How important is passion for the organ system you're operating on?

[user123456]

At a bit of a cross-roads. I'm at an Albertan medical school and our school has us pick electives relatively early so I'm squished for time. Initially I was interested in neurosurgery however after spending time in the OR over the past summer I've decided on cardiac surgery. I also know I wouldn't be happy not doing surgery.

Here's where the issue lies: Cardiac surgery has a notoriously difficult lifestyle and poor job prospects, however it is the only part of medicine I am truly interested in. I'm trying to decide if me doing surgery on another organ system (I've been leaning towards things with good lifestyles e.g., ophtho/plastics/ENT) will make me happy in the long-term or if I will regret my decision.

I have quite a few papers published in a variety of fields and met with the chair in one of these specialties at my school to talk chances over - they think I have a fair shot so I'm not worried about the late switch as much.

I'm mainly asking if there's anyone that's been in a similar circumstance and ultimately came out happy with their choice. So, how important is passion for the organ system you're operating on? Would be happy with any insight...

 

[offmychestplease]

optho/plastics/ENT don't have good lifestyles...you're looking at 7 brutal years of residency+fellowship(s) (+/- grad degree(s)) and then staff life is hard as well (and that's if you can even land a job in a half-decent location).

If lifestyle and job prospects are in anyway important to you (and it looks like they are) forget about surgery altogether. 

[LostLamb]

17 minutes ago, offmychestplease said:

optho/plastics/ENT don't have good lifestyles...you're looking at 7 brutal years of residency+fellowship(s) (+/- grad degree(s)) and then staff life is hard as well (and that's if you can even land a job in a half-decent location).

If lifestyle and job prospects are in anyway important to you (and it looks like they are) forget about surgery altogether. 

OP made ZERO mention of lifestyle and job prospects. They mentioned the usual elephant in the room but ALSO said that cardiac surgery is the only part of medicine that he or she is truly interested in. 

You need to stop pushing YOUR agenda and YOUR opinion about FRCPC/FRCSC residencies and careers as a response to a post.

To OP: I was not in your situation at all, but what you need to do is talk with as many trainees in all those surgical fields as possible and get their perspectives on your situation. 

A couple people I know from my class were told the same drivel about awful job prospects and horrible training conditions, crappy lifestyle, etc etc...they both found jobs and truly cannot see themselves doing anything else but operate. Passion and drive for what you want keeps you going when the days and nights and call are horrible. Delayed gratification sucks but if cardiac surgery is where your heart lies, go for it.

[offmychestplease]

2 minutes ago, LostLamb said:

OP made ZERO mention of lifestyle and job prospects. They mentioned the usual elephant in the room but ALSO said that cardiac surgery is the only part of medicine that he or she is truly interested in. 

You need to stop pushing YOUR agenda and YOUR opinion about FRCPC/FRCSC residencies and careers as a response to a post.

To OP: I was not in your situation at all, but what you need to do is talk with as many trainees in all those surgical fields as possible and get their perspectives on your situation. 

A couple people I know from my class were told the same drivel about awful job prospects and horrible training conditions, crappy lifestyle, etc etc...they both found jobs and truly cannot see themselves doing anything else but operate. Passion and drive for what you want keeps you going when the days and nights and call are horrible. Delayed gratification sucks but if cardiac surgery is where your heart lies, go for it.

they mentioned the reason they are steering away from cardiac surgery was due to job prospects and lifestyle and why they wanted ENT/Optho/Plastics...and I simply said from what I know ENT/Optho/Plastics also don't have good lifestyles and job prospects....maybe that isn't the case.....

[user123456]

1 minute ago, offmychestplease said:

they mentioned the reason they are steering away from cardiac surgery was due to job prospects and lifestyle and why they wanted ENT/Optho/Plastics...and I simply said from what I know ENT/Optho/Plastics also don't have good lifestyles and job prospects....calm down 

Sorry this is my miscommunication. 

