger university so I may be able to make some connections. I honestly need to learn more about it though. I have been so focused on surgery I don't know much about what makes a good family program.

 

[You shall know the Truth]

As far as I know it was one of the better options to SOAP into, it is affiliated with a larger university so I may be able to make some connections. I honestly need to learn more about it though. I have been so focused on surgery I don't know much about what makes a good family program.

I wish you the best

 

[Billroth_III]

To get straight to the point: I wanted to be a surgeon. Statistically I should have matched. I did the sub-Is, had the letters, had the interviews, somehow I fell through the cracks. I did not match. This broke my heart. (My board scores were on the low end of surgery applicants, so I think this played a big part.) But after seeing prelims on the interview trail and how desperate they seemed, I promised myself I would not go that route. I am 30 years old, I did not want to spend a year of life for the small chance that I would actually match next year. So I SOAPed family medicine. I like preventative medicine, I am passionate about it. So I thought I could be happy with this course. Now I am struggling. And grieving that I will not be able to work in the OR. I find myself about to start a residency that actually don't know much about and not sure I want to do it. I am posting on this thread because I WANT to be excited about family medicine. Any advice about the directions a family medicine doctor can go, or in a broader sense, wisdom to help me cope with these circumstances, would be much appreciated.

Really sorry to hear about your current situation and wish you all the best. I'm sure you will end up where you want to be whether it was part of the original plan or not. How many programs did you apply to if you don't mind me asking?

 

[daffodildog]

Really sorry to hear about your current situation and wish you all the best. I'm sure you will end up where you want to be whether it was part of the original plan or not. How many programs did you apply to if you don't mind me asking?

82

 

[Spectreman]

Had some convos with OP. Just want to say in this forum that OP is top notch. Did all the right things, just wasn’t in the cards to do GS. I go to church with an FM doc that did the same thing, he said he doesn’t regret one bit his choice to soap into FM. He works in the hospital at Broward, also runs 2 walk-in clinics. He lives a great life, married with 3 girls. He thought he’d do the OB thing and go practice rural, but quickly realized that all of medicine is incredibly rewarding. OP is gonna do great things.

 

[Dr. Death]

It's hard for me to envision someone who is passionate about general surgery being happy doing FM... Of course, it can happen but I would not count on it.

This is the attitude of someone with an external locus of control who wouldn't be happy doing anything. There are a lot of great things about family medicine. The relationships you foster with your patients are unparalleled and your scope of practice is the same. Salaries can be excellent and depending where you work you could work outpatient, inpatient, obstetrics, peds, academics, sports medicine, emergency medicine, direct primary care as well as doing a whole host of procedures from vasectomies and biopsies to c-sections and wound care. There's something in that list for basically everyone that went to med school.

Sorry you're in this position but keep your chin up and you'll find happiness and fulfillment in your career.

 

[daffodildog]

Had some convos with OP. Just want to say in this forum that OP is top notch. Did all the right things, just wasn’t in the cards to do GS. I go to church with an FM doc that did the same thing, he said he doesn’t regret one bit his choice to soap into FM. He works in the hospital at Broward, also runs 2 walk-in clinics. He lives a great life, married with 3 girls. He thought he’d do the OB thing and go practice rural, but quickly realized that all of medicine is incredibly rewarding. OP is gonna do great things.

Thank you! I really appreciate this!

 

[SurgeDO]

I am a surgical subspecialty resident. I was like you as a pre-med and medical student. I was fortunate enough to match.

However, now that I am a couple years in, the excitement of the OR and surgery has become duller. While I love what I do and would pick this career again, I’ve come to realize that this career isn’t what fulfills me.

I’m sorry you didn’t match, OP. If I were in your shoes as a 4th year medical student, I could understand the disappointment. However, you will be fine. If my career didn’t go down the surgery road, I would still be happy. Surgery isn’t everything—despite what you may think right now.