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What makes surgery great?
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You get to cut people.
You get to do definitive therapies ("chance to cut is a chance to cure")
You are respected in the "old boys club" even if you're a chick.
You get to look down on everyone else (even though everyone knows more than you do).
Our current health care system is pay-for-service. Pretty easy to tell when you should get paid.
Most of the time Patients are one and done. None of this lingering for 37 years with the same whiney complaints.
Clinic is only to get patients in your OR.
You get to cut people.
You get to be INSIDE people and get PAID for it (creepy, but true).
You get to do surgery, how cool is that?
I'm doing Internal Medicine. I literally despise surgery. I wanted to literally murder every surgeon on my surgery rotation. It was a god awful experience. But if that environment CLICKS with you, you actually LIKE being mean to people, to suffer under some false pretense that it makes you better, to "pay it forward" to the next batch of underlings, why WOULDNT you do surgery?
What you've just encountered is the realism behind specialty selection. No matter what you've set yourself up for, you really do feel a specialty. As much as medical students hate that (rigid, boundaries, OCD), its true. You pick your career path based on how you feel, the gut reaction you have to a specialty. The worst part is that experiences are Rotation, Resident, and Location Dependent. It really does change everything, shifts perspective. I promise you'll get over it and you'll be happy you aren't a surgeon.
I often help students try to figure out what they want. The way I pose it to them is "if you can sit under those hot lights, sweating your ass off, unable to move, back aching, barely able to see the surgery, you, replacing a simple tool without bathroom breaks, civility, or good humor, and you LOVE it? You're a surgeon. Period... If on the other hand you can't wait to stand up, walk around for 4 HOURS digressing on every single little factoid, dwelling on labs, and pouring your brain over an obvious diagnosis? You're medicine. Period. Anything else is just variations around the two. Except psych. Then you're doing it just to prove to yourself you ARENT crazy..."
If you dont fit in to the boys club, you'll be miserable the rest of your life.
You get to do definitive therapies ("chance to cut is a chance to cure")
You are respected in the "old boys club" even if you're a chick.
You get to look down on everyone else (even though everyone knows more than you do).
Our current health care system is pay-for-service. Pretty easy to tell when you should get paid.
Most of the time Patients are one and done. None of this lingering for 37 years with the same whiney complaints.
Clinic is only to get patients in your OR.
You get to cut people.
You get to be INSIDE people and get PAID for it (creepy, but true).
You get to do surgery, how cool is that?
I'm doing Internal Medicine. I literally despise surgery. I wanted to literally murder every surgeon on my surgery rotation. It was a god awful experience. But if that environment CLICKS with you, you actually LIKE being mean to people, to suffer under some false pretense that it makes you better, to "pay it forward" to the next batch of underlings, why WOULDNT you do surgery?
What you've just encountered is the realism behind specialty selection. No matter what you've set yourself up for, you really do feel a specialty. As much as medical students hate that (rigid, boundaries, OCD), its true. You pick your career path based on how you feel, the gut reaction you have to a specialty. The worst part is that experiences are Rotation, Resident, and Location Dependent. It really does change everything, shifts perspective. I promise you'll get over it and you'll be happy you aren't a surgeon.
I often help students try to figure out what they want. The way I pose it to them is "if you can sit under those hot lights, sweating your ass off, unable to move, back aching, barely able to see the surgery, you, replacing a simple tool without bathroom breaks, civility, or good humor, and you LOVE it? You're a surgeon. Period... If on the other hand you can't wait to stand up, walk around for 4 HOURS digressing on every single little factoid, dwelling on labs, and pouring your brain over an obvious diagnosis? You're medicine. Period. Anything else is just variations around the two. Except psych. Then you're doing it just to prove to yourself you ARENT crazy..."
If you dont fit in to the boys club, you'll be miserable the rest of your life.
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A friend of mine once told me that she has a strong instinct to cut things and people and becoming a surgeon is a good way to do that legally. (in psychiatry we call this sublimation)
A surgeon that I shadowed said that having his hands inside of people is a good way to keep them warm in the morning and he hates cold hands.
