To surgery or not to surgery

[Storph]

Hey all. Sorry if this is dumb or ignorant, but I don't know much about the subject.

I am interested in surgery for a career (my mentors and experiences are mostly surgically related), but of course I recognize that many people change their mind in medical school, and I am not even starting medical school until this fall. The big problem I have is that many of my family members have autoimmune diseases, and I am worried that I won't be able to pursue a surgical career because I could potentially develop Rheumatoid Arthritis later in life.

I have heard rumors that people can get insurance in case they develop a disease that prevents them from practicing. Is this a real thing, or should I avoid getting to into surgery as a field?

Thanks for the help everyone.

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[Winged Scapula]

1) no one has a crystal ball; if you have not been diagnosed with a degenerative disorder or a genetic mutation, it seems unwise to worry about something that is unlikely to ever happen
2) you will most likely purchase disability insurance; this is what most of us do, even without a family history of any potentially incapacitating diseases. It will provide coverage for you in the event of injury or disease (there will be coverage exceptions) which render you unable to practice.
3) moving to PA

 

[palatopharyngeus]

Hey all. Sorry if this is dumb or ignorant, but I don't know much about the subject.

I am interested in surgery for a career (my mentors and experiences are mostly surgically related), but of course I recognize that many people change their mind in medical school, and I am not even starting medical school until this fall. The big problem I have is that many of my family members have autoimmune diseases, and I am worried that I won't be able to pursue a surgical career because I could potentially develop Rheumatoid Arthritis later in life.

I have heard rumors that people can get insurance in case they develop a disease that prevents them from practicing. Is this a real thing, or should I avoid getting to into surgery as a field?

Thanks for the help everyone.

if you get the grades and scores for it, go for urology or ENT. both have a nice mix of surgery and clinic. if youre unable to perform surgeries in the future, you can just resort to being purely clinic-based

edit: interventional cards, optho, derm, and GI would be other good options. theyre not "surgical" specialties per say, but you can choose to do as many or as few procedures as youd like

bottom line is that you should go into a field where you can do as much surgical/procedural stuff as youd like, but a field where you can also get away with doing little to none, should that be necessary

 

[Winged Scapula]

if you get the grades and scores for it, go for urology or ENT. both have a nice mix of surgery and clinic. if youre unable to perform surgeries in the future, you can just resort to being purely clinic-based

edit: interventional cards, optho, derm, and GI would be other good options. theyre not "surgical" specialties per say, but you can choose to do as many or as few procedures as youd like

bottom line is that you should go into a field where you can do as much surgical/procedural stuff as youd like, but a field where you can also get away with doing little to none, should that be necessary

While unpalatable to most surgeons, planning for the possibility of a non-operative career is a good piece of advice.

I was just thinking about this the other day after discussing in another thread what surgeons do when they retire. I realized that I could fill my schedule with nonoperative breast complaints and still practice. I'll probably burn out after a few months because breast pain patients are crazy but I could still work (and collect disability).

 

[karayaa]

You could try for a office/outpt-based surgical specialty that includes medical aspects (ophth, urol, ob/gyn). Or you could just transition to academic medicine (admin, teaching, research) or do any of the other myriad non-clinical things that doctors can do.
Don't stress about it too much. You don't even know if you like working in the OR.

 

[karayaa]

if you get the grades and scores for it, go for urology or ENT. both have a nice mix of surgery and clinic. if youre unable to perform surgeries in the future, you can just resort to being purely clinic-based

edit: interventional cards, optho, derm, and GI would be other good options. theyre not "surgical" specialties per say, but you can choose to do as many or as few procedures as youd like

bottom line is that you should go into a field where you can do as much surgical/procedural stuff as youd like, but a field where you can also get away with doing little to none, should that be necessary

+Interventional rads.

 

[Storph]

Thanks for the advice guys! I hadn't really considered the fact that you could still practice non-operatively. I just assumed that you would have to switch specialties or do something like a new residency.

 

[Winged Scapula]

Thanks for the advice guys! I hadn't really considered the fact that you could still practice non-operatively. I just assumed that you would have to switch specialties or do something like a new residency.

You could but who wants to go back to residency including the lifestyle and the pay after earning an attending salary? Most people can't or won't.

 

[palatopharyngeus]

While unpalatable to most surgeons, planning for the possibility of a non-operative career is a good piece of advice.

I was just thinking about this the other day after discussing in another thread what surgeons do when they retire. I realized that I could fill my schedule with nonoperative breast complaints and still practice. I'll probably burn out after a few months because breast pain patients are crazy but I could still work (and collect disability).

are you a general surgeon? just curious

You could but who wants to go back to residency including the lifestyle and the pay after earning an attending salary? Most people can't or won't.

+1 the extra time and effort required to do that would be better spent in medical school trying to match into something like ENT or uro

 

[NeuResurgens]

if you get the grades and scores for it, go for urology or ENT. both have a nice mix of surgery and clinic. if youre unable to perform surgeries in the future, you can just resort to being purely clinic-based

edit: interventional cards, optho, derm, and GI would be other good options. theyre not "surgical" specialties per say, but you can choose to do as many or as few procedures as youd like

bottom line is that you should go into a field where you can do as much surgical/procedural stuff as youd like, but a field where you can also get away with doing little to none, should that be necessary

Could neurosurgeons perhaps transition into neurologists?

 

[ridethecliche]

@Winged Scapula , I work with a few surgeons that retired from the OR. They work way less and essentially do the first few visits and manage patients. If they're operative cases, they refer them to another surgeon in the practice. If they're not, they manage their conservative therapy.

