In my last column, I touched on some commonly chosen medical specialties and hopefully cleared up some confusion on what they do, their day to day responsibilities, and career opportunities after residency training. I remember not knowing the difference between some of the surgical specialties when I was going through my first and second year as well, so I’ll do my best to outline the most commonly pursued ones.
One of the things that scared me off of general surgery was the anatomy aspect of it. I wasn’t a fan of trying to pick out nerves, arteries and veins in the anatomy lab, so I wasn’t really looking forward to doing it in a living person either. This could not have been further from the truth. I absolutely loved my general surgery rotation, and it was the biggest reason I decided to pursue a surgical specialty—I loved everything about the OR and surgery itself. Many say that you either love being in the OR or you hate it. There really isn’t much middle ground. I obviously fell into the former group.
General surgery training is anywhere from five to seven years with at least five years being in the operating rooms. Programs that are seven years long usually have their residents take two years off to do a research project. This can be great for both the institution, which gets some thoroughly researched projects and the residents, who get some semblance of a normal life during these years. General surgery is truly that—they can operate on most anything except bones/fractures, inside the thoracic cavity, peripheral neurovascular supply, and inside the brain. The bread and butter of this specialty includes appendectomies (appendix removals), gall bladder removals, hernia repairs, and bowel resections. When I was on my surgery rotation, I got to see plenty of each of these. I would have chosen to go into general surgery if it had not been for the trauma call which some institutions have their general surgeons cover (those without specific trauma services). This can mean spending the day in either the clinic or OR and then covering the ED for any trauma or emergent cases that come through the door. I don’t do well with trauma cases so that was out for me.
There are also plenty of fellowship opportunities following a residency in general surgery: trauma, minimally invasive surgery, pediatric surgery, colorectal surgery, vascular surgery, surgical critical care, cardiothoracic surgery, surgical oncology, and many more. Needless to say, the doors are wide open for general surgeons (who are also in high demand). This can be a very fulfilling field especially for those who like to see an immediate impact of their care on the lives of their patients.
Another popular surgical specialty is orthopedic surgery. This is particularly competitive and generally requires higher board scores and some research in order to match successfully. I have a few friends who chose orthopedic surgery, and these people ate, slept, breathed, dreamt about orthopedic surgery. It was intense to say the least. Many of the people I’ve spoken with who chose this field wanted to do so because of an injury they had in the past which exposed them to orthopedics in the first place. It can offer a great lifestyle in terms of both hours worked and reimbursement. This specialty is also usually involved in trauma cases which can add to the variety.
Obstetrics and Gynecology
I’ll briefly touch on a surgical specialty near and dear to my heart: obstetrics and gynecology. What most people usually exclaim when I tell them I’ll be going into this field is “babies!” This is true, but this is not the reason that I’m doing it. (The cuteness factor does help though). In fact, if this is the only reason someone decides on OB/GYN, they should strongly consider something else. The specialty overall deals with women of reproductive age and any needs they might have regarding reproductive health. It does largely involve following these patients throughout pregnancy, but also includes health maintenance.
I love it because I get to be in the OR and operate on patients who I’ve gotten to know in the clinic. The continuity of care along with surgical practice is what sealed the deal for me. Though in-house call hours can be brutal even for attending physicians, it can be relatively easy to tailor your practice to your interests. There are also a variety of fellowship options available: maternal fetal medicine (high-risk pregnancy), urogynecology, reproductive endocrinology and infertility, gynecologic oncology, family planning, along with many others. I’m excited to see where I end up in terms of my own career.
Surgery can be very rewarding for both physicians and patients. As someone who is a “surgery convert”, I hope this helps in terms of keeping your options open!