Thursday, May 27, 2004

An email from a reader:

I am an incoming 1st year medical student at the Medical College of Georgia and am starting some introspection regarding residency options. Upon choosing to enter the medical profession, Hem/Onc has been my primary consideration as a future career path. Recently and probably very naively, I have been looking at surgery because I believe from limited experience it suits many characteristics that I find in my own personality and for the simple reason of the challenge of the work. More to the point of this email, is to ask about the balance between your profession and other aspects of your life. Also, how do you see the future landscape of surgery in the changing medical system, ie. demand, increasing mal-practice insurance, decreasing reimbursements.

First off, congratulations on your acceptance to the Finest Medical School in the Free World. When I started medical school I had the experience of working in a hospital ED for several years and would spend my vacations following physicians in various specialties around while they did their work. This gave me an informed perspective on how various specialties work in the "real world". I actually started medical school wanting to be an orthopedist but a kind surgical resident took me under their wing and got me interested in general surgery. Don't be surprised if you get into school and change your mind about what you want to do, and feel free to explore multiple career choices. That being said the competitiveness of many residency programs requires one to commit early to a path to allow for maximization of placement options. You might find this book, Iserson's Getting into a Residency: A Guide for Medical Students, Sixth Edition helpful.
As to the balance between surgery and the rest of my life, well I am fortunate that I am in practice with a group that recognizes that serious time must be made for families. I still miss more than my share of school functions and the like, and it will probably get worse as my children become older. Luckily Mrs. Parker has the patience of Job with such things, and has throughout medical school and residency.
The future of surgery is going to be one of increasing use of laparoscopy and other minimally invasive techniques. As far as the effects of reimbursement and liability premiums on the practice of surgery only time will tell. I fear that it will take more actions such as the one described below before things get better. I do not see the work that a surgeon does diminishing anytime soon, and surgeons may become busier with 60 percent of respondents to an American College of Surgeons survey between 40 and 59 years old.
The student then wrote again:

Also, just out of curiosity could you give me insight into some of the emotions you had when first entering your intern year of surgery? More specifically, I do consider many aspects of my personality and interests in line with surgery, but looking from the distance and innocent position of an incoming first year med student, I have what could be described as anxiety about the contemplation of a life as a surgeon, but this is what also seems attractive, the challenge. Is this feeling a normal part of the student or intern experience, or were you as a surgeon without anxiety about your occupation?

I was scared to death of making a mistake. The feeling of many is similar to that expressed by Dr. John Carter of ER fame. When faced with a difficult patient he yells, "Somebody get the doctor!!" to which a nurse replies: "You are the doctor." Then it hits you. As you progress through your residency the ability to deal with such matters improves and your anxiety level falls as well. The anxious feeling is natural and a good thing because it shows you are concerned about your patients and your performance. I have anxious moments from time to time even now. The important thing that you have to learn, all macho BS aside, is to not lose control. Once you do the confidence that your patient and other members of the team has for you is gone and difficult to recover.

I hope you have found this helpful. This site sponsored by the ACS: "SO, YOU WANT TO BE A SURGEON..." may also be useful. It is from a book by the same name that is no longer in print, but was a treasure trove of information for me back in the day.

Just try not to get stereotyped. (via Michelle Au).
Weblog Commenting and Trackback by HaloScan.com

This page is powered by Blogger. Isn't yours?