¶ Medical Student's Career Dilemma
I'm torn between general surgery and EM . I'm worried . If I choose EM , I'll always wish I was in the OR operating , and if I choose surgery , I'll lose the other parts of me that make me who I am . Music . Try to use your 80-year-old self to make your decisions .
When you old as hell on your gravestone , what's the story that you want people to say about you when you're 80 , are you gonna be regretful that you didn't go for what you really , really wanted to do , which it sounds to me ? It sounds like you want to be a dope doc and you also want to be an amazing musician , A hip hop artist .
Do you want to be the Drake hybrid ?
Or do you want to be Kendrick ?
Being a doctor is no joke . It takes a lot of dedication , a lot of sacrifice . You're going to feel like you're on an island a lot of times . So I would say is like listen , like shoot for the stars If you really love surgery . Now is not the time to compromise what's good . Everybody , Welcome to another episode of Docs Outside the Box .
This is what y'all say . We're super psyched about everybody who writes to us . There's so many different ways that you can reach out to us Instagram , twitter actually not Twitter Instagram email . There's text hey , listen , you know , there's man there's a lot .
Just go on the show notes , you'll find all the things .
Yeah , you'll find it all there and we just want to say thank you very much . And today , before we jump into today's question , which is a really super deep question about what specialty to go into specifically if you have a passion for it , let's jump into real quick about our previous episode where we talked about LLC versus S Corp and all that stuff .
So , guys , we recorded an episode where we were talking about the different entities , the different types . Entities for your business there's LLC , there's sole proprietorship . Then there is well , how do you want to get taxed by the IRS ? There's LLC , there's sole proprietorship . Then there is well , how do you want to get taxed by the IRS ?
There's S corporation and C corporation . And in that episode I thought I was whooping some ass and I thought I was being super clear as possible . But there's always that one person who writes in and has to , like you know , share their information about certain things . So we got a message here to , like soup your head up even some more .
Let me see if I can share this page . Let me see Boom .
You gotta put somebody on blast , like that me . You know no , boom no .
So he says Darkwa says Renee definitely won the LLC versus S Corp argument . She's two and O . I don't know where the other one came from .
I mean , he probably listened to another episode where I knocked you down there Also go .
Alfred , you're letting me down knee , so Daquan , my cousin , my chalet , listen , that was great .
Why you gotta put him on blast like that .
Yo that's great that you did that . You know how do I stop my screen . That's great . I listen . I guess I wasn't being very clear , but , guys , this is on purpose . This is just to say listen , even if I'm not perfect with my answer , it doesn't matter . I'm moving forward with being an S-Corp , moving forward being an LLC , right ?
Because , guys , listen , as doctors , we need to know , like you know , from A to Z before we go ahead and take that test or board exam and so forth . And it's like yo , for the test of life and the test for business . You ain't got to know all the answers , you just got to know that you're moving in the right direction .
And I think , for 95% of the people that I was telling the information for , I think I was correct . He 95% of the people that I was telling the information for , I think I was correct he didn't say you were wrong , no , he said that you got me .
Yeah , because you were explaining something , you were saying something and there wasn't like the background context for someone who didn't know at all what you were talking about .
No , I think you were just being nitpicky .
I wasn't being nitpicky .
Let me find small little things to just go at it . And this person Right again Say that all these different things , Tell me if I'm three for O .
But listen , guys , go check out that episode because it's a really good discussion primer on what exactly is a business entity , right , like how do you create a business , or why you create a business , and then how does that business get taxed , how do you figure out all those different ways .
It's a short episode we did it while we were literally like having an amazing vacation while the kids were gone but it is a true to form discussion , right , about what we do with our business entities .
Not all of them , right , because our real estate entities are not S-Corps , correct , our real estate entities are just LLCs , you know , and we just make it work that way . The podcast business is just an LLC and we make it work like that . But , don Juan , we appreciate what you wrote . That was amazing .
I appreciate that , on purpose , I let Renee win these things because I think it's .
I think you don't have a choice .
I think it's better when I'm the bad guy on the show . Everybody appears to want to make me the bad guy , so it's all good and on that note . On that note , I got to give a quick shout out to my wife , dr Renee . She had a birthday this past weekend .
I'm not sure when this episode is going out , but just know , whenever I recorded this this past weekend , we celebrated your birthday . I'm not going to say what age you are , just know that we can make more contributions to your IRA because of that yeah , girl Doing your job . So you guys figure it out from there .
