Surgery Cold Feet

[Anicetus]

Hey all,

Yes, I did make a previous thread about "surgery or bust" attitude previously in the surgery thread. This is because I have absolutely despised everything up until surgery.

I am currently in surgery and love the OR. It is the only stimulating thing in medicine for me and it is currently my plan to go into surgery for this reason. However, unfortunately I'm a pretty lazy vacation loving non-workaholic, which doesn't jive well with surgery lifestyle. I am not getting cold feet as an MS3 because I don't live to work. I work to live, if that makes sense. If I didn't have to, I wouldn't work at all. Oddly enough, surgery was what attracted me to medicine in the first place due to the adrenaline of surgery itself. I am not sure what to do and am hoping from some anonymous internet input from MS3/4 and even residents and attendings about if I should avoid surger now while it's still not too late.

My aspirations: I have zero desire to do research, and I would love to take weeks off at a time to travel and raise a family (doesn't sound like the surgery lifestyle).

Why I have not liked other specialties:
Subspecialties in surgery: ruled out due to subpar stats and zero publications so please no one suggest optho/ent/derm as a potential solution.

Obgyn: pass. Hated the residents and monitoring pregnant women. Wanted to shoot myself.
Psychiatry: Pass. I valued their lifestyle so much but it was incredibly unfulfilling and seemed miserable having to deal with those types of patients
Internal medicine: I honored this. The fact that I honored this is the ONLY reason I would pursue it in hopes of nabbing GI fellowship, but this is very very competitive from what I've been told and am not confident that I would match a fellowship where I'd do internal medicine. Also, I absolutely DESPISED rounds and managing the patients their multiple problems. Had I not known medicine was like this I would've considered a different career.
Family medicine: outpatient clinic makes me want to shoot myself but the lifestyle is absolutely ideal.
Pediatrics: I hate kids. Plain and simple.
Anesthesiology: looks boring as **** honestly.
Radiology: same as anesthesiology.
Emergency medicine: I absolutely hate the ED.

Not sure where to go from here.

TLDR: I hate surgery lifestyle, but hate rounding and clinical management and mental stimulation of medicine. I would only really prefer GI if succeeding in internal medicine wasn't a hoop to get through. I've only loved surgery in medical school so far. I don't have anywhere near the stats for the competitive lifestyle surgery specialties. What should I do?

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[LaurenMD]

PM&R?

 

[DrfluffyMD]

I was in your boat and I found IR or interventional radiology to be a good fit. There are jobs with over 20 weeks of vacation if thats your thing.

 

[Crayola227]

Hey all,

Yes, I did make a previous thread about "surgery or bust" attitude previously in the surgery thread. This is because I have absolutely despised everything up until surgery.

I am currently in surgery and love the OR. It is the only stimulating thing in medicine for me and it is currently my plan to go into surgery for this reason. However, unfortunately I'm a pretty lazy vacation loving non-workaholic, which doesn't jive well with surgery lifestyle. I am not getting cold feet as an MS3 because I don't live to work. I work to live, if that makes sense. If I didn't have to, I wouldn't work at all. Oddly enough, surgery was what attracted me to medicine in the first place due to the adrenaline of surgery itself. I am not sure what to do and am hoping from some anonymous internet input from MS3/4 and even residents and attendings about if I should avoid surger now while it's still not too late.

My aspirations: I have zero desire to do research, and I would love to take weeks off at a time to travel and raise a family (doesn't sound like the surgery lifestyle).

Why I have not liked other specialties:
Subspecialties in surgery: ruled out due to subpar stats and zero publications so please no one suggest optho/ent/derm as a potential solution.

Obgyn: pass. Hated the residents and monitoring pregnant women. Wanted to shoot myself.
Psychiatry: Pass. I valued their lifestyle so much but it was incredibly unfulfilling and seemed miserable having to deal with those types of patients
Internal medicine: I honored this. The fact that I honored this is the ONLY reason I would pursue it in hopes of nabbing GI fellowship, but this is very very competitive from what I've been told and am not confident that I would match a fellowship where I'd do internal medicine. Also, I absolutely DESPISED rounds and managing the patients their multiple problems. Had I not known medicine was like this I would've considered a different career.
Family medicine: outpatient clinic makes me want to shoot myself but the lifestyle is absolutely ideal.
Pediatrics: I hate kids. Plain and simple.
Anesthesiology: looks boring as **** honestly.
Radiology: same as anesthesiology.
Emergency medicine: I absolutely hate the ED.

Not sure where to go from here.

TLDR: I hate surgery lifestyle, but hate rounding and clinical management and mental stimulation of medicine. I would only really prefer GI if succeeding in internal medicine wasn't a hoop to get through. I've only loved in medical school so far. I don't have anywhere near the stats for the competitive lifestyle surgery specialties. What should I do?

Sounds like life and work aren't about adrenaline fixes or vacations. Maybe work and boredom.

Why did you decide "why medicine" in the first place? Not to be mean. Sometimes it helps students if they can reconnect with what they wanted before, hopefully experienced as pre-meds, with the disillusionment they now feel MS3, for getting back in touch with their core values.

Anita Taylor's test and others can sometimes help to do that and consider fields of medicine maybe a touch outside the core clerkships.

Honestly, it's not that I don't empathize with some of what you're saying. But the suck exists in all fields of medicine. Medicine is WORK. You're going to have to make some compromises and decide how hard you are willing to work for what you want.

 

[mimelim]

I came here assuming that this thread was about vascular surgery because of the title. But please don't apply to vascular surgery, you sound like a terrible fit.

 

[lemoncurry]

there's always Oral Surgery, but you would have to go to dental school first. Best of both worlds, IMO.

