Wanting to see the path ahead as an OMS-1. Is it possible to do internal medicine and general surgery?

[EliteKiller2020]

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Hi! I am an OMS-1 (just started a few weeks ago)! This may be a bit early, but I wanted to get a general plan/idea going. I know, first and foremost, grades and passing/scoring high on boards are important. My school also requires research as part of the curriculum, so I'll be starting that soon (hopefully this semester). I don't know if it's possible to do both. I realize that my interests may change, and I am still very open to exploring specialities. As of right now, I am really interested in internal medicine and being a hospitalist, but I also want to do general surgery. The other dilemma I'm facing is I want to have a mix of surgery, clinic, and hospitalist in the future. Are these things possible?

 

[Calizboosted76]

So, this is not going to happen. I will say this, as someone who wanted the same practice set up, to be a GOOD general surgeon you have to be one of the best medicine doctors in the hospital as well. You will not be able to be a hospitalist and GS. The closest thing for you will be to do GS with a trauma and critical care fellowship. You spend ample time rounding on patients in the SICU as well as operating.

Edit for clarity: So you can have almost all of it if you go the route that I mentioned above. However you wont be a "Hospitalist or internist". You can have inpatient, clinic, and OR by going GS. BUT, people who go GS normally dont "like" much aside from the OR. I dont fully believe that sentiment because I am similar to you but figured Id say it before a surg bro jumps on and says it.

 

[Doctoscope]

Become an NP and you can do both plus some more

 

[ciestar]

Possible if you want to do two grueling residencies. You cannot be an attending hospitalist general surgeon without doing so.

 

[ciestar]

Become an NP and you can do both plus some more

Lol.. well, you’re not wrong.

 

[EthylMethylMan]

Become an NP and you can do both plus some more

I know this is a somewhat facetious comment, but you won’t be the primary surgeon as an NP. If OP really wants to be a surgeon then being a gen surg NP wouldn’t quench that thirst.

 

[voxveritatisetlucis]

lol why would you do this

 

[GoSpursGo]

As others have said, this isn't really a thing. Surgeons also round on their post-op patients in the hospital, and see patients in clinic, so you really wouldn't need to do two entirely different residencies to be able to create the kind of practice you want.

It's great that you're interested in several different things. Focus on doing as well as you can in your courses, do quality research, and then during 3rd year see which specialty you really enjoy most.

 

[Dral]

This will likely change over time. I had analogous thoughts about practice back when I was at your stage in the game. We're not here to hold anyone back, but you'll just find that if you choose to be a surgeon, you'll want to be a surgeon and you'll find that medicine practice won't be what you're interested in day to day (and vice versa).

Also, I'll tell you from someone who works in a specialty and subspecialty, it's more difficult than I expected when shifting from one to another either throughout the day or week.

I get it that it's an exciting time with a bunch of possibilities, but you'll have to close some doors to be able to open the ones you really want to go through.

 

[voxveritatisetlucis]

Also to iterate above, ACS surgery can be very much like medicine. Though if you have any inkling towards surgery, you have to be a top performer from the beginning as it’s become a lot more competitive

 

[DOVinciRobot]

No, that’s not a thing.

 

[kayakh smith]

I am OMS-1 and wondering which year should I start researching opportunities? Thanks.

 

[voxveritatisetlucis]

I am OMS-1 and wondering which year should I start researching opportunities? Thanks.

Now….

I have 4 pubs in low tier journals and they still all took like a year to be accepted. Plus I probably wouldn’t have had time to do them during clinicals

 

[AlbinoHawk DO]

Hi! I am an OMS-1 (just started a few weeks ago)! This may be a bit early, but I wanted to get a general plan/idea going. I know, first and foremost, grades and passing/scoring high on boards are important. My school also requires research as part of the curriculum, so I'll be starting that soon (hopefully this semester). I don't know if it's possible to do both. I realize that my interests may change, and I am still very open to exploring specialities. As of right now, I am really interested in internal medicine and being a hospitalist, but I also want to do general surgery. The other dilemma I'm facing is I want to have a mix of surgery, clinic, and hospitalist in the future. Are these things possible?

This is an unrealistic naive take on how medicine works. As you progress, you'll understand why there are specialties, and why in particular there is no IM/GS combined residencies or fellowships. However, I think GS can offer you the closest to what you're looking for. It's very normal for a surgeon to go and evaluate patients pre-surgically and post-surgically, which includes outpatient visits probably once a week. This is a very grueling lifestyle as you'll be working likely 80 to 120 hours a week for the rest of your career to be able to maintain this. Why? Because only a private practice surgeon is able to pull this off, and being in private practice means you running the entire show, unless you allow some company to open a clinic for you and steal your income which will end up likely making less money than an employed surgeon or someone in a group. Your other alternative would be to hyperspecialize by doing something like Urology, Ophthalmology, or Plastics which allow to do this with less time commitment due to the higher reimbursement.