Another surgeon enjoys showing off pictures of his yacht.
Everybody has their own reasons.
A surgeon that I shadowed said that having his hands inside of people is a good way to keep them warm in the morning and he hates cold hands.
Another surgeon enjoys showing off pictures of his yacht.
Everybody has their own reasons.
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I've been as anti-surgery as anyone since I started med school, but lately I've been wondering if maybe I like it more than I think I do. There's something very comforting or something about the single-minded focus of a surgeon. In medicine, I feel like you're carrying around a bunch of patients, getting labs for one, results for the other, rounding 100 times a day and re-doing the same thing over and over again...etc. In surgery, at least when you're in the OR, your entire focus is dedicated to that one patient, that one thing you're doing with your hands. I'm kind of ADD so I find learning surgical skills to be a very nice, calming experience for me.
Who knows. Maybe I'll end up being a surgeon.
Who knows. Maybe I'll end up being a surgeon.
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In brief, I felt that becoming a surgeon would make ME the best doctor that I could be. General surgeons know a TON of medicine, and are very skilled with their hands. When I wanted to be a doctor, I didn't dream of a job where I'd work 40 hrs a week... I dreamed of a job where I can do a lot to help sick patients. Surgery does that. I even get excited about starting in lines, putting tubes, and all the other small procedures. Unfortunately, today's medicine doctors hardly do any of these bedside procedures (or maybe I should say fortunately for me).
Then you add to that what surgeons do in the OR. It is like no other. You take a person with a clear disease, and you cure them from that disease (fine, not always a cure, but it's often as definitive as it gets).
Just think of it this way, if you were stranded in a hospital (third world country, etc), with only 1 type of doctor who had access to information (ie a smart phone), who would you rather that doctor be? The truth is, surgeons CAN provide medical care, even if less efficient or with slightly more errors, if given sometime with a computer. The same can't be said about a non-surgeon.
Finally, what you are complaining about here seems to be residency, and not the life afterwards. If your going to let 5 years of training determine what you do for the next 30, then that's your call.
Then you add to that what surgeons do in the OR. It is like no other. You take a person with a clear disease, and you cure them from that disease (fine, not always a cure, but it's often as definitive as it gets).
Just think of it this way, if you were stranded in a hospital (third world country, etc), with only 1 type of doctor who had access to information (ie a smart phone), who would you rather that doctor be? The truth is, surgeons CAN provide medical care, even if less efficient or with slightly more errors, if given sometime with a computer. The same can't be said about a non-surgeon.
Finally, what you are complaining about here seems to be residency, and not the life afterwards. If your going to let 5 years of training determine what you do for the next 30, then that's your call.
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Does NOT really describe of the surgery attendings that I know. Plus, surgeons have the best humor of all fields. They might be serious/angry when things go wrong, but a lot of fun every other time.
However, your descripton of IM is right on.
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Surgical experience truly is dependent on the attending.
It can be as brutal as ever, or as benign and easy going with lots of twisted humor mixed in. Of course, when **** goes wrong, there'll be cursing and shouting as their asses are on the line... you dont want a routine surgery to go wrong.
If I had to pick b/w the 2, I'd had chosen surgery. Actually, I was gung ho surgery until I shadowed an anesthesiologist, and later cemented my decision to go into anesthesiology after a 3rd year rotation. I loved it. I LOVE the OR anyway. I was fine with watching surgeries. I love instant gratification. Being able to do things with meds and seeing its effects attracted me to the field. The ability to do procedures was the other piece of the puzzle for me. I get to do both, in an acute setting. I don't have to round on patients (outside of the ICU). I dont have clinic. I get to deal with ALL types of patients. Not just adults. Not just kids. Everyone.
ALSO... for me, I didn't want general surgery, I wan't to subspecialize. Thus, I knew pursuing a fellowship afterwards would have me be in training for almost a decade. I didn't want that.