But my baby , my wife , my partner , my co-host , almost ex-co-host she turned a certain age and I have seen you grow from the age of 27 to where you are right now . And I gotta say , right now I'm super proud of where you are right now .
As a mom , um , as a sister , as a wife , um , as a podcast host , as a as a daughter um , you've grown in so many different ways .
You were amazing when I met you there then , but you're even so like amazing right now and the things that you're able to accomplish is just amazing the way in which you take care of our kids , the way in which you take care of me , the way in which you take care of this podcast , among other things , and you know , obviously , being a great sister to you ,
know your brothers and your sisters , I think it's amazing and being a great role model to the kids , as well as to your nephews and nieces . Super dope , super dope . This is a huge milestone for you .
And listen , let's make it happen over the next , you know , several decades , because we don't have many more left , right , you don't have many turns around the sun left , so let's maximize it , Right ? Remember who wins these arguments , right ?
Y'all heard it here don't focus too much on okay , when you could be , you know , focus on living , life and stuff , right so thank you very much . I had a great , great , great , great , great birthday not only do I lose arguments , I'm like the worst , like I have to give the worst speeches . I do give the worst speeches . Let me do give the worst speeches .
Let me tell you guys real quick what I'm really bad at , not to cut you off .
Yes .
I'm really bad at , but that's the way it works , though I'm really bad at speeches . I'm really bad at line picking . Ask her .
Line oh , lane picking , lane picking .
Even at TSA , whether it's TSA lanes or lines , if it's on traffic trying to get to New York and you're trying to choose which traffic , which lane is moving faster than the other , just know , whatever one I'm going to pick , you're going to end up blasting because it makes no sense . I'm horrible at it , but no , go ahead and say your stuff .
I was going to say thank you , thank you , thank you , thank you for an amazing birthday . So I am officially over the hill , right in time . So my husband and my sister threw me an amazing party . We had a get-together at my sister's house with decorations , food . The food was amazing .
What kind of food did you have ?
We had that Haitian food . We had that duet djon , djon , duet , boi . We had tasso . Oh my God , the tasso was so good .
What is tasso ? Tell them what tasso is . Tasso is goat meat .
It's one of my favorite meats . It's my second favorite meat after oxtail .
Yeah , tasso is is good , but goat meat in general is just , it's just so good . There's too much work you gotta do .
Oh my god , it's so good . Will you ever see a baby goat and you just be like he looks so tasty . I can't look at a goat without thinking how tasty it looks . I'm sorry , sorry for all you vegans and vegetarians out there , but a goat , they look tasty .
Well , I think for the majority of people outside of the United States I think that's how they look at goat They'll see a baby goat and be like I can't wait for you to grow in four or five years .
Oh , I can't wait .
I can't wait for you to go to high school .
A lamb too . Ooh , lamb chops , good , good , good . But anyway , my brother , one of my brothers , bought me a tres leches cake , which I absolutely love . Tres leches cake .
It's very good .
Very , very good . Yeah , just had a great time , so you're not even going hold on a second Wait , wait , and then my uncle and his wife got me this , which , let me tell you something , when I opened this gift , I was so excited . I've never been excited about a gift like this in the last like maybe five years .
Why is there a compass on this ?
Just in
¶ Using Your 80-Year-Old Self for Decisions
case I get lost while I'm drinking . Depends on what's in it . You could get lost if you're drinking that much . Okay , it's so great . So it's this water bottle and it's called RBX and it's just amazing . It's a great water bottle . It can hold cold , it can hold heat . So shout out to my uncle and his wife for giving this to me .
One thing that I realized that you didn't mention was the Costco cake that I got you , but that's okay though .
Well , I guess it was memorable .
So so Listen , I'm just going to say this . No , no , before you even listen . Guys , if you're ever looking for a cake , I'm telling you right now , costco has really dope cake .
I love Costco and check out the size of their buck fifty wiener .
But I do feel like I feel a type of way , right Like I got a cake Anybody who knows if you get a cake from Costco ? Like it's pretty basic but the cake tastes amazing . Right Like , yeah , they'll put like candles and like you know , you know what else would they put .
Decoration They'll put like candles and like you know , you know what else would they put on Decorations ? They'll put decorations , they'll put like a cross on it , they'll put a rainbow on it , they'll put balloons on it and stuff like that .
