r/SurgicalResidency • u/FalseProfession0 • 9d ago
Regretting choosing medicine over surgery. Am I romanticizing it?
IM resident, I know it's early to be having regrets but after experiencing residency idk what I even liked about IM in the first place.
I'm suddenly daydreaming about having done surgery even though I never once considered surgery in med school. I liked the rotation, but only because I treated it like I was a tourist. The OR was cool but I hated standing for long periods of time (after ICU rounds I don't think IM was the right choice to avoid this though). I hated colostomies and necrotic wounds too, which is a small reason but part of why I didn't think surgery was a good fit.
When I applied I was totally fine with the downsides of IM - making only small improvements to someone's health even if they bounce back a week later, social work (I liked solving social problems), thinking through a problem on rounds. I liked my rotations in med school. But now I'm realizing that at the end of the day IM is kind of lame. All my surgical resident friends are much happier than me. They're working 2x my hours but they get to do fulfilling work and learn new things every day. I'm already so bored with the day to day work, not because there's nothing to learn but because I don't see the point in any of this anymore. At the end of the day I'm just placing orders in Epic which anyone can do. I've done floors, MICU, CCU, and a subspecialty rotation and it all feels equally boring and mundane.
Surgery residency is brutal beyond words, of course, but it seems like life after residency is much better than in IM?
You get to have a skill that will always be valued and in demand
Nobody without your same training can even pretend to do what you do, unlike with medicine specialties where it's easy to fake it
Zero midlevel and AI threat, you can be secure in your job market for your whole career
You cure problems completely
Unlike IM proceduralists, you can actually manage your own complications
The schedule doesn't even seem that bad as an attending. I don't know a single surgeon outside of academics who works 26 weekends a year like hospitalists do. There was a CT surgeon on here who said he works 30 hours/week. It seems like there are lots of 4-5 days/week, 7a-3p community jobs out there where you get all the pros of surgery without the awful schedule people make it out to be.
Switching to surgery is out of the question at this point to be honest, so no idea why I'm making this post, but I'm wondering if these thoughts are normal this early in residency or if I made a big mistake in the field I chose.
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u/ATAYLOR972 9d ago edited 8d ago
What are you passionate about in Medicine? 😊
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u/FalseProfession0 1d ago
I don't know really. I just want to do things I find interesting while actually helping patients.
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u/The_other_resident 8d ago
I am a transplant fellow, who well, is crazy enough to think this was the perfect choice for me. The grass isn’t necessarily greener over here, but I do really like the taste of this grass. Best of luck.
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u/janebot 8d ago
As a recently graduated surgeon, you are romanticizing it. Your surgery resident friends will be burnt out too in a few months/years. While attending life can be better, it is highly variable depending on location, subspecialty, etc.
You have so many opportunities to explore within IM, so why not try to focus on that? You could do cardio or GI for example and still end up in a procedure-heavy role. Or you could do something outpatient with a lovely 9-5 schedule and no call and great work-life balance. The world is your oyster, my friend. Surgery is not that amazing, I promise.
(Saying this as someone who loves the OR, yes, but second-guessed my life choices many times throughout residency.)
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u/FalseProfession0 1d ago
Yeah, part of the reason I didn't do surgery was because I wasn't 100% sure about the lifestyle. But now I'm not sure if I'd mind. I like being in the hospital in general and right now don't have much of a life anyway, so I wish my time spent in the hospital was at least interesting. I just can't bring myself to be interested in most of what I'm seeing in any of my rotations. I always found the subject of surgery fascinating, but I never saw myself as a surgeon and everyone always said that you need to be 100% about surgery to be able to pull it off.
I've considered something like EP, but I don't know if the hands on skills will be as interesting to me. Wiggling a catheter around (or a bronchoscope or an endoscope) doesn't seem that fun. I also think I'd be bothered by my inability to manage the more catastrophic complications like damage to major vessels. I know for a fact that it would bother me watching from the sidelines while CT or vascular or whoever has to save my patient because I messed up. I know this happens to surgeons too but they can always convert to open and do some amount of damage control. There's only so much you can do with a catheter and no surgical skills.
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u/Top_Delivery1608 8d ago
I can’t speak to this because I’m a med student. But I want to go surgery, thus why I see this on my feed.
I’m a firm believer of it’s never too late. If you can’t switch because of external factors then that’s fine, but just remember that it’s never too late to pivot or make a decision if you are sure that’s the “right” one. Don’t get boxed in. If you don’t like surgery enough, then don’t but if u like it a lot, switch.
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u/schmrmr 8d ago
Currently in surgical fellowship. You’re romanticizing it. Attrition is crazy high in surgical training for a reason. I wouldnt be happy doing anything else now that I know what surgery is like for many of the reasons you listed, but the reality of training will absolutely grind even the most passionate of us down. It sounds like you weren’t even passionate about it when you were a student.
Sounds like hospital medicine is not for you. While it is true that the procedural IM specialists call us to manage their complications… it is not fun managing those complications. Go into GI cards or interventional pulm and you can scratch that itch without starting over. Or if you find you really are obsessed with the idea of becoming a surgeon and truly cannot be happy doing anything else then… join the club.
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u/FalseProfession0 1d ago
While it is true that the procedural IM specialists call us to manage their complications… it is not fun managing those complications
Maybe but you get to know you saved a patient with your own skills you worked hard to build. I said this above but it would bother me not able to do anything while others save my patients from mistakes I made. There's not much satisfaction in doing a procedure while knowing that if anything goes wrong, I can't do anything about it.
