Surgery Cold Feet

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

This is the first year it's offered so nobody knows what they're looking for. I can tell you my step 1 was 230s, step 2 250s and I was dead average in my class at a top 40 med school. I was more successful than most in getting interviews. Probably because I did a dual degree program which gave me time to get my name on a couple papers and present at a conference (surgery related actually)

If you find that you really like it, try to get involved in the IR community to show dedicated interest (particularly the resident fellow section where you can get your name recognized by some well known PDs). If you love IR but worry about your competitiveness, think about a professional loa that can also give you more time to do research and be involved. Also, away rotations can help.

All that said, you can do jack ****, match with no problem in anesthesia, and get a cush job where you barely have to think straight out of residency. I know a girl who did that and started at $500K in boo foo Indiana. If you actually like medicine, then think about IR. Sorry if I offended any anesthetists out thurrr

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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.

Word on the street is Pm&R is getting a lot more competitive... especially this year
 
Word on the street is Pm&R is getting a lot more competitive... especially this year

People finally catching on? Even if it is more competitive, a score in the 230s should be okay
 
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No.

And IR is still an option through DR, which is pretty uncompetitive these days.

The number of IR spots available after DR residency will be fewer because many of those spots are going to be filled through the integrated residency. This year there are 122 integrated spots which means there will be 122 fewer available IR fellowships (being rebranded as "independent 1 year IR residency) 5 years from now
 
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No it's not.
No IR isn't an option through DR anymore? Because as far as I'm aware, not all the fellowships are converting to an integrated track, at least not yet.

Or no that DR is uncompetitive these days? Because there's plenty of data re: match rates that shows that DR is the least competitive of the "competitive" specialties for something like 4 or 5 years running. Getting into a "top" DR program isn't that easy, but getting into radiology for almost any US grad without huge red flags? It's doable.
 
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No IR isn't an option through DR anymore? Because as far as I'm aware, not all the fellowships are converting to an integrated track, at least not yet.

Or no that DR is uncompetitive these days? Because there's plenty of data re: match rates that shows that DR is the least competitive of the "competitive" specialties for something like 4 or 5 years running. Getting into a "top" DR program isn't that easy, but getting into radiology for almost any US grad without huge red flags? It's doable.
This coming cycle is the last year for DR residents to go the fellowship route - https://www.sirweb.org/learning-center/ir-residency/post-match-fellowships/
Kind of a kick in the balls for PGY-1s and 2s hoping to go into IR.
 
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.
Ms1 here. sounds like there are some hidden cons you are not bringing up for a job like this... 220 for 3 weeks off just doesn't seem right, what's the catch besides just 1 week of hard work?
 
Ms1 here. sounds like there are some hidden cons you are not bringing up for a job like this... 220 for 3 weeks off just doesn't seem right, what's the catch besides just 1 week of hard work?
It's not terribly uncommon and likely entails minimal benefits and being in a rural/undeserved region, which is a death sentence according to the SDN masses.
 
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Ms1 here. sounds like there are some hidden cons you are not bringing up for a job like this... 220 for 3 weeks off just doesn't seem right, what's the catch besides just 1 week of hard work?

You're the sole hospitalist at night in a hospital with ~30-40 patients on the floor, and taking in new admits from the ED. The regular hospitalists who work the night usually get to rest for about 30 minutes.

Plus it's not the NICEST hospital. They still have mostly paper charts and their EMR is garbage.
 
"If your favorite room in the hospital is the OR, go into Anesthesia. If your favorite room in the whole world is the OR, go into surgery."

What this old saying means, if you don't want to spend most all your time in the OR - the surgical life might not be for you (particularly a surgical residency)
 
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This coming cycle is the last year for DR residents to go the fellowship route - https://www.sirweb.org/learning-center/ir-residency/post-match-fellowships/
Kind of a kick in the balls for PGY-1s and 2s hoping to go into IR.

