BlackJack Posted August 26, 2011 Report Share Posted August 26, 2011 From personal experience, it is best to concentrate your efforts and electives on one specialty rather than divide them up between two. Otherwise, both specialties may consider this division as indicative of a lack of commitment, and neither one knows which one is the backup and which one is the desired one. Shameless request: if anyone has any information regarding any programs besides family medicine that regularly welcome residents for transfer outside the match, please let me know. Thank you. Link to comment Share on other sites More sharing options...
Lactic Folly Posted August 27, 2011 Report Share Posted August 27, 2011 Well, if someone leaves a program unexpectedly, usually a program will look for a replacement... I know people who have emailed across the country asking that their names be kept in mind should this occur. Link to comment Share on other sites More sharing options...
itimebomb2 Posted August 28, 2011 Author Report Share Posted August 28, 2011 Did you really think your attempt to discredit my post by reminding me where in my training I am was going to go un-noticed? A lot of my colleagues would love to do surgery but are actually turning to other specialties due to job market issues, spouses/significant others, etc. I'm making the argument that choosing your specialty is a career choice that should incorporate your interests but not entirely revolve around what you are interested in. Some people like surgery because of the acute aspect of care. Some like it because they like to work with their hands. Some aspects of internal medicine can be pretty procedural too. yah i agree with that. im mainly interested in Gsx atm, but I'd rather do family or internal if it means I can stay near home. I have too much invested in my relationships and community to leave , even to do what I like best in medicine. When I think about how desperate I was to get into med school a few years ago, I remember that I'd be pretty happy doing pretty much anything. Link to comment Share on other sites More sharing options...
shannn Posted September 14, 2011 Report Share Posted September 14, 2011 Is ortho still competitive? Is ENT really that competitive? I was thinking of back up EM with either ortho, GS or ENT I love GS (have been first assist on a couple of cancer excisions, which was awesome, especially since I was doing that as a pre-clerk), but I love being in the ED. I guess I have one last pre-clerkship year and 1 year of clerkship before CaRMS applications start. Sigh...decisions Link to comment Share on other sites More sharing options...
Lactic Folly Posted September 14, 2011 Report Share Posted September 14, 2011 If you go into GS, you'll spend your fair share of time as a resident seeing consults in the ED... Can't say I've ever heard of anyone backing up with ENT, but you can always try. Link to comment Share on other sites More sharing options...
shannn Posted September 14, 2011 Report Share Posted September 14, 2011 If you go into GS, you'll spend your fair share of time as a resident seeing consults in the ED...Can't say I've ever heard of anyone backing up with ENT, but you can always try. I guess the big thing is that I enjoy the lifestyle of EM, but not so much for GS. Link to comment Share on other sites More sharing options...
NLengr Posted September 14, 2011 Report Share Posted September 14, 2011 Backing up with ENT is probably not optimal. It's too competitive. But if you like you can try. The risk you run is splitting electives and appearing not interested enough in either. Link to comment Share on other sites More sharing options...
coastalslacker Posted September 15, 2011 Report Share Posted September 15, 2011 Did you really think your attempt to discredit my post by reminding me where in my training I am was going to go un-noticed? A lot of my colleagues would love to do surgery but are actually turning to other specialties due to job market issues, spouses/significant others, etc. I'm making the argument that choosing your specialty is a career choice that should incorporate your interests but not entirely revolve around what you are interested in. Some people like surgery because of the acute aspect of care. Some like it because they like to work with their hands. Some aspects of internal medicine can be pretty procedural too. No, people don't typically write things they want to go unnoticed. I found your post which I was responding to rather strident - especially given that your context is that of someone with little experience in medicine. You make an excellent point about the important of choosing a specialty that will fit with one's outside interests - this is of fundamental importance and I doubt anyone would dispute it. Again, I was simply re-iterating the very stark differences between the two specialties and encouraging careful consideration. After you have rotated through medicine and surgery as a clerk, and perhaps even as a resident, you will probably be able to make informed comments about the differences as well. Link to comment Share on other sites More sharing options...
thebouque Posted September 15, 2011 Report Share Posted September 15, 2011 No, people don't typically write things they want to go unnoticed. I found your post which I was responding to rather strident - especially given that your context is that of someone with little experience in medicine. You make an excellent point about the important of choosing a specialty that will fit with one's outside interests - this is of fundamental importance and I doubt anyone would dispute it. Again, I was simply re-iterating the very stark differences between the two specialties and encouraging careful consideration. After you have rotated through medicine and surgery as a clerk, and perhaps even as a resident, you will probably be able to make informed comments about the differences as well. Well I certainly wouldn't call that a quick come back Link to comment Share on other sites More sharing options...