It can be as brutal as ever, or as benign and easy going with lots of twisted humor mixed in. Of course, when **** goes wrong, there'll be cursing and shouting as their asses are on the line... you dont want a routine surgery to go wrong.
If I had to pick b/w the 2, I'd had chosen surgery. Actually, I was gung ho surgery until I shadowed an anesthesiologist, and later cemented my decision to go into anesthesiology after a 3rd year rotation. I loved it. I LOVE the OR anyway. I was fine with watching surgeries. I love instant gratification. Being able to do things with meds and seeing its effects attracted me to the field. The ability to do procedures was the other piece of the puzzle for me. I get to do both, in an acute setting. I don't have to round on patients (outside of the ICU). I dont have clinic. I get to deal with ALL types of patients. Not just adults. Not just kids. Everyone.
ALSO... for me, I didn't want general surgery, I wan't to subspecialize. Thus, I knew pursuing a fellowship afterwards would have me be in training for almost a decade. I didn't want that.
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The problem is general surgeons are becoming a rare breed, even "general surgeons" typically only do a select number of procedures, unless you are very rural.
To answer your question I'd say an ER doc, so I can be stabilized and flown home to specialists....bc honestly just because your a "general surgeon" doesn't mean you have the expertise to perform a triple bypass, a hip replacement or remove a brain tumor. You cannot be House, there is too much medicine too learn to do it all.
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👍👍👍
I've been telling people that I want to be a surgeon because I like carpentry but I'm tired of squatting to reach my toolbox, but this is an even better excuse.
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Rotate with a private practice surgery group. The longest case I did was probably 4 hours, and most of the gall bladders were <45 minutes. An appy is a 20-30 minute case. The two longest cases I've ever done were a neurosurgery case and a gyn case (both 8 hours), and I'm almost done with my intern year.
If your surgery patients are ungrateful, what makes you think your [insert other specialty] patients are going to be better? For the record, nearly all of my patients are very grateful, but that is location dependent. I have a great patient population here.
General surgeons haven't done CABGs or hip replacements in probably 40+ years. This isn't exactly a new change.
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Exactly. I rotated with a private practice general surgery group and being an attending surgeon there looked awesome. A lot of what the OP is complaining about is surgical residency. You'll be hard pressed to to find an attending rounding at 5am, lol. At the private practice group, the surgeons would roll in just before there cases, like at 7:30 or 8. It was a group of like 7 surgeons or so, so call was q week, from home. First call was the surgical resident/intern, in other practices that don't have residents, first call would be a PA.
Lifestyle of an attending general surgeon in private practice is as chill or as hard as you want it to be. Surgical residency is tough, but it has to be since you have to learn so damn much!
PS: to The Prowler, we are probably talking about the same group, CSM hospital?
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Leaving by 7:30PM? Getting almost 10 hours between leaving the hospital and going back in... is pretty sweet.
I know Overactivebrain was being sarcastic when he mentioned "definitive therapies," but that really is one of the things I like about it. I hated the onc cases on medicine, because they were all Stage IV. Onc in surgery isn't nearly as bad, because you get the cases that might be curable. You do the lobectomy or you do the esophagectomy... and the patient has a fighting chance of survival. There are definitive evidence-based therapies for specific diseases, and I like well-defined problems that sometimes require complex solutions.
Different people like different things. Thinking about how to position the patient, where would I make my incision, trying to predict what's going to happen next, identifying anatomy... these are things that I like to think about throughout a case even if I just retract. It seems like a lot of the people who hate surgery just stand there without thinking about the case expecting to be given a lecture on anatomy, pathophysiology, and operative technique. It's hard to like something if you're completely out of your depth.
Regarding closing the 2cm incision, you gotta practice at home, and you can't let anyone rush you until you have some experience. After doing a few good ones, they'll change their tune.
