Incoming gen surg resident realizing maybe I never actually liked gen surg?
I’m an incoming general surgery resident and I feel like I’ve spent most of 4th year trying to figure out whether I’m just burned out and panicking… or whether I genuinely chose the wrong field.
I’m a DO student and did 7 audition rotations, so by the end of 4th year I kept telling myself my feelings were probably just exhaustion from nonstop Sub-Is. I came into med school knowing I wanted to do something procedural. Before med school I worked in derm and really liked the procedures there, but once I got into clinicals I honestly didn’t get much exposure to other surgical specialties. My gen surg clerkship was mostly colorectal-heavy, and the only other real exposure I got was urology because my preceptor was kind enough to let me shadow one during clerkships when I was trying to figure my life out.
At the time, I didn’t really know what else to do, so I figured I’d just stick with gen surg and maybe find a fellowship I liked later.
The problem is… over time I started realizing there were huge parts of gen surg that I actively disliked.
I HATE abdominal pathology. Like genuinely. I don’t enjoy bowel surgery or a lot of the pathology that makes up bread-and-butter gen surg. I also realized I don’t enjoy incredibly long surgeries. By the end of 4th year I basically concluded that my only shot at being happy in surgery would be ending up in a fellowship that keeps me mostly outside the abdomen.
I did a breast surgery elective in May of third year and there actually were parts I loved. I liked talking to patients about cancer. I enjoy women’s health, endocrine, and immunology. One of the things I justified was that lumpectomies and mastectomies reminded me of skin cancer removals so that was exciting. But over time, the day to day also started to feel repetitive; its a pretty niche subspecialty so hard to have much variety. I also realized depending on where you practice there’s still a chance you’re taking general surgery call as a breast surgeon, which honestly made me spiral a little.
I also considered endocrine surgery for a while, but once I looked realistically at the pathway during 4th year, I realized I probably wouldn’t be training at a major academic center and the odds of matching endocrine from that position felt low.
Then at the end of 4th year I did a plastics rotation. At first I honestly didn’t love plastics either… until I saw flap reconstruction. That was probably the first time in a while I got genuinely excited in the OR again. My attending also did a lot of skin cancer removals because it was kind of a small-town practice setup, and it reminded me how much I missed derm.
After that rotation I basically went down a rabbit hole researching dermatology again and questioning every decision I’ve made over the last 4 years.
At this point I’m seriously considering leaving general surgery after intern year and trying to pursue derm. My thought process right now is stay for my intern year, leave and hopefully complete a research year while applying. I know this sounds completely insane. Trust me, I know. But I’ve had these feelings for a long time, and honestly the massive pit in my stomach after finding out I matched gen surg kind of made me realize maybe these feelings were actually real and not just temporary stress. I genuinely think I’m so burned out and unhappy with where I’m headed that derm feels like the only specialty I can actually picture myself being happy in long term. \*\*I do want to add academically/scores wise, I should be competitive. I have taken both steps and scored +260 on step 2. I have only one derm article published from first year, and only a few other pubs non derm related. I am not first author on any so I do understand that research and networking are were I would need to improve if I pursue this path.
I do also think gen surg itself just may not be for me regardless. So, if derm is completely unrealistic at this point, then I honestly need to figure out what specialty actually fits me better before I get too deep into residency. I’ve thought about radiology just to get out potentially look into breast rads, anesthesia since its proceduraly, even OB because I enjoy women's health and do have interest in MFM and REI (though that is also incredibly competitive), but I genuinely don’t know right now.
I know I should have figured this out before. I do understand the weight that is on me right now!
I’m open to literally any advice about how to move forward, especially from people who switched specialties or seriously considered it. Has anyone else realized this late that they might have chosen the wrong specialty?