 

[Mad Jack]

Have you considered ENT? Ophtho and rads (interventional- but that's a work hard/play hard job) might also be up your alley. Maybe even ortho.

 

[Anicetus]

PM&R?

^i can't stop feeling that it's like PT but glorified to some extent.

Have you considered ENT? Ophtho and rads (interventional- but that's a work hard/play hard job) might also be up your alley. Maybe even ortho.

Don't have the stats or research for any of those specialties.

 

[Mad Jack]

^i can't stop feeling that it's like PT but glorified to some extent.



Don't have the stats or research for any of those specialties.

You don't have a pulse to get into rads?

 

[Anicetus]

Sounds like life and work aren't about adrenaline fixes or vacations. Maybe work and boredom.

Why did you decide "why medicine" in the first place? Not to be mean. Sometimes it helps students if they can reconnect with what they wanted before, hopefully experienced as pre-meds, with the disillusionment they now feel MS3, for getting back in touch with their core values.

Anita Taylor's test and others can sometimes help to do that and consider fields of medicine maybe a touch outside the core clerkships.

Honestly, it's not that I don't empathize with some of what you're saying. But the suck exists in all fields of medicine. Medicine is WORK. You're going to have to make some compromises and decide how hard you are willing to work for what you want.

I always thought of surgically fixing patients and then when I started medical school I tried to think less about surgery and keep an open mind about other specialties. This led me to be pretty depressed during the other clerkships when I realized how much I didn't like them.

i agree the suck exists in all fields of medicine, but maybe I have to weight which sucks hurt me most in life whether it's hating what I do for 40 hours a week but doing it and getting by just to have a job and contribute to society in some way (family or internal medicine), or do what I find most fun and interesting (surgery) but the suck is literally probably a crap lifestyle with no traveling, staying home to raise kids, go out on weekends and just being the lazy bum I am after work is over.

 

[Anicetus]

You don't have a pulse to get into rads?

The problem I notice with rads is that most people's incentive is for the lifestyle and nothing more. Is this really a legitimate reason to choose the field even if sitting in a dark room and vaguely coming up with stuff to say about some black and white images all day and night (with intermittent little biopsies) doesn't rock your world?

 

[Redpancreas]

Hey all,

Yes, I did make a previous thread about "surgery or bust" attitude previously in the surgery thread. This is because I have absolutely despised everything up until surgery.

I am currently in surgery and love the OR. It is the only stimulating thing in medicine for me and it is currently my plan to go into surgery for this reason. However, unfortunately I'm a pretty lazy vacation loving non-workaholic, which doesn't jive well with surgery lifestyle. I am not getting cold feet as an MS3 because I don't live to work. I work to live, if that makes sense. If I didn't have to, I wouldn't work at all. Oddly enough, surgery was what attracted me to medicine in the first place due to the adrenaline of surgery itself. I am not sure what to do and am hoping from some anonymous internet input from MS3/4 and even residents and attendings about if I should avoid surger now while it's still not too late.

My aspirations: I have zero desire to do research, and I would love to take weeks off at a time to travel and raise a family (doesn't sound like the surgery lifestyle).

Why I have not liked other specialties:
Subspecialties in surgery: ruled out due to subpar stats and zero publications so please no one suggest optho/ent/derm as a potential solution.

Obgyn: pass. Hated the residents and monitoring pregnant women. Wanted to shoot myself.
Psychiatry: Pass. I valued their lifestyle so much but it was incredibly unfulfilling and seemed miserable having to deal with those types of patients
Internal medicine: I honored this. The fact that I honored this is the ONLY reason I would pursue it in hopes of nabbing GI fellowship, but this is very very competitive from what I've been told and am not confident that I would match a fellowship where I'd do internal medicine. Also, I absolutely DESPISED rounds and managing the patients their multiple problems. Had I not known medicine was like this I would've considered a different career.
Family medicine: outpatient clinic makes me want to shoot myself but the lifestyle is absolutely ideal.
Pediatrics: I hate kids. Plain and simple.
Anesthesiology: looks boring as **** honestly.
Radiology: same as anesthesiology.
Emergency medicine: I absolutely hate the ED.

Not sure where to go from here.

TLDR: I hate surgery lifestyle, but hate rounding and clinical management and mental stimulation of medicine. I would only really prefer GI if succeeding in internal medicine wasn't a hoop to get through. I've only loved surgery in medical school so far. I don't have anywhere near the stats for the competitive lifestyle surgery specialties. What should I do?

IM --> GI
Anesthesiology
Interventional Radiology


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[Anicetus]

IM --> GI
Anesthesiology
Interventional Radiology


Sent from my iPhone using SDN mobile

I was under the recent impression that GI is incredibly competitive in that really only upper/top tier IM residents go into them. The match rate is pretty abysmal from NRMP.

 

[Psai]

Thank god you're not interested in anesthesiology

 

[Taddy Mason]

The problem I notice with rads is that most people's incentive is for the lifestyle and nothing more.

Well, with the priorities you provided...

 

[Anicetus]

Thank god you're not interested in anesthesiology

Whenever I've asked an anesthesiologist why they like it, they just jump to how it's better than the surgeon's and that they somehow make more money too.

 

[OnePunchBiopsy]

...I don't live to work. I work to live, if that makes sense. If I didn't have to, I wouldn't work at all.
I would love to take weeks off at a time to travel and raise a family (doesn't sound like the surgery lifestyle).

Don't do surgery.
Even though surgeons love the OR, they also have to run a clinic and see patients in the ED.