But then , like your brother straight up went and your sister straight up went to a place that can put your damn picture , a real life picture , on your cake and I'm like yo don't you guys think you need to clear that by me first ?
Yeah , you need to clear that by me first . Yeah , you need to show my brother's cake . You need to show my brother's cake .
I'm like , yo , I got the cake . I told them I got the cake , but then they're like , nah , we got this and they went ahead and like up the ante and got a better cake that had your picture on it , and I'm like , okay , that's messed up , that's really messed up .
Well , I will say my Costco Costco cake was amazing .
as well it tasted so good , but you didn't mention it , though it's so chocolate , but you didn't let me finish . No , but you like went straight to like the damn water bottle .
Well , because I remembered it and I didn't want to forget . But the chocolate cake was good . So I'm the kind of person for those of you who might be like why you went to Costco to get your wife a cake , especially for a milestone birthday . So that was my .
I don't care about those people who said it .
I didn't say it . Costco has the best return policy . Oh my God .
You can return the cake , I think .
You know what , nia ? You can't return no cake to Costco . What you gonna do ? Cut into the cake , eat it and then return it . How , how , nia ? Anyway , listen . So I requested a Costco cake because I am the kind of person I actually don't like those fancy schmancy .
You like a cake that tastes good . I like a cake that tastes good , not just looks good .
I mean the cake looked good . That's great .
But at the end of the day , the cake gotta taste good , guys , the cake . Well that was a cake that looked good and tasted good , the cake that Holly bought Tres leches , but I'm just saying he still should have cleared a body , tres leches , but hey , from Newark , new Jersey . But listen , that's a great . You insulted .
Alfred .
Hello , my name is Alfred . You said tres leches Prepare to die .
That's a great great great cake , alfred , tell them how to say tres leches .
Tres leches , tres leches , tres leches Is that Spanish ?
Isn't that ? French Tres leches cake is Mexican cake . What are you talking about ? Isn't that flan ? Flan is Puerto Rican . It's not no flan .
It's flan . Write in and let us know what you think you don't like . Put the message Anyway . Tell them about the Costco cake . Tell them how good my cake was .
It was really good . It was very chocolatey , Of course . I tasted it . It was good , it was very chocolatey Actually . Your cake went really really fast Always does and there was literally only like a little slice of tres leches left anyway , so yeah , but it was really good . I mean , the whole event was good , the whole weekend was great .
I love if anybody knows me , I love being around my family , Absolutely love , Like I . You can take anything else away from me , but just don't take my family away from me . I love being around my family . Love , love , love . Whether it's my side , your side , I just love being around my family .
Then we went to your sister's house on Sunday , Spent a little bit of time . We probably could have spent a little bit more , but yeah , I just love being around my family .
Yeah . So shout out to you , listen , everybody , everybody . Just so y'all know too . Like don't think that , like we don't think about just life in general and how things go so fast , like yes , I met this woman 27 years ago .
You didn't meet me , no , 27 years ago .
Oh sorry , I met you when you were 27 . Excuse me , met you when you were 27 . Add on years . Haven't met you yet for your entire , like for half of your life yet . Right , not there yet .
But what's really interesting is we started this whole journey of paying off debt , listening to podcasts over 10 years ago and it's crazy , crazy , how a lot of things have changed . And we have an episode that's coming up where we're going to talk about you know how I've been .
You know , like , when you listen to , when you listen to social influencers and you listen to people who are on you know just various forms of social media , like , if you kind of are not really um , if you're not really smart with the decisions that you're making and what you decide to take in and take action on , like , you're gonna find yourself doing so many
different things and we're gonna talk about how we have so many things on our stove . You know , so to speak , ir the stove , it could be overwhelming at times . So we got to check out that episode . So , listen , let's get back to what someone wrote for us , because this is going to be , or wrote to us .
This is going to be a really interesting concept , so let's jump into that . You ready , all right ? So we got a question . So you do not want me to share this page anymore , right ? Give it to Alfred . Give it to Alfred , all right ? So this is from an anonymous medical student .
Eight five , six , hey , dr Nee , first off , I love your podcast , just found it today . And I love just found it today and I love due in a few weeks and I'm torn between general surgery and EM . What a shocker . I'm sure you've never heard that one before Sarcasm .
