The Lifestyle Factor. Residents? Attendings?

[MNMD123]

M3 here.

I've been debating career choices and it's hard to know how much to weigh lifestyle in. I've been interested in Surgery in the past, and honestly might be most proud of myself for becoming a surgeon. That said, I think everyone would draw the line somewhere--i.e., at some point, no matter who you are, additional hours and stress are not worth it. I mean, hell, I could just choose another specialty...it's ridiculous to think I just couldn't be happy doing anything else...but I just might always wonder...I have never been afraid to put myself on the line, but considering how priorities can change as you get older, and it is hard to turn back, it is somewhat intimidating.

Any resident or attending thoughts or advice? Thank you

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[badasshairday]

Lifestyle is important. Maybe asome a 20 something you think you can work all night and weekends easy... someday you may have a family of your own and won't want to be in the hospital at 3 am when you are 40 years old.

 

[Dr.Smexy]

All the surgeons I talked to are either very happy with their work or extremely bitter/miserable (haven't come across middle in the road of happiness surgeons yet). However, all of them have one thing in common which is that they all told me if I can see myself doing any other non-surgical specialty than do exactly that and don't look back. If you are not one of the unlucky few who fall in love with surgery deeply then it's not worth it man. Who wants to spend more time with nurses, techs, and anesthesiologists than your own family...

 

[Gymnast89]

Our surgery clerkship director advises uncertain students to do a radiology elective early in M4 year. Some students fall in love and are thrilled to discover that there are better ways to live than waking up at 4 am to hold retractors and deal with butt pus. Other students lose their freakin minds sitting in the reading room diagnosing things but not being able to actually fix the problem.

Sounds like a goofy strategy but really did help my roommate and a lot of our classmates figure it out.

 

[MNMD123]

Thanks everyone. Good advice. I think things become a bit more clear with each rotation.

 

[J ROD]

The question is "Do you want to cut or not?

That simple. And then think about being in the OR.

 

[bonedrone14]

You may have already figured it out for yourself, but since I asked a million people myself, I'll give the best advice I got.

What would you do for free? Or to put it another way, what would you pick if someone told you that anything you wanted could be your job? Playing video games? Cutting people open? For me, it was spending time with my family. I'd do that for free all day every day. I liked surgery but liked spending time with my wife and kids more. So then I looked for a specialty where I enjoyed the work/pathology/patients but gave me time to do the thing I enjoyed most in life. When youre truly happy, you'll take better care of your patients.

As medical students it's easy to get the idea that our career must be our greatest passion and fulfillment. For some of us it is. For others of us, it's not, and that can leave you feeling like there's something wrong with you until you realize that it's ok. Going to work and taking good care of your patients, then going home and doing your true passion is ok. I think, at least at my school, that was looked down on. Maybe you've already figured this out or found your own way. I know I struggled hard and felt like there was something wrong since I wasn't like the other people who got to the hospital at 4 am and were like "zomg! I get to hold this guy's leg while someone slices it open!!" Different strokes for different folks.

Just be honest with yourself about what you truly enjoy in life. This is your life and no one else's, so make sure you find what is important to you, whether that's in the OR, somewhere else in the hospital, or evenot outside the med center.

 

[gregoryhouse]

You may have already figured it out for yourself, but since I asked a million people myself, I'll give the best advice I got.

What would you do for free? Or to put it another way, what would you pick if someone told you that anything you wanted could be your job? Playing video games? Cutting people open? For me, it was spending time with my family. I'd do that for free all day every day. I liked surgery but liked spending time with my wife and kids more. So then I looked for a specialty where I enjoyed the work/pathology/patients but gave me time to do the thing I enjoyed most in life. When youre truly happy, you'll take better care of your patients.

As medical students it's easy to get the idea that our career must be our greatest passion and fulfillment. For some of us it is. For others of us, it's not, and that can leave you feeling like there's something wrong with you until you realize that it's ok. Going to work and taking good care of your patients, then going home and doing your true passion is ok. I think, at least at my school, that was looked down on. Maybe you've already figured this out or found your own way. I know I struggled hard and felt like there was something wrong since I wasn't like the other people who got to the hospital at 4 am and were like "zomg! I get to hold this guy's leg while someone slices it open!!" Different strokes for different folks.