This is for spine, but it's interesting all the same. It allows a practice to Bill more than they could for a PA, but allows a surgeon to keep working.

Might be worth considering.

 

[ridethecliche]

To whomever said IR...

Um. If your hands aren't steady enough to operate, you probably shouldn't be sticking needles in people...

 

[Winged Scapula]

Could neurosurgeons perhaps transition into neurologists?

No.

Neurology and Neurosurgery are two totally different training paths. The former and the latter may know quite a bit about each other fields, but it would unlikely that you could get credentialed at a hospital to admit and treat patients without evidence of having formal training in Neurology, as a Neurosurgeon.

 

[Winged Scapula]

are you a general surgeon? just curious

I completed a general surgery residency followed directly by a breast surgical oncology fellowship. I do not do any general surgery.

+1 the extra time and effort required to do that would be better spent in medical school trying to match into something like ENT or uro

This sounds as if you are propagating the hoary myth that general surgeons are simply those who did not spend the "extra time and effort" and couldn't match into ENT, Uro etc.

 

[Winged Scapula]

@Winged Scapula , I work with a few surgeons that retired from the OR. They work way less and essentially do the first few visits and manage patients. If they're operative cases, they refer them to another surgeon in the practice. If they're not, they manage their conservative therapy.

This is for spine, but it's interesting all the same. It allows a practice to Bill more than they could for a PA, but allows a surgeon to keep working.

Might be worth considering.

Definitely.

Perhaps you missed the other thread in which we talk about what surgeons do when they retire. Surgical assisting is very popular, however, it cannot be done if you are disabled (ie, referencing back to the OP's query) and still claim disabilty insurance pay out.

Last week I had a surgical assist who was a wonderful retired GS from DC in his late 60s. He had a winter home out here and decided to retire her and do GS cases a couple of times a week. I inquired about doing spine and other ortho, as I'm aware that it pays quite a bit more than GS cases, and his response was that he hated those cases and loved GS (thus poking a hole in the other myth that GS are just losers who couldn't compete for Ortho but really wanted to. Of course, back in his day, Orthopedics was not competitive at all).

 

[palatopharyngeus]

I completed a general surgery residency followed directly by a breast surgical oncology fellowship. I do not do any general surgery.

very cool. thanks for the response

This sounds as if you are propagating the hoary myth that general surgeons are simply those who did not spend the "extra time and effort" and couldn't match into ENT, Uro etc.

not at all. what I'm trying to say is that if the OP wants to go into a field where surgery is possible but not mandatory, then ENT and uro are ideal, and that he/she is better off spending that time and effort NOW (i.e. during med school) than going back and doing it 20 years down the line.

i do apologize for any misunderstanding, and agree 100% with you that the idea of people going into gen surg b/c they couldn't match into other surgical subspecialties is naive and immature, to say the least

 

[Winged Scapula]

very cool. thanks for the response

Sure.

not at all. what I'm trying to say is that if the OP wants to go into a field where surgery is possible but not mandatory, then ENT and uro are ideal, and that he/she is better off spending that time and effort NOW (i.e. during med school) than going back and doing it 20 years down the line.

True. There are general surgical fields where there is a lot of office time as well; you just have to be able to figure out your niche.

i do apologize for any misunderstanding, and agree 100% with you that the idea of people going into gen surg b/c they couldn't match into other surgical subspecialties is bullsh*t

No worries or apologies needed. We get sensitive sometimes.

 

[palatopharyngeus]

No worries or apologies needed. We get sensitive sometimes.

it also doesn't help that intent is hard to communicate over the internet

 

[superdoc2.0]

Hey all. Sorry if this is dumb or ignorant, but I don't know much about the subject.

I am interested in surgery for a career (my mentors and experiences are mostly surgically related), but of course I recognize that many people change their mind in medical school, and I am not even starting medical school until this fall. The big problem I have is that many of my family members have autoimmune diseases, and I am worried that I won't be able to pursue a surgical career because I could potentially develop Rheumatoid Arthritis later in life.

I have heard rumors that people can get insurance in case they develop a disease that prevents them from practicing. Is this a real thing, or should I avoid getting to into surgery as a field?

Thanks for the help everyone.

Medicine is probably not for you, plus there is a large surplus of doctors. I would suggest going to law school, with such a shortage of lawyers your pay would be better and you job security greater.

 

[NYCdude]

Can someone comment on ENT residency? Is it more or less brutal than GS?

 

[ridethecliche]

Definitely.

Perhaps you missed the other thread in which we talk about what surgeons do when they retire. Surgical assisting is very popular, however, it cannot be done if you are disabled (ie, referencing back to the OP's query) and still claim disabilty insurance pay out.

Last week I had a surgical assist who was a wonderful retired GS from DC in his late 60s. He had a winter home out here and decided to retire her and do GS cases a couple of times a week. I inquired about doing spine and other ortho, as I'm aware that it pays quite a bit more than GS cases, and his response was that he hated those cases and loved GS (thus poking a hole in the other myth that GS are just losers who couldn't compete for Ortho but really wanted to. Of course, back in his day, Orthopedics was not competitive at all).

I think it depends on how much you care about calling pain consults for problem patients. There are a lot of drug seekers in ortho spine and ortho in general. You canmake it someone else's problem...

As a spine patient myself, I love this patient population. It's really tough sometimes and I see the PAs and attending physicians really frustrated with it.

Retiring from the OR and doing triage and management for ortho spine is really valuable here. It means that the surgeons get more operative cases and don't have to see misreffered patients.