SURGERY VS. MEDICINE?? help!!!

[snowinter]

Hi Everyone,

I'm trying to decide between Surgery Vs. Medicine. (like a surgical subspeciealty like ENT which I really loved) vs. Medicine -- which seems equally tolerable (maybe better lifestyle during residency).

I keep thinking: these next 5 years are just as important as the 5 years afterward;... so i'm not buying the "well its tougher now but in 5 years it will be sweet" thing. u know?

Anyone out there in the same dillemma wanna consider pros and cons of Medicine vs. Surgery? (like a surgical subspecialty -- not general)

Medicine pros:
not too competitives-- more choice over WHERE TO GO
sit down a lot during day so if get pregnant during residency -- easier
look at whole body -- not just one area-- if u don't catch it-- the patient goes home and can die.
3 years; can choose a number of specialties but dont have to decide right now.
Cons:
more thinking and talking; less DOING
and does anything ever really get DONE?
lots of paper work/typing on computers.


Surgical subspecialties:
Pros:
you actually get something done!!
really cool surgeries; can tailor to whateveryou want to do after you get out
kind of differnet from my personality -- so it would be a challenge and just really amazing; even though its not exactly what ive always seen myself as doing (didn't grow up fixing things or playing video games, or being all mechanical ..) but doesn't mean i CAN'T DO IT. its an amazing feeling in the OR when i'm actually doing something. (not retracting)
learn lotz of anatomy
CONS:
longer hours during residency
can't really get pregnant if am going to stand around in OR all day (some cases are LONG)
very competitive ... harder to get in
less control of your time during the days -- since you have to be in the OR
learn lotz of anatomy

anyone else have a similar debate/dillema wanna share their thoughts?
thanks!!

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[doc05]

pretty rare to see someone torn between medicine and surgery. go with what fits your personality best.

 

[Whisker Barrel Cortex]

Yes, I am a radiology resident, but I seriously considered both medicine and surgery as my other two options while in medical school before I fell in love with radiology. I also did an internship in medicine, so I have a little bit of knowledge on how that residency works. So here is my input.

It seems the very first thing you need to decide is how much you love procedures. Medicine residents, in general, do very few. Although it depends on the location, the trend seems to be that they are doing less and less procedures. Of course this changes once you start fellowship (cardiology and GI especially).

In terms of hours, I don't think the divide between surgery and medicine is that steep, especially with 80hr rules slowly taking effect. As a medicine intern, I routinely worked 80 hour weeks, sometimes up to 100 hours. Sure, the surgical interns probably had several hours more on average, but the difference was not as great as you would expect. The length of training is longer in surgery, but if you do a fellowship after medicine, the overall training length is simlar. If you do a surgical sub like ENT, you hours will definitely get better as you move up the residency ladder.

As for the pregnancy thing, it is definitely workable in surgery, but more difficult. One of our senior surgery residents has 3 kids, two during residency, and is still one of the most respected and best surgery residents around. It does, however, take a tough personality to do well in this field.

As a consultant, I have interacted extensively with residents in both fields. I have worked with my share of disgruntled or dissillusioned medicine residents and surgery residents. Many medicine residents seem to have a general sense of dissatisfaction about them, but they stick it out until fellowship or graduation, when things will get better. No medicine resident has dropped out of residency at our hospital since I started. Of surgery residents, there is a mix. Some seem to revel in their craft, despite the hours and hardships. Then there are those that are extremely miserable. I have seen 4 surgery residents leave for other fields after 1st or 2nd year, 3 of them female.

Good luck in your decision.

 

[my alias]

from the point of view of a first year med student who doesn't know much about surgery OR medicine ....

go back and read your pros ... it sounds like you really love surgery, but think medicine might be more convenient. being female, i can relate to the whole children/having a life thing... but have you worked this hard and put up with all this crap to settle for something convenient? it doesn't sound that way. good luck.

 

[souljah1]

I agree with your pro and con list. However, I would add that certain fellowships in medicine allow you to do quite a lot. i.e. gastro, cards. I enjoyed my surgery rotation and definitely appreciated the activity. Medicine can be a lot of rounding and discussing, but I think that it is a great arena for transfering knowledge. Things do get done on medicine, they just get done slower and less visibly.

 

[ekimsurfer]

if you're planning on getting pregnat, why not just become a stay at home mom (after you've graduated and have you MD) and marry a surgeon? isn't that like the best of both worlds?

/puts on flame suit

 

[Winged Scapula]

A surgery residency does not mean you cannot have children; many residents who decide to have children during residency do so during a lab/research year (or two) when you can sit down plenty. Most academic programs will allow you time in the lab.

WBC is correct; the hours during residency are not all that much different these days between medicine and surgery residents *at most hospitals* (ie, there are some which do violate the work hour restrictions pretty regularly).

There is some evidence that use of video games and the like helps with starting to learn lap procedures but the differential soon evens out; its just harder in the beginning for those of us who didn't grow up on the games.