Initially I decided to just default to EM because I like acuity , shift work and I have a musical career that I was hoping to keep somewhat alive through residency , even if just barely , and return to after training , after listening or , excuse me , after finishing all my rotations , it's become clear to me that surgery is where I enjoy myself the most .
In the hospital I practice knots for fun . I enjoy the technical aspects of operating , learning steps to procedures and taking care of surgical patients . I enjoy the structured flow of the day-to-day of surgery residency patients . I enjoy the structured flow of the day-to-day of surgery , residency , rounding cases , consults , rounds .
I still enjoy EM somewhat , but I realize the chaos makes it very hard for me to feel like I am focused on one patient at a time . Surgery is one of the few specialties where you can spend hours on one patient . As a trauma surgeon that has incorporated locums into his career , I feel like you are the best person to ask this question .
Is it very difficult rare to have a setup as an attending general or a trauma surgeon where you work seven on seven off or seven on 14 off ? Is it possible to keep a 30-minute-per-day habit alive during 80-hour weeks of surgical training ? Or should I let go of my love of surgery so I can keep balance in my life ? I'm worried .
If I choose EM , I'll always wish I was in the OR operating , and if I choose surgery , I'll lose the other parts of me that make me who I am music . I'm terrified that I'm either about to make the worst or the best decision of my life . Warm regards a very confused MS3 . Kick Renee off the show . Warm regards A very confused MS3 .
Kick Renee off the show . You know exactly what you talk and you can do this solo . Dolo Anonymous Met student .
That part didn't the last part you can erase Alfred ?
because never that that was not said . Anonymous Met student . This was a great question . First of all , I appreciate you being vulnerable with this . A lot of people think about these things but you know , I like I was doing an episode or I did a recording with Peter Kim because he's talking with his summit that he normally does .
And I was saying that he asked me like how do you feel almost being close to 10 years being in this space ? And I said one of the proudest things that I look back on and I smile about is knowing that I was part of the . You know , like the fabric , I was part of that quilt that made it easier for medical students to submit a question like that .
Right .
Because I think 10 years ago , 15 years ago , nobody was out there really in public talking about how like they want to be more than just a doc . They want to be more than just a doc .
People were complaining about their lifestyle and complaining about certain things , but they necessarily weren't creating content that showcased that hey , I'm a med student or I'm a doc and I'm just interested in doing different things with my life . That's not clinically focused . So I feel really souped about being part of that storytelling .
So , anonymous med student , thank you for writing that . Writing that in Cause I know it's it's hard to share those things .
Yeah , actually , one of your very first posts , if not your very first post , introducing your podcast . The hashtag was more than just a doc .
Yep , yep , yep . You remember that ?
at your age that is amazing , Holy Ooh that's why I can't stand you . Holy shh Ooh . That's why I can't stand you . Answer the damn question me All right .
So this is a really good question . So just so y'all know , as a trauma surgeon for the past 10 years I have worked in a shift-based model , from the beginning as working as an attending , I have worked whether it was . I would do a 24-hour shift and then I would have 24 hours off and then the next day after that .
So let's say , monday I'm 24 hours in the hospital , tuesday I'd be 24 hours off and then Wednesday I'd be back , do the same thing 24 hours in , then Thursday I'd be off .
And then I would do that , but you'd be on backup when you're off .
When I'm off . I'm not completely off , I'm just available . I was like 15 minutes away and I would alternate that schedule with another person and us two would do that for two weeks and then the rest of the month I would have two weeks off .
Now you probably won't see programs like that anymore , because 24 hours to make decisions and 24 hours on straight is really tough in surgery . I don't think you're going to see that much anymore .
You don't think so .
Not the majority of programs , the majority of programs . If you're going to see 24 much anymore , you don't think so . Not the majority of programs , the majority of programs . If you're going to see 24 hours , it's going to be with residents , but it's very rare that you're going to see 24 hours at a standalone , attending by yourself .
It's too much , unless it's the weekends , and that doesn't happen that often , right ? Like , if they make you do weekend call and you do 24 hours . You're probably going to do a weekend every six weeks or so , right ? And if you're listening to this and you're doing more than that , I suggest you find someplace else . That is a very tough place to be at .
You know you do 12 hour shifts , right ? So Monday through Friday or even Saturday , you are working , you know , 7am to 7pm , or you're working 7pm to 7am , and then , during the daytime or during the nighttime , when you're off , you may be back up or you are just sleeping , it doesn't . You know , it doesn't matter . I like that better , right ?