SIR created way too much confusion by stating that fellowships were going to sunset. They are being replaced by something virtually identical called "independent residency". The independent IR residency follows the DR residency and is 2 years or 1 year if you did the ESIR track in your DR residency. SIRs great way of causing mass confusion where there didn't need to be. There is separately something called "integrated IR residency" which is the one that people apply to directly out of med school and includes both the DR and IR training at one institution. Essentially, fellowships are just being rebranded as independent residencies. Those will be available to everyone who is a pgy-1, 2, etc. right now
 
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OP - if you "work to live" and dont live to work, then it really doesn't matter what you are going to go into - you won't like it.

From what you typed, the lifestyle of outpatient clinic was something you liked. Just figure out how to do it while hating it the least. Maybe run a medical marijuana mill or something.
 
Do 4th year sub-Is in medicine and anesthesia and see what sticks there.

My medicine sub-I was WAY different from my 3rd year medicine clerkship in terms of the level of responsibility I had and how comfortable I felt with writing notes, seeing patients, interacting with my team and other specialties. It was much more fun than the 3rd year clerkship where you are basically just a glorified note writer who can't even seem to do that right most of the time. For me, I finally felt like I was contributing and had some idea of what I was doing which made it a lot more enjoyable than 3rd year medicine.

Also, I think it's really hard to judge what anesthesia is like unless you've done a rotation in it, particularly a sub-I. I even did a 3rd year rotation in anesthesia but it wasn't until my 4th year rotation that I really got a good appreciation for what they do.

I really think you're going through some burnout right now-- third year is really really hard and everyone experiences this to some extent. Keep an open mind going into the first few rotations of 4th year and you will find something that interests you. Good luck!
 
I disagree with most of the people here, dont pursue IM. IM sucks a little bit less than GS, but during those sucky times you are going to wonder, if this has to suck so much why didnt i choose GS.

You clearly only have two choices, go all out and choose GS or choose FM and be done with it. Anesthesiology, Rads or EM wont solve your problems.
 
I disagree with most of the people here, dont pursue IM. IM sucks a little bit less than GS, but during those sucky times you are going to wonder, if this has to suck so much why didnt i choose GS.

You clearly only have two choices, go all out and choose GS or choose FM and be done with it. Anesthesiology, Rads or EM wont solve your problems.

Right... OP clearly only has two choices :lame:

There are literally more than 50 posts in this thread about why choosing general surgery is a terrible idea for the OP. I honestly can't even imagine how crappy it would be to have somebody with that attitude as a co-resident.
 
I disagree with most of the people here, dont pursue IM. IM sucks a little bit less than GS, but during those sucky times you are going to wonder, if this has to suck so much why didnt i choose GS.

You clearly only have two choices, go all out and choose GS or choose FM and be done with it. Anesthesiology, Rads or EM wont solve your problems.

Thanks for all of the responses. This thread brings back memories of how bad my lack of sleep was getting to me. At this time I decided against surgery because it got to a point where my inability to function on less than 5 hours of sleep led me to get numb to the OR and all I wanted to do at that point was get out of the surgery to go and study for the shelf since there wasn't enough time to do that as it was and the lack of sleep was messing with my ability to recall details and fund of knowledge.

I quoted the post above me in particular because this was my thought process lately but still decided more towards IM after talking to hospitalists about my dilemma. The 'suck' of surgery vs the 'suck' of IM doesn't seem all that different on a simple day to day basis but the average year looks way different. On top of that, if we were to only talk about residency, IM is only 3 years of 'suck' if you even count chief year vs surgery which is 5 years of 'suck'.

If anything I do see why people are starting to move towards the shift work. I can't tell you how many times I've seen surgeons cancel any plans they made later in the day because they had to go back to the OR.