With this mentality you are probably going to be miserable during ANY residency, but medicine sounds like your best bet in the long run and here's why:

A community hospital in my area is looking to hire a new nocturnist (a nighttime hospitalist) Why is this relevant? This new hire is going to be working 7 days A MONTH and starting pay is $220,000

Yes, they'll be working hard for 1 week, but they don't have to deal with a clinic and get 3 weeks off a month.

 

[Crayola227]

Don't do surgery.
Even though surgeons love the OR, they also have to run a clinic and see patients in the ED.

With this mentality you are probably going to be miserable during ANY residency, but medicine sounds like your best bet in the long run and here's why:

A community hospital in my area is looking to hire a new nocturnist (a nighttime hospitalist) Why is this relevant? This new hire is going to be working 7 days A MONTH and starting pay is $220,000

Yes, they'll be working hard for 1 week, but they don't have to deal with a clinic and get 3 weeks off a month.

hahahahah there is so much to this than meets the eye

don't become a hospitalist if you don't genuinely like hospital medicine
and being a nocturnist is a different ballgame than that

you realize in order, that is like the two most despised parts of like 90% of doctors' residencies? Their general medicine year? Not just cuz it's intern year and not in the specialty they want.

Internists get burnt, not as bad as EM or some others.

 

[OnePunchBiopsy]

hahahahah there is so much to this than meets the eye

you realize in order, that is like the two most despised parts of like 90% of doctors' residencies? Their general medicine year? Not just cuz it's intern year and not in the specialty they want.

Internists get burnt, not as bad as EM or some others.

Never said it wouldn't be hard work. Just giving OP, who wants "weeks of vacation" a suggestion that would allow them to do it.

don't become a hospitalist if you don't genuinely like hospital medicine

Tell that to the 25% of internists who would choose the same profession, according to AAMC careers in medicine. At the end of the day, a job is a job.

 

[Crayola227]

Never said it wouldn't be hard work. Just giving OP, who wants "weeks of vacation" a suggestion that would allow them to do it.

Tell that to the 25% of internists who would choose the same profession, according to AAMC careers in medicine. At the end of the day, a job is a job.

Yes, seeing as you know what it is to choose IM and choose it again.

I'm searching for the ultimate description I have preserved on what the medicine service is.

Listen, I wasn't trying to be hard on you.

But for someone who doesn't like WORK, hospitalist and nocturnist are like two of the worst. Why do you think one week on and one off? Burn out is that bad. Hence why even then only 1 in 4 would do it again. There's better numbers elsewhere.

 

[OnePunchBiopsy]

Yes, seeing as you know what it is to choose IM and choose it again.

I'm searching for the ultimate description I have preserved on what the medicine service is.

Listen, I wasn't trying to be hard on you.

But for someone who doesn't like WORK, hospitalist and nocturnist are like two of the worst. Why do you think one week on and one off? Burn out is that bad. Hence why even then only 1 in 4 would do it again. There's better numbers elsewhere.

Thick skin, no worries.

I'm not saying I know what it's like to choose medicine again. I'm just reflecting what 2,648 internists told Medscape in a survey.

TBH, OP sounds like he would be miserable in most/all specialties. Medicine is for people who want to work hard, and hospitalists are amongst the hardest working people in the hospital. Hell, I don't want to even touch that profession.

If you know another specialty that could possibly get 38-39 weeks off a year in practice, I would be open to see it so maybe OP could hear about it.

 

[OrthoTraumaMD]

I would love to take weeks off at a time to travel and raise a family

Honestly, that is unrealistic for medicine in general, but since you're already there...Don't do surgery, definitely. Do another specialty that allows procedures but that is more lifestyle friendly. Anesthesia/ER/PM&R.

 

[Crayola227]

Thick skin, no worries.

I'm not saying I know what it's like to choose medicine again. I'm just reflecting what 2,648 internists told Medscape in a survey.

TBH, OP sounds like he would be miserable in most/all specialties. Medicine is for people who want to work hard, and hospitalists are amongst the hardest working people in the hospital. Hell, I don't want to even touch that profession.

If you know another specialty that could possible get 38-39 weeks off a year in practice, I would be open to see it so maybe OP could hear about it.

EM vs IM --> both are hospital based, shift work, part of someone's admission process. Totally different in every other way. So aside from schedule, which you pick will depend on personality and how you like to approach problems. High burnout. High flexibility. EM you could make a living working 1-2 shifts a week if your spouse works, and be "OK." I don't know that you can get your shifts down this low in IM. IM there controveries should you try to go the Urgent Care route which sees all ages usually, another way to work spotty days and is open to ED docs I believe.

Can't recommend locums forever, people do them for I've heard of a couple years at a time.

 

[*brobro*]

Well, just an MS4 here but definitely don't do surgery. It's something that you live, eat, and breathe for quite some time before it ever fits anything close to the description of the lifestyle you're referring to. Sure, the occasional PP surgeon that has spent 5-10 years building a practice might be lucky enough to have all elective cases, nice clinic hours, and no call...but getting there was tons of work. There really isn't any field that meets your description...especially if you're ruling out highly competitive fields. You should just accept that there's nothing perfect and see if you can tolerate a job in rads. You should be able to match into a program somewhere without an overly impressive app, you can pretty much avoid all clinical mgmt of patients after pgy-1, the pay is still quite good, and the lifestyle is certainly reasonable.

 

[y123]

Pathology?
No rounds or managing the patients or outpatient clinics

 

[Crayola227]

Honestly, that is unrealistic for medicine in general, but since you're already there...Don't do surgery, definitely. Do another specialty that allows procedures but that is more lifestyle friendly. Anesthesia/ER/PM&R.

You didn't know this, but the OP made it clear none of those will work either.