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I think this statement is true for the most part, at least for those of us who chose to go into a specialty with longer hours and sicker patients. I remember liking the OR, the SICU, and those quick decisions like, "Do we take him to the OR NOW?" Though at some point I didn't care for what I perceived to be the "culture" or surgery - and as some have pointed out a lot of that was really a product of busy surgery dept. in a large surgery residency at a university teaching hospital. And based on my friends who went into surgery and my surgery resident colleagues it seems to be all about the OR. If none of the other nonsense (which they don't like much either) can outshine that OR experience - if it's all worth those few few hours where you're cutting and tying - then you're probably a surgeon. (I'd add if you like the smell of your own farts and are secretly suspicious [you'd need a placebo controlled RCT, of course, to make sure] they might cure AIDS, you're probably also a surgeon)
And I don't think putting on of today's modern surgeons into a third world country would be good for the surgeon or the patient's there necessarily . . . we've all grown accustomed to all of the technology, bells and whistles, and expert consultation that most of us would be pretty hard pressed working in a third world hut. A lot of "possible" diagnosis without much ability to be able to do anything about it, even a basic open appy in that kind of setting wouldn't be near as "basic" as we've grown accustomed.
tl;dr: You know if you know
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I didn't say that a general surgeon is an expert in every surgical or medical field, I just think they get broad based training. In residency, you care for almost every organ system. You operate on most organ systems, and do about several months to a year of critical care/ICU rotations. There is obviously a good reason why we have medicine/ortho/FP, etc docs out there, but I truly believe that general surgeons can do (surgically) and treat (medically) more than any other super-specialized or generalist physician - if they chose.
Will I be that good? I can only hope that my residency program will give me the technique and knowledge base that I need. I'll have to supplement that with a lot of reading to get better at some of the minutiae of medical management.
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Sadly, this is true. I'm hoping to spend some of my vacation time/lab time (if I go into the lab) as a resident going on medical trips with older surgeons who've learned how to work in third world countries where many of our luxuries are missing. Once I'm out in practice, I'll still try to go along with more experienced doctors until I become experienced myself.
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I don't know if it's really that sad when you think about it. There's a lot of surgeries that simply should not be done outside of a place that has not only has expert surgical hands, but expert anesthesia support, expert SICU nursing, and expert ancillary staff. Modern medicine has allowed us to do so much that was impossible working out of a mud hut, which isn't a bad thing.
I guess for me I don't feel that bad that I know how take care of people with the bells and whistles, because that's how I (and you and the rest of us in the US and western world) trained, and if available should be used.
Though it would be interesting to hear what could be done and what the minimal amount of support a surgeon needs to do say, appy's, chole's, and hernias in the field.
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Apparently can do an appendectomy on yourself in the antarctic:
http://www.bmj.com/content/339/bmj.b4965.full
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Going to a third world country from the west isn't so bad. The same basic skills apply no matter what the operating conditions are, and it doesn't take too long to learn what can and cannot be done in very basic working conditions. When I worked on the Africa Mercy, the local surgeons were delighted at the chance to study operating techniques in our hospital. They knew full well that when they went into the bush they wouldn't have the equipment, sterile environment or reliable electricity that we had on the ship, but they all agreed that our hospital was a great environment to learn in. First of all, we had more surgical patients then they would in a bush hospital, so there were that many more opportunities to learn. Our reliable equipment and electricity meant that we could constantly be operating, so we didn't have to constantly delay or cancel learning opportunities. Also, the local surgeons agreed that it was better to learn how to do things the right way and then adapt to what was possible in the bush rather than just learning improvisations.
I faced more or less the same challenge with my construction work, switching between a fully equipped American wood shop to a shade tree operation in Gambia, West Africa. Some jobs that I could do back home were now impossible, others were possible but not to the same level of quality, and everything took longer than it would have in the west. Still, the basics were the same. Building a roof in Africa out of split palm trees and corrugated tin is very different from the prefabricated truss and shingle American roofs I was used to, but a saw and tape measure work the same all over the world.
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Well, it's not "as chill as you want it to be," especially because the larger surgery practices aren't that common, so you're on call more, but yes, of course it's usually better than residency in many/most ways.
I didn't rotate at CSM, I'm talking about the one way west of the main hospital.
