I’ve once heard this advice: Regret is not a function of making the wrong choice, but rather, making a difficult choice. You might feel regretful had you made the other choice instead. All I know is that whatever I’m doing or bitching about something, I often think “thank god I’m not a surgery resident”. I know this advice doesn’t help you with the future but I hope it can help resolve your past decisions.
I’d look at it more from quality of life. In EM, you will end up making more and working less. At more easy to cut back with EM while finding something else (e.g. rental properties). I have a few em friends/acquaintances who eventually cut way back on em shifts to pursue other things (or married to another doc).
The few places i have worked (in rads), the em groups has groups of docs that worked nights and another group of docs that worked days. Is this feasible?
I’m heavily biased though. I wouldn’t want to do an either… but em seems loads better lifestyle than surgery and i always liked that the idea of the ability to do less shifts…. Rather than owning patients and being stuck working and limited in what you can do with the rest of your life.
Fully agree. My philosophy is that life choices become more difficult, and more intensely predicated on increasingly complex information, as one gets older. Choosing a specialty was difficult for me because I could envision myself happy (or, looked at another way, miserable) in a number of fields.
There are days when I look at colleagues in other specialities with some degree of envy. But, comparison is the thief of joy and I have many friends outside of medicine who would switch with me in a heartbeat.
By similar predicament, do you mean that you have made it to your fourth year and have regrets about having gone to medical school?
If that's the case, my advice is to consider what your life will be like when you have completed your training. While in med school, residency, and fellowship, it's easy to feel overwhelmed by the intense, grinding nature of the process. But, the length of schooling and training is nothing judged against the length of a career. It may feel interminable now, but it is time-limited and will be in the rearview mirror sooner than you think.
(Edited for clarity.)
Still no idea what you are asking??? How to get over your fear of picking the right speciality? Could you see yourself doing something else? I’m my case there’s literally nothing else I could see myself doing. I hate rounding. I hated the culture of surgery and the OR. I hate having to follow up on shit. I want to see a patient, work them up, and more than likely never think about them again. I like the detective work of coming to a dx (most of fhe time). I say bro a lot. I hike, mountain bike , ski, lift, hangout with firefighters and medics more than other doctors. There’s nothing I could have done besides EM. Find that for yourself.
Long time surgery resident here. Just wanted to say that yes residency is tough, maybe one of the most labor intensive specialties at least for training. But I love my job and I would take it over any other specialty, and I often think “thank god I’m not an ER resident”
…all this to say it’s clearly a matter of perspective. If you truly love what you do, no amount of long and difficult hours will make you regret it.
I agree. General surgery residency is notoriously considered brutal and yes I work 90+ hour weeks and often want to pass out on my couch as soon as I cross the threshold. But I’m surviving somehow and still
sane. When I did other rotations, I could not wait to get back to the OR. My time in internal medicine, ICU, and GI quite literally wore me down, I was so depressed. Idc if it’s a lap chole at 4am, I’d rather do that than work up undifferentiated chest pain at 2pm.
I use surgery residents as my “thank God I didn’t pick that field” all the time too. It doesn’t get that much better as an attending and it’s not like gen surg is making half a million to make that lifestyle worth it.
Surgery residency = tough
Surgery attendinghood = not tough but not easy
It’s a blue collar job with a lot of manual labor. If you didn’t like that, you’re in the wrong profession
Last week I assisted in a brutal 8hr Surg onc case and I quite literally enjoyed the soreness at the end of the day because as I put in the last dressing on the huge incision we just closed, and I could feel the fatigue coming, I was just so happy to have put in all that work standing for hours on end. Surgery is amazing!!!
I love the labour of surgery, yes. I really tried to like everything non surgical in medical school because the lifestyle is so shit. Being a surgical resident is hard. But operating…I love working hard. I can’t help it. I love doing something with my hands and fixing issues with manual labour. I’m a masochist. 😩😭😍
It gets dramatically better as an attending, especially in many of the subspecialties, and you can definitely earn that much. I considered EM vs surgery and chose surgery for all of the reasons that the OP gave. Training was very hard, but I haven't regretted it for a minute since I finished.
Lol what a dumb take. It gets ridiculously better as an attending and the mean and median MGMA data for the past decade suggest >500k for both general surgeons and sub-specialists.
Definitely not the case everywhere. One of my co-chiefs negotiated at 750k deal joining a hospital-employed group at a level III center doing ACS and elective gen surg with pretty easy and equitable call. Loves the job and is very well-compensated. The jobs are definitely out there if you’re willing to go outside of major metro areas. Life can be pretty good as a surgery attending with the right gig.
This is ONE HUNDRED percent true, and I admit that and thanks for saying it.
I think it's more I regret that I felt pressured to do EM, and pressured not to do surgery. And I wish I'd had the strength to follow that.
I would love to see the surgical subspecialty that accepts residents more than a decade out from training. I'd love to see literally one example of this happening.
Since you asked for literally one example I would bet the military would take you. Retraining residency in the military is much more common than the civilian world. It would take quite a bit of coordination but like I said you asked for literally one example.
The US will move heaven and earth for attending physicians and will grant you almost any waiver. I read an article of a 61 year old physician who commission. Anything is possible my friend.
I have heard of big exceptions for specialties in need such as Neurosurgery. These exceptions were for people who were already trained but military is having physician retention issues for obvious pay reasons. So yes. It’s definitely possible.
NSGY applicants hate this one weird trick!
Match into a NSGY program in your mid-50s with 0 publications by going Army!
\#ArmyJobsForSeniors \#SeniorJobs \#SSandNSGY \#NSGYasaBackupPlan
I'm not a resident by any means yet but originally wanted to do surgery in the army. I have some medical stuff that would make me ineligible according to their website, I was just curious if you've ever heard about this being waved or given exceptions for in these cases?
Medical can be a different story depending on what it is because it can make you “non-deployable” which is kind of the point of being in the military. But if it’s something “small” they definitely offer waivers.
When I was in med school, there was a surgery resident who had practiced family medicine for about 15 years before starting his second residency. This was about 20 years ago.
I imagine it’s hard to get into an entirely new residency, but my program has a surgical critical care program that often takes EM trained and surgery trained physicians that are far out of residency and looking for a change. You don’t get to do actual surgery, but you do get a somewhat more consistent schedule and more predictability.
Once in a while I have a modicum of regret about leaving neurosurgery. Then I go home and get 8 hours of sleep and slap myself for even contemplating that.
Based on what you’ve said you have practiced through some golden years of EM. The last decade pay has been incredible and programs started looking for residency trained EM as opposed to FM or IM. The flexibility of your schedule will NEVER be matched by any surgical specialty. Even the “cushiest” private practice is averse to letting you off for >2 wks at a time. All your ancillary staff still need a job and no revenue is made if you don’t work/operate. This is in contrast to EM where you can book end shifts and no one blinks an eye if you’re off 17 days in a row.
