unsure 4th year- help!

[varicella]

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I fell in love with surgery during my 3rd year clerkship. I loved being in the OR, I got a lot of positive feedback from the surgery residents and attendings, and I found myself to be very comfortable doing things with my hands. I didn't mind the long hours, they flew by. I did a 4th year general surgery elective and even though it was mostly bread and butter cases I really enjoyed it and thought surgery was for me.

Then I did my required E-med rotation at a busy level 1 trauma center. The whole month all I heard was the lifestyle of surgery sucks, be sure you know what you are getting into. There were two ER attendings who said they actually were in surgical training programs but switched out because they couldn't take the lifestyle or at least didn't want to (it was before the 80hr limit). I went into the ER rotation thinking I was only going to enjoy seeing the trauma cases, which I did, but I also enjoyed the rest of my shifts as well. I liked the fast pace, I liked never knowing what was going to come in next, and I have to admit it was nice being able to go home at the end of a shift if I wanted to. All of this combined with constantly hearing, "you want to go into surgery- ha, better you than me" or "do you not plan on having kids" etc. really has me worried.

I remember the first several times of being in the OR was absolutely thrilling. The first time I got a femoral central line in, I was so happy and proud of myself I was floating on cloud 9 all day and the next. I love my experinces in surgery. I'm not sure if I can say I loved ER, but I did enjoy it more than other rotations. I'm concered that the thrill and rush I feel in surgery might wear off in years to come. But I feel picking ER because it seems like a safe lifestyle bet is a cop out.

Application season is here and I need to figure this out asap. If anyone else found themselves in a similar situation, I'd appreciate your input. Thanks!

 

[THP]

From my experience ER residents (really anybody in a lifestyle residency) are jerks to med students who don't also want a lifestyle residency. They constantly make fun of those who choose more demanding schedules saying we are idiots and going to all end up divorced. I am going into OB/GYN also with a heavy work schedule and hear this crap all the time. I don't know why residents care so much what others choose to do with their career and take unsolicited shots at students.

I do think that ER residents are the biggest jerks of them all though.

 

[Winged Scapula]

Remember the "thrill and the rush" will wear off of most anything you do day in and day out after awhile. However, that doesn't mean you should choose something you love less because it you don't find it thrilling now, you most certainly won't in 10 years.

The surgery lifestyle is difficult and it can be hard defending it as a student and a resident. Almost all of us have heard such disparaging remarks and almost all of us know people who fit the stereotype of the unhappy surgeon. However, it is certainly possible to have a family and a lifestyle while being a surgeon; there are surgical subspecialties that are more lifestyle friendly and there are practice options which are.

If it were me, I would rather be doing something I love wherein the hours seem much less of a problem and making it work for me and my life (after residency), than choosing something I just merely liked and/or tolerated.

 

[varicella]

okay, thank you.

 

[amelie4i's]

Hi there,

I am not doing surgery or EM, but wanted to share my opinion. I also really liked surgery, but lifestyle was more of an issue for me. I am currently doing a surgery pre-lim, but will be doing ophtho next year. I am really enjoying my year in surgery (am at a program that is not super busy and they let interns do a lot in the OR). Sometimes I question my choice, but think I will be very happy in optho. Anyway, as far as your question goes...most of the surgeons I work with seem very happy and to have full lives outside of work. Where I went to medical school, the stereotype of unhappy surgeon did seem more prevalent. I think once you get to private practice (if you aren't looking at academics) it can be what you make it. Of course, you have 5 hard years ahead of you. Just be careful where you choose to train. Where I went to medical school, the surgery residents were very unhappy and more than half of the interns were talking about quitting (some actually did). This, of course, influenced my decision greatly.

As far as EM goes, I also enjoyed that rotation during med school a lot, but did not do it until the end of 4th year so never considered it as a career. However, I have done EM here as an intern and did not like it nearly as much. We are not level 1 trauma so we did not have nearly as much interesting stuff come into the ED (lots of psych, lots of back pain, colds, etc.). I have a feeling that most EM physicians end up in this type of setting rather than a high volume trauma center like the one you were at as a student. There is definitely some excitement in any ED, but it seems to be more like 20% of your time. So it just depends where you see yourself in the future. For me, I like the variety of a surgical field and technical skill involved.

Just wanted to share my opinion since I seem to have the same tastes and had the same concerns that you have. Good luck on a tough decision.

 

[Tn Family MD]

I would say choose very carefully. I started medical school thinking I would do surgery but unfortunately due to many concerns not the least of which was lifestyle I veered another direction. So, I ended up applying for and matching in Family Medicine. This due to the fact that I am non-trad, a little older and have a family to think about. I have pretty much regretted doing FM. I think it is in part the program I am at and the other part is that I just want to do something more procedurally oriented. I am getting very frustrated with FM due to the nature of the work and how it is so low level and basically in a lot of ways just glorified social work. So, I am re-applying through ERAS for both FM and General Surgery at this point. Basically, the only FM programs I am considering are the "cowboy" types like John Peter Smith where the FM docs do all the procedures you can think of. The real crux of my app is trying to get into a surgery program though. That's what I should have done the first time around and not wasted two years of my life. Basiclly, what I am saying is find what you love to do. Even if you work a little more, the fact that you enjoy it will more than make up the difference.

 

[Blade28]

I think it is in part the program I am at and the other part is that I just want to do something more procedurally oriented. I am getting very frustrated with FM due to the nature of the work and how it is so low level and basically in a lot of ways just glorified social work. So, I am re-applying through ERAS for both FM and General Surgery at this point. Basically, the only FM programs I am considering are the "cowboy" types like John Peter Smith where the FM docs do all the procedures you can think of.

You sure you aren't more suited for something like EM (since it sounds like you like procedures and a well-rounded practice)?

 

[H_Caulfield]

Remember also that some people who made lifestyle choices (e.g. EM residents) seem to need constant justification that they made the right choice. It would suck to be looking longingly at the surgical cases while you were stuck doing something you enjoyed less, and if that were me...then I too would probably make many comments alluding to the horrible lifestyle in surgery, inability to have kids, etc. etc. I'd need to remind myself of why I was missing out on what I really should have done instead.

 

[Tn Family MD]

You sure you aren't more suited for something like EM (since it sounds like you like procedures and a well-rounded practice)?

I absolutely despised both my EM rotations. The only rotation I have liked so far in residency were my Trauma Surgery rotation, my MICU rotation for the procedures, and my OB rotation where I got to help out with C-Sections. Trust me, I have put the thought into this and what I want to do is surgery.

 

[Blade28]

I absolutely despised both my EM rotations. The only rotation I have liked so far in residency were my Trauma Surgery rotation, my MICU rotation for the procedures, and my OB rotation where I got to help out with C-Sections. Trust me, I have put the thought into this and what I want to do is surgery.

Didn't you also like your FP rotation (since you went into it)?

 

[blz]

If you really like surgery and I want a better lifestyle, check out something like ENT or urology.

 

[Tn Family MD]

I think ENT or Uro would be too focused for me. That's why GenSurg. I do like more broad medical training but crave the procedures, too. I think GenSurg sounds more exciting for that reason.