I don't think there is anything wrong with not having work be the #1 priority in one's life. Starting a family and enjoying hobbies and traveling outside of work will always be above a career in terms of importance to me. Maybe it's because this is SDN with a select personality of followers that value career above all else, but it's hard to imagine there are hospitalists that don't value career over their other aspects of life. If that were the case then a lot of parents should be hiring more nannies instead of working 1/2 or even 1/4 time gigs.
 
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Thanks for all of the responses. This thread brings back memories of how bad my lack of sleep was getting to me. At this time I decided against surgery because it got to a point where my inability to function on less than 5 hours of sleep led me to get numb to the OR and all I wanted to do at that point was get out of the surgery to go and study for the shelf since there wasn't enough time to do that as it was and the lack of sleep was messing with my ability to recall details and fund of knowledge.

I quoted the post above me in particular because this was my thought process lately but still decided more towards IM after talking to hospitalists about my dilemma. The 'suck' of surgery vs the 'suck' of IM doesn't seem all that different on a simple day to day basis but the average year looks way different. On top of that, if we were to only talk about residency, IM is only 3 years of 'suck' if you even count chief year vs surgery which is 5 years of 'suck'.

If anything I do see why people are starting to move towards the shift work. I can't tell you how many times I've seen surgeons cancel any plans they made later in the day because they had to go back to the OR.

I don't think there is anything wrong with not having work be the #1 priority in one's life. Starting a family and enjoying hobbies and traveling outside of work will always be above a career in terms of importance to me. Maybe it's because this is SDN with a select personality of followers that value career above all else, but it's hard to imagine there are hospitalists that don't value career over their other aspects of life. If that were the case then a lot of parents should be hiring more nannies instead of working 1/2 or even 1/4 time gigs.

I respect your decision. So here are the field that is conductive to what you like.

-EM
- psych
- radiology, you can 1 week on 2 week off night job or have 3 month of vacation in day job
- anesthesia
- pm and r

Please add more as I am forgetting something I am sure. OP said hes not the most competitive candidate so dern, opth and radonc prob arent in the cards.
 
Thanks for all of the responses. This thread brings back memories of how bad my lack of sleep was getting to me. At this time I decided against surgery because it got to a point where my inability to function on less than 5 hours of sleep led me to get numb to the OR and all I wanted to do at that point was get out of the surgery to go and study for the shelf since there wasn't enough time to do that as it was and the lack of sleep was messing with my ability to recall details and fund of knowledge.

I quoted the post above me in particular because this was my thought process lately but still decided more towards IM after talking to hospitalists about my dilemma. The 'suck' of surgery vs the 'suck' of IM doesn't seem all that different on a simple day to day basis but the average year looks way different. On top of that, if we were to only talk about residency, IM is only 3 years of 'suck' if you even count chief year vs surgery which is 5 years of 'suck'.

If anything I do see why people are starting to move towards the shift work. I can't tell you how many times I've seen surgeons cancel any plans they made later in the day because they had to go back to the OR.

I don't think there is anything wrong with not having work be the #1 priority in one's life. Starting a family and enjoying hobbies and traveling outside of work will always be above a career in terms of importance to me. Maybe it's because this is SDN with a select personality of followers that value career above all else, but it's hard to imagine there are hospitalists that don't value career over their other aspects of life. If that were the case then a lot of parents should be hiring more nannies instead of working 1/2 or even 1/4 time gigs.

Only on SDN will you be chastised for expressing a desire to live life and have time to enjoy it. You've got to realize there are a lot of uptight people in medicine, and SDN isn't an exception. Those of us that aren't that way become the black sheep, which becomes "wrong", or lazy/unmotivated, etc. If someone in medicine expresses the desire to enjoy life, spend time with family, etc. the snoody replies, such as "why did you even choose medicine in the first place?" will always arise. Honestly, I'm tired of the "better than thou" attitude so often seen on this forum.

The short answer is, yes I believe there is a way to have family time, vacation and enjoy what you do. But there also isn't anything perfect out there.