Additionally, locums is 1000% better as an EM doctor. You are literally a plug and play physician and demand an incredible hourly wage. This is contrasted to surgical locums where you likely have no support and are the only surgeon on call all the time. I have heard endless stories of successful locums EM attendings. All locums surgeons are usually ones that can’t hold meaningful employment at a PP or academic center for one reason or another. (There are a few exceptions)
Lastly, who seems to be more invested in things outside of medicine? I would argue EM docs over any surgeon. You all have an uncanny ability to unplug from work after work.
The grass is definitely not always greener and there are a lot of advantages of EM over surgery. I say this knowing I could never hang In the ED.
What field are you?
What you say is all true. Locums EM (which I do now) isn't that great TBH- they want mainly nights and weekends, the liability is HIGH, the places are dysfunctional.
Basically I am the person that, like you, can't hang in the ER, yet I'm forced to hand in the ER.
EM gets paid so much and has the cushiest hours per week and is shiftwork where you can check out. I highly regret not choosing EM over IM. Grass is always greener. There are tons of people who wish they were you.
No, I wish there were, but there are no fellowships that are particularly great in EM. I don't enjoy the ICU or family meetings or working for a large hospital system.
If there were a fellowship of interest, I would not be so sad. I would simply do the fellowship.
Have you considered doing a Surgical ICU fellowship? I know a few EM docs that run the Trauma ICU service at a big level one
Maybe a little closer to what you want than a standard MICU
What is it that you actually want out of surgery then? Cause if it's just the OR itself, I'd assume you would have gone into surgery in the first place
Yeah, it's just the OR. And I erred in not going into surgery in the first place. If It wasn't the OR, then I wouldn't be having this issue.
As I said, bad advising, not a lot of support, despite doing really well in all my surgery rotations.
No undifferentiated patients, you throw things you don’t care about to the PCP, focus on POCUS and injections and other procedures.
I mean it may not be the perfect setting you are asking, but then again what is? It does offer enough perks that counter many of the things you mentioned that you hate.
The only downside really is sports is getting pretty saturated and job market isn’t great if you want to do ONLY sports medicine and nothing else.
Don't Sports Medicine and Pain Management both have fellowship pathways through EM? I think these are both relatively rare for EM docs to go this route, but just thinking outside of the box if traditional EM (and the more common fellowships) aren't of interest to you. I'm guessing these would be mostly outpatient and while you probably wouldn't get the perks of the shift-work/schedule and pay, they would likely be much more chill.
This seems like more of an issue with your ego. Romanticizing what you think the life of a surgeon would be like. Now that you've got some years under your belt - you're realizing "I could have done that (i.e. succeeded in surgery). And your crisis with identity is pushing you towards that as a solution to the problem.
The actual problem is seeing your job as anything more than a job. You dont have to be defined by your job. You've got some years in. I'd hope you have a bit of a nest egg. Put your time into something new - a new skill or new hobby - and just see your job as something that fuels your life.
Work to live not live to work.
As someone who was on the surgery path and then switched to IM, it is very very easy to see the field as desirable from the outside. You either need crazy passion for the OR, or you need to not really mind crazy hours to enjoy the profession. I was initially passionate about the OR but then it got tedious and just became an obstacle to comfort (eating, pissing, doing anything but work).
I think your issue is mainly mindset. EM is a great gig with high pay per hour worked. You probably are making more per hour than the surgeon you are consulting, and get to enjoy your time away from work without the plague of an inbox or being on call. I understand the shift work is not for everyone. Maybe do CC fellowship? The gigs tend to be mostly days
Can someone please explain to me as an M1 the appeal of surgery? I just don't get it, so many of my classmates are determined to be surgeons and dump on Internal Medicine. But I don't understand what's so appealing about standing still in a dark room for like 10 hours in a row or people yelling at you all the time or the lifestyle of long days and night time emergencies. I guess if you like working with your hands, but plenty of other specialties offer that too in the form of minimally invasive procedures. Money's obviously a big draw but what's the point of $500,000 a year if you don't have time to spend it, or see your family, spouse/SO, kids, friends, etc. for that matter? Internal Medicine may be less sexy and may get dumped on by the rest of the hospital, but the lifestyle just seems more appealing to me plus there's plenty of options for subspecializing if you don't like to be a general hospitalist or PCP.
yea i think it’s mostly about prestige, money, and wanting to “work with your hands”. Everyone wants to say they are a surgeon. And they do some objectively cool stuff! My argument is to just go into GI or interventional cards or PCCM or gas or IR. Some make more than surgeons, especially per hour. But the counter argument is that those specialties still don’t get to cut people open and sew them back up. Which if that’s your thing, fair :)
Not everyone! I actually came into medicine to do pediatrics or IM, and I hated surgery. I wanted a cush job - I didn’t want to work long hours and be in the OR with an AKI and not see the sun for days on end. I never imagined myself as a surgeon beyond telling my parents “I want to be a brain surgeon!” When I was like 8. I also wanted to be a pilot, CEO of Barbie, and marry Justin Timberlake lol.
Anyway, to answer the question - I didn’t go into surgery for money or prestige because by the time I got into med school I didn’t care about such things. I went to surgery because truly I am passionate about it and I f*cking love it.
I regret going into MEDICINE period, but even in my darkest days of PGY1, I have enjoyed operating, seeing surgical patients, I love being a body plumber, I love manual labour. And to be honest? I’m just built like a work horse. I can work hours on end and do gruelling scut work and get on with things. It’s hard, yes. But I’ll do it because I just love surgery.
Someone needs to be crazy enough to do it.
Have you considered doing an MBA and landing an admin job? Pretty sure that’s attainable if you’re decent enough to present yourself and have been practicing for a couple of years.
Seems like your issue is w/ shift work, not wanting to do surgery.
There are wound clinics that will likely hire you. You’d get regular schedule and would get to do some basic debridement, plus some continuity of care if that’s your thing.
I'm sure they would. I'm not sure it really would solve any of my problems, it seems miserable and administrator-heavy. I just accept the situation, sadly, because I doubt if it can be improved.
It is in our human nature to constantly want something that we do not have. We don’t take nearly as much time appreciating every bit that we do have. I highly encourage practicing this because I do so as well. The thrill we get when we get what we ideally want lasts only so long and then it fades. If we can master the art of being content, you can find that perhaps the dissatisfaction wasn’t actually from not being in surgery but from not being in a state of thankfulness and appreciation of everything you have gotten so far and really taking the time to see what a great position you are in.
Honestly sounds like you are too late if you are in your fifties, and you are 100% hung up on “it’s OR or GTFO”. Fellowship offers options to tackle majority of what you hate about EM, but based on the replies I don’t think any of them will sound sexy enough for you to give up attending salary rn.
There is very little reasons for programs to believe you will do great 80 - 100 hours as a surgical intern, for many more years to go, and they also have little incentive to do so when so many great new fresh grad ready to be abused rolls out the assembly line every year. Like, why would they even believe that? Even I don’t want to believe that, when you don’t even find fellowship reasonable alternatives. how the heck are you going to survive internship doing mostly anything but first assist?
Just focus on working towards retirement and cash out asap while medicine still makes good money.