Just be honest with yourself about what you truly enjoy in life. This is your life and no one else's, so make sure you find what is important to you, whether that's in the OR, somewhere else in the hospital, or evenot outside the med center.

That describes what I'm going through exactly. For the past month I have felt completely destroyed because I thought I was destined to be a surgeon and now I am not so sure. For me its partially the time and length of residency but much more than that was the complete lack of passion I felt going through my rotations. Not one thing I've done so far has made me go wow I definitely want to do this everyday regardless of the cost.

On IM I took great care of my patients, wrote great notes, and genuinely did my best, yet I really didn't feel any fulfillment from it. I think part of this was that I wasn't the one who had the responsibility of these patients lives in my hands. I'm sure the interns and residents do feel like they accomplish things and get their fulfillment that way but as an observer I didn't feel anything. Yet, a lot of my classmates became even more sure of their choices over this time frame and that made me feel like something was wrong with me.

I have continually felt worried that I entered the wrong profession because nothing in it so far excites me. Surgery definitely seems awesome and I haven't rotated through it yet but losing my passion in all the other rotations makes me doubt if surgery is right for me. I've began to think a lot about ophthalmology as a career, but it feels so different than my initial thought of what kind of doctor I would be that its hard to feel like I'm making the right choice. I constantly go back and forth between ophthalmology and surgery because its hard for me to give up on my initial dream I had coming in. I'm hoping my plastics rotation next week sparks some passion back into me.

 

[operaman]

No easy answers to this question. Medicine seems to do a great job of showing us what we hate, but is often more elusive when it comes to finding something we want to do for 30-40 years. It's also hard to judge how much you'll like something when doing it is no longer new and exciting. Also beware the pied piper effect where a particularly great faculty or set of residents can make a field seem more appealing than it would be under other circumstances. Ditto for the reverse - don't exclude a field you thought you'd like based on one rotation as you might feel very differently after a different one.

 

[Merely]

No easy answers to this question. Medicine seems to do a great job of showing us what we hate, but is often more elusive when it comes to finding something we want to do for 30-40 years. It's also hard to judge how much you'll like something when doing it is no longer new and exciting. Also beware the pied piper effect where a particularly great faculty or set of residents can make a field seem more appealing than it would be under other circumstances. Ditto for the reverse - don't exclude a field you thought you'd like based on one rotation as you might feel very differently after a different one.

Good to see you back and posting!

 

[bonedrone14]

That describes what I'm going through exactly. For the past month I have felt completely destroyed because I thought I was destined to be a surgeon and now I am not so sure. For me its partially the time and length of residency but much more than that was the complete lack of passion I felt going through my rotations. Not one thing I've done so far has made me go wow I definitely want to do this everyday regardless of the cost.

On IM I took great care of my patients, wrote great notes, and genuinely did my best, yet I really didn't feel any fulfillment from it. I think part of this was that I wasn't the one who had the responsibility of these patients lives in my hands. I'm sure the interns and residents do feel like they accomplish things and get their fulfillment that way but as an observer I didn't feel anything. Yet, a lot of my classmates became even more sure of their choices over this time frame and that made me feel like something was wrong with me.

I have continually felt worried that I entered the wrong profession because nothing in it so far excites me. Surgery definitely seems awesome and I haven't rotated through it yet but losing my passion in all the other rotations makes me doubt if surgery is right for me. I've began to think a lot about ophthalmology as a career, but it feels so different than my initial thought of what kind of doctor I would be that its hard to feel like I'm making the right choice. I constantly go back and forth between ophthalmology and surgery because its hard for me to give up on my initial dream I had coming in. I'm hoping my plastics rotation next week sparks some passion back into me.

