Switching into Surgery

[Womper]

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Anybody ever heard of anybody doing this?

I'm in PGY1 medicine right now. I like the actual medicine but really frustrated with the amount of social work and bullcrap I have to spend most of my time doing. I love the time I get to spend acutally doing medical work, talking to patients, examining them, doing procedures, running codes, talking to families etc. I don't mind working hard. I also miss working with my hands. Have been thinking about switching into Surgery. Maybe its just the intern blues or the preception that the grass is always greener, but I feel like the surgery residents spend more time doing, and when its time to deal with social issues, or finding a dialysis site they just punt to medicine. I don't think these things arn't important, just not what I went to medical school to do. As far as I can tell, this doesn't really get better as I move up residency years in medicine.

Advice? Anybody ever heard of anybody doing this?

 

[mercaptovizadeh]

Anybody ever heard of anybody doing this?

I'm in PGY1 medicine right now. I like the actual medicine but really frustrated with the amount of social work and bullcrap I have to spend most of my time doing. I love the time I get to spend acutally doing medical work, talking to patients, examining them, doing procedures, running codes, talking to families etc. I don't mind working hard. I also miss working with my hands. Have been thinking about switching into Surgery. Maybe its just the intern blues or the preception that the grass is always greener, but I feel like the surgery residents spend more time doing, and when its time to deal with social issues, or finding a dialysis site they just punt to medicine. I don't think these things arn't important, just not what I went to medical school to do. As far as I can tell, this doesn't really get better as I move up residency years in medicine.

Advice? Anybody ever heard of anybody doing this?

I'm not at or beyond your training level, so this may be advice of limited value, but here goes. I think internal medicine is too diverse of a field for you not to be able to enjoy it. You probably went into it because you enjoyed the breadth and diagnostic aspects. General surgery has good (but lesser) breadth and diagnosis, but it's just an entirely different approach to the problem. You really have to like surgery a lot for it to be worth devoting your life to it. Why not look into a more procedural subspecialty of IM, like CC or GI?

Documentation is everywhere. The pathologists who love to study disease and the radiologists who love different imaging modalities all have to deal with extensive documentation. If you want to avoid as much documentation, you may want to consider international medicine. You can practice the full scope of medicine in an international/developing world setting, and no one will expect anywhere nearly as rigorous documenting, social work, or CYA as we have here in the US.

 

[Winged Scapula]

Please note that your experience may be institutionally dependent.

During my surgical residency, we did not "punt" social work issues or finding dialysis sites to medicine. WE did the dialysis access and we consulted social work, had family meetings (especially in the SICU), talked to PT, case managers, etc.

Switching fields to do less paperwork/social work is a horribly shortsighted decision: I do more and more paperwork and social work stuff as an attending in a surgical PP than I ever did as a resident. Perhaps if I was in academic medicine I could have punted talking to the Case Manager about post op home health for my 92 yo to a resident, but someone would still have to do the work. This will be the case for IM as well.

Please do not be fooled into thinking surgery does less paperwork. As a matter of fact, given the potentially higher litigation in some fields, there may be more documentation required.

So, no I've never heard of someone switching from IM to Surgery to do less bull****. There is BS in EVERY field of medicine.

 

[Top Gun]

I'm not a surgeon, but during my surgery rotations in med school, the surgery interns did have to deal with social work issues. You're going to find plenty of social work BS in surgery too. Why not just stick with internal medicine, and do a procedural subspecialty like gastroenterology. As a gastroenterologist, you're primarily acting as a consult, so you probably won't have to deal with the social work crap that the PCP does.

 

[Smurfette]

Approximately 1 day on the trauma service would give you social work issues you never dreamed of that surgery residents have to deal with on a daily basis.

Unless you love the idea of operating in an OR, for hours every day, switching to surgery from IM is a bad idea. There is still BS, and some of the BS may be different, but is no less annoying.

 

[SouthernSurgeon]

Approximately 1 day on the trauma service would give you social work issues you never dreamed of that surgery residents have to deal with on a daily basis.

This.

My favorite was the trauma patient w/ massive intracranial injuries who was intubated and we needed to discuss withdrawal of care...except their DPOA also had a restraining order taken out against them by the patient...

 

[LucidSplash]

This.

My favorite was the trauma patient w/ massive intracranial injuries who was intubated and we needed to discuss withdrawal of care...except their DPOA also had a restraining order taken out against them by the patient...

Seconded. Or the one who walked away from his psychiatric halfway house and intentionally walked in front of a bus. Multiple bilateral lower extremity fractures, some level of brain injury (though tough for us to tell what was baseline and what was injury). Psychiatric places wouldn't take him because of his non-weight bearing status, skilled nursing/rehab wouldn't take him because of his lack of insurance (and his history), no one would consider a charity bed because of the history of self-harm, and there was no family. We tried arguing that chances of future incidents using his preferred method of self-injury were negated by his inability to walk... no such luck.

The nurses would put him in the hallway in a chair because he yelled "Help me!" every 15 seconds or so. He was in the hospital about 3-4 months before we managed to find a psych place to take him...

 

[45408]

Honestly, I don't know of anyone who has switched into surgery from another field. I'm sure it happens, but it's not common.

 

[Dejavu]

Reading this thread, I am so glad there is none of this "social services" crap in anesthesiology.

 

[Raryn]

Honestly, I don't know of anyone who has switched into surgery from another field. I'm sure it happens, but it's not common.

I know a fair few that have gone the other direction though. Ranging from going to anesthesia to medicine to psychiatry (what a change!)

 

[cabinbuilder]

Honestly, I don't know of anyone who has switched into surgery from another field. I'm sure it happens, but it's not common.

I switched from traditional rotating intern year/FP into general surgery.

Spent one week there. TOTALLY HATED THE RESIDENCY PROGRAM, not surgery

Went back to family practice where it was happier.

 

[peppy]

I switched from traditional rotating intern year/FP into general surgery.

Spent one week there. TOTALLY HATED THE RESIDENCY PROGRAM, not surgery

Went back to family practice where it was happier.

Wow, it's pretty unusual for someone to switch and then switch back. Were you able to switch back into the program you left or did you have to find a new program?

 

[cabinbuilder]

Wow, it's pretty unusual for someone to switch and then switch back. Were you able to switch back into the program you left or did you have to find a new program?

I went back to the same program. They let me know when I left that I was always welcome to come back so it was easy. The hard part was trusting the surgery program to release me from my contract so I wouldn't have to wait a year. I think they were tired of watching me cry everyday so let me go without too much grief.

 

[ShyRem]

I know someone who was in pathology and switched to surgery.... and is a totally awesome, nice, intelligent, outstanding surgeon who is very happy they dd so.

Now that aside, you are basing your decision on just a few months into a residency. You may want to wait and get a flavor for other rotations. I know more than a few people who didn't like most medicine rotations but absolutely loved the ICU. They live for the ICU, and those ICU months and calls made the rest of residency worth it for them.

Wait for a little bit and see what else medicine has to offer that you might like. Every program has social problems and telephone calls that will drive you insane.

 

[Dral]

Don't forget the medicine specialties that are more 'doing' like GI.

Have fun as a fellow on consults though. Again, as everyone else has said, more BS.

Ps, I'm not a GI fellow, I just saw what they had to deal with where I did my intern year.

I'm in Derm and we have the BS stuff too, pt's with cancers that don't show up for appointments that we have to keep up with, belligerent HIV patients demanding their Sculptura, spending hours on the phone calling in prior auths for meds that aren't covered because they're 'for cosmetics' with complainy pants patients on the other line who don't want to pay for meds out of pocket. It's not as bad as intern year social issues, but they're still there.