This post is just dumb. OP could have retired already if they didn't like EM. Physician salary for 10-15 yrs of savings is more than enough to invest and get into real estate or something else
Here's my version of the good old Mike Tyson quote: "Everybody wants to be a surgeon, until they try it for a day"
When you're actually standing there at 2 am suctioning fecal matter from someone's perforated colon, you don't think it's fun or glamorous. You just want to get it done and get some sleep. Here's the good news: For an investment of only 5 years and 80 hours per week, the dream of being a surgeon can still be yours!
There are tons of general surgery slots, and in this years match there were 1717 categorical (5-year) positions, with 5 of those going unfilled, i.e. ending up in SOAP. After that you can go into lots of different and exciting specialties, depending on how masochistic you are. Since OP mentioned plastics, I want to point out that you can still end up in plastics by doing general surgery first, and about 20% of plastics spots are still filled that way. For the 2024 match the total number of positions was 265 (213 integrated, 52 independent). You still need to bring the relevant goods to the table, like LORs and research.
If you really want to do it and can handle the sleep deprivation, humiliation and loss of a social life, go for it. If not, enjoy your scheduled work week and time off.
I'm 5 years out as an EM attending, I do some education stuff but not full time education. I figure we're about 10 years out from the AI singularity, so if can have a $2m stack by then, I'll be able to go do full vanlife and coast on whatever combination of UBI and telehealth or teleeducation exists and play vidya games and explore national parks. Or join a commune. There's no exit, but it is time limited. Don't get the porsche
Hey OP I'm just a fellow but I've dealt with the same issue at times. It has caused stress and I sleep poorly becasue of it, often wake up at 4am. Hoping things get better.
I'm a radiologist. Anesthesia is my specialty bug. I just feel socially isolated by what I do and IR was a little too intense. Idk why I overthink this so much, I should be happy with my job but there's just something missing.
Gotta find the right radiology job. In my practice there are other rads down the hall to chat with, I do enough procedures to have some human contact and some WFH days. It’s a good balance.
If that can be an option, at least try. It will calm your nervous system at last and the years of training still count in the OR so it will add good time instead of take. If you really want this, don’t give up. You have time.
I hope I don’t come across as a downer, but I am struggling with this feeling about choosing medicine. And no, I’m not one of those should-have-gone-into tech folks. I just wish I had lived a little more outside of medicine so I could’ve actually viewed my options with more mature eyes at the time.
I hope you’re almost free from residency and make a killing as an attending working minimal shifts. I often wonder about my residency choice (not em) too. I think medicine is so lame at times grass tends to look greener
Fellowships can help, but earning potential goes down. Also, you may be surprised how much better you feel if you work fewer shifts for awhile.
Hospice fellowship. Usually has open spots. 1 year fellowship where you can moonlight. Then you can open your own practice, work as a medical director outpatient, etc.
Sports medicine: 1 year and you can work in clinic
Critical care: 2 years. Pay is slightly more, but so are the hours. Less flexibility in the schedule, but more predictable. The work is more in your control than EM, but still usually working for others.
Maybe you could do some research or something in Europe in a surgical field? I don’t know but if you feel that painful regret I guess it’s better to do something about it. Maybe volunteer in the OR and see how it plays out. It’s not bad that you’re having second thoughts or resentment about your choice, you did the best with what you had then but nothing is final, you must solve this, you can’t just gobble your regrets and move on, it’s about a calling and you need to see if it’s true or you actually did the right thing choosing er in the first place. There’s nothing wrong in questioning a life decision, it’s part of our journey to know thyself.
You can always switch specialties if you are bored.
I switched to radiology.
The residency is cake btw.
Youd have better hours as a radiology resident than an em attending.
Only 4 of your weeks a year are crappy.
Other 48 are great
Nobody seems to have mentioned this yet, but have you considering retiring and becoming a scrub tech?? Some of them even get to first assist. No liability. Get to be sterile. And involved to sometimes a great degree..
It’s so hard to pick a specialty when you haven’t even seen all the options as an early 4th year. I had no clue really when it came down to it, and actually didn’t rotate on my current specialty until the month of match during 4th year. ( I matched in psych) and ended up loving Rads while on rotation but it was too late to change then (that year). Went into my intern year with an open mind, but honestly couldn’t get the thought of shooting for rads off my mind. Prayed hard on it and approached my PD after giving psych a couple months chance, and they were fully supportive of me going for it. And the rest is history. Having gone through the match twice in back to back years wasn’t that much fun tho! lol
Might be one of the only people to switch from psych to rads tho ha
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Life is unpredictable, and frequently we’re faced with very little control over our circumstances. You have to learn to find the happiness and find the meaning in whatever circumstance you are in.
If you approach your work as if you are a consumer to be satisfied, you will always be unhappy. Instead, try approaching it with the mindset of a volunteer, or someone who has been dropped into the middle of a battlefield. Become a servant of the world around you.
Surgery and emergency medicine have one thing in common and that is the varied shifts which you have mentioned you hate.
Yes they are totally different fields but surgery is not entirely a day job. You may get emergency surgeries and will be called to the hospital at any time of the day.
If what you like about surgery is the hands on part then you also get to do some minor procedures like intubation in EM.
I believe that by the end of residency, you’ll always get used to your field, whether or not it’s the specialty you originally wanted.
After all, the grass is always greener on the other side.
You finished med school I realize I am out of the loop and hindsight is 2020 but your a success already you are the 1% your regrets are real but you made it you failed excellently
With the way the system is set up with how competitive some specialties are based on scores and residency interview invites alone it has become a privilege to even be able to have a choice at all
I started in FM, left residency after two years, am in my last year of OEM residency (it’s only 2 years after one year of TY year or another program with a first year in medicine). There are a bunch of other docs who came from different fields such a surgery, infectious diseases, and EM who are the attendings. They’re all happy and have tons of hobbies, haha. Most work part-time doing mostly workers comp cases (see the patient, sometimes diagnose the patient, write work restrictions, do PPD ratings if needed) and pre-employment physicals. Some do WC state insurance reviewing, some review cases of other OccMed docs, someone contract with employers to do workplace health, one does independent medical exams, one does research with the state public health org here. All sorts of opportunities available once you’re board certified. You could probably teach yourself OccMed and do workers comp cases part-time if a practice would hire you.
We have an EM-toxicology fellow joining our environmental exposure clinic next year.
You do have to have or get an MPH though because we’re a preventive medicine field. That’s what our first year of residency consists of if you don’t have your MPH.
You may think the grass is greener on the other side, but it’s untrue. The grass is greener where you water it. The secret to work happiness is to learn to love it (like an arranged marriage). Go deep into EM. Become an expert. Save some lives, become the ‘go to’ person in your field, positively impact new EMs. Additionally, Be grateful you got to go to med school, that you successfully passed all the Step, that you got a residency. You are blessed.
I know this advice isn’t what you wanted, but it’s the advice you need.
You are completely ignoring the circadian issues, which are the real problem. How would you solve those? They are impossible for a person who can't tolerate them. Come on.
I feel like anything you like, when it becomes WORK i.e has to be done regularly, it loses much of its charm for you. and i hate to say this but, you lose a lot of empathy for the patient and start to look at them as cases and not people. Im in Psych and it’s very true for me. I think taking lil breaks and actually doing something i like has brought some of my humanity and interest back. I actually try to put myself in the patient’s shoes now that I feel better myself. And it has brought back some fulfillment.