They made things clear:
THEY ONLY LOVE SURGERY & ADRENALINE
THEY HATE HARD WORK
They are a pretty average student and WILL NOT have their pick of lifestyle procedural specialties
Predictably, they hate clinic.
They hate rounds.
They hate patient contact.
They hate research.
They hate anesthesia - not competitive anyway
They hate FM.
They hate Psych.
They hate ED.
They hate Peds.
They hate Ob/gyn.
They hate Rads.
They hate PMR - "overglorified PT."

We didn't talk Path. I'm not hopeful, not much adrenaline there.
Sports medicine isn't adrenaline, but it's young healthy people mostly, for a clinic population they're not exciting but they can be satisfying.

Surgery is the only thing that excites them, but they won't have enough time off.

It actually feels like we're being trolled right now with the Match around the corner.

How someone that is only motivated by adrenaline and not working hard managed to ever sustain enough interest before admissions and to this very day is entirely beyond me.

This is why those "clinical shadow hours," most of which should be with a PCP, are not box ticking. Most medicine is practiced in outpt clinic and if you can't imagine a reality of it for the rest of your career you should have burned your med school app before submitting it.

JFC.

OP - you're going to have to sack up and decide there is some job that is not beneath you now that you're this far in

 

[Crayola227]

I came to be nice, I did. But this is just beyond. At some point you're going to have to spit out something that shows you're even engaged in medicine in some way for people to keep trying to think of something for you, like you have to pretend some advice might be OK, but hey give me more

OP - Maybe there's a reason. I'll put my not annoyed cap on for you, because I'm smelling something.

Not med advice, but sometimes in med school people have ADHD (Surgery is the only thing that keeps my attention) or depression "Nothing is good" or burnout "I hate everything".

You need to go to your Dean's office. Whoever does career advising. Mentors. People who can see your app to date, and know who goes where from your school, to help you figure out what's in your grasp.
If you haven't seen a personal physician, annual wellness and bring this stuff up.

 

[*brobro*]

you could finish dental school in the time it takes to finish most residencies.

 

[Taddy Mason]

I'm not calling out OP, but its situations like this that tend to annoy me about people going straight into medicine without any actual real life experience, or actual (meaningful) experience working in healthcare (i.e., not just scribing, shadowing, volunteering, working VERY part time as an aide or sitter, doing research, etc.). Too many people pursue medicine with a very naive and romantic delusion, which just provides kindling for burnout.

 

[ProfMD]

Maybe skip residency and be a consultant. Or you could be one of those doctors that reviews insurance pre-authorizations.

Surgery is not for you. Sounds like most areas of medicine are not for you.

 

[Anicetus]

I came to be nice, I did. But this is just beyond. At some point you're going to have to spit out something that shows you're even engaged in medicine in some way for people to keep trying to think of something for you, like you have to pretend some advice might be OK, but hey give me more

OP - Maybe there's a reason. I'll put my not annoyed cap on for you, because I'm smelling something.

Not med advice, but sometimes in med school people have ADHD (Surgery is the only thing that keeps my attention) or depression "Nothing is good" or burnout "I hate everything".

You need to go to your Dean's office. Whoever does career advising. Mentors. People who can see your app to date, and know who goes where from your school, to help you figure out what's in your grasp.
If you haven't seen a personal physician, annual wellness and bring this stuff up.

I apologize for stirring up anger or frustrations about typical posts such as mine.

I have gone to talk to deans/counseling offered by school as a matter of fact. But the reality is I really do love medicine and learning it but unfortunately, as I've come to find in third year, I'm just not good at histories and physicals and the basic stuff compared to the average medical student. This may be the perfectionist in me but it just killed me in internal medicine when I couldn't remember a symptom of a particular disease or answer a pimp question correctly, which would cause me to lose interest. I would actually love being able to do internal medicine if I had the memory capacity and just be able to "think" in the way that better medical students, residents, and attendings do but constantly dropping details from my head is what made me despise most of my clerkships and has more or less transformed me into despising all of these clerkships that require vast clinical knowledge and the ability to figure out a difficult case.

This really pushed me back to pursue surgery due to a great amount of time "doing" instead of "thinking". Maybe it's just what med students go through, maybe it's just lack of sleep, who knows. But I hope that explains my surgery or bust attitude I've developed this year because it seems like the only skill I have left to see if I'm good at.

The vacation stuff is hopeful naivety I admit. But traveling one day is one of the things I still like to be hopeful for to help get through this journey. It seems like most doctors put this in their "about me" pages so it it just BS or do docs actually travel for only like a couple days at a time?

 

[*brobro*]

Almost all fields will allow a few weeks vacation every year. Most residencies have at least 3 weeks vacation structured into them. There's a big difference between a nice lifestyle and taking a few weeks vacation. It's just very clear from your posts that you should not choose surgery. If the question you wanted answered was "Should I be a surgeon?" Then the answer is most certainly, "No!" Not..."well, maybe, but if, sort of, it depends..." No. The answer is No. Let that be liberating for you...

Now, as far as trying to find a field that might work best for you, there's a thousand different opinions on that and I doubt anyone's gonna offer you an epiphany that you can't reach on your own by combing these forums. Good luck. It's not easy but there are lots of good options.

 

[zoopers]

I'm just not good at histories and physicals and the basic stuff

You should suck at this stuff. You're in your 3rd year of medical school, your first year of clinical training. If a baby can't walk in its first 2 years, do we give up on it? No, we have them work on walking, and eventually they can run just as well as anybody else!

The idea that you're not good at this, and will never be good at this is not what I think to be a good reason to go into surgery. You will do thousands more H&P's over your residency, and way more over your lifetime. As with everything in medicine, it will get easier with experience. This really won't be the limiting factor to anything I wouldn't think.