coastalslacker Posted September 15, 2011 Report Share Posted September 15, 2011 Is ortho still competitive? Is ENT really that competitive? I was thinking of back up EM with either ortho, GS or ENT I love GS (have been first assist on a couple of cancer excisions, which was awesome, especially since I was doing that as a pre-clerk), but I love being in the ED. I guess I have one last pre-clerkship year and 1 year of clerkship before CaRMS applications start. Sigh...decisions ENT is extremely competitive, much more so than EM. Ortho is probably slightly tougher to match to than GS, but both are easier than EM. That said, to match Emerg you'd have to have several emerg electives (usually, not always). That would be a huge red flag to many surgical programs - the perception is that many people are in emerg for the lifestyle, so there would be concern about willingness to work and also whether they would actually stick out the drudgery for 5 years or bail. I think most people in emerg are doing it because they love it, but if you talk to them ALOT of them loved surgery but didn't want to do the time. A resident switching out of a surgical program puts a little bit more work on everyone else's table (ie call) so we try to avoid it. I'm not saying don't back up with GS or Ortho, just trying to present how an emerg heavy CV would potentially be interpreted. I wouldn't bother considering ENT as a back-up. Those spots usually go to ENT gunners, with the odd exception. Link to comment Share on other sites More sharing options...
coastalslacker Posted September 15, 2011 Report Share Posted September 15, 2011 Well I certainly wouldn't call that a quick come back I'll be sure to check in more often... "Come back" is probably a misnomer - clarification would be more appropriate. All advice is not equal and one thing I've learned and am continuously re-learning is that those with experience, even if I disagree with them, often have useful advice. I don't spend much time here anymore and have never been one for writing much. However, I'm continuously amazed by the definitve statements people make with very little experience. Pre-clinical medical students talking about the differences, or lack thereof, between specialties is akin to pre-medical students professing to have knowledge of medical school (or beyond in medical training Link to comment Share on other sites More sharing options...
shannn Posted September 15, 2011 Report Share Posted September 15, 2011 ENT is extremely competitive, much more so than EM. Ortho is probably slightly tougher to match to than GS, but both are easier than EM. That said, to match Emerg you'd have to have several emerg electives (usually, not always). That would be a huge red flag to many surgical programs - the perception is that many people are in emerg for the lifestyle, so there would be concern about willingness to work and also whether they would actually stick out the drudgery for 5 years or bail. I think most people in emerg are doing it because they love it, but if you talk to them ALOT of them loved surgery but didn't want to do the time. A resident switching out of a surgical program puts a little bit more work on everyone else's table (ie call) so we try to avoid it. I'm not saying don't back up with GS or Ortho, just trying to present how an emerg heavy CV would potentially be interpreted. I wouldn't bother considering ENT as a back-up. Those spots usually go to ENT gunners, with the odd exception. Thanks for the input I agree, I really like Emerg for the lifestyle and I feel that it provides enough procedures for me to stay interested in it. I love surgical procedures (I love ortho and gen surg, and I'm doing a few ENT electives soon), but I love the high pace days in the ED with the good hours. But yea, I am not really keen on surgery hours. I love the procedures, but, for the sake of having a family, I don't think I could handle the hours. I want my kids to know who I am. All my research right now is in Emerg and Ortho, but, I still have to truly figure out what I want to do. CaRMS is just a scary thing to think about right now I guess. Link to comment Share on other sites More sharing options...
coastalslacker Posted September 16, 2011 Report Share Posted September 16, 2011 Talk to some EM attendings and ask them about the procedural aspect. From what I have seen it's really not there at the attending level. 5 year EM is, historically, for those who want to be in academic centres (although as more graduate this is changing). If you're an EM doc in an academic centre your residents will be intubating, putting in the lines, chest tubes, sewing things up. If you're in a smaller centre you may do those things, but they probably won't come in very often. At my centre they like to have surgical services come down to sew up big wounds even if it's pretty straightforward - the name of the game is patient flow, so they need to keep seeing patients. However, throughtout my EM rotation as a PGY-1 I kept WISHING I could like the job because my life during that month was awesome.... As an ortho resident, my kids know my name and my family does pretty well. It's about choices. My theory for a busy residency program is that you can have two of the three following things: a good family life, a good social life/hobbies, and your job. Basically, you have to pick between the first two or change residency programs. I get ragged on for not going out much and my hobbies don't get as much time as I'd like, but I look at it as five years to focus so I can do what I love to do for the rest of my career. If you're not planning to have kids during residency, it's basically a non-issue because your significant other, if you have one, will be involved in your social life. No ortho resident I know plans to work as hard as those in previous generations have - we all want to have a life, we just have to get through the slog of residency. That said, with work hour restrictions, mandatory post call days, and night float in some programs, those of us who are getting close to done can't help but note how much better the new PGY-1's have it already than we did only a few years ago. Link to comment Share on other sites More sharing options...
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