to be or not to be...

[bottomlesspit]

...a surgeon. that is the question. i'm a third year med student, and while my first two years i was committed (intellectually, at least) to med-peds, i absolutely fell in love with my general surgery rotation. the adrenaline, expertise, craft, and breadth and depth of knowledge all took my breath away. but now that i'm more than halfway through my third year, i'm disappointed to say that surgery seems to attract the most naysayers of any residency out there.

everyone i've run into tells me, "if ANYTHING ELSE makes you even the least bit happy, do that. don't do surgery." even surgery residents and PD's tell me this! i've spoken with a surgery resident who survived intern year, only to switch to another field, claiming that surgery was too stifling. my surgery chief resident told me that 20% of GS residents change their minds. comments? thoughts? as a forewarning, i'm new to this board, and will be posting a lot re: surgery. i have tons of questions, and want to get a feel for different people's answers ... thanks in advance!

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[Dock In A Box]

You just have to look at yourself and decide what you want and do it. Yes, surgery residency will be tough and if you have a family it might reduce the amount of time you get to spend with them. However, if you love surgery, you have to do it. Why would you want to settle for something else that you wouldn't enjoy as much just because you THINK the lifestyle of surgery will be bad.

 

[Leukocyte]

...surgery seems to attract the most naysayers of any residency out there.

everyone i've run into tells me, "if ANYTHING ELSE makes you even the least bit happy, do that. don't do surgery." even surgery residents and PD's tell me this!

"Naysayers"!!!!! These are people who have actually BEEN THERE!!!! Who are we to act all tough and "matcho", and be-little their advice?

As a 30 year old, If life had tought me one thing it would be to listen to the advice of the MAJORITY of the people who have "been there, done that".

How we view surgery now as medical students and residents WILL CHANGE once we become attendings. This is true for ANY profession.

The real question should be is how do you see yourself 20-30 years from now. What do you think your priorities will be when you are 40 and 50 years old? Are you willing to wake up at 4am in the morning when you are 50 years old to do an emergency appendectomy? When the re-embursments for general surgery procedures fall down, are you still willing to practice surgery at the age of 50, and put in long hours to make ends meet knowing that the Anesthesiologist on the other side of the curtain is making 3x a surgeon's average income?

Disclamier: I am a "pending" undesignated prelim surgery intern for the year 2007 who is yet to experience the long hellish road to categorical surgery. Did I think long and hard, and eliminated every possible medical specialty before throwing my self to the sadistic surgical attendings? You bet.

My thought process was like this:

-I do not like to treat patients medicaly, or via a catheter (I am not a flea)
-I am not welcome in OB/GYN as a Male (It is a chick's world)
-I do not have the "stats" to go into a surgical subspecialty like Orthopedics, ENT....
-I am left with General Surgery

That is the price I have to pay for being an IMG. Regardless, I will be VERY GRATEFULL if I became a General Surgeon...It is still better than being a Cardiologist of a Gastroenterologist.

Good Luck!

 

[Winged Scapula]

The tendency for surgery residents and attendings to discourage medical students, and even their own children, from pursuing a surgical career, has several factors in its etiology:

1) by discouraging students, only the most committed will pursue surgery

2) by discouraging students, you might be able to offer some insight into "what its really like".

Its a time-worn tradition, one that I experienced as did others before me. I honestly believe that you have to be committed to the field to be able to survive the training and the field beyond residency/fellowship. Surgery does have a high attrition rate and some wags are predicting that it will increase as those who think they can enjoy surgery now with the work hour restrictions realize:

1) many places do not adhere/enforce work hour restrictions

2) 80+ hours is still miserable and exhausting, especially if you are not committed to the field and absolutely cannot see yourself doing something else.

Do not forget that besides the work hours and the enormous amount of information required in residency, it is often true that surgeons and the training in the field, are harsher than others. Many of the most socially inappropriate and worst teachers I've ever met are surgeons. Even if you could stand the workhours, the amount of studying outside of work required, it is extremly emotionally draining to work day after day, year after year, without positive reinforcement, without anything even approaching human kindness.

We try and discourage you because we know what the training is like - if you are truly committed and you can't see yourself doing anything else, then you should pursue a career in surgery. As far as declining reimbursements go, the pay is still good, and frankly, if you don't know any different (ie, your salary didn't decline from 20 years ago), it shouldn't make any difference. I will admit that there is a limit to this however; I've seen newly minted CT surgeons making $10 K/year more than the service PA (who is making $95 K/year). These are CT surgeons from prestigious programs...now that is depressing.

At any rate, take the "advice" for what its worth, assess the source and really decide if you would still go through a surgery residency if there weren't work hour restrictions (in many places that appears to be the case), if you can find solace in yourself and/or a SO, and can be flexible as the field changes.