Thinking surgery is the easy way out, as it doesn't require "vast clinical knowledge," I think is very misguided. Because surely, it does. Your clinical knowledge will grow, and I don't think this should play a major factor in your decision for your lifelong career.

 

[SunsFun]

People I've met such as you, if uncompetitive for optho/derm/ortho end up pursuing EM. Others turned off from surgery by hours or patient management also seem to favor EM. Maybe you should look into it?


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[Wordead]

Agree with above, truth of the matter is that people who cant cut it in surgery seem to trickle into EM (if they have some passable stats) or Anesthesia.

There are still plenty of good anesthesia residents at the good programs but truth of the matter is that it's become the de facto dumping ground for the dumb students who want to not work a lot and make a lot of money since there are so many spots.

 

[masaraksh]

Agree with above, truth of the matter is that people who cant cut it in surgery seem to trickle into EM (if they have some passable stats) or Anesthesia.

There are still plenty of good anesthesia residents at the good programs but truth of the matter is that it's become the de facto dumping ground for the dumb students who want to not work a lot and make a lot of money since there are so many spots.

Sounds like a nice gig. So whats the catch?!

 

[DocWinter]

Good grief man, you hate everything.

Medicine is work. I just finished a 16 hour shift on call in a specialty I have little interest in. It sucked, to be honest, but it's part of the job.

You seem like you'll be best suited in a field with the last effort and time put in. I second IM or ER, as there are options to work less as posted above. But i really hope you come to view medicine and work in a better light because it's a disservice to your future patients

 

[Crayola227]

IM and EM sound like mistakes. I'd love to have some IM or EM docs chime in. Besides, OP said they didn't like those either.

Paging @Raryn & maybe he knows what EM doc we could bug to give advice.

If Raryn comes in, basically we have a student thinking about careers.
Not a competitive student, only likes surgery and adrenaline, hates every single other specialty suggested.
Issue is they don't like hard work, and they want to be able to have weeks off for travel.
People suggest EM or IM, because of potential to have time off.

I think even with time off, IM is too much work to be good for someone who doesn't like work, and burnout will be high for someone like that.
Thoughts?

Useful post from OP on IM:

I apologize for stirring up anger or frustrations about typical posts such as mine.

I have gone to talk to deans/counseling offered by school as a matter of fact. But the reality is I really do love medicine and learning it but unfortunately, as I've come to find in third year, I'm just not good at histories and physicals and the basic stuff compared to the average medical student. This may be the perfectionist in me but it just killed me in internal medicine when I couldn't remember a symptom of a particular disease or answer a pimp question correctly, which would cause me to lose interest. I would actually love being able to do internal medicine if I had the memory capacity and just be able to "think" in the way that better medical students, residents, and attendings do but constantly dropping details from my head is what made me despise most of my clerkships and has more or less transformed me into despising all of these clerkships that require vast clinical knowledge and the ability to figure out a difficult case.

This really pushed me back to pursue surgery due to a great amount of time "doing" instead of "thinking". Maybe it's just what med students go through, maybe it's just lack of sleep, who knows. But I hope that explains my surgery or bust attitude I've developed this year because it seems like the only skill I have left to see if I'm good at.

The vacation stuff is hopeful naivety I admit. But traveling one day is one of the things I still like to be hopeful for to help get through this journey. It seems like most doctors put this in their "about me" pages so it it just BS or do docs actually travel for only like a couple days at a time?

 

[Crayola227]

I apologize for stirring up anger or frustrations about typical posts such as mine.

I have gone to talk to deans/counseling offered by school as a matter of fact. But the reality is I really do love medicine and learning it but unfortunately, as I've come to find in third year, I'm just not good at histories and physicals and the basic stuff compared to the average medical student. This may be the perfectionist in me but it just killed me in internal medicine when I couldn't remember a symptom of a particular disease or answer a pimp question correctly, which would cause me to lose interest. I would actually love being able to do internal medicine if I had the memory capacity and just be able to "think" in the way that better medical students, residents, and attendings do but constantly dropping details from my head is what made me despise most of my clerkships and has more or less transformed me into despising all of these clerkships that require vast clinical knowledge and the ability to figure out a difficult case.

This really pushed me back to pursue surgery due to a great amount of time "doing" instead of "thinking". Maybe it's just what med students go through, maybe it's just lack of sleep, who knows. But I hope that explains my surgery or bust attitude I've developed this year because it seems like the only skill I have left to see if I'm good at.

The vacation stuff is hopeful naivety I admit. But traveling one day is one of the things I still like to be hopeful for to help get through this journey. It seems like most doctors put this in their "about me" pages so it it just BS or do docs actually travel for only like a couple days at a time?

Eh, this isn't that typical. Now I feel less irritated and just feel bad for you..
@Raryn probably has ideas about how to improve from an IM/thinking perspective.
(Infernal Internist I have great respect for on this board).

Docs do travel, but they use their vacation time. Most Americans only get a few weeks a year, you know.

I think post residency, even if a busy general surgeon you can have up to 4-6 weeks, depending what gig you get.
If every year you spend a week or so somewhere in the world, it wouldn't be that long before you've racked up a nice list.
A lot of docs it's not until their loans are paid off (common in the 50s) that they scale back.
A lot of people don't get a lot of their "world travel" done until they get into their Golden Years with loans paid and kids out of the house.
Have to be realistic about how much.

 

[CCC_MD]

Hey all,

TLDR: I hate surgery lifestyle, but hate rounding and clinical management and mental stimulation of medicine. I would only really prefer GI if succeeding in internal medicine wasn't a hoop to get through. I've only loved surgery in medical school so far. I don't have anywhere near the stats for the competitive lifestyle surgery specialties. What should I do?