I enjoy the OR, of course, but I like a lot of other aspects of surgery. I like the types of disease we deal with, the people we interact with, the hospital-based nature of a lot of the work (rather than a strictly clinic-based specialty or a specialty where you're often completely by yourself), the to-the-point nature of surgery with a brief but nuanced physical exam, and I like the people I work with. I like most of the personalities with me in surgery.
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Can you describe the said personalities? I've heard the stereotypes, but I'm curious if they are true. I shadowed a surgeon the this year, and I found him the funniest, sarcastic, yet most intense guy. Totally loves work...and being stressed out.
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You're either a surgeon or you're not. OP is clearly not. It's neither a good or bad thing.
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Everyone expects everyone else to work hard, which is probably the most important thing. We do have a fair number of funny/sarcastic types, and most people swear pretty regularly (staff and residents). Patient presentations need to be short and sweet, but you need to know a lot more details about the patient than what you're presenting (i.e., pertinent positives only).
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I garuantee he drinks dos equis... Lol
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For me anyway it comes down to curing disease vs. treating disease. Going into medical school you feel like all doctors cure people, but that's not really the case. As you learn more you realize that almost all of most non-surgical specialties is about managing chronic illness. It's pretty cool knowing a person had a problem causing pain/illness, and in the course of a few hours you made them better. Sure there are satisfying aspects of other specialties, but nothing out there is quite as satisfying as seeing that tumor sitting in a basin on the mayo stand. Instant gratification.
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I just have to say, wow, I can't believe someone else just articulated one of the exact reasons why I am so interested in surgery. (I haven't started med school yet but I have done rodent surgeries and I got that feeling from it.)
WOW. That is truly badass.
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deleted263296
I'm as perplexed as is the OP. Surgery as a medical student sucks so bad. I really don't see what would attract someone to it. Arrogant personalities, lots of cussing and crude behavior, horrible hours, etc. etc.
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Holy ****.
mmmcdowe
Duke of minimal vowels
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People are missing the point. The obvious reason people go into surgery is the scrubs. I hate doing laundry,
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god complex
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I love using saws and power tools, hence ortho...
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👍 I like the idea of getting paid to drill someone, so that left me with ortho or adult films. My wife didn't seem to like the latter unfortunately, so here I am...🙄
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For those of you that say that it's hard to see how someone could be attracted to surgery as a student, has anyone ever let you do anything in the OR?
For me, the rush from closing the fascia or doing an awesome running sub-q can't be beat by writing a note in medicine or talking ad nauseum about a differential. I like to think about what it'll be like to actually do the case. 😍
For me, the rush from closing the fascia or doing an awesome running sub-q can't be beat by writing a note in medicine or talking ad nauseum about a differential. I like to think about what it'll be like to actually do the case. 😍
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Heavens no!
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Yeah I am worried act because I want to be a surgeon but I still have another year before I get to step foot in the OR and actually see what its like and I'm hoping I'm going to like it. If not I guess I'll have to do some serious soul searching because I've felt like surgery is always something I wanted to do..the only thing that deters me are the hours/no life but I figure once your out of residency you have a lot more control over that (not that the hours arer going to be easy regardless..but better).
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Underrated post.
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Haha! So does this lady. http://www.smh.com.au/articles/2004/06/01/1086037758224.html
IMPO (in my pre-med opinion), I could maybe see myself doing surgery. I'm mostly worried about how demanding residency will be and those SDN urban legends (I have no idea how true they are) about some programs that brag about the divorce rate of their students like it's a good thing. I did greatly enjoy playing with the laparoscopic surgery drill toys at the sim center at second look day at the school where I'll be matriculating, though and I was good at it. I can also definitely see the appeal of "fixing" the patient and seeing results quickly. Time will tell.
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The specific interactions you have during the clerkship can paint wildly different pictures. If you are belittled, humiliated, and sleep deprived, you will hate a lot of things. If you are made to feel a member of a team, have some purpose, and get some positive comments along the way, that can make a difference. For what it's worth, I am a surgery resident now. But even during the first half of the clerkship, I hated it and asked the same questions as you did. Once I got used to the rotation, and received compliments along the way, that allowed me to see the positive aspects of surgery that I was not recognizing in my frustrated and bitter state.