 

[McAllenHopeful]

"My thought process was like this:

-I do not like to treat patients medicaly, or via a catheter (I am not a flea)
-I am not welcome in OB/GYN as a Male (It is a chick's world)
-I do not have the "stats" to go into a surgical subspecialty like Orthopedics, ENT....
-I am left with General Surgery"

Calling medicine people "fleas" and saying OB-GYN is a "chick's world," then quoting Matt 7:1? Seriously??

 

[mcindoe]

That is the price I have to pay for being an IMG. Regardless, I will be VERY GRATEFULL if I became a General Surgeon...It is still better than being a Cardiologist of a Gastroenterologist.

__________________
”Judge not, that ye be not judged. For with what judgment ye judge, ye shall be judged: and with what measurement ye mete, it shall be measured to you again."
- Matthew 7:1

and what do you know about what life would be like as a cardiologist or a gastroenterologist? and that it's inferior to a career in general surgery?

it's ironic...borderline pathetic...that you chose that quote (Matthew 7:1) after writing one of the most judgmental, ignorant posts i've seen in a while.

well fear not...you'll know soon enough what it feels like to be judged when your applications are headed straight to the "rejection" bin because you're a FMG and PDs tend to be judgmental when it comes to evaluating anything that is "foreign" to them. and you have quite some nerve scoffing at cardiologists and gastroenterologists...you obviously don't know how competitive it is to get a fellowship in one of these fields, and being an FMG, it's even farther out of your reach.

make sure on graduation day you don't mix up some words and say the "hypocritical oath" instead of the "hippocratic oath".

 

[footcramp]

this joker isn't worth your energy. he's been posting emo crap for like two years about how general surgery sucks. if it's so bad why is he applying undesignated prelim? that shows he's a confused mental case.

 

[Winged Scapula]

If you'll read leukocyte's previous posts, you'll see that a Prelim year in Surgery is not his first choice; he simply believes he will not match into a categorical position.

Nevertheless, there is no reason to be insulting to other users. Please keep things civil here folks.

 

[Tigger14]

...a surgeon. that is the question. i'm a third year med student, and while my first two years i was committed (intellectually, at least) to med-peds, i absolutely fell in love with my general surgery rotation. the adrenaline, expertise, craft, and breadth and depth of knowledge all took my breath away. but now that i'm more than halfway through my third year, i'm disappointed to say that surgery seems to attract the most naysayers of any residency out there.

everyone i've run into tells me, "if ANYTHING ELSE makes you even the least bit happy, do that. don't do surgery." even surgery residents and PD's tell me this! i've spoken with a surgery resident who survived intern year, only to switch to another field, claiming that surgery was too stifling. my surgery chief resident told me that 20% of GS residents change their minds. comments? thoughts? as a forewarning, i'm new to this board, and will be posting a lot re: surgery. i have tons of questions, and want to get a feel for different people's answers ... thanks in advance!

Kimberli is right... if you are not 100% committed, you may not make it through a surgery residency. It seems from this and other posts that her experiences parallel a lot of mine... inhumane teachers, lack of education, no social skills among educators, and a brutal working environment.

There are MANY times I have wondered if it was worth it, and as I have posted before, times when only my student loans stood between me and a resignation and a job at Starbucks.

It should not be like this, and does not have to be like this, but no matter how carefully you educate yourself about residency choices, it is difficult and unfortunately, "should be" and "reality" are not very close to each other in surgical education.

Search the threads, you will find more discussion on this topic. In the meantime, good luck, and PM me if you need more advice or a sounding board. I was in your spot 5 years ago...

 

[MD Dreams]

Dr. Cox,

Because general surgery has such a high attrition rate, would you say that it's fairly easy to switch into a spot from a different residency program if one was inclined to do so? Thank you.

 

[Winged Scapula]

Dr. Cox,

Because general surgery has such a high attrition rate, would you say that it's fairly easy to switch into a spot from a different residency program if one was inclined to do so? Thank you.

Fairly easy? No. But it is possible - most attrition takes place during the first year, but others will drop out later in residency. At times I see ads for PGY3 and 4 positions that are open. A little too late to switch from a different specialty, but if you were so inclined, to change programs...

Bear in mind that since most people would drop out after PGY1, the open position would be as a PGY2, so if you don't have a PGY1 year in a surgical program, your chances of getting the PGY2 spot would be rather slim.

 

[Leukocyte]

I apologize to those who missunderstood what I was trying to say. Just to clarify:

-I love surgery (that is why I am going through hell to become a surgeon).

-I am a "joker"...meaning I am not a serious person. When I say "chicks" and "fleas", I am doing so to lighten up moods...not to make fun off women or "medicine" folks.

-When I said "It is still better than being a Cardiologist or a Gastroenterologist" I was refering to MY SELF...not that GS is better/worse than cardiology. Again, for me....GS is more interesting than Cardiology/GI.
Is it wrong for me to prefer a field over another? By choosing surgery over IM, am I wrongfuly judging IM?

please just ignore me.

Good Luck.