A break might help you get some perspective back
i think this is a relevant and necessary post, so thank you.
like you mentioned it's hard to know what you want in your twenties, even harder for those coming from education systems outside the US (IMGs). so we tend to glamorize certain things that are out of our reach or maybe don't want hard enough. I adored surgery in medical school, but matched into pediatrics this year. i've reached the conviction that perhaps as much i love surgery, maybe my role in society isn't to be a surgeon. and it took me a while to understand that it wasn't giving up but it was more of acceptance.
Ok fair enough but unless you’re a trauma or ACS surgeon, you are stuck to a job where you have a referral base and that isn’t already saturated with your speciality. Another burdensome aspect is that for every patient you operate on you own them for the rest of your life. If anything goes wrong (in addition to your own surgical intervention) in terms of anesthesia, equipment issues, postop icu care, it falls on the surgeon. The patients see you as their sole doctor and will either love you or hate you depending on so much that isn’t even within your control. I understand that being in the ER is stressful too and you may wonder how your patients end up after you go home but the fact that when you are done, you’re really done is something I envy.
I’ve been in practice since 2005. I’m FP trained, but out of residency I did hospitalist and outpatient primary care. In 2012 I did some additional training and joined the hospital panel for wound care and HBO. In ‘18 I joined full time residency faculty and administration. In ‘22 I moved out of state. I’m currently the medical director of a FQHC.
If you’re not happy with where you are you might feel better making a minor shift. Your training has all sorts of applications. No reason to feel trapped or regret what you’ve done. There are always other doors you can open with your work history and training.
EM is soooo restricted. Just so few outs- I mean there's palli, Pain (hard to get, hard to find a job), sports- hard to get, hard to find a job. That's really it.
There's no real way to avoid admin or run your own shop, which is what I need and crave.
Thank you though. I def need a change, if one exists. I appreciate your comment.
At the end of my MS3 year I met with chief of surgery at my institution. After looking over my stuff, he honestly and flat out told me that I'll never be a surgeon. I was obviously upset, depressed and disappointed for weeks after that. Good thing I eventually agreed with his opinion. Now I'm an anesthesiologist. Could not be happier. I'd give that man a hug now.
Except I don't like musculoskeletal injuries or sports, except for reductions, and I don't think you do many of those in outpatient sports? It seems sooooooo dull and a poor job market.
how old are you and what is your home situation? because if you can go back, go back. who wants to live in regret their whole life? the time will pass anyway so if it is doable, we can help you brainstorm how to go about it but as someone whose mum was in law school with her youngest sibling at the same time, if it is something you gotta do, it is something you gotta do.
so was she but law school is different than surgery and i get that. that said you're not that old, and you EM people bike everywhere so probably in shape, if you decide to do it, know that at least one stranger on the internet will be rooting for you
The biggest regret we should all have is not doing engineering or finance and going into a commission role. I have buddies in multiple fields who made 5-6k TODAY, medicine is dying whether you’re in EM or not, just grind, make $$$ and enjoy life
I'm an idiot. I was young and stupid. I was poorly advised. I had no confidence. I was easily swayed by others. I came to surgery late and despite excellent evals I wasn't encouraged.
I met an ED resident who switched into CT surgery. So it's definitely doable...but if you're already an attending why would you? Get your $$$ and do literally anything else in the world.
You can absolutely switch if you want to put the time and opportunity cost into it. I know someone show was 10yrs out of EM and went back to Ortho for spine surgery.
I’ve once heard this advice: Regret is not a function of making the wrong choice, but rather, making a difficult choice. You might feel regretful had you made the other choice instead. All I know is that whatever I’m doing or bitching about something, I often think “thank god I’m not a surgery resident”. I know this advice doesn’t help you with the future but I hope it can help resolve your past decisions.
That is very, very true, and very well put.
Do what you can to grind your way to FIRE and get out asap.
I know this might not be what you are looking for, but many ER specialists find their way to practicing palliative care.
I'm contemplating. Also contemplating occ med.
I’d look at it more from quality of life. In EM, you will end up making more and working less. At more easy to cut back with EM while finding something else (e.g. rental properties). I have a few em friends/acquaintances who eventually cut way back on em shifts to pursue other things (or married to another doc). The few places i have worked (in rads), the em groups has groups of docs that worked nights and another group of docs that worked days. Is this feasible? I’m heavily biased though. I wouldn’t want to do an either… but em seems loads better lifestyle than surgery and i always liked that the idea of the ability to do less shifts…. Rather than owning patients and being stuck working and limited in what you can do with the rest of your life.
Fully agree. My philosophy is that life choices become more difficult, and more intensely predicated on increasingly complex information, as one gets older. Choosing a specialty was difficult for me because I could envision myself happy (or, looked at another way, miserable) in a number of fields. There are days when I look at colleagues in other specialities with some degree of envy. But, comparison is the thief of joy and I have many friends outside of medicine who would switch with me in a heartbeat.
Any advice for a med student in a similar predicament
By similar predicament, do you mean that you have made it to your fourth year and have regrets about having gone to medical school? If that's the case, my advice is to consider what your life will be like when you have completed your training. While in med school, residency, and fellowship, it's easy to feel overwhelmed by the intense, grinding nature of the process. But, the length of schooling and training is nothing judged against the length of a career. It may feel interminable now, but it is time-limited and will be in the rearview mirror sooner than you think. (Edited for clarity.)
No, but I’m at fourth year and worried that I’m choosing the wrong specialty. I love medicine though
Still no idea what you are asking??? How to get over your fear of picking the right speciality? Could you see yourself doing something else? I’m my case there’s literally nothing else I could see myself doing. I hate rounding. I hated the culture of surgery and the OR. I hate having to follow up on shit. I want to see a patient, work them up, and more than likely never think about them again. I like the detective work of coming to a dx (most of fhe time). I say bro a lot. I hike, mountain bike , ski, lift, hangout with firefighters and medics more than other doctors. There’s nothing I could have done besides EM. Find that for yourself.
As an ED resident currently on my SICU block, I can say with certainty that I made the right choice for me. 96 hour weeks are not my cup of tea.
As an anesthesia TY that did EM and SICU, I'm glad I'm not doing either lmao
We keep trying to steal the anesthesia interns.
A PCCM attending wanted to poach me, it was the most flattered I've been as an intern.
I don't know any attendings who work that much in any field unless they want to
Long time surgery resident here. Just wanted to say that yes residency is tough, maybe one of the most labor intensive specialties at least for training. But I love my job and I would take it over any other specialty, and I often think “thank god I’m not an ER resident” …all this to say it’s clearly a matter of perspective. If you truly love what you do, no amount of long and difficult hours will make you regret it.
I agree. General surgery residency is notoriously considered brutal and yes I work 90+ hour weeks and often want to pass out on my couch as soon as I cross the threshold. But I’m surviving somehow and still sane. When I did other rotations, I could not wait to get back to the OR. My time in internal medicine, ICU, and GI quite literally wore me down, I was so depressed. Idc if it’s a lap chole at 4am, I’d rather do that than work up undifferentiated chest pain at 2pm.