So I'll work for seven days in a row and then I'm off , and when I'm off , I'm off , and when I'm off , I'm off . There's no committee meetings , there's no outside of Eminem , which occurs once a month . There's no hospital committee duties that I have , and when I'm home , I'm allowed to be . You know , I'm able to be husband to my beautiful wife .
I'm able to be . You know everything to my kids , everything to the rest of my family , and I'm super proud of that , and I've been doing that for 10 years . I've been ringing the bell about that for 10 years . I've been telling my attendings who taught me about that . A lot of them criticize me for that .
They're saying , well , you don't have the patient continuity , you don't have um , like , don't you feel like you're giving up some of your skills ? And I'll tell you right now the majority of those folks who are saying that at that time have come and called me and said hey , doc , can you teach me more about locums ?
Can you teach me more about how you work , how you figure it out ? Because you know , like I just I don't have any time off . Or you know , I don't have time off with my , my spouse or my kids hate my guts or whatever . It may be Right , it looks in various different forms , but there is absolutely shift work in general surgery .
There is absolutely shift work in trauma , critical care . And it's amazing , one of the things that I saw from you that I wanted to focus in on real quick because it's low hanging fruit , is I still enjoy EM somewhat , but I realize that chaos makes it very hard for me to feel like I'm focused on one patient at a time .
Surgery is one of the few specialties where you can spend hours on one patient .
Do you want to get into that , or you want me to start ? I'm not a surgeon , I don't do this . Well , I'll tell you right now that I did ER . I didn't like er , for that is the specific reason that I didn't like er is the rotation you mean , or , yeah , the pure chaos ? okay , the pure chaos . You know it's not .
It doesn't mean that as soon as you walk into an er that , like everybody is like everything there's just mayhem all over . I don't like handling , you know , five or ten patients at the same time and having to keep up with them at the same time , and I just don't like that . Is it busy on surgery ?
Yes , but it's a bit more calm compared to the chaos that's in ER . I'm not saying that it's , you know , I'm not poo-pooing it , I'm just saying that it's not for me . So I definitely understand what you're saying about the chaos and you got to realize I mean at this point , ms3 the fact that you're able to say that and recognize that .
I give you my props for that , because a lot of folks at that time can't really verbalize you know that . This is the reason why I'm not really feeling er is that I just feel like everything is happening all at once . The other thing I don't like about ER is I feel it to be very restricting .
What do you mean ?
Like there's just , you're stuck in this ER .
Oh , you don't go anywhere else in the hospital .
Right and there's no place to hide .
Right , right , there's no place to hide .
Everybody knows where you are .
Right , I'll be honest At all times .
I'm an introvert like to have like my me time . There's times where I just need to think and get away .
I like to eat on my own , or if I eat with , you know , my team , it's it's a very , um , intimate type of experience where it's just like three or four of us , right right , but while I'm eating , nobody has the possibility to ask me questions from another department or anything like that , or , you know , one of the nurses can't reach me and ask me like I .
I just like that aspect and that's the part of , that's another part of ER that doesn't work for me . So I think that you bring up some really , really good points and I'm going to tell you something right now . Like this is a bit of advice is try to use your 80 year old self to make your decisions Right .
You may have heard this , as I don't know what they call it , like the graveyard .
Or begin with the end in mind .
Yeah , begin with the end in mind , like you always say things better than me . There's that , there's the I don't know , the nursing home metaphor , whatever it may be . When you old as hell or when it's on your gravestone , what do you want people to say ?
What's the story that you want people to say about you and what I mean by that is , when you're 80 , are you going to be regretful that you didn't go for what you really , really wanted to do , which it sounds to me ? It sounds like you want to be a dope doc and you also want to be an amazing hip hop artist . Yeah , do you want to be the Drake ?
You know of hybrid . Or do you want to be Kendrick or the hybrid Right ? Do you want to be a purist like Kendrick or do you want to be in hybrid right ? I'm going for Kendrick , you're going for Kendrick . But with that being said , I think the key things are this you know , being a doctor is no joke . It takes a lot of dedication , a lot of sacrifice .
You're going to be saying no to a lot of things . You're going to feel like you're on an island a lot of times , but listen like this , is you like literally going for a home run ? So I would say is like listen like shoot for the stars . If you really love surgery more so than ER .
