Gen Surg vs. Medicine

[rugger48]

hey all,

 

having a lot of trouble deciding between applying for General Surgery and Medicine. any ideas/tips/pros and cons.

both sides welcome.

 

Gen Surg: get to operate (can be a plus or minus), immediate results, crappy lifestyle, long hours, lower pay, "less recognized" than other surgical specialties?, higher prestige in the mind of the public, manage ward, clinic and OR, get to scope (endoscopy, colonoscopy etc) and have clinics, many options for fellowship (thoracics, vascular, surg onc, MIS, thyroid etc), longer training program than medicine if doing a fellowship

 

Medicine: better lifestyle, many options for fellowship, more longer term interaction with patient in some cases, don't operate but can do smaller procedures (eg. paracentesis, central line insertion etc), can still scope, lower prestige, higher pay in some specialties, only ward and clinic work

 

 

What do you guys think?

what other factors should I be considering?

[boodog]

hmm, well I suppose what has to be asked are which factors are most important to you? is it a deal breaker if you don't get to be in the OR, or is the recognition the most important to you?

 

ps. it does not appear to me like there is much difference in prestige with general surgeons vs. almost all other specialties, so i hope that this is not the deal breaker for you.

[Satsuma]

These are 2 really different specialties. Have you done your rotations in each of them?

 

If no, you will probably have a better idea how you felt in each after you do.

 

In my 2nd year I was trying to decide between neurosurgery and neurology. When speaking to the director of a neurology program they were completely astounded I could be debating between these and that the choice between to two should be pretty clear cut. I didn`t understand at the time. But after doing my surgery rotation I completely did. I do not care for the OR at all. If I never set foot in an OR again for the rest of my life, I could be completely happy. (unfortunately, I will )

 

If you have done your rotations and you seriously like both, you have to weigh how important the pros and cons of each are to you personally. Nobody can really do that for you.

 

Consider how you felt in each rotation, how did you "mesh" with the staff and residents. Did you feel like you fit in? Could you envision yourself doing that for the rest of your career? Will you be able to balance the other things that are important to you in your life? What are the job prospects once you are done training, etc.

[007]

You may want to consider the type of centre you see yourself working in. If you want to be in an academic setting, the residents will likely do all of the procedures if you end up in medicine. At least, I never saw an internal medicine specialist doing procedures themself unless it was in the cath lab.

[ploughboy]

I'll insert the question I usually ask in these kinds of threads: have you considered specialties that combine medical and surgical practice (gyne, ENT, etc) ?

[piratefan]

I am also debating about gen surg (gen surg vs emerg). I recently received some really great advice. To paraphrase: "If you want to go home at the end of the day having operated, then surgery is for you. Everything else (hours, work expectations, lifestyle) will be different in ten to twenty years, so you can work out the details later."

[A-Stark]

I am also debating about gen surg (gen surg vs emerg). I recently received some really great advice. To paraphrase: "If you want to go home at the end of the day having operated, then surgery is for you. Everything else (hours, work expectations, lifestyle) will be different in ten to twenty years, so you can work out the details later."

 

I think that's the key for me - right now I'm thinking gen surg vs. subspecialties (plastics or ENT - arrgh, competition!) vs. emerg. I will have done horizontal/summer electives in all but emerg by the spring, so I imagine I should get some idea from that.