The honest truth is - you won't have everything in medicine in any specialty, i.e having a stimulating/exciting field at all times with great hours, pay and that you can get into with your stats. You will get bits and pieces at different times throughout your career. Sometimes its all work, sometimes its really cool.

Also, you may know this, you really don't know how medicine or surgery really is until you actually do it and are higher up. Unfortunately, you have to make a choice. I hated rounding in IM as well as a medical student, but I really enjoyed many other aspects of it. When I actually was the sole provider, I got a great kick out of it. It gave me great options to be a nocturnist/hospitalist/office practice at the 3 year mark but I
ended up doing a busy fellowship at that point. Point is, I had a way out should I have chosen to do so.

Surgical/ER specialties may seem exciting, but can get boring after several lap chole's etc...Don't let the excitement of a field determine your decision, rather the intrinsic aspects of it. Personality is just as important.

From what you've described - Aim for ER/Anesthesia. It requires quick decision making, no patient followup, occasional excitement, procedures. Lots of flexibility in locuming if you want to travel a lot early on in your career, short residency of 3-4 years. its gets at most of what you want out of life and you can get in with middle of the ground stats. It can be boring at times, but the hours are not that bad even during residency. Do surgery or internal medicine only if you want to work, and work hard.

 

[Raryn]

Hey all,

Yes, I did make a previous thread about "surgery or bust" attitude previously in the surgery thread. This is because I have absolutely despised everything up until surgery.

I am currently in surgery and love the OR. It is the only stimulating thing in medicine for me and it is currently my plan to go into surgery for this reason. However, unfortunately I'm a pretty lazy vacation loving non-workaholic, which doesn't jive well with surgery lifestyle. I am not getting cold feet as an MS3 because I don't live to work. I work to live, if that makes sense. If I didn't have to, I wouldn't work at all. Oddly enough, surgery was what attracted me to medicine in the first place due to the adrenaline of surgery itself. I am not sure what to do and am hoping from some anonymous internet input from MS3/4 and even residents and attendings about if I should avoid surger now while it's still not too late.

My aspirations: I have zero desire to do research, and I would love to take weeks off at a time to travel and raise a family (doesn't sound like the surgery lifestyle).

Why I have not liked other specialties:
Subspecialties in surgery: ruled out due to subpar stats and zero publications so please no one suggest optho/ent/derm as a potential solution.

Obgyn: pass. Hated the residents and monitoring pregnant women. Wanted to shoot myself.
Psychiatry: Pass. I valued their lifestyle so much but it was incredibly unfulfilling and seemed miserable having to deal with those types of patients
Internal medicine: I honored this. The fact that I honored this is the ONLY reason I would pursue it in hopes of nabbing GI fellowship, but this is very very competitive from what I've been told and am not confident that I would match a fellowship where I'd do internal medicine. Also, I absolutely DESPISED rounds and managing the patients their multiple problems. Had I not known medicine was like this I would've considered a different career.
Family medicine: outpatient clinic makes me want to shoot myself but the lifestyle is absolutely ideal.
Pediatrics: I hate kids. Plain and simple.
Anesthesiology: looks boring as **** honestly.
Radiology: same as anesthesiology.
Emergency medicine: I absolutely hate the ED.

Not sure where to go from here.

TLDR: I hate surgery lifestyle, but hate rounding and clinical management and mental stimulation of medicine. I would only really prefer GI if succeeding in internal medicine wasn't a hoop to get through. I've only loved surgery in medical school so far. I don't have anywhere near the stats for the competitive lifestyle surgery specialties. What should I do?

"Also, I absolutely DESPISED rounds and managing the patients their multiple problems."
"I really do love medicine and learning it but unfortunately, as I've come to find in third year, I'm just not good at histories and physicals and the basic stuff compared to the average medical student."

This first statement in and of itself would lead me to suggest not doing medicine. In the long run, practicing as an internist in the community doesn't mean sitting around mentally masturbating about electrolytes, but you still have to get through residency, and managing multiple problems is part and parcel of being an internist. GI, Cardiology, Pulm/Critical care might give you the procedures you desire, but p/cc will *certainly* give you multiple medical problems, and GI/Cards will have long hours during training and are not guarantees besides. OTOH the second statement is not a reason to not do IM. The purpose of med school/residency is to train you to be better at those things.

So lets think through what fields might be reasonable. You love procedures and hate rounds, can't stand clinic, and don't want to deal with more than one problem at a time. You also don't want to work long hours and aren't competitive enough for ophtho. Well, we can just start at the full list of 20+ residencies and narrow it down.

First we'll knock off the surgical subspecialties and GS itself given your hatred of hours. IM is discussed above. That leaves Anesthesia, Derm, EM, FM, Neurology, Pathology, Peds, PMR, Psych, Rad Onc, rads (either DR or IR). We can knock a few more off the list due to your expressed preferences (explicit hatred of EM, FM, peds, psych) and competitiveness (Derm, Rad Onc...), leaving us only with: Anesthesia, Neurology, Pathology, PMR, and Rads. I think a hatred of rounds, mental masturbation, and clinic takes Neurology straight off the list. Pathology has zero "adrenaline" components, so off it goes too.

Anesthesiology has been described in the past as "hours of boredom interspersed with minutes of sheer terror", but it's actually a fascinating field. They pretty much exclusively do procedures, and while they do manage multiple medical problems, they do so in a limited context (i.e. keep the patient alive until they can be handed over) unless they do a critical care fellowship. I strongly considered it once upon a time, and certainly wasn't bored during the month I did as a student.