Like now is not the time to compromise , right , right , because you really don't want to compromise of your career , because you want to talk about regret , having that notion of , like that wonderlust or that specialty lust . It sticks with you , right , and it's one of those hard things to shake off . Other thing , too , is when you're burnt out .
You could could say , okay , I'm burnt out from what I'm doing and maybe , if I decrease the amount of time , I still love what I'm doing . But you don't want to get to a point where you burnt out and you really hate your career because you compromised and went in a direction that you didn't really want to go into right . Because what if music doesn't work ?
Then all you're left to really is your specialty to give you the satisfaction .
See , I would say this , though I wouldn't even think about what if music doesn't work ? Music will always work , right . However , scale you decide to do it on , right . We're not necessarily talking about are you going to win a Grammy , are you going to whatever . It will always work .
If you are a musician , you are a musician , so you will always be one , no matter what . But you know , you just have to think about what it is that you absolutely love to do , and when you love to do something , you will make time for that thing , no matter what it is .
So if you love surgery , you're going to figure out how to bring music into your doing surgery , right ? Whether you mesh , you know mesh them together , or you know you do them separately and then you find time separately to do each of them . You love what you're doing . You're going to find the time to do it .
So you know , one of the things that I want you know , ms3 to understand and anybody else out there who's thinking about pursuing medicine , is that you don't necessarily have to choose one over the other , right ? Like sometimes people think , oh well , you know , should I have a life or should I have a career ? And it's like why can't you have both ?
Why can't you have the life ?
I think it happens a lot more with women , of course , with childbearing , with childbearing and things like that .
What you should be looking at is not how your career is going to necessarily affect your life or not , how your life is going to affect your career , but how your career is going to be incorporated into your life . That's what you should really be looking at .
So you should have life , music inside there , surgery inside there , being a family member inside there and whatever else you identify as something that is important to you , but it shouldn't be career . And then let me figure out how to make my life work .
You know around this career , so you can , I'll leave it to you like this . You can ask Renee , she'll tell you . Like I don't have many regrets with my the path towards medicine . In medicine , becoming a surgeon , there's not many regrets that I have . The one regret that she knows that I have is I want to read something that you wrote .
It says and if I choose surgery , I'll lose the other parts of me that make me who I am . And you put in there about music . I'm terrified that I'm either about to make the worst or the best decision of my life .
So the regrets that I have center in how I responded to stress , how I responded to people who are either stressful , malignant in their nature and letting basically some of that ooze and that filth come on me and then allow me to actually act like some of my captors , so to speak .
Right , so , because you know my residency was a sink or swim type residency at least that's what I perceived it to be yeah , I just be . I developed a certain type of armor . I developed a certain type of mentality of I'm not gonna be killed , I will kill , will kill someone , but I'm not going to be killed .
Kill or be killed .
This is metaphorically everyone we're in this .
Yeah , hopefully you ain't kill nobody as a surgeon , right .
So I ? There were certain characteristics that I took on that I think Renee had to call me out on , right . Remember I was doing a schedule once and I was just taking a very vindictive approach to certain requests that were made for the schedule and after a while it's just like look , someone came at me really nasty , more than sideways .
Then I'm deciding to take that out on somebody else , right .
So when I say , and if I choose surgery , I'll lose other parts of me , there was a part in residency that I look back on and I regret I lost a little bit of me because in order to survive , I felt like that's what I needed to do and I started to see a bit of that even in the beginning of my term as an attending .
I wasn't changing , but I saw the results of people being assholes , people being really difficult to deal with , people taking literally some of the personalities that they could get away with in the hospital and doing it at home . Let's just say some of them went through divorces and so forth .
Right .
And this is not calling anybody out , but it's just saying that , listen , like all of this stuff has a , has a . What's the word ? An expiration date ? Right , it's going to be an expiration date on your relationship or an expiration on . People want to spend time with you . So if you are letting a specialty change you , that's on you .
And I look back and I'm like I should not have allowed people , I should not have allowed my situation to change my personality or to change how I speak to my family or even to speak to my girlfriend at the time . Like that's on me , like there's a point where you have to be like listen , this is some nasty behavior .
This is some really like what's the word I want to use ? What's the word that starts with an M ? This is some malignant behavior . And the book stops with me . I'm not going to be the person who's going to continue that . Choose EM . Choose it because you can see yourself doing it in 10 years .