I will say that, based on what you said, Radiology sounds like it could be a good choice for you. The sooner you come to terms with the fact that any specialty in medicine is just a job, the sooner you will know what the right specialty is for you. Sometimes it's not choosing what you "love", but rather choosing what you don't hate. That led me to choose Rads. Plus, I think you may find that Radiology is much more interesting than you currently perceive it.
 
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Thanks for all of the responses. This thread brings back memories of how bad my lack of sleep was getting to me. At this time I decided against surgery because it got to a point where my inability to function on less than 5 hours of sleep led me to get numb to the OR and all I wanted to do at that point was get out of the surgery to go and study for the shelf since there wasn't enough time to do that as it was and the lack of sleep was messing with my ability to recall details and fund of knowledge.

I quoted the post above me in particular because this was my thought process lately but still decided more towards IM after talking to hospitalists about my dilemma. The 'suck' of surgery vs the 'suck' of IM doesn't seem all that different on a simple day to day basis but the average year looks way different. On top of that, if we were to only talk about residency, IM is only 3 years of 'suck' if you even count chief year vs surgery which is 5 years of 'suck'.

If anything I do see why people are starting to move towards the shift work. I can't tell you how many times I've seen surgeons cancel any plans they made later in the day because they had to go back to the OR.

I don't think there is anything wrong with not having work be the #1 priority in one's life. Starting a family and enjoying hobbies and traveling outside of work will always be above a career in terms of importance to me. Maybe it's because this is SDN with a select personality of followers that value career above all else, but it's hard to imagine there are hospitalists that don't value career over their other aspects of life. If that were the case then a lot of parents should be hiring more nannies instead of working 1/2 or even 1/4 time gigs.
Thanks for all of the responses. This thread brings back memories of how bad my lack of sleep was getting to me. At this time I decided against surgery because it got to a point where my inability to function on less than 5 hours of sleep led me to get numb to the OR and all I wanted to do at that point was get out of the surgery to go and study for the shelf since there wasn't enough time to do that as it was and the lack of sleep was messing with my ability to recall details and fund of knowledge.

I quoted the post above me in particular because this was my thought process lately but still decided more towards IM after talking to hospitalists about my dilemma. The 'suck' of surgery vs the 'suck' of IM doesn't seem all that different on a simple day to day basis but the average year looks way different. On top of that, if we were to only talk about residency, IM is only 3 years of 'suck' if you even count chief year vs surgery which is 5 years of 'suck'.

If anything I do see why people are starting to move towards the shift work. I can't tell you how many times I've seen surgeons cancel any plans they made later in the day because they had to go back to the OR.

I don't think there is anything wrong with not having work be the #1 priority in one's life. Starting a family and enjoying hobbies and traveling outside of work will always be above a career in terms of importance to me. Maybe it's because this is SDN with a select personality of followers that value career above all else, but it's hard to imagine there are hospitalists that don't value career over their other aspects of life. If that were the case then a lot of parents should be hiring more nannies instead of working 1/2 or even 1/4 time gigs.

Seems like you've made a decision, and so congrats!

I'll mention that there are many ways to have good work-life balance as a surgeon. Nearly impossible as a surgical resident, but very doable as an attending.

One can be an acute care surgeon working 100 call shifts a year. You'll work no more than an IM hospitalist but earn twice as much doing work that is a lot more fun. Not talking locums either.

One can be an academic surgeon dealing with elective problems with a low complication rate, and thus, almost never having to cancel life plans.

The bottom line is: do you love surgical diseases and the idea of learning to do the operations you observed as a student? Love it enough to go through 5 grueling years? If so, do surgery. If not, then don't. And ps- watching people operate is boring. Learning to operate and actually conducting an operation is the coolest thing out there...
 
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Depending on practice setting, vascular interventional radiologists often work more than general surgeons.
 
What about pathology!?


Yeah. But please do yourself a favour and dont match General Surgery. sounds like it would be absolute torture for someone like you. would feel bad for you if it comes to that.
 
