u/No_Painter_1473

There have been a few posts lately from residents who started in a non-surgical specialty and either had a change of heart or had an existing feeling confirmed that the OR is a better fit.

From the threads I’ve read, the consensus seems to be that switching into surgery is difficult, but not impossible, there are people who have done it. Whether the risk is worth taking is obviously an individual decision.

What I haven’t found much information about is the actual logistics of preparing to make an attempt, especially while you're still a resident in another specialty.

For people who have switched, helped someone switch, or have insight from the surgery side:

1. Who do you talk to first? I’ve heard a good first step is talking to the PD of the surgical program at your own institution. But then what? Do you tell your current PD before having that conversation
2. How do you get meaningful surgical letters? If your current residency doesn’t include surgical rotations, how do you develop relationships with surgeons strong enough to get credible LORs?
3. What can you concretely do to improve your chances while still a resident? 
4. For people who actually made the switch, what did the timeline look like?

Any insight is greatly appreciated!

PGY1 in neuro wanting to switch to ortho. I know there couldn't be two specialties further apart, I wanted to do Neuro going into med school and had an app around that. I still love the cerebral aspect of it, but during rotations found myself drawn to the OR, technical mastery, and immediate impact that restores function and ability. I fell to the sunk cost fallacy, and didn't want to take a research year, but now it feels like such a misfit it that I'm struggling to imagine getting through this as a residency, let alone a career.

I was also intimidated by the barriers to entry as a DO, which my school repeatedly told me made a late pivot very unrealistic when I did consider it at the end of third year. Overall I told myself I could make a career out of Neuro and will grow to find my niche, but day in and out it feels like I made the wrong decision, am craving to be in the OR, and feel stuck in a mistake.

I know Neuro-interventional is an option, but I honestly think I'm drawn to surgery, not just procedures. I like the idea of constantly improving my craft, working across different age groups, and having a diverse technical skill set. I even considered ophtho at one point, but wanted more acuity and OR time.

I did have a competitive step 2 score, good leadership and experiences, non-ortho research.

Is this even worth consideration, and if so, how would I even start? Any advice is appreciated