I feel you. It's tough for sure. I was in your shoes this time last year (I'm am m4). I came to med school sure I was going into surgery. It fit my big man on campus personality that I'd had through high school and college. I was "that guy" or at least I thought so. So letting go of surgery when I realized it wasn't for me was really hadd. It was an ego check. It was painful even, not just letting go of this dream I'd had of what my life would be, but actually having it right there in front of me and turning my back on it all. It stung. I felt like I didn't know who I was, cause I'd been the ortho jock guy for so long. Then I did a lot of introspection like I alluded to my post above. I found what I really wanted in life and then found something that fit with that. So I submitted my rank list today for psych. It was tough going from the "popular" specialty to one that's often seen as for IMGs and weird people. It was a big hit to my pride at first, as vain as that sounds. But man, it felt right. I actually enjoyed work duringy ai. I never enjoyed any thing else in med school. When you let the pressure of what you THINK you should do go and find what you WANT to do, life feels awesome again. I didn't realize how depressed I'd actually been during 3rd year till I felt like myself again in 4th year. I know I'm writing novels here, but I felt so lost during all of this and felt like I was the only one in the spot I was in that I want to do anything I can to help those behind me going through the same thing. Feel free to pm me if you want. I won't push psych on you or be anti surgery. Good luck!

 

[Tenk]

If you aren't in love with surgery, don't do it.

If you are doing it to make yourself "proud," for sure don't do it...

 

[WingedOx]

The question is "Do you want to cut or not?

That simple. And then think about being in the OR.

well the cutting, hammering, and drilling of Ortho was awesome...

...but surgeons get up so damn early. No thanks.

 

[Law2Doc]

... Also beware the pied piper effect where a particularly great faculty or set of residents can make a field seem more appealing than it would be under other circumstances. Ditto for the reverse - don't exclude a field you thought you'd like based on one rotation as you might feel very differently after a different one.

I would actually say embrace this pied piper effect-- most of us are strongly influenced along the way by dynamic mentors who really enjoy what they are doing and inspire us to be just like them. Conversely if a field is full of people you feel are jerks, it might not be the one for you. Yes this can skew your views on a field, and you'll see a lot of people from a particular program going into X because they have the best mentors and avoiding Y because of the opposite. But I think that's the natural order of the profession -- people are drawn to the field that's a "fit" as much as a field they "want".

 

[Merely]

I would actually say embrace this pied piper effect-- most of us are strongly influenced along the way by dynamic mentors who really enjoy what they are doing and inspire us to be just like them. Conversely if a field is full of people you feel are jerks, it might not be the one for you. Yes this can skew your views on a field, and you'll see a lot of people from a particular program going into X because they have the best mentors and avoiding Y because of the opposite. But I think that's the natural order of the profession -- people are drawn to the field that's a "fit" as much as a field they "want".

Are you in IM?

 

[ACSurgeon]

This is a very difficult topic to give or get advice on. Anyone who makes it seem easy has no insight. You can't decide on specialty based on "do you like to spend more time at the hospital vs. at home. As an attending, you'll have enough control of your lifestyle, even in general surgery.

Surgery is freakin' sweet. Even on days that I'm exhausted, jaded and feeling like I need a break/vacation, it doesn't take much to remind me how much better surgery is (for me). Example: I see medicine residents coming to work at 8 am, then proceed to spend most of the day in a work room talking/calling consults/writing notes. I'm happy to come an extra 2 hours early and get to operate… I came to med school to be a physician. I feel like a physician by diagnosing and personally managing problems medically and surgically. Unique satisfaction.

I'm not sure that the notion of "don't do surgery unless it's the only thing you can see yourself doing" is meaningful. For one thing, some people have better insight than others. Some eagerly come to absolute conclusions without good reason (i.e. third year med student who proclaims that surgery is the only thing I can be happy doing). Also, you won't really know the gratification of becoming a surgeon until you walk down that path. You also won't realize the mental/social/physical toll that it takes to train to be a surgeon, until you walk down that path. So, it's healthy to not be confident that surgery is the only thing you can see yourself doing as a student.