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I absolutely loved surgery. In another life I would have applied to surgery for the match. However, I'm like you in that I prioritize having a family, days off, reasonable hours, good work/life balance, etc. I decided on FM. I like that you can do a combination of outpatient, hospitalist, work in an ED, urgent care, OB with c-sections, colonoscopies/EGD's, etc.
Any of that sound appealing?
In the end, there's no perfect specialty. Choose the one that you can tolerate the "Cons" the most.


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Word on the street is Pm&R is getting a lot more competitive... especially this year

They only had one spot left over in this year's match, when they had several the previous years.

People finally catching on? Even if it is more competitive, a score in the 230s should be okay

I hate the fact that people are catching on (LOL). Scores will probably go up a bit more, but a 230 should definitely be enough to match.
 
Something people often don't realize is that medicine is a very important part of surgery, especially general surgery. You don't get to just forget about the dozen comorbities of a patient you're taking to the OR. Surgical subspecialtists worry about these issues to a lesser extent but if you're considering general surgery and hate medicine, you will be unhappy.

Other than the fact that you can't use a shelf exam to test someone's ability to operate, there's a reason the shelf exam is primarily medicine.
 
Something people often don't realize is that medicine is a very important part of surgery, especially general surgery. You don't get to just forget about the dozen comorbities of a patient you're taking to the OR. Surgical subspecialtists worry about these issues to a lesser extent but if you're considering general surgery and hate medicine, you will be unhappy.

Other than the fact that you can't use a shelf exam to test someone's ability to operate, there's a reason the shelf exam is primarily medicine.


The amount of 'medicine' in ortho is pleasantly minimal - CBC, ESR, CRP, cultures, antibiotics (ancef, vanc, gent), lovenox, and pain meds. For everything else there is anesthesia and comanagement by medicine - I bet medicine loves admitting and managing all the non-fracture related issues in 60+yo pts with hip fractures.
 
I bet medicine loves admitting and managing all the non-fracture related issues in 60+yo pts with hip fractures.

That's what they signed up for. If I had a penny for every time I was consulted for a sprain or a problem with the "tibula..."
In this day and age, many physicians are specialists in certain things. I am happy to see "silly" ortho related things because I have more experience in it, even though much of it can be managed by a PCP. If people call me because they need help, I will never refuse; it is my job to know the thing I am trained in. There is no reason a medical person shouldn't do the same if I don't feel comfortable managing some abnormal EKG finding. If it were my family member, I wouldn't want some orthopod who has not read any cardiology journals managing my medical issues--just as I don't want some pcp who can barely tell one joint from another managing my knee pain.
 
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Thanks for all of the responses. This thread brings back memories of how bad my lack of sleep was getting to me. At this time I decided against surgery because it got to a point where my inability to function on less than 5 hours of sleep led me to get numb to the OR and all I wanted to do at that point was get out of the surgery to go and study for the shelf since there wasn't enough time to do that as it was and the lack of sleep was messing with my ability to recall details and fund of knowledge.

I quoted the post above me in particular because this was my thought process lately but still decided more towards IM after talking to hospitalists about my dilemma. The 'suck' of surgery vs the 'suck' of IM doesn't seem all that different on a simple day to day basis but the average year looks way different. On top of that, if we were to only talk about residency, IM is only 3 years of 'suck' if you even count chief year vs surgery which is 5 years of 'suck'.

If anything I do see why people are starting to move towards the shift work. I can't tell you how many times I've seen surgeons cancel any plans they made later in the day because they had to go back to the OR.

I don't think there is anything wrong with not having work be the #1 priority in one's life. Starting a family and enjoying hobbies and traveling outside of work will always be above a career in terms of importance to me. Maybe it's because this is SDN with a select personality of followers that value career above all else, but it's hard to imagine there are hospitalists that don't value career over their other aspects of life. If that were the case then a lot of parents should be hiring more nannies instead of working 1/2 or even 1/4 time gigs.
Good choice!
 
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