If surgery will make you happier, then that's what you should pursue; also consider that there are some surgical subspecialties (as you mentioned) which will allow a better lifestyle and there are medical fields (like Derm, Gastro, Interventional rads) which will also allow you more independence and a more controllable lifestyle while doing procedures. Interventional Rads is often a good choice for those who wouldn't consider surgery but love procedures (of course, you'll have to do a Rads residency first).

 

[Jeff05]

you actually have a classic dilemma.

it sounds like you should do ENT.

they do a lot of medical intervention. range of procedures. from 3 minute tubes to 10 hr neck dissections. lifestyle is fine, even during residency.
i mean the first 2 years as gen surg suck, but it gets a bit better after that.


i would also consider optho - good mix of medicine, procedures, and delicate surgery.

medicine - the huge plus - it has so many options. if you really want to do procedures - GI and interventional cards are always there. and if you're seriously thinking about ENT (which is very comp) you'll be able to match into a medicine residency from which you should get GI/cards.

i would go with what you LIKE and what will be most conducive to your bottom line (lifestyle, kids, etc). i would really urge you not to compromise much on either.

 

[GrandMasterB]

wash u's ent program takes two? ppl into its 7 yr prigram each year. year as intern, then two yrs of research (ie more time to have kids etc) then 4 yra ent. other fields and programs might be similar. also look into UC surgery and surgical subspecialty programs- they might have research yrs built in as well. i had the same problem to work through as you. lots of ppl do!

 

[femme_fatal]

While ENT may seem lucrative because of its quasi-medicine reputation, you have to remember it is still a surgical sub, and you will spend lots of your time in the OR. You have to decide for yourself how much you love the OR and how much you like the clinic. Another thing is continuity of care--are you someone who likes brief interactions or more long-term relationships with patients? If you don't have a particular passion for surgery, I'd say do medicine and don't kill yourself. You can always, as others suggested, do a fellowship that will allow you to do procedures later on.
If you develop or already have a burning desire to cut and sew, I'd say go with your gut and do surgery. As a private attending you can have whatever schedule you want. Good luck to you! I went through the same process.

 

[cchoukal]

Several attendings have weighed in on this issue at various times, and I've heard the following advice several times. If you are truly conflicted between surgery and medicine, and ultimately end up in medicine, chances are you'll find yourself into one of the more hands-on fellowships (cards, GI, etc), in which case you'll do 6-7 years of training (comparable to general surgery) anyway. Ultimately, it seems like these folks are at the hospital all the time, as well, so I get the feeling the lifestyle advantage may be more perception than reality. I would bet that to choose something because it's "easier" than what you love would ultimately be dissatisfying, and you'd either be less happy than you could be or you'd change courses later on and waste a lot of time.

 

[Whisker Barrel Cortex]

Smurfette,

I tried responding to your PM, but your profile is set not to accept PMs. Turn your PMs back on and PM me again and I can send you a response.

Two of the four surgery residents I saw drop out were not at my current hospital, but during med school. PM me and I can tell you more.

 

[snowinter]

Hi Everyone,

I just wanted to say thanks for all ur replies -- especially Whisker Barrel Cortex and Kimerly Cox for the long well thought out posts

and everyoen else too... for ur encouragement & support and really down right good advice. I should do what I like the most.!

take care
snowinter

 

[xqcx]

What did you end up doing snowinter?

 

[samsamani]

Hi Everyone,

I'm trying to decide between Surgery Vs. Medicine. (like a surgical subspeciealty like ENT which I really loved) vs. Medicine -- which seems equally tolerable (maybe better lifestyle during residency).

I keep thinking: these next 5 years are just as important as the 5 years afterward;... so i'm not buying the "well its tougher now but in 5 years it will be sweet" thing. u know?

Anyone out there in the same dillemma wanna consider pros and cons of Medicine vs. Surgery? (like a surgical subspecialty -- not general)

Medicine pros:
not too competitives-- more choice over WHERE TO GO
sit down a lot during day so if get pregnant during residency -- easier
look at whole body -- not just one area-- if u don't catch it-- the patient goes home and can die.
3 years; can choose a number of specialties but dont have to decide right now.
Cons:
more thinking and talking; less DOING
and does anything ever really get DONE?
lots of paper work/typing on computers.


Surgical subspecialties:
Pros:
you actually get something done!!
really cool surgeries; can tailor to whateveryou want to do after you get out
kind of differnet from my personality -- so it would be a challenge and just really amazing; even though its not exactly what ive always seen myself as doing (didn't grow up fixing things or playing video games, or being all mechanical ..) but doesn't mean i CAN'T DO IT. its an amazing feeling in the OR when i'm actually doing something. (not retracting)
learn lotz of anatomy
CONS:
longer hours during residency
can't really get pregnant if am going to stand around in OR all day (some cases are LONG)
very competitive ... harder to get in
less control of your time during the days -- since you have to be in the OR
learn lotz of anatomy

anyone else have a similar debate/dillema wanna share their thoughts?
thanks!!

I personally like surgery but I won't do it. Why? Because 40 years from now my arthritic knees and hands won't tolerate it. As for medicine, you can practice until the day you die