You have to be excited (not just willing) to work hard. You have to pride yourself in your handwork. If you dread working hard, you won't make it through residency. After all, the long hours are NOT the reason that surgical training is hard. So, that has to be a non-issue.

Those excited to hold retractors or hold a leg as someone else operates are naive. As a senior resident, I'm just now beginning to appreciate watching someone else operate, because I've done that type of case several (dozen) times before, and it's nice to see a skilled surgeon do the case to learn some of the subtle aspects of making it smooth. If you're a medical student excited to watch your 10th gallbladder, that doesn't mean you're destined to be a surgeon.

Finally, there is no shame in realizing that your decision is made based upon a small amount of information that likely paints a biased picture. Again, a little uncertainty is normal and healthy.

 

[Psai]

I think long hours make a big difference. It's disheartening to come in by 6, spend all day at the hospital, leave at 8 and get a quick dinner before sleeping every day. It was hard to read and have a life because I was too tired to want to do anything. I know the residents were doing much more than me and I didn't complain but it definitely affected me

 

[URMD]

This might sound naive, but from my experience shadowing surgery my biggest gripe is how long you spend standing. I mean, how the hell do you guys stand for 4-5 hours straight with no break?? 2 hours in my feet and back were killing me and by the time i got home i had to literally soak my feet in a bowl of warm water, and even then the pain did not dissapear for another hour.

 

[URHere]

The best way to know which specialty is right for you is to rotate through as many things as possible, preferably well before ERAS opens so you still have the chance to overhaul your app if you need to.

One of my biggest gripes with our current training model is that so many schools (including my own) don't have any real elective time until MS4 year. I went through MS3 liking most things (with the exception of OB and surgery), but I didn't find anything I really LOVED until I hit my PICU rotation in Fall of MS4. I went through an EM rotation this spring and had a very similar reaction, to the point where I think I would have been perfectly happy applying in EM if I had discovered it earlier. Thank god I ended up applying in a specialty where both PICU and Peds EM remain open to me as fellowships (Med-Peds), but I came so close to applying IM-only and I think I would have really regretted that decision knowing what I know now. Ultimately, all you can do is pick the thing that feels most right to you and hope it works out in the end.

 

[Psai]

This might sound naive, but from my experience shadowing surgery my biggest gripe is how long you spend standing. I mean, how the hell do you guys stand for 4-5 hours straight with no break?? 2 hours in my feet and back were killing me and by the time i got home i had to literally soak my feet in a bowl of warm water, and even then the pain did not dissapear for another hour.

I've stood for 12 hours in a row in the or before
aint no thang

 

[PhillyMed777]

This might sound naive, but from my experience shadowing surgery my biggest gripe is how long you spend standing. I mean, how the hell do you guys stand for 4-5 hours straight with no break?? 2 hours in my feet and back were killing me and by the time i got home i had to literally soak my feet in a bowl of warm water, and even then the pain did not dissapear for another hour.

Although I understand what you are saying, I think you could benefit from some total body conditioning. 2 hrs isn't that much.

 

[Slack3r]

A few things:

-Sometimes there is "good" sore and "good" tired. I like that feeling after a long day in the OR. Means I actually did something that day.

-Standing v operating. When you're actually doing the operation it feels a lot different. I don't notice the time and then all of a sudden I look at the clock and 2 hours have gone by.

-Ergonomics are really important. Workplace injuries among surgeons are common and underreported/recognized. I know a frightening number of surgeons who've had neck fusions, elbow and wrist surgery, etc. It's also really hard to work on as a resident because few take it seriously and you often have to cater to your attendings' whims. But if you can develop good ergonomic habits it makes a big difference. I do a much better job now of not hunching over or stressing one side of my body than I used to (have a bad habit of putting almost all my weight on one leg most of the time when I'm standing).

-Compression stockings and good shoes are huge.

How do you go about learning good ergonomics? I feel like I'm always hunching and already feel like my neck is taking a beating as a student.