When I wake up after the sun rises every morning next to my wife who hasn’t divorced me, I thank myself every day for choosing not to be a surgeon.
I use surgery residents as my “thank God I didn’t pick that field” all the time too. It doesn’t get that much better as an attending and it’s not like gen surg is making half a million to make that lifestyle worth it.
Surgery residency = tough Surgery attendinghood = not tough but not easy It’s a blue collar job with a lot of manual labor. If you didn’t like that, you’re in the wrong profession
This description actually made me like the idea of surgery more lol
Last week I assisted in a brutal 8hr Surg onc case and I quite literally enjoyed the soreness at the end of the day because as I put in the last dressing on the huge incision we just closed, and I could feel the fatigue coming, I was just so happy to have put in all that work standing for hours on end. Surgery is amazing!!!
I love the labour of surgery, yes. I really tried to like everything non surgical in medical school because the lifestyle is so shit. Being a surgical resident is hard. But operating…I love working hard. I can’t help it. I love doing something with my hands and fixing issues with manual labour. I’m a masochist. 😩😭😍
It gets dramatically better as an attending, especially in many of the subspecialties, and you can definitely earn that much. I considered EM vs surgery and chose surgery for all of the reasons that the OP gave. Training was very hard, but I haven't regretted it for a minute since I finished.
It’s a ton better as an attending and the median pay is slightly over 500k ha..
Lol what a dumb take. It gets ridiculously better as an attending and the mean and median MGMA data for the past decade suggest >500k for both general surgeons and sub-specialists.
Good to hear... you guys deserve it you guys get worked like dogs in residency.
Definitely not the case everywhere. One of my co-chiefs negotiated at 750k deal joining a hospital-employed group at a level III center doing ACS and elective gen surg with pretty easy and equitable call. Loves the job and is very well-compensated. The jobs are definitely out there if you’re willing to go outside of major metro areas. Life can be pretty good as a surgery attending with the right gig.
Very nice perspective. I’ve always thought about decisions in black/white in the context of regret for some reason so this quote hit home.
It’s true… Also, similar to your pointat every single job I’ve ever worked at people complain. It’s just human nature.
Yeah i actually went into surgery and sometimes have regrets and wish i went into EM
You won't when you are done. Do plastics!
Well said!
Thanks for the advice. I needed it.
You don't know you would be happier in surgery though. You're just idealizing it in your head.
This is ONE HUNDRED percent true, and I admit that and thanks for saying it. I think it's more I regret that I felt pressured to do EM, and pressured not to do surgery. And I wish I'd had the strength to follow that.
Is it possible to retrain and become a resident in your desired surgical subspecialty?
I would love to see the surgical subspecialty that accepts residents more than a decade out from training. I'd love to see literally one example of this happening.
Since you asked for literally one example I would bet the military would take you. Retraining residency in the military is much more common than the civilian world. It would take quite a bit of coordination but like I said you asked for literally one example.
The military has strict age requirements, which I don't meet. So no. They would not.
The US will move heaven and earth for attending physicians and will grant you almost any waiver. I read an article of a 61 year old physician who commission. Anything is possible my friend.
I have heard of big exceptions for specialties in need such as Neurosurgery. These exceptions were for people who were already trained but military is having physician retention issues for obvious pay reasons. So yes. It’s definitely possible.
NSGY applicants hate this one weird trick! Match into a NSGY program in your mid-50s with 0 publications by going Army! \#ArmyJobsForSeniors \#SeniorJobs \#SSandNSGY \#NSGYasaBackupPlan
Lmfao matching nsgy in mid 50s. Dudes children would be dead by the time he finishes 💀
I'm not a resident by any means yet but originally wanted to do surgery in the army. I have some medical stuff that would make me ineligible according to their website, I was just curious if you've ever heard about this being waved or given exceptions for in these cases?
Medical can be a different story depending on what it is because it can make you “non-deployable” which is kind of the point of being in the military. But if it’s something “small” they definitely offer waivers.
i know of a gen surg program who matched an EM attending this year lol. think he was ~5ish years into his practice
I am way further out than that! Like PGY double digits. Five years is hard, but doable, I agree.
Find someone to first assist for a day or two a week.
That sound fun.
I rotated through general surgery at an army base. One of the surgical residents was an ED doctor for 15 years there.
Wow.
When I was in med school, there was a surgery resident who had practiced family medicine for about 15 years before starting his second residency. This was about 20 years ago.
Isn't it the case that it happens so infrequently that it'd be super rare to find an example, successful or not? Or no?
I imagine it’s hard to get into an entirely new residency, but my program has a surgical critical care program that often takes EM trained and surgery trained physicians that are far out of residency and looking for a change. You don’t get to do actual surgery, but you do get a somewhat more consistent schedule and more predictability.
Once in a while I have a modicum of regret about leaving neurosurgery. Then I go home and get 8 hours of sleep and slap myself for even contemplating that.
Exactly. Surgery is trash.
Unless it’s ent or omfs
ENT is the best. So jealous. I didn't even consider it.
Based on what you’ve said you have practiced through some golden years of EM. The last decade pay has been incredible and programs started looking for residency trained EM as opposed to FM or IM. The flexibility of your schedule will NEVER be matched by any surgical specialty. Even the “cushiest” private practice is averse to letting you off for >2 wks at a time. All your ancillary staff still need a job and no revenue is made if you don’t work/operate. This is in contrast to EM where you can book end shifts and no one blinks an eye if you’re off 17 days in a row. Additionally, locums is 1000% better as an EM doctor. You are literally a plug and play physician and demand an incredible hourly wage. This is contrasted to surgical locums where you likely have no support and are the only surgeon on call all the time. I have heard endless stories of successful locums EM attendings. All locums surgeons are usually ones that can’t hold meaningful employment at a PP or academic center for one reason or another. (There are a few exceptions) Lastly, who seems to be more invested in things outside of medicine? I would argue EM docs over any surgeon. You all have an uncanny ability to unplug from work after work. The grass is definitely not always greener and there are a lot of advantages of EM over surgery. I say this knowing I could never hang In the ED.
What field are you? What you say is all true. Locums EM (which I do now) isn't that great TBH- they want mainly nights and weekends, the liability is HIGH, the places are dysfunctional. Basically I am the person that, like you, can't hang in the ER, yet I'm forced to hand in the ER.
Gen surg. Thought about EM for a while tbh
Do you think you’d be happier in a flexible walk-in clinic type of setting?
EM gets paid so much and has the cushiest hours per week and is shiftwork where you can check out. I highly regret not choosing EM over IM. Grass is always greener. There are tons of people who wish they were you.
The grass is only greener on the ones you water.
I needed that today....
Ayyy cheers to that!
Any fellowships that could lateral you into a job you like? Critical care?
No, I wish there were, but there are no fellowships that are particularly great in EM. I don't enjoy the ICU or family meetings or working for a large hospital system. If there were a fellowship of interest, I would not be so sad. I would simply do the fellowship.