Radiologists, even without an interventional fellowship, can do some procedures and have no clinic. Interventional radiologists basically exclusively do procedures without clinic. You don't need great stats to match DR, though getting into "top" programs will be difficult without them and the IR fellowship isn't guaranteed. The last 4-5 years, radiology has been the least competitive of the competitive fields,

PM&R? I'll plead general ignorance to this field, but as far as I know they don't do that many procedures outside of a pain service and have to have at least some comfort managing multiple medical problems. Doesn't sound like the perfect fit.

So my conclusion after Crayola sent up the bat signal? Your only reasonable options are IM with a fellowship (cards vs GI, with the understanding you'll be absolutely miserable in training), Radiology, and Anesthesia. If you haven't done an elective in the latter two, you can consider it, but there's literally no other fields that can come anywhere close to meeting your listed desires.

IR is probably the best option based on everything you said, but you aren't competitive enough to do integrated IR, and a fellowship isn't a guarantee. That said, I'd think you'd be happier in DR than in flat out IM, so maybe that's the best option regardless.

 

[Slack3r]

Sounds like a nice gig. So whats the catch?!

Table up.

 

[Anicetus]

Thanks guys.

I appreciate the responses from each of you and as frustrating as my core human wants are, I still am going to grind with an end goal in mind. I probably should've mentioned that I study about 10-12 hours solid a day on Non clinic days, and about 5-6 hours on clinic days despite the lack of sleep so when I say I'm lazy, it's my inherent want to finally reach the end of this tunnel. Seeing more work (which to me is just general third year duties and studying afterwards for the shelf in mind) is just dreadful, but from what some of you, like @CCC_MD Mentioned, I may actually enjoy IM if I'm the one in the attending position. I can be more specific.

Reason I despised rounds on IM: it was following the residents around with an attending and falling asleep listening to residents present. Meanwhile when you present a patient everyone looks at you like you're a little puppy doing a trick and pats you on the back for doing a good job. I get it, but maybe the third year role really started to get to me after doing 4 rotations of this and surgery is something incredibly different.

@Raryn also brings up a good point about rads, like some of you have done as well and I admit I am quick to judge as it seems like a bunch of slide reading, but same attitude as before, is it a lot different doing the actual readings yourself instead of watching a radiologist do them? I can't really imagine students going into radiology really expressed "**** this seems like the most amazing job in the world" when they walked into the reading room and had radiologist residents give them weird looks for actually wanting to shadow them read and dictate images. Maybe a radiology resident or MS4 could comment on that.

@Crayola227 thanks for not giving up. Oddly enough SDN can be quite therapeutic at times. Spent the last couple days talking to surgery residents and attending with this cold feet feeling and starting to look back at IM again given what some of you are saying. I also assume given an honors in IM and my step 1 in 230's I would have more choices for that than in general surgery right? I'm aware fellowships are a grind and not easy to match but doesn't a lot of that also have to do with the reputation of the IM program?

 

[Crayola227]

Thanks guys.

I appreciate the responses from each of you and as frustrating as my core human wants are, I still am going to grind with an end goal in mind. I probably should've mentioned that I study about 10-12 hours solid a day on Non clinic days, and about 5-6 hours on clinic days despite the lack of sleep so when I say I'm lazy, it's my inherent want to finally reach the end of this tunnel. Seeing more work (which to me is just general third year duties and studying afterwards for the shelf in mind) is just dreadful, but from what some of you, like @CCC_MD Mentioned, I may actually enjoy IM if I'm the one in the attending position. I can be more specific.

Reason I despised rounds on IM: it was following the residents around with an attending and falling asleep listening to residents present. Meanwhile when you present a patient everyone looks at you like you're a little puppy doing a trick and pats you on the back for doing a good job. I get it, but maybe the third year role really started to get to me after doing 4 rotations of this and surgery is something incredibly different.

@Raryn also brings up a good point about rads, like some of you have done as well and I admit I am quick to judge as it seems like a bunch of slide reading, but same attitude as before, is it a lot different doing the actual readings yourself instead of watching a radiologist do them? I can't really imagine students going into radiology really expressed "**** this seems like the most amazing job in the world" when they walked into the reading room and had radiologist residents give them weird looks for actually wanting to shadow them read and dictate images. Maybe a radiology resident or MS4 could comment on that.

@Crayola227 thanks for not giving up. Oddly enough SDN can be quite therapeutic at times. Spent the last couple days talking to surgery residents and attending with this cold feet feeling and starting to look back at IM again given what some of you are saying. I also assume given an honors in IM and my step 1 in 230's I would have more choices for that than in general surgery right? I'm aware fellowships are a grind and not easy to match but doesn't a lot of that also have to do with the reputation of the IM program?

I'm glad it's started to be helpful, sorry I was sort. It's easy 3rd year to feel pretty crappy about medicine and long for more than a couple weeks vacation. 3rd yr, intern yr, first yr attending, all the hardest. Things get easier when you start to know what you're doing.

Being competitive for fellowship has a lot to do with reputation of the IM program, and university programs tend to be better, they often have departments where you can get research for the subspecialty, and network to get better LORs from people who know others in their field, and you can see what placement they have. It's possible to get a fellowship from a community program, but you have to look hard at them. When you want a competitive fellowship you have to really really bust ass in residency. Residency is a grind no matter what. I knew I didn't want any competitive fellowship, so I was able to "take it easy" at least when it came to not needing research or to push myself to network or whatever. So I'm not the expert on getting poised for fellowship.

