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Neurosurgery vs. Radiology


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Hey guys, I'm at a bit of a crossroads. I love anatomy and I think I would enjoy taking on the role of a diagnostic expert and combined with the potential to lead a reasonably busy lifestyle and the ability to get a job without much hassle think that radiology would be a good fit for me. However, I've always wanted to become a neurosurgeon since as long as I can remember and in my heart of hearts I feel as if I would regret not going down this path even if it meant going through hell to get a job and enduring an unfavorable lifestyle in the end. 

Was anyone here ever in my boat and had to make a decision between radiology or surgery and if so which did you end up pursuing and why? 

N.B. I realize there are very few of any neurosurgery trainees that frequent the forums, if anyone could maybe provide a second-hand recount of a neurosurgery trainee/neurosurgeon that you know who had to negotiate this split in the decision tree, feel free to do so!

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Have you spent much time in the OR or shadowing in neurosurgery yet? There are people who decide between surgery and radiology, but operating is quite different from reporting. I would first try to arrange a surgical observership and see if you can get a sense whether the OR is for you - often people find they tend to lean strongly one way or the other.

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23 hours ago, Mathmaximum said:

Hey guys, I'm at a bit of a crossroads. I love anatomy and I think I would enjoy taking on the role of a diagnostic expert and combined with the potential to lead a reasonably busy lifestyle and the ability to get a job without much hassle think that radiology would be a good fit for me. However, I've always wanted to become a neurosurgeon since as long as I can remember and in my heart of hearts I feel as if I would regret not going down this path even if it meant going through hell to get a job and enduring an unfavorable lifestyle in the end. 

Was anyone here ever in my boat and had to make a decision between radiology or surgery and if so which did you end up pursuing and why? 

N.B. I realize there are very few of any neurosurgery trainees that frequent the forums, if anyone could maybe provide a second-hand recount of a neurosurgery trainee/neurosurgeon that you know who had to negotiate this split in the decision tree, feel free to do so!

As an incoming M1 you should explore as many fields as you can (i.e. family) before settling on neurosurgery or radiology—one of the biggest mistakes is forming an identity too early and becoming attached to it. It's not unheard of to hear about a med student who always wanted to be a neurosurgeon realize his/her mistake the first week shadowing.

I have known a few people who have switched out of neurosurgery into other specialties, including radiology. Mostly it boiled down to years and years of endless job training (6 years residency, 1-2 years fellowship plus often 1-4 years advanced degree) in a residency infamous for its hellish hours. That's a minimum of 8-9 years of inhumane, grueling training in most cases, though 10+ years is not uncommon. The end result is that you are a highly specialized surgeon waiting for someone to retire, probably in a place you may not like, just so you can take their job. You need a very specific personality and family life (or lack of) for that to work and for you to not hate/regret your life. There's not much upside either if you want to do neuro IR: the training pathway through radiology is shorter (~7 years total).

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Have you also wanted to be unemployed for as long as you remember? :lol: seriously, neurosurg has terrible job prospects. Most of them I know ended up doing multiple (2-3) fellowships, Master/PhDs and still had difficulty finding employment.

But, I agree with everyone above: you need to go to the OR and shadow. That is the first step to see if you like surgical specialties at all. Personally, I'd recommend trying a couple of them (neurosurg isn't you typical surgical specialty).

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Throughout most of med school, I was really into neurosurgery and spine. After spending 2weeks at on rotation, I crossed it off my list. I was doing 5am-6pm daily, but the residents were staying much much later everyday. The chief resident did not go home once during the 2 weeks I was there. All the residents were really nice people who were genuinely passionate about neurosurgery, but I knew I couldn't handle their level of sacrifice for 6+ years. All in all, I agree with other posters - go spend some time with the residents and do a week of call with them during your vacation to see if you stay passionate.

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On 2/13/2020 at 9:55 PM, Mathmaximum said:

Hey guys, I'm at a bit of a crossroads. I love anatomy and I think I would enjoy taking on the role of a diagnostic expert and combined with the potential to lead a reasonably busy lifestyle and the ability to get a job without much hassle think that radiology would be a good fit for me. However, I've always wanted to become a neurosurgeon since as long as I can remember and in my heart of hearts I feel as if I would regret not going down this path even if it meant going through hell to get a job and enduring an unfavorable lifestyle in the end. 

Was anyone here ever in my boat and had to make a decision between radiology or surgery and if so which did you end up pursuing and why? 

N.B. I realize there are very few of any neurosurgery trainees that frequent the forums, if anyone could maybe provide a second-hand recount of a neurosurgery trainee/neurosurgeon that you know who had to negotiate this split in the decision tree, feel free to do so!

The horror that is a surgical residency is real. You have to recognize that choosing to do neurosurgery will mean you make sacrifices in every aspect of your life. Who you date, where you live, what you can do for hobbies, your relationships with your friends and family. Read: fewer opportunities and time for relationships and friends, little choice in where you live for the rest of your life (which also goes on to affect relationships with everyone), little time for hobbies (pick one or none). The hours are brutal, the visceral pain of being overworked will be real, but unlike almost any job in the world this will last for 8-11 years of your life and you don't really have a way out unless you transfer. Job market is not good and will never be good, which means you will have to work your gut out during residency to stay competitive. The benefit? You get to do neurosurgery, you have pride in your work, one day hopefully, you'll make a great income. 

I totally get the feeling of "regret if you don't choose it", i think you'll have to manage that on your own. You will meet probably 3 to 4 people in specialties that are non surgical specialties who at one point seriously considered x surgical specialties who ultimately chose non surgical for every 1 surgical specialty resident. You really need to want this so badly you will give up everything to be it. 

If that fits with your FOMO for neurosurgery, hop aboard.  

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