 

[ACSurgeon]

I think long hours make a big difference. It's disheartening to come in by 6, spend all day at the hospital, leave at 8 and get a quick dinner before sleeping every day. It was hard to read and have a life because I was too tired to want to do anything. I know the residents were doing much more than me and I didn't complain but it definitely affected me

This might sound naive, but from my experience shadowing surgery my biggest gripe is how long you spend standing. I mean, how the hell do you guys stand for 4-5 hours straight with no break?? 2 hours in my feet and back were killing me and by the time i got home i had to literally soak my feet in a bowl of warm water, and even then the pain did not dissapear for another hour.

For those who know the long hours or physical stress is too much for them, they shouldn't do surgery. My point was to say these issues are usually not the reason people quit. It's the stress and challenges of training that make it impossible for some.

Things are much better as a resident. You have a defined role. You gradually get more respect and autonomy. You get to operate. For most residents, getting to operate makes everything else worthwhile. The problem is, depending on your program, you might not operate much for the first 2-3 years. That can make the first half of residency miserable.

 

[ACSurgeon]

I've stood for 12 hours in a row in the or before
aint no thang

And that's why you chose to be on the other side of the drapes

 

[Psai]

And that's why you chose to be on the other side of the drapes

Other side, best side

 

[URMD]

I'm a 6ft 200lb guy who works out pretty often, I would say I'm in pretty good shape, at least I thought so - maybe I should work on my posture?? I dont know; and i'm too embarrased to ask residents/attendings in real life because it doesn't seem like anyone talks about it, when I ask my other medical students they concur with me but i dont know how residents feel about it.

I've heard that optho and urology do surgery sitting down alot, is this true?

I dont think "good" sore is me hobbling back to my apt after a day of shadowing in the OR so I don't think its that.

What makes a shoe "good"? the arch?? are there popular shoes you guys wear that are reliable to help with standing?

 

[DubVille]

I'm a 6ft 200lb guy who works out pretty often, I would say I'm in pretty good shape, at least I thought so - maybe I should work on my posture?? I dont know; and i'm too embarrased to ask residents/attendings in real life because it doesn't seem like anyone talks about it, when I ask my other medical students they concur with me but i dont know how residents feel about it.

I've heard that optho and urology do surgery sitting down alot, is this true?

I dont think "good" sore is me hobbling back to my apt after a day of shadowing in the OR so I don't think its that.

What makes a shoe "good"? the arch?? are there popular shoes you guys wear that are reliable to help with standing?

Hand surgery. Unfortunately you just need to get through general, plastics, or ortho first. But at the end of the tunnel is a glorious stool.

That last sentence wasnt a metaphor for poo, btw.

 

[Optimus-Prime]

foot and ankle tends to be pretty quick... there are always exceptions though

 

[NickNaylor]

Lifestyle was pretty critical in my decision-making for my ultimate field. I loved surgery and could see myself as a surgeon in another life but there's no way that I would choose that lifestyle. I was initially going to do pediatrics but when I found that I enjoyed psychiatry just as much if not more than pediatrics, I chose the kushier psych residency and overall practice lifestyle over pediatrics (in addition to other reasons).

Some fields just suck with respect to lifestyle, and if that's where your heart is then you'll have to accept that or redirect your heart to something else. But I certainly wouldn't discount lifestyle, both immediately and 10, 20, 30 years down the line when you're actually out in practice. If you're one of the folks that doesn't subscribe to the "medicine is the pinnacle of my life" philosophy, then it's completely valid to think about things like lifestyle so that you can have a family, do the things you want to do that fulfill you outside of your work, etc.. But if that sort of thing is of importance to you, you also need to understand that that prioritizing will, by necessity, impact your career options. Alternatively, if you love something enough that a crappy lifestyle seems doable, then that's fine, but, again, you should do as much as you can to understand the choice that you're making and accept it.

I wouldn't choose a field strictly based on lifestyle, but if you have interests in multiple fields and are looking for a way to choose among them, lifestyle would certainly be (and was, in my case) high on my list of things to think about.