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done with IM residency - subspecialty or Surgery

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7 years 7 months ago #84020 by plentdoc
Hi all,
I always knew I wanted to work with my hands, and although I wanted to be a neurosurgeon, was discouraged to become so by my in-laws. (oh how I regret listening to them). I compromised by going into internal medicine, happily thinking I would do interventional cardiology. However, i learned that it was not my passion.

I am now happily married at age 29 with an absolutely adorable 7 month old baby. I completed internal medicine residency in June of 2012 and did damn well at it (appointed chief resident, and cardiology research under my belt).

I STILL want to be a surgeon, however, I don't want a bad lifestyle any more. I myself have no problem working my ass off, intact, my best days at work were those that were super busy and those filled with procedures. However, the long hours away from home are an issue because I don't want to deprive my baby and husband of my time as a good mother and wife. I want to teach her things, be able to look after her if she's sick, spend time with her, take her to swimming and dance classes etc. Thus i'm looking for a surgical residency that will still give me time with my little munchkin.

If I could choose my perfect specialty, it would probably be plastic surgery - However, I would have to go through three years (or 5) of general surgery for that - (which i personally would love i'm sure but doesn't seem like a good option because I would basically be non-existent for my baby. Not to mention, there is no guarantee i would get into plastic surgery - where would that leave me?

I thought of ophthalmology, but it doesn't give me the satisfaction of cutting into skin and the body. There's also too much clinic time - I just don't enjoy sitting in a clinic, questioning patients. I hated IM for the clinic time, the long H&Ps and the long progress notes and the long conversations with patients.

So then I considered ENT. It wouldn't be my favorite thing because of the type of surgery (lots of things through the mouth and through the nose), however, facial plastics and reconstructive surgery sounds amazing and i'm sure I would love it. Here is where I need your help. Does ENT residency require you to be away from home just as much as general surgery residency?
My other concern with ENT is that i'm an Foreign grad from a carribean med school. board scores are 233, 243, 229, no research in ENT. Got all A's for my core rotations in medschool except a B for general surgery (missed the A by 1% but a B is a B no matter how you look at it). What can I do to better my chances of matching. Another problem is that I hear it's hard to do a second residency because the program doesn't get funded for your spot.

I want to be a surgeon, but I want to be there for my baby girl. While at work, I can work my butt off better than anyone and am fine with having no chill time. but it's the time away from home that is my conflict because I have this beautiful baby at home who I want to be available for. I've tried to like the medicine subspecialties but sitting in clinic and talking to patients just doesn't do it for me. I always think of being in the OR or doing procedures. Surgeries and procedures that have an impact!.

I'm so conflicted- I must make a decision soon. Any advice from you guys will be great.

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7 years 7 months ago #84059 by efex101
I think you may want too much. You want to be a surgeon hence will need to do a surgical residency yet to want to be there for your child...not possible hardly at all during surgery residencies whichever that may be. ENT is a hard residency just as general surgery is. You need to pick your poison or wait until your child is older then do residency. Sorry but not much help just some reality.

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7 years 7 months ago #84079 by xyzmummy
I'm not in the US, so I don't know too much about your system, I'm afraid, but have you considered a medical speciality such as dermatology or gastroenterology?
Both of those are mainly office-based, but do involved doing some small procedures on a regular basis.

Dermatology, especially, can be fairly close to plastics, depending on how specialised you become after your training!

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7 years 7 months ago #84086 by AmmaMD
My understanding is that ENT is certainly a very hours-intensive specialty during training.

Overall, I have to agree with efex101 - I think it sounds like it's going to be really hard to find something that's actually surgery but that will let you be home as much as you are wishing to be.

If procedures of other sorts are satisfying, there's always a pain fellowship with injections... or even retraining in anesthesia... but..... I just don't know of any short-cut to being a surgeon, unfortunately. I think even people who get through the initial years before having kids really struggle to make it work - starting now it would be even more difficult to match your goals.

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7 years 7 months ago #84118 by plentdoc
I appreciate the honest responses from you guys. I tried to love medicine subspecialties (I requested extra GI months so that i could fall in love with it) but it just didn't excite me the way surgery did.
I've never rotated through dermatology, however, it just has never appealed to me. my understanding is that it is still very clinic oriented intermixed with office procedures but no surgery really.

Anyone out there who has been in this position? Anyone who went back and did a surgical residency while having a small baby? I would love your input as to how hard it was, whether there are things you regret and if I would still do it again if you had a chance to do it all over. I just love surgery, but I love my baby too.

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7 years 2 months ago #86015 by nightowl
Plentdoc,

I can't say that I have your answer, but I am in such a similar position. I wanted to do general surgery- I loved plastic surgery- but let my own career take the backseat to my gen surg husband at the time. We ended up divorced and I am now doing internal med. That is after switching out of ob/gyn because I am a single mom and wasn't spending much time with my baby. I know, very confusing, but I feel your pain. I really miss surgery, I love procedures, and I loathe internal med for the long notes, slow pace, and just tedium in general. I'm not sure how you got through it so successfully considering you didn't like it? I feel like it's pulling teeth to suffer through IM. I constantly wonder if I made the right decision switching out of a surgical specialty and I wish I had just done general surgery to begin with... think I would have made an excellent breast surgeon or plastic surgeon. I love the OR and never got bored, even in really long cases. I am curious what your plans are for the future?

btw, like you, I feel like I "want to much" and I'm not sure if there is an answer for doctor/mommas like us =/

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