As far as rads, I actually really enjoyed my rads rotation. They are really smart people. Reading yourself is always better. I really liked the systematic approach to reading most things, there's a puzzle quality as you put together the reason for the image, the petinent chart/patient history & HPI, and then when you go looking for abnormalities. You look at the trees, you look at the forest. It can be very detail oriented. You have use some judgment (is that medastinum really widened?) and also be good at developing a gestalt, like, is this normal in context, what's my overall feeling? Pattern recognition, especially with CTs & MRIs. In order to put all that together, they really need a lot more medical knowledge than people would think. So many diseases have imaging findings of one kind or another that they really retain a lot of what you learn in medical school, to maintain a broad ddx.

There's a lot more science to it as well, as fair as thinking about the sensitivity and specificity of findings and at what point you pull the trigger and say that an image suggests a certain disease. To that end, that's a lot where the field is always advancing.

Radiologists get to interact with people more than people think, it's just mostly with other doctors if they want to call and talk to you about a study. Some radiologists really like that they talk to other doctors and not so much patients (others hate talking to other doctors, it can be unpleasant or pleasant depending).

Radiology is also pretty hard too, though. I think the pace is OK in residency, and you have your images double checked, but when you get out the pace can be brutal for slides, and there's still liability and it can be really easy to miss things if you're going real fast and you're not that good.

The job market for radiology is sooooooo crap hard right now too. On this board I've heard horror stories like people without jobs for a few years, working at Best Buy. Dunno.

 

[DJNYY]

The job market for radiology is sooooooo crap hard right now too. On this board I've heard horror stories like people without jobs for a few years, working at Best Buy. Dunno.[/QUOTE]

I think the rads job market myths are a bit overblown. Everyone does a fellowship and I honestly haven't seen a single instance where someone didn't get a job right after. Naturally I'm biased because I'm going into this field. But if you do a double fellowship in women's imaging and interventional radiology, you're basically a unicorn waiting to be captured for a sizeable fee. If you network and play to the market needs, you will be fine. Market fears should not be a deterrent to a career in rads

 

[DJNYY]

For OP, if you're getting cold feet about surgery, IR could be for you. If you think about it, all the endovascular stuff that vascular surgery and interventional cardiology does was pioneered by IR. Those specialties took those procedures because IR wasn't very clinical in the past. Now days, IRs mostly do other endovascular work like splenic embolizations, fibroid embos, chemo or radio embolizations for HCC or mets to the liver, fistula work, TIPS, BRTOs, etc. etc. The new kid on the block is prostate artery embolizations for BPH which is the hot kid on the block. Lots of exciting stuff going on, lots of sweet procedures in critically ill patients, and as I alluded to it's becoming more clinical so you'll get to see patients in clinic and follow them up like you would in any surgical subspecialty. I would say, if you investigate IR and it's for you, get to know someone at your institution and work/ research with them because now with the new integrated IR residencies, med students know what it is and it's getting more competitive. IR is a relatively small field so dedicated research, going to SIR conference, and networking are HUGE if you want to. For anyone with surgery cold feet, IR is the next best option to be perfectly honest (IMO)

 

[Psai]

Agree with above, truth of the matter is that people who cant cut it in surgery seem to trickle into EM (if they have some passable stats) or Anesthesia.

There are still plenty of good anesthesia residents at the good programs but truth of the matter is that it's become the de facto dumping ground for the dumb students who want to not work a lot and make a lot of money since there are so many spots.

Or maybe they didn't like surgery and liked EM or anesthesia. For some reason, not everyone wants to be a surgeon.

 

[nlax30]

I've skimmed through some of these and to keep it short either IR or anesthesia came to mind as possible options.

I actually loved my IR rotation as a med student but just could not have stomached a DR residency.

The other aspect that I didn't see mentioned was the factor of what sort of job environment would you be looking at.

The other thought that came to mind was the VA may be a good fit for you.

At least the VA we did some training at certainly had a more laid back feeling than our private main hospital and really most of the specialities there enjoyed a very nice schedule.

I'm going into EP and actually that field could be an option just in terms of very procedure oriented and in general more "lifestyle" friendly than general cardio or interventional. That can vary though as our EP guys cover multiple hospitals and when on call can get slammed. Plus you'd be looking at 8 years of difficult residency/training.....

If I had to pick ONE for ya.... maybe anesthesia at a local VA.

 

[Anicetus]

For OP, if you're getting cold feet about surgery, IR could be for you. If you think about it, all the endovascular stuff that vascular surgery and interventional cardiology does was pioneered by IR. Those specialties took those procedures because IR wasn't very clinical in the past. Now days, IRs mostly do other endovascular work like splenic embolizations, fibroid embos, chemo or radio embolizations for HCC or mets to the liver, fistula work, TIPS, BRTOs, etc. etc. The new kid on the block is prostate artery embolizations for BPH which is the hot kid on the block. Lots of exciting stuff going on, lots of sweet procedures in critically ill patients, and as I alluded to it's becoming more clinical so you'll get to see patients in clinic and follow them up like you would in any surgical subspecialty. I would say, if you investigate IR and it's for you, get to know someone at your institution and work/ research with them because now with the new integrated IR residencies, med students know what it is and it's getting more competitive. IR is a relatively small field so dedicated research, going to SIR conference, and networking are HUGE if you want to. For anyone with surgery cold feet, IR is the next best option to be perfectly honest (IMO)

Thanks for the advice, but isn't IR like plastics level competitiveness?

 

[Frogger27]

PM&R --> pain fellowship? you would have to be able to work with that patient population and it's pretty competitive, but I heard it has a nice lifestyle/compensation.

If not you could stay in PM&R which is called "plenty of money + relaxation", which is pretty much what you are saying you want.