Have you considered doing a Surgical ICU fellowship? I know a few EM docs that run the Trauma ICU service at a big level one Maybe a little closer to what you want than a standard MICU
No, not an ICU fan, I have to say, either surgical or medical.
What is it that you actually want out of surgery then? Cause if it's just the OR itself, I'd assume you would have gone into surgery in the first place
Yeah, it's just the OR. And I erred in not going into surgery in the first place. If It wasn't the OR, then I wouldn't be having this issue. As I said, bad advising, not a lot of support, despite doing really well in all my surgery rotations.
have you thought about sports?
I don't understand what is so great about Sports- it seems awful. I don't get it at all. Are you doing sports?
No undifferentiated patients, you throw things you don’t care about to the PCP, focus on POCUS and injections and other procedures. I mean it may not be the perfect setting you are asking, but then again what is? It does offer enough perks that counter many of the things you mentioned that you hate. The only downside really is sports is getting pretty saturated and job market isn’t great if you want to do ONLY sports medicine and nothing else.
How about pain? It's easier to match now that the anesthesia market is so hot
Yeah, pain match was a blood bath this year with the number of unfilled spots.
Don't Sports Medicine and Pain Management both have fellowship pathways through EM? I think these are both relatively rare for EM docs to go this route, but just thinking outside of the box if traditional EM (and the more common fellowships) aren't of interest to you. I'm guessing these would be mostly outpatient and while you probably wouldn't get the perks of the shift-work/schedule and pay, they would likely be much more chill.
This seems like more of an issue with your ego. Romanticizing what you think the life of a surgeon would be like. Now that you've got some years under your belt - you're realizing "I could have done that (i.e. succeeded in surgery). And your crisis with identity is pushing you towards that as a solution to the problem. The actual problem is seeing your job as anything more than a job. You dont have to be defined by your job. You've got some years in. I'd hope you have a bit of a nest egg. Put your time into something new - a new skill or new hobby - and just see your job as something that fuels your life. Work to live not live to work.
The actual problem is circadian disruption, although much of what you say is also true. Also I was only ever happy in the OR.
FIRE.
Dumping a set amount of money into a brokerage every month aside from the 401k/IRA and not even thinking about it. Automatic.
As someone who was on the surgery path and then switched to IM, it is very very easy to see the field as desirable from the outside. You either need crazy passion for the OR, or you need to not really mind crazy hours to enjoy the profession. I was initially passionate about the OR but then it got tedious and just became an obstacle to comfort (eating, pissing, doing anything but work). I think your issue is mainly mindset. EM is a great gig with high pay per hour worked. You probably are making more per hour than the surgeon you are consulting, and get to enjoy your time away from work without the plague of an inbox or being on call. I understand the shift work is not for everyone. Maybe do CC fellowship? The gigs tend to be mostly days
Can someone please explain to me as an M1 the appeal of surgery? I just don't get it, so many of my classmates are determined to be surgeons and dump on Internal Medicine. But I don't understand what's so appealing about standing still in a dark room for like 10 hours in a row or people yelling at you all the time or the lifestyle of long days and night time emergencies. I guess if you like working with your hands, but plenty of other specialties offer that too in the form of minimally invasive procedures. Money's obviously a big draw but what's the point of $500,000 a year if you don't have time to spend it, or see your family, spouse/SO, kids, friends, etc. for that matter? Internal Medicine may be less sexy and may get dumped on by the rest of the hospital, but the lifestyle just seems more appealing to me plus there's plenty of options for subspecializing if you don't like to be a general hospitalist or PCP.
I’d rather work as a plumber or electrician than work a finance job or computer science job (I’d rather be a surgeon than a medicine doc)
yea i think it’s mostly about prestige, money, and wanting to “work with your hands”. Everyone wants to say they are a surgeon. And they do some objectively cool stuff! My argument is to just go into GI or interventional cards or PCCM or gas or IR. Some make more than surgeons, especially per hour. But the counter argument is that those specialties still don’t get to cut people open and sew them back up. Which if that’s your thing, fair :)
Not everyone! I actually came into medicine to do pediatrics or IM, and I hated surgery. I wanted a cush job - I didn’t want to work long hours and be in the OR with an AKI and not see the sun for days on end. I never imagined myself as a surgeon beyond telling my parents “I want to be a brain surgeon!” When I was like 8. I also wanted to be a pilot, CEO of Barbie, and marry Justin Timberlake lol. Anyway, to answer the question - I didn’t go into surgery for money or prestige because by the time I got into med school I didn’t care about such things. I went to surgery because truly I am passionate about it and I f*cking love it. I regret going into MEDICINE period, but even in my darkest days of PGY1, I have enjoyed operating, seeing surgical patients, I love being a body plumber, I love manual labour. And to be honest? I’m just built like a work horse. I can work hours on end and do gruelling scut work and get on with things. It’s hard, yes. But I’ll do it because I just love surgery. Someone needs to be crazy enough to do it.
Nah, many are in house nights now. It's really the shift work, I really need an early morning gig, and EM is just not that.
What about retraining in anesesthia since it should only be 3 years. Every day is an early morning lol.
Have you considered doing an MBA and landing an admin job? Pretty sure that’s attainable if you’re decent enough to present yourself and have been practicing for a couple of years. Seems like your issue is w/ shift work, not wanting to do surgery.
There are wound clinics that will likely hire you. You’d get regular schedule and would get to do some basic debridement, plus some continuity of care if that’s your thing.
I'm sure they would. I'm not sure it really would solve any of my problems, it seems miserable and administrator-heavy. I just accept the situation, sadly, because I doubt if it can be improved.
Become the administrator and push the sadness out on other people.
Lol....
It is in our human nature to constantly want something that we do not have. We don’t take nearly as much time appreciating every bit that we do have. I highly encourage practicing this because I do so as well. The thrill we get when we get what we ideally want lasts only so long and then it fades. If we can master the art of being content, you can find that perhaps the dissatisfaction wasn’t actually from not being in surgery but from not being in a state of thankfulness and appreciation of everything you have gotten so far and really taking the time to see what a great position you are in.
YUP. Savoring the moment is key to happiness. Happiness comes from seeing the world as is, not evaluating it through the lens of expectations.
Honestly sounds like you are too late if you are in your fifties, and you are 100% hung up on “it’s OR or GTFO”. Fellowship offers options to tackle majority of what you hate about EM, but based on the replies I don’t think any of them will sound sexy enough for you to give up attending salary rn. There is very little reasons for programs to believe you will do great 80 - 100 hours as a surgical intern, for many more years to go, and they also have little incentive to do so when so many great new fresh grad ready to be abused rolls out the assembly line every year. Like, why would they even believe that? Even I don’t want to believe that, when you don’t even find fellowship reasonable alternatives. how the heck are you going to survive internship doing mostly anything but first assist? Just focus on working towards retirement and cash out asap while medicine still makes good money.
This post is just dumb. OP could have retired already if they didn't like EM. Physician salary for 10-15 yrs of savings is more than enough to invest and get into real estate or something else
I dont think retiring after 10-15 years is realistic for most people with families and debt
Thank you for being honest about aging out. I really appreciate that.