I need to do surgery, it's just deciding what type of surgery. I also don't care about residency/grad/fellowship, what I'm more concerned about is when I'm 40, 50, 60, etc... 

Is the gradient between doing something more lifestyle like ophtho and cardiac surgery big enough that it warrants reconsidering my passion?

[offmychestplease]

1 minute ago, user123456 said:

Sorry this is my miscommunication. 

I need to do surgery, it's just deciding what type of surgery. I also don't care about residency/grad/fellowship, what I'm more concerned about is when I'm 40, 50, 60, etc... 

Is the gradient between doing something more lifestyle like ophtho and cardiac surgery big enough that it warrants reconsidering my passion?

no problem. That I don't know but I am sure others will be more knowledgeable. 

[1D7]

20 hours ago, user123456 said:

At a bit of a cross-roads. I'm at an Albertan medical school and our school has us pick electives relatively early so I'm squished for time. Initially I was interested in neurosurgery however after spending time in the OR over the past summer I've decided on cardiac surgery. I also know I wouldn't be happy not doing surgery.

Here's where the issue lies: Cardiac surgery has a notoriously difficult lifestyle and poor job prospects, however it is the only part of medicine I am truly interested in. I'm trying to decide if me doing surgery on another organ system (I've been leaning towards things with good lifestyles e.g., ophtho/plastics/ENT) will make me happy in the long-term or if I will regret my decision.

I have quite a few papers published in a variety of fields and met with the chair in one of these specialties at my school to talk chances over - they think I have a fair shot so I'm not worried about the late switch as much.

I'm mainly asking if there's anyone that's been in a similar circumstance and ultimately came out happy with their choice. So, how important is passion for the organ system you're operating on? Would be happy with any insight...

 

If you're into cardiac surgery and NSx because you love big procedures & caring for sick patients you may not be satisfied doing ophtho. Even ENT unless you are the go-to head and neck oncology guy/gal working in an academic centre, you will probably spend most of your time doing smaller procedures. I do find that to do ophtho/ENT you should like the anatomy, otherwise the eyes & nose/ears/throat/sinuses gets boring very fast... you are doing very specialized things and have very specific QOL outcomes.

If you're happy just working with your hands taking care of sick patients that widens your options a bit. General surgery has big procedures and you can specialize in thoracics which is another field that does relatively big procedures. Interventional radiology & interventional cardiology are other options to consider, though you have to be okay doing radiology or medicine first.

Ultimately if you would not be happy doing anything else, you could try for cardiac surgery and aim to work in America, though you'd have to look into how likely you are to get hired given you will only possess the cardiac skill set (whereas they train CT surgeons with both skill sets).

I will say that long-term lifestyle generally becomes more important (usually once you have kids they will become your #1 priority... meaning you want to live somewhere you can comfortably raise them, you want to be able to see them rather than doing your 3rd fellowship, etc.).

[Snowmen]

I wouldn't consider ophthalmology and ENT to be 100% surgical specialties in the sense that they also do a lot of clinic and conservative treatment compared to "classic" surgical specialties. As mentioned, if you're interested in cardiac surgery because of the big cases, ophthalmology won't cut it and ENT probably won't either. What's for sure is that the lifestyle in those specialties (as well as plastic surgery) is MUCH better than the lifestyle in cardiac surgery (but it's still surgery).

And, as mentioned, ignore @offmychestplease since he's on a crusade to prove that all specialties suck except for family medicine.

[jb24]

On 8/15/2021 at 8:48 PM, offmychestplease said:

they mentioned the reason they are steering away from cardiac surgery was due to job prospects and lifestyle and why they wanted ENT/Optho/Plastics...and I simply said from what I know ENT/Optho/Plastics also don't have good lifestyles and job prospects....maybe that isn't the case.....

 Ophtho, and Plastics have pretty good lifestyles for someone interested in surgery.   

[mm88]

I won't say it's "passion" per se but there is definitely a right "fit". Even within surgical specialties there are subspecialty practices you will know that are the right or wrong fit for you.

