Is surgery really worth it? A perspective.

Well, a while ago I was talking about how I jumped ship to anesthesiology and was refocusing my application for residency.

The allure of surgery still lingers in my mind, much like the haze of incense, or a low morning fog.

I had a conversation with one of my friends who just finished numerous residency interviews for general surgery, and completed his ICU rotation.  He told me all about it, how he put in so many lines in trauma patients, did a lot of suturing, some bronchoscopy, and assisted on some cases.

That all seems really exciting to me, and I remember how I enjoyed acute situations on my surgery rotation, though it wasn't as advanced as what he did.  I crave closing wounds and doing procedures (I can't say operating, because I haven't really done much more than simple abscess incision and drainage), but I don't know if I want to be paged relentlessly while draining butt abscesses at 11 at night until I'm 50+ years old.

Surgery has a really big draw and there are more people applying to general surgery than in the past, with the change in residency work-hour rules.  But you know, when you're an attending, there aren't work hour restrictions and you might not always have assistance.  I hope people realize that when they're applying for a general surgery residency.

I don't want to keep saying "No, I can't," to my family and friends, and maybe even future interests/girlfriend, I'm just tired of having to say that after university and at this point in my medical training.  I also keep thinking about how I've never met a resident so far who said he or she wants to stay a general surgeon.  The more popular paths are surgical oncology, breast surgery, and endocrine surgery, which have less intense hours.

If you happen to have surgery residents that are nice and respect you like I did, be sure to tell them you're interested in surgery and they will often offer you advice and let you ask them questions about their training and their plans.

Anesthesiology "historically" has better hours than surgery, and while you do work more when you're in the ICU, I think I'm willing to do that because I think I'm enjoying reading the critical care literature greatly and there's the prospect of doing procedures.  What I missed on my surgery rotation was "what drug is best for this patient?" moments, because you really only end up administering antibiotics, fluids, and changes in diet.

The only qualm I have of doing neuro ICU or spending a lot of time in the ICU is futility of care and the uncertainty of how hospitals are going to deal with the expense of caring for ICU patients with health care reform looming on the horizon.  More on that later.

Just some reflections.