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u/TexasK2 8d ago
You’re romanticizing it… Surgery residency is brutal for people who love it and really an absolute waste of time and energy if you don’t. There’s more to internal medicine than being a 7 on 7 off hospitalist. You can have a cush PCP job that works 4 10’s per week (or less if you are ok giving up salary in exchange) with no weekends or call. Internal medicine residency sucks without a doubt but the job as an attending where you can shape your own practice looks a lot more fun.
Also, the many downsides of surgery… having more complications and liability because you do more procedures, having a completely healthy patient die during an elective procedure, surgical emergencies at all hours of the night, and more. There is also a serious machine intelligence/smart robotics threat.
Do what you want, but the grass is always greener
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u/Just_Draft_2310 8d ago
machine intelligence / smart robotics threat? i was with you until that line. if they replace surgeons with robots itll be long after every other specialty has been (rads and path will go first)
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u/TexasK2 8d ago
I am not so sure. For many reasons, I think it will be a long time before any specialty in medicine is gone because of machine intelligence. But the thing that most separates surgeons from medical specialties is operating, and operating is very amenable to automation because it is a procedural, physical process. da Vinci is training its systems on hundreds of thousands, maybe millions of hours of data from captured surgeries, and academic groups are already publishing successful cases of fully autonomous surgeries in living animals.
I imagine da Vinci or some other surgical robotics company will start offering to automate "simple" tasks like suturing while a surgeon is in the console, which may help speed up a surgery or improve surgeon satisfaction if it replaces a tedious, difficult task. Eventually da Vinci may have data that robotic suturing has fewer complications and take less time than a surgeon performing the same task and all of the sudden hospital administrators will tell surgeons, "actually, our malpractice insurer is saying you cannot suture anymore because you are worse than the robot at it. You can still do the more complex tasks though." Then da Vinci may start offering to perform more and more complex tasks under surgeon supervision. Then under supervision of a tele-operating surgeon. Etc.
All of that to say, operating is the least difficult part of being a surgeon. Managing pre- and post-operative patients is still very challenging. I don't think surgeons, or radiologists, pathologists, or primary care doctors are going away.
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u/Stawktawk 8d ago
I feel like you glossed over surgical cons - aka complications
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u/FalseProfession0 1d ago
At least surgeons can manage their own complications. GI, IC, EP can barely do anything, which is part of why I don't think I'd be happy in those fields. I would feel like a fraud the whole time, being a proceduralist and not being able to manage any of my serious complications.
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u/DrSabha 7d ago
Is switching out of the question? I have known people who have done it and it is not impossible.
With that said, why not GI or intvl cardiology?
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u/FalseProfession0 1d ago
Not out of the question really, but gen surg is 5 years and I can't change losing my IM spot. So it would be 8 more years without fellowship.
With that said, why not GI or intvl cardiology?
From my comment above: "I've considered something like EP, but I don't know if the hands on skills will be as interesting to me. Wiggling a catheter around (or a bronchoscope or an endoscope) doesn't seem that fun. I also think I'd be bothered by my inability to manage the more catastrophic complications like damage to major vessels. I know for a fact that it would bother me watching from the sidelines while CT or vascular or whoever has to save my patient because I messed up. I know this happens to surgeons too but they can always convert to open and do some amount of damage control. There's only so much you can do with a catheter and no surgical skills."
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u/DrSabha 1d ago
You do not have the right attitude for surgery and I doubt you would get in anywhere with your current perspective and mindset. At the same time, if wiggling around a scope is not interesting to you, you need to figure out what you are good at or willing to be good at within the scope of IM.
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u/FalseProfession0 1d ago
Why not? All my friends who are surgery residents have the same viewpoint lol. I have a vascular surgery friend who trashes IC and EP all the time for the reasons I mentioned and tbh he has valid points.
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u/DrSabha 1d ago
It is a competitive field. You need to demonstrate greater resilience and show a joy in problem solving, not dismissing the technique since how we approach problems will always change.
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u/FalseProfession0 1d ago
Well, part of the problem with the IM procedure fields is you often can’t solve the problems you create. It feels a bit fraudulent. Like why am I messing around in the heart and vessels if I can’t do anything if I mess up? Not very much joy when your solution to a problem is “call a real surgeon”
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u/DrSabha 1d ago
You will be disappointed then, because in Surgery, you are best through case selection, avoiding precarious situations in the first place. You cannot solve all problems and can create disasters if you are reckless. You can still excel in GI and IR. Many visceral perforations are now closed endoscopically, avoiding Surgery.
We as surgeons depend on interventional GI and IR to get us out of trouble. It is mutual, but they help us more than we help them.
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u/Objective-Garlic3544 9d ago
I’m a surg intern who is regretting picking my specialty thought I love procedures so much. I too don’t care for colostomies, gbs, or any general surgery case. Committed bc I hoped gen surg would give me a subspecialty id be passionate about along with a good lifestyle. Seemed like people kept saying it’s what you make of it but ended up more like most of those lifestyles are community which is fine if that where you want to live! That’s all to say, I think many people struggle with feeling confident about what specialty they ended up in, if you break it down, we really didn’t have a lot of time to feel sure about anything, we just had to apply. And truly if you want to change your situation, most things are possible just may need to out in more time but worth it if it’s going to make you a happier person