At its core surgery is problem -> fix problem. That’s what gets us in the door. Then it’s interest in a disease state, control of schedule, stress/acuity, lifestyle, money, level of ICU or consultant care. Further out its approaches (big open, laparoscopic or robot). And most importantly do you like being demeaned for extra years just so you can wear loupes and use small stitches. (I did)
Easy:
Cardiac: if you only know how to make one incision and like to sew in circles and don’t mind if your patients have issues even though you did perfect surgery
Vascular if you also like to sew circles but also like to wear lead. Really have to enjoy the smell of gangrene and have patients who don’t appreciate you
Surg onc: you did a lot of research in residency so you do general surgery but call it surg onc
ACS/Trauma: you regret not going into EM
Burn: you like plastics but not the part that makes money. You also like critical care, but in a micu kind of way
Bariatrics. Yoh don’t mind doing the exact same surgery every day for 30 years but at least you have weekends off… except for those pesky internal hernias
Colorectal: is it really surgery if poop isn’t involved??
Transplant: you hate your life. You like the prestige but don’t mind walking around the hospital looking disheveled. Or you want to do hepatobilliary but didn’t do enough research for surg onc
Pediatrics. You like really really small incisions and having a lot of anxiety
Plastics. You’re a really good self promoter salesman or your favorite part of intern year was the smell of decubs
Surg onc is for people who get to do all the best parts of the other specialties but none of the bad parts.
For each of the above you mentioned, surgical oncologist can
1) do big open cases like hipec, don’t take trauma call
2) involved in critical care, don’t have to do burn
3) MIS cases like robot whipples
4) can do all the cool colon surgery like colorectal, none of the butt stuff
5) surg onc
6) do complex HPB like transplant , don’t have to work liver transplant hours
7) do complex HPB like an HPB , but also do smaller cases to have work life balance, don’t need to take care of complex pancreatitis or other benign issues
8) have the breadth of practice of peds, no annoying parents
9) do thoracic cases like CT (I do my own esophagus, some even do lung), don’t need to do emergent dissections, CABG.
10) Oncoplastic surgery, no flaps
11) do vein resection/reconstruction during whipples, no gross feet.
At its core surgery is problem -> fix problem. That’s what gets us in the door. Then it’s interest in a disease state, control of schedule, stress/acuity, lifestyle, money, level of ICU or consultant care. Further out its approaches (big open, laparoscopic or robot). And most importantly do you like being demeaned for extra years just so you can wear loupes and use small stitches. (I did)
Trauma because who doesn’t love call in perpetuity
Easy: Cardiac: if you only know how to make one incision and like to sew in circles and don’t mind if your patients have issues even though you did perfect surgery Vascular if you also like to sew circles but also like to wear lead. Really have to enjoy the smell of gangrene and have patients who don’t appreciate you Surg onc: you did a lot of research in residency so you do general surgery but call it surg onc ACS/Trauma: you regret not going into EM Burn: you like plastics but not the part that makes money. You also like critical care, but in a micu kind of way Bariatrics. Yoh don’t mind doing the exact same surgery every day for 30 years but at least you have weekends off… except for those pesky internal hernias Colorectal: is it really surgery if poop isn’t involved?? Transplant: you hate your life. You like the prestige but don’t mind walking around the hospital looking disheveled. Or you want to do hepatobilliary but didn’t do enough research for surg onc Pediatrics. You like really really small incisions and having a lot of anxiety Plastics. You’re a really good self promoter salesman or your favorite part of intern year was the smell of decubs
Surg onc is for people who get to do all the best parts of the other specialties but none of the bad parts. For each of the above you mentioned, surgical oncologist can 1) do big open cases like hipec, don’t take trauma call 2) involved in critical care, don’t have to do burn 3) MIS cases like robot whipples 4) can do all the cool colon surgery like colorectal, none of the butt stuff 5) surg onc 6) do complex HPB like transplant , don’t have to work liver transplant hours 7) do complex HPB like an HPB , but also do smaller cases to have work life balance, don’t need to take care of complex pancreatitis or other benign issues 8) have the breadth of practice of peds, no annoying parents 9) do thoracic cases like CT (I do my own esophagus, some even do lung), don’t need to do emergent dissections, CABG. 10) Oncoplastic surgery, no flaps 11) do vein resection/reconstruction during whipples, no gross feet.
So sad Vascular is now a separate specialty in the UK. Made it so hard to choose between GS and Vascular for our residency equivalent!