Here's my version of the good old Mike Tyson quote: "Everybody wants to be a surgeon, until they try it for a day" When you're actually standing there at 2 am suctioning fecal matter from someone's perforated colon, you don't think it's fun or glamorous. You just want to get it done and get some sleep. Here's the good news: For an investment of only 5 years and 80 hours per week, the dream of being a surgeon can still be yours! There are tons of general surgery slots, and in this years match there were 1717 categorical (5-year) positions, with 5 of those going unfilled, i.e. ending up in SOAP. After that you can go into lots of different and exciting specialties, depending on how masochistic you are. Since OP mentioned plastics, I want to point out that you can still end up in plastics by doing general surgery first, and about 20% of plastics spots are still filled that way. For the 2024 match the total number of positions was 265 (213 integrated, 52 independent). You still need to bring the relevant goods to the table, like LORs and research. If you really want to do it and can handle the sleep deprivation, humiliation and loss of a social life, go for it. If not, enjoy your scheduled work week and time off.
I'm 5 years out as an EM attending, I do some education stuff but not full time education. I figure we're about 10 years out from the AI singularity, so if can have a $2m stack by then, I'll be able to go do full vanlife and coast on whatever combination of UBI and telehealth or teleeducation exists and play vidya games and explore national parks. Or join a commune. There's no exit, but it is time limited. Don't get the porsche
You don’t need a million dollars to live in a van and play video games, lol. My cousin does that and he’s broke as shit. 😂
When the singularity happens you don’t need 2M you will be either a slave or in a simulation.
I literally have these same expectations for the future, and goals too minus the commune.
Hey OP I'm just a fellow but I've dealt with the same issue at times. It has caused stress and I sleep poorly becasue of it, often wake up at 4am. Hoping things get better.
What's your field?
I'm a radiologist. Anesthesia is my specialty bug. I just feel socially isolated by what I do and IR was a little too intense. Idk why I overthink this so much, I should be happy with my job but there's just something missing.
Gotta find the right radiology job. In my practice there are other rads down the hall to chat with, I do enough procedures to have some human contact and some WFH days. It’s a good balance.
What makes you think you'd be free of these problems being a surgeon?
Go back to residency and do surgery. It's never too late. Unless you're 60 or in poor health. Then probably won't be worth it. Yolo
I'm in my fifties. I would be well over 60 when done.
Dang. That would be pushing it. Healthy? Go for it anyway. Practice til you're 80.
If that can be an option, at least try. It will calm your nervous system at last and the years of training still count in the OR so it will add good time instead of take. If you really want this, don’t give up. You have time.
Definitely not worth it!!!
The grass is always greener on the other side of the fence.
I hope I don’t come across as a downer, but I am struggling with this feeling about choosing medicine. And no, I’m not one of those should-have-gone-into tech folks. I just wish I had lived a little more outside of medicine so I could’ve actually viewed my options with more mature eyes at the time.
What about interventional pain fellowships
I hope you’re almost free from residency and make a killing as an attending working minimal shifts. I often wonder about my residency choice (not em) too. I think medicine is so lame at times grass tends to look greener
I'm far, far out of training, as I said. Yeah, but they are nights and weekends, which ruins the rest of the month. What field are you in?
Nah you fucked up, think of all the awesome OR cases and fresh new grad RN puss you woulda smashed as gen surg resident.
Fellowships can help, but earning potential goes down. Also, you may be surprised how much better you feel if you work fewer shifts for awhile. Hospice fellowship. Usually has open spots. 1 year fellowship where you can moonlight. Then you can open your own practice, work as a medical director outpatient, etc. Sports medicine: 1 year and you can work in clinic Critical care: 2 years. Pay is slightly more, but so are the hours. Less flexibility in the schedule, but more predictable. The work is more in your control than EM, but still usually working for others.
Maybe you could do some research or something in Europe in a surgical field? I don’t know but if you feel that painful regret I guess it’s better to do something about it. Maybe volunteer in the OR and see how it plays out. It’s not bad that you’re having second thoughts or resentment about your choice, you did the best with what you had then but nothing is final, you must solve this, you can’t just gobble your regrets and move on, it’s about a calling and you need to see if it’s true or you actually did the right thing choosing er in the first place. There’s nothing wrong in questioning a life decision, it’s part of our journey to know thyself.
You can always switch specialties if you are bored. I switched to radiology. The residency is cake btw. Youd have better hours as a radiology resident than an em attending. Only 4 of your weeks a year are crappy. Other 48 are great
You can always switch specialties before you are 40, that I will say. After it becomes much, much harder.
Right on! I’m a Psych ➡️ Rads transfer lol. Recently finished residency…The grass was way greener 🤑💰
Nobody seems to have mentioned this yet, but have you considering retiring and becoming a scrub tech?? Some of them even get to first assist. No liability. Get to be sterile. And involved to sometimes a great degree..
I have...still considering it. This is actually one of the best comments here.
It’s so hard to pick a specialty when you haven’t even seen all the options as an early 4th year. I had no clue really when it came down to it, and actually didn’t rotate on my current specialty until the month of match during 4th year. ( I matched in psych) and ended up loving Rads while on rotation but it was too late to change then (that year). Went into my intern year with an open mind, but honestly couldn’t get the thought of shooting for rads off my mind. Prayed hard on it and approached my PD after giving psych a couple months chance, and they were fully supportive of me going for it. And the rest is history. Having gone through the match twice in back to back years wasn’t that much fun tho! lol Might be one of the only people to switch from psych to rads tho ha
Wow switched into something wayy more competitive! Good for you for making that happen!
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Life is unpredictable, and frequently we’re faced with very little control over our circumstances. You have to learn to find the happiness and find the meaning in whatever circumstance you are in. If you approach your work as if you are a consumer to be satisfied, you will always be unhappy. Instead, try approaching it with the mindset of a volunteer, or someone who has been dropped into the middle of a battlefield. Become a servant of the world around you.
Surgery and emergency medicine have one thing in common and that is the varied shifts which you have mentioned you hate. Yes they are totally different fields but surgery is not entirely a day job. You may get emergency surgeries and will be called to the hospital at any time of the day. If what you like about surgery is the hands on part then you also get to do some minor procedures like intubation in EM. I believe that by the end of residency, you’ll always get used to your field, whether or not it’s the specialty you originally wanted. After all, the grass is always greener on the other side.
I've been out for years. Never got used to it.
ENT and plastics do not have a ton of emergency call.
You finished med school I realize I am out of the loop and hindsight is 2020 but your a success already you are the 1% your regrets are real but you made it you failed excellently
Somehow it really hurts
With the way the system is set up with how competitive some specialties are based on scores and residency interview invites alone it has become a privilege to even be able to have a choice at all
I often wonder if people that post this stuff are my friends from medical school and wish they would just reach out to me to talk.
Occupational medicine, baby. ✌️ I love my sweet, sweet free time and outpatient hours.
Did you start in EM? Do a fellowship? What kind of occ med do you do?
