Any Family Med residents/doctors who failed to match to surgery?

[Knightmd]

So I've been trying to get into Surgery for the past 2 years but it seems to be virtually impossible for IMGs with every single spot pre-booked for a staff favorite... I've started thinking about trying to get into Family Medicine.

 

From what I hear, Family Medicine has the best lifestyle (working 9 to 5), with no calls, excellent doctor-patient relationship, and no pressure to diagnose/treat.... I'm not sure about the compensation as I've heard to very different versions of that.

 

I'm not exactly crazy about surgery. I like the idea of being a great surgeon, but I don't want to spend a lifetime opening up abscesses and removing appendices/gall bladders. I'd like to know if there are any guys/gals here in FM who initially wanted surgery. How do you honestly feel about your decision? If you had the opportunity to get into surgery now, would you do it?

[NLengr]

So I've been trying to get into Surgery for the past 2 years but it seems to be virtually impossible for IMGs with every single spot pre-booked for a staff favorite... I've started thinking about trying to get into Family Medicine.

 

From what I hear, Family Medicine has the best lifestyle (working 9 to 5), with no calls, excellent doctor-patient relationship, and no pressure to diagnose/treat.... I'm not sure about the compensation as I've heard to very different versions of that.

 

I'm not exactly crazy about surgery. I like the idea of being a great surgeon, but I don't want to spend a lifetime opening up abscesses and removing appendices/gall bladders. I'd like to know if there are any guys/gals here in FM who initially wanted surgery. How do you honestly feel about your decision? If you had the opportunity to get into surgery now, would you do it?

 

Gall bladders, appy's and abscesses are the bread and butter of gen surg. Even if you don't do them during the day, you will get lots and lots on call.

 

Family med can be the sweet life if you know how to run your clinic. You could always do surgical assist to get your hands dirty once a week.

[cardiomegaly]

 

I'm not exactly crazy about surgery. I like the idea of being a great surgeon, but I don't want to spend a lifetime opening up abscesses and removing appendices/gall bladders. I'd like to know if there are any guys/gals here in FM who initially wanted surgery. How do you honestly feel about your decision? If you had the opportunity to get into surgery now, would you do it?

 

You kind of have to be crazy about surgery to choose it.... otherwise you'll drop out of your 5 year residency long before you've finished.

 

Every specialty has its bread and butter. Abscesses and gallbladders, appys, bowel obstructions/perforations... and lots of Poo. That is gensurg. If you can't stand poo, pick something else. Some people don't mind pee, some people don't mind spit, some people don't mind vaginal discharge. Pick your poison.

 

As for family med docs doing surgical assists I have met many in my clerkship rotation and they all seem to be very happy with their extra duties. They're usually first assist (hired when there is no resident coverage), they get to sew and tie stuff and leave at the end of the case without any responsibility for what happens to the patient. Pay is pretty decent too.

[Mandibular]

You kind of have to be crazy about surgery to choose it.... otherwise you'll drop out of your 5 year residency long before you've finished.

 

Every specialty has its bread and butter. Abscesses and gallbladders, appys, bowel obstructions/perforations... and lots of Poo. That is gensurg. If you can't stand poo, pick something else. Some people don't mind pee, some people don't mind spit, some people don't mind vaginal discharge. Pick your poison.

 

As for family med docs doing surgical assists I have met many in my clerkship rotation and they all seem to be very happy with their extra duties. They're usually first assist (hired when there is no resident coverage), they get to sew and tie stuff and leave at the end of the case without any responsibility for what happens to the patient. Pay is pretty decent too.

\\How much is pay for a surgical assist?

[moo]

In BC it depends on how much was billed for the procedure by the surgeon.

 

For anything less than $317, you get $130. Between $317 to 529, you get $183. For anything over $529 it's $240. After 3 hours of continuous surgical assist, it's then $27.47 per 15 minutes. You also get a bonus of $75.76 for the first assist of the day (to account for time having to drive to the hospital).

 

Note that there is also no overhead attached to these billings. Thus billing $130 here would be like billing $200 in clinic (if you were a locum and paid 35% overhead, not unheard of in major urban areas).

[Knightmd]

You also get a bonus of $75.76 for the first assist of the day (to account for time having to drive to the hospital).

You know you're in a first world country when they pay you extra for the time it took the assist to drive to the hospital.

[failingtothrive]

So I've been trying to get into Surgery for the past 2 years but it seems to be virtually impossible for IMGs with every single spot pre-booked for a staff favorite... I've started thinking about trying to get into Family Medicine.

 

From what I hear, Family Medicine has the best lifestyle (working 9 to 5), with no calls, excellent doctor-patient relationship, and no pressure to diagnose/treat.... I'm not sure about the compensation as I've heard to very different versions of that.

 

I'm not exactly crazy about surgery. I like the idea of being a great surgeon, but I don't want to spend a lifetime opening up abscesses and removing appendices/gall bladders. I'd like to know if there are any guys/gals here in FM who initially wanted surgery. How do you honestly feel about your decision? If you had the opportunity to get into surgery now, would you do it?

 

 

i disagree...if you're a good family doctor who wants to care for your patients, you're on call.

 

and family doctors absolutely diagnose and treat...isn't that a definition of a doctor?

[Lactic Folly]

Plus, they are the ones patients keep returning to after the consultant has said it's not a [insert x specialty] problem...

[justletmein]

i disagree...if you're a good family doctor who wants to care for your patients, you're on call.

 

and family doctors absolutely diagnose and treat...isn't that a definition of a doctor?

 

Agreed. The OP doesn't seem to have a good grasp of what an FP does, nor what a general surgeon does.

I think you should probably be better informed when making these kinds of decisions.

[Jochi1543]

You'd be really surprised how much a family doctor can do. A patient may have multiple medical problems - and as a specialist you only see a tiny portion of it. Often times specialist won't listen to other issues because "that's not their area".

Yeah, it's a shame. I remember a rheumatologist who picked up metastatic lung cancer on a routine exam just because he had a hunch that something was up because the patient was not quite as coherent as she should've been at her age and so he ordered a CT scan. But he could've easily gotten away with not doing it and sending the pt home because joint-wise, nothing was wrong with her. It was a great example of what really makes a good doc.

[Knightmd]

By "no pressure to diagnose and treat", I mean relative to a surgeon who would schedule diagnostic contrast CT studies and could open up the patient based on that study. It's always important to realize a Family Doctor can refer to a specialist, but specialists have the bigger burden of diagnosis/treatment when that happens.

[Lactic Folly]

What about when the surgeon says "based on my assessment, this is not a surgical problem" and refers the patient and their complaint back to the family doctor?

[meshuga3]

Is this a cleverly-disguised troll? To repeat an earlier response, the OP does not have a solid grasp of what FMDs do, nor of their scope of practice... and it should also be pointed out that medical "treatment" is as valid as surgical "treatment" (the "cutting open" referred to 2 posts prior). FMDs do both (i.e. an excisional biopsy cures melanoma; HCTZ, with a bit of imagination, cures hypertension).

 

You can do plenty of surgical assist as an FMD, and if you're really gung-ho, you could probably travel to the middle of nowhere and do a few appys. But, seeing as you appear pretty down on FM -- and you're not entirely clear on what it involves, to boot -- I'd suggest sticking with susrgery.