To answer the question, I would say surgery can be very frustrating at times. We work very hard over very long hours. However there are moments that make it all worth it; for some it's the operating room. For me it's the acute moments where you genuinely have a chance to save a life, and succeed, due to your training and hard work. I also find that humanizing the experience of surgery, i.e. thinking of an operation as a chance to significantly improve someone's life, rather than just a technical, virtuoso aspects, also significantly augments job satisfaction.
To answer the question, I would say surgery can be very frustrating at times. We work very hard over very long hours. However there are moments that make it all worth it; for some it's the operating room. For me it's the acute moments where you genuinely have a chance to save a life, and succeed, due to your training and hard work. I also find that humanizing the experience of surgery, i.e. thinking of an operation as a chance to significantly improve someone's life, rather than just a technical, virtuoso aspects, also significantly augments job satisfaction.
aww shucks, you're condescending attitude is not appreciated!
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I feel that the type of person you are has already been determined by this point......
I love building stuff....working with tools.....performing extremely tedious tasks (anybody measure the distances between the frets on a guitar? they are measured in fractions of Millimeters....I just finished laying one out a few hours ago.....).........I am good with my hands and enjoy seeing something go from broken to fixed in a fairly short amount of time.......
I feel that I will like surgery, and that is because of reasons that the OP noted as obnoxious.......
if you are questioning whether or not you'll enjoy it focusing on the details you already see as negative, you probably won't....and that all depends on who you know yourself to be now........
I love building stuff....working with tools.....performing extremely tedious tasks (anybody measure the distances between the frets on a guitar? they are measured in fractions of Millimeters....I just finished laying one out a few hours ago.....).........I am good with my hands and enjoy seeing something go from broken to fixed in a fairly short amount of time.......
I feel that I will like surgery, and that is because of reasons that the OP noted as obnoxious.......
if you are questioning whether or not you'll enjoy it focusing on the details you already see as negative, you probably won't....and that all depends on who you know yourself to be now........
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Or being very charming...?
[YOUTUBE]http://www.youtube.com/watch?v=3pbKRc-0mSs[/YOUTUBE]
"...How far could you coast on charm? ... Well, pretty far, actually!"
matching into porn as a heterosexual male is probably tougher than matching into surgery.
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LOL so good.
In all seriousness, do people seriously go into ortho because they enjoy using power tools? That's... interesting. (This is coming from someone who is considering ortho, but mine comes from the satisfaction of doing joint replacements).
C
cowme
I was the same way as you. Liked surgery a lot, but the sacrifice seemed a little too much.... I can barely function with less than 7 hours of sleep a night, which is not compatible with a life in surgery. I would get home every night at 7, go to sleep at 9 just to make it to the hospital at 530 the next morning. I couldn't live like that for 7 years. That's why IR is dope. You may not be a "surgeon" but you are definitely operating, doing awesome procedures, and get to go through radiology residency instead.
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I was the same way as you. Liked surgery a lot, but the sacrifice seemed a little too much.... I can barely function with less than 7 hours of sleep a night, which is not compatible with a life in surgery. I would get home every night at 7, go to sleep at 9 just to make it to the hospital at 530 the next morning. I couldn't live like that for 7 years. That's why IR is dope. You may not be a "surgeon" but you are definitely operating, doing awesome procedures, and get to go through radiology residency instead.
Plus you'll never need a flashlight because you'll glow in the dark!
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Gigolo?
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matching into porn as a heterosexual male is probably tougher than matching into surgery.
You have to make sacrifices in both fields I guess...The weird stuff pays better in both though.
I don't think people just go into it for the hammers and drills, but you'll be using them a lot so you can't dislike using them. As you said though, there is more to it, such as the satisfaction that comes from restoring mobility in some one who's quality of life has suffered as a result of joint pain.
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They do use lots of cool toys and gadgetry.