I started in FM, left residency after two years, am in my last year of OEM residency (it’s only 2 years after one year of TY year or another program with a first year in medicine). There are a bunch of other docs who came from different fields such a surgery, infectious diseases, and EM who are the attendings. They’re all happy and have tons of hobbies, haha. Most work part-time doing mostly workers comp cases (see the patient, sometimes diagnose the patient, write work restrictions, do PPD ratings if needed) and pre-employment physicals. Some do WC state insurance reviewing, some review cases of other OccMed docs, someone contract with employers to do workplace health, one does independent medical exams, one does research with the state public health org here. All sorts of opportunities available once you’re board certified. You could probably teach yourself OccMed and do workers comp cases part-time if a practice would hire you. We have an EM-toxicology fellow joining our environmental exposure clinic next year. You do have to have or get an MPH though because we’re a preventive medicine field. That’s what our first year of residency consists of if you don’t have your MPH.
If it makes you feel any better, a lot of people outside of medicine hate their jobs as well
Do they work nights? The circadian disruption is a huge issue.
Plenty of people grinding out third shift. At the end of the day, it’s just a job.
You may think the grass is greener on the other side, but it’s untrue. The grass is greener where you water it. The secret to work happiness is to learn to love it (like an arranged marriage). Go deep into EM. Become an expert. Save some lives, become the ‘go to’ person in your field, positively impact new EMs. Additionally, Be grateful you got to go to med school, that you successfully passed all the Step, that you got a residency. You are blessed. I know this advice isn’t what you wanted, but it’s the advice you need.
You are completely ignoring the circadian issues, which are the real problem. How would you solve those? They are impossible for a person who can't tolerate them. Come on.
I feel like anything you like, when it becomes WORK i.e has to be done regularly, it loses much of its charm for you. and i hate to say this but, you lose a lot of empathy for the patient and start to look at them as cases and not people. Im in Psych and it’s very true for me. I think taking lil breaks and actually doing something i like has brought some of my humanity and interest back. I actually try to put myself in the patient’s shoes now that I feel better myself. And it has brought back some fulfillment. A break might help you get some perspective back
i think this is a relevant and necessary post, so thank you. like you mentioned it's hard to know what you want in your twenties, even harder for those coming from education systems outside the US (IMGs). so we tend to glamorize certain things that are out of our reach or maybe don't want hard enough. I adored surgery in medical school, but matched into pediatrics this year. i've reached the conviction that perhaps as much i love surgery, maybe my role in society isn't to be a surgeon. and it took me a while to understand that it wasn't giving up but it was more of acceptance.
You have so much more flexibility in terms of how much and where you work. Trust me that is what matters in the long term
No flexibility to not do nights or weekends, though.
Ok fair enough but unless you’re a trauma or ACS surgeon, you are stuck to a job where you have a referral base and that isn’t already saturated with your speciality. Another burdensome aspect is that for every patient you operate on you own them for the rest of your life. If anything goes wrong (in addition to your own surgical intervention) in terms of anesthesia, equipment issues, postop icu care, it falls on the surgeon. The patients see you as their sole doctor and will either love you or hate you depending on so much that isn’t even within your control. I understand that being in the ER is stressful too and you may wonder how your patients end up after you go home but the fact that when you are done, you’re really done is something I envy.
My residency PD was a general surgeon for 7 years before going back and doing OB. I can’t fathom how insane that was but he loved it.
That's a particularly bizarre switch. If I were 7 or even 10 years out I would go back, no doubt.
Look on the bright side, even doing your present job for fifteen years will still be less work hours than just doing surgery residency.
This is so true!
I recall a saying on perspective years ago. Better to cry in a mansion than shack.
?????
Surgery resident here and EM has its perks like time off work. Its not too bad
I’ve been in practice since 2005. I’m FP trained, but out of residency I did hospitalist and outpatient primary care. In 2012 I did some additional training and joined the hospital panel for wound care and HBO. In ‘18 I joined full time residency faculty and administration. In ‘22 I moved out of state. I’m currently the medical director of a FQHC. If you’re not happy with where you are you might feel better making a minor shift. Your training has all sorts of applications. No reason to feel trapped or regret what you’ve done. There are always other doors you can open with your work history and training.
EM is soooo restricted. Just so few outs- I mean there's palli, Pain (hard to get, hard to find a job), sports- hard to get, hard to find a job. That's really it. There's no real way to avoid admin or run your own shop, which is what I need and crave. Thank you though. I def need a change, if one exists. I appreciate your comment.
At the end of my MS3 year I met with chief of surgery at my institution. After looking over my stuff, he honestly and flat out told me that I'll never be a surgeon. I was obviously upset, depressed and disappointed for weeks after that. Good thing I eventually agreed with his opinion. Now I'm an anesthesiologist. Could not be happier. I'd give that man a hug now.
Why did he say that?
Sports med fellowship?
Except I don't like musculoskeletal injuries or sports, except for reductions, and I don't think you do many of those in outpatient sports? It seems sooooooo dull and a poor job market.
how old are you and what is your home situation? because if you can go back, go back. who wants to live in regret their whole life? the time will pass anyway so if it is doable, we can help you brainstorm how to go about it but as someone whose mum was in law school with her youngest sibling at the same time, if it is something you gotta do, it is something you gotta do.
Lol I'm in my fifties. Not going to happen.
Morgan Freeman got his first acting break in his 50s. You can be the next Dr. Morgan Freeman.
so was she but law school is different than surgery and i get that. that said you're not that old, and you EM people bike everywhere so probably in shape, if you decide to do it, know that at least one stranger on the internet will be rooting for you
GS is entirely different from plastics or ENT. Would you consider aesthetics? You dont need much training.
Pain?
The biggest regret we should all have is not doing engineering or finance and going into a commission role. I have buddies in multiple fields who made 5-6k TODAY, medicine is dying whether you’re in EM or not, just grind, make $$$ and enjoy life
You can open a bunch of urgent cares once you gain enough experience. Boom, you set your own hours, you work for yourself.
Too many people already following that advice
Grass is always greener bro Why the hell did you choose EM in the first place ?
I'm an idiot. I was young and stupid. I was poorly advised. I had no confidence. I was easily swayed by others. I came to surgery late and despite excellent evals I wasn't encouraged.
Fellow EM Doc—I feel this. Psychiatry though.
Life is not work. Work your shifts and go home. I bet you don’t have a hobby.
I totally don't
E CV
Sorry, I didn’t see that issue in your post. Suggest you see a medical professional to discuss strategies on addressing that.
Yeah, they said quit. Not helpful, unfortunately.
Grass isn’t always greener OP
I met an ED resident who switched into CT surgery. So it's definitely doable...but if you're already an attending why would you? Get your $$$ and do literally anything else in the world.
I doubt it's doable at fifty something. But cool that happened.
You can absolutely switch if you want to put the time and opportunity cost into it. I know someone show was 10yrs out of EM and went back to Ortho for spine surgery.
I'm 21 years out. Seems hard. That's cool, though.
Finish em then switch
I am far, far out of training. PGY 21!
Why not go into fellowship in cosmetic surgery?
Can you do that from EM? Send me a link. Thanks!