My advice is you need to find out if you want to be a medicine doctor or you want to be a surgical doctor. Everything flows from there. You may also want to refrain from being an "elite killer" if you want a long-term career in medicine 😛

 

[threeroses]

Hi! I am an OMS-1 (just started a few weeks ago)! This may be a bit early, but I wanted to get a general plan/idea going. I know, first and foremost, grades and passing/scoring high on boards are important. My school also requires research as part of the curriculum, so I'll be starting that soon (hopefully this semester). I don't know if it's possible to do both. I realize that my interests may change, and I am still very open to exploring specialities. As of right now, I am really interested in internal medicine and being a hospitalist, but I also want to do general surgery. The other dilemma I'm facing is I want to have a mix of surgery, clinic, and hospitalist in the future. Are these things possible?

A little late to the game, but I think it is also worth remembering that internal medicine subspecialties often do procedures - not surgery, but may scratch your surgical itch. For example, GI is an internal medicine fellowship and they round in the hospital, have clinic, and do scopes and other such procedures. Endocrinology does fine needle aspirates, among other things. EP Cards does ablations, pacemakers, etc. I think any of these is more likely to give you what you want than general surgery as well as a much better lifestyle.

 

[dpmd]

This is an unrealistic naive take on how medicine works. As you progress, you'll understand why there are specialties, and why in particular there is no IM/GS combined residencies or fellowships. However, I think GS can offer you the closest to what you're looking for. It's very normal for a surgeon to go and evaluate patients pre-surgically and post-surgically, which includes outpatient visits probably once a week. This is a very grueling lifestyle as you'll be working likely 80 to 120 hours a week for the rest of your career to be able to maintain this. Why? Because only a private practice surgeon is able to pull this off, and being in private practice means you running the entire show, unless you allow some company to open a clinic for you and steal your income which will end up likely making less money than an employed surgeon or someone in a group. Your other alternative would be to hyperspecialize by doing something like Urology, Ophthalmology, or Plastics which allow to do this with less time commitment due to the higher reimbursement.

My advice is you need to find out if you want to be a medicine doctor or you want to be a surgical doctor. Everything flows from there. You may also want to refrain from being an "elite killer" if you want a long-term career in medicine 😛

I am a general surgeon in private practice who sees patients pre and postop in addition to operating on them and see nonoperative consults and think about the medical issues the patient has while working on optimizing those if they don't have someone doing that already. I don't work anywhere near those hours you mention. In fact I have been part time for much of my career. It isn't the same as being IM and GS together but where I trained in residency we admitted almost all our own patients and managed them medically except for stuff like calling nephrology for dialysis or cardiology for MI so I am comfortable managing a variety of medical issues at least in the short term.

 

[AlbinoHawk DO]

I am a general surgeon in private practice who sees patients pre and postop in addition to operating on them and see nonoperative consults and think about the medical issues the patient has while working on optimizing those if they don't have someone doing that already. I don't work anywhere near those hours you mention. In fact I have been part time for much of my career. It isn't the same as being IM and GS together but where I trained in residency we admitted almost all our own patients and managed them medically except for stuff like calling nephrology for dialysis or cardiology for MI so I am comfortable managing a variety of medical issues at least in the short term.

If your experience is different, I'm happy to concede. I'm not a GS, but what I wrote is based on my interactions with surgeons in residency, fellowship, and my current workplace. I really don't know anyone who doesn't put at least 60 hours of work weekly. However, you say you're part-time in your career, so I suppose if OP wants to earn less just to be able to get a similar experience as you, that's on them

 

[dpmd]

If your experience is different, I'm happy to concede. I'm not a GS, but what I wrote is based on my interactions with surgeons in residency, fellowship, and my current workplace. I really don't know anyone who doesn't put at least 60 hours of work weekly. However, you say you're part-time in your career, so I suppose if OP wants to earn less just to be able to get a similar experience as you, that's on them

The nice thing is that earning less in this case means I only made 390k of business income. Not bad for averaging 20 hours a week.

 

[ciestar]

The nice thing is that earning less in this case means I only made 390k of business income. Not bad for averaging 20 hours a week.

Dear god i need to find a way out of primary care

 

[dozitgetchahi]

Hi! I am an OMS-1 (just started a few weeks ago)! This may be a bit early, but I wanted to get a general plan/idea going. I know, first and foremost, grades and passing/scoring high on boards are important. My school also requires research as part of the curriculum, so I'll be starting that soon (hopefully this semester). I don't know if it's possible to do both. I realize that my interests may change, and I am still very open to exploring specialities. As of right now, I am really interested in internal medicine and being a hospitalist, but I also want to do general surgery. The other dilemma I'm facing is I want to have a mix of surgery, clinic, and hospitalist in the future. Are these things possible?

If you want a specialty where there is a mix of some surgery, some clinic, and some “hospitalist” like work, probably the closest you’d get is OB/GYN. You can do some of each as a typical OB doctor.