One of my friends in med (UofC) was considering general surgery then changed her mind and started pursuing plastics, then discovered vascular during her surgery core rotation and then flip flopped a bunch between whether she wanted vascular or plastics. During CaRMS Interviewed for both across and country, ultimately ended up ranking plastics first and loves it.

There is probably some overlap you can make a case for between NSx and Cardiac Surg if you really can't decide - meticulous work/sewing forever (open heart surgery and repairing dural tears are basically the same, right?) and long ass procedures (spine stuff vs transplants). I personally would not advise either of those specialties. Plastics, vascular, gen surg oncology and ortho oncology or spine are all better options if you want sick & complex patients, long procedures and meticulous work.

[Edict]

On 8/15/2021 at 10:55 PM, user123456 said:

At a bit of a cross-roads. I'm at an Albertan medical school and our school has us pick electives relatively early so I'm squished for time. Initially I was interested in neurosurgery however after spending time in the OR over the past summer I've decided on cardiac surgery. I also know I wouldn't be happy not doing surgery.

Here's where the issue lies: Cardiac surgery has a notoriously difficult lifestyle and poor job prospects, however it is the only part of medicine I am truly interested in. I'm trying to decide if me doing surgery on another organ system (I've been leaning towards things with good lifestyles e.g., ophtho/plastics/ENT) will make me happy in the long-term or if I will regret my decision.

I have quite a few papers published in a variety of fields and met with the chair in one of these specialties at my school to talk chances over - they think I have a fair shot so I'm not worried about the late switch as much.

I'm mainly asking if there's anyone that's been in a similar circumstance and ultimately came out happy with their choice. So, how important is passion for the organ system you're operating on? Would be happy with any insight...

 

I think it is important. To do any surgical specialty you need to have passion for it. I think you need to take a careful look at if you really can be satisfied with ophtho, plastics or ENT. If you really think you can, then ask yourself if you feel comfortable letting go of cardiac surgery. If you can, then you can consider those specialties. 

You said you spent time in the OR over the past summer, did you just go to the ORs? Consider doing a week or two week long "preclerkship elective". As I say to med students, going to a few ORs and deciding on a surgical specialty is like going to a few NBA games and deciding you want to be a NBA player, or watching a few air shows and deciding you want to become a fighter pilot. The OR is just the tip of the iceberg. It isn't wrong to like cardiac surgery because of the OR, just like most fighter pilots grew up watching air shows, but you have to explore more than just that to know it is what you want. 

Also, regarding passion for the organ system, how passionate are you about the heart, do you spend your free time reading about it? Is it something you enjoy learning about, but don't necessarily jump into reading about it in your free time? 

Don't worry about the job prospects, worry about your grit, passion and determination to meet challenges. There are plenty of jobs for those who are willing to sacrifice their free time, family time and relationships (and yes, you will have to do these things) for the passion of the job. However, there are no jobs for those who aren't willing to make that sacrifice. The issue with cardiac is that you either make it or you don't. It's a long residency and some people choose to prioritize lifestyle and often find a way to make it work as a surgical first assist or in ICU. There isn't a more chill, back-up option with lifestyle. The staff surgeons work almost as hard as the residents, which is unique for a lot of surgical specialties. You can do vascular or thoracic surgery fellowships but unless you find they are significantly more interesting, you probably wouldn't be able to call either of those significantly more chill. 

[Arztin]

On 8/20/2021 at 10:04 PM, Edict said:

 

Don't worry about the job prospects, worry about your grit, passion and determination to meet challenges. There are plenty of jobs for those who are willing to sacrifice their free time, family time and relationships (and yes, you will have to do these things) for the passion of the job. However, there are no jobs for those who aren't willing to make that sacrifice.  

I think this is the most important part. As a non surgeon, I think they definitely need a certain amount of passion that keep them going 20 years after residency, when I call them at 3 AM, and they need to come in for a stat OR case.