You can see yourself doing it 15 years and be extremely you know , have extreme fun with it . But I can tell you right now , whether you choose surgery or you choose EM and you decide to go into music , there's going to be people who are going to give you a hard time about it .
You can go into internal medicine Someone's going to give you a hard time about it . You can go into preventative medicine it's going to be less people saying about it , but you can go into preventative medicine and people are going to be like listen . Anonymous med student 856 . Are you serious about preventative medicine ? Yeah , Are you serious about pathology ?
Yeah , Right , so it's just like listen , I just the way how I look at it is . You got to remain who you are Now . Obviously , you got to be appropriate for the situation , but also , the same time , you can't let people change you situation . But also , at the same time , you can't let people change you .
And that's the truck , that's the , that's the um , the flex that I wish someone had taught me before . You know , I started to realize certain bad behaviors and you realize it in me .
I think you know , I hear when you say , you know that that was on you and ultimately right . Your behavior is always going to be on .
You's trying to change it . Now , that's what you said to me . You try to change it , don't try to go back .
I think that there are now more forums , kind of like what you were saying before .
Right , there are more forums now to be able to be very , very vulnerable and be able to express things like this so that you , those who are still up and coming , can recognize that there's something that you can do about it and that this is not normal , right , this is not normal
¶ Responding to Medical Student's Question
to lose yourself . I don't think that we talk about that enough , about people being afraid of losing themselves or realizing that they actually have lost themselves , and I think it can lead people down very , very , very dark paths . You know and so I commend , you know , ms3 for writing in about this .
I'd say to everyone who's out there , who's up and coming , going , you know , into medical school , into residency and even as attendings , if you are realizing , you know , if you sit , if you sit in the quiet , right , if you sit in the quiet , you will know . You will know if you have lost who you are and if you have .
Ask someone who you really really trust , ask someone who you really Ask someone who you really really trust . Ask someone who you really really trust , to be very candid , and ask the question do you think I'm different than I used to be , and not in a good way . Do you think I'm different and not in a good way than I used to be ?
Ask that question , because the people who you trust the most , the people who love you the most , they will tell you the truth . You know , and if you listen to them , you just might find that you know you can fix some things about your life to make you happier than what you are right now .
But I can tell you right now , surgery is dope . Though it's aight , Surgery is dope yo .
Let me tell you something right now it ain't OB Surgery , you do yo . Let me tell you something right now it ain't OB Surgery , you do everything . The giver of life .
You know , some people have to say things to make themselves feel better .
But I'm going to tell you right now You're a trauma surgeon , so Listen , and it's amazing . And we know how all your cases end up .
That's fine . Like we love fixing people's mistakes , it's all good . And like we love fixing people's- mistakes .
It's all good . Okay , we love it . Why I always got the Grim Reaper standing right in the trauma bay ?
It is . So I'm just waiting . I'll tell you this right now Surgery , or at least trauma surgery , at least you know it's . It's you pulling people from the gates of you know where ?
Oh yeah .
You really are . You win some , you lose some , but you lose some . But I think definitely you lose some . I think definitely the you know the team approach with trauma surgery is unlike anything else . It's funny , like you know , er is the same way .
Like you rely on your nurses , you rely on a big team to kind of get you through the process of taking care of people , but with trauma surgery , definitely it's a team approach , right ?
Not only is other specialties helping you , um , but you know you have nurses , you have uh , case managers , you have social managers to help you through the problems that you know you can't account for , that you don't even have the training for , right , like how do you get someone out of the hospital once you've like taken care of all their ribs ?
and they're in home right , that's the toughest part , yeah those are really tough things , but I could tell you this right now like you , like you can , like you remember , like like once I did my surgery rotation , I knew like this is what I wanted to do , even though when I first came into med school I was like I want to go into ob , or you know , like
I'm going to try to give everything a chance . And you know , I did like orthopedic surgery only because I thought maybe I wanted to do orthopedic surgery . When I did that , I was .
You know you wanted to work at Home Depot .
Yeah , I just did not like orthopedic surgery . I did not like guys listen like it's amazing how you can do surgery and say you really love surgery , but like when you see different parts of surgery you're like , yeah , this is not for me when I look at the ortho room , I'm like , oh hell , no , I could not do orthopedic surgery .
And no shade to all the orthopedic surgeons who are listening , it is not for the faint of heart , and you know real quick once again I got to say this again .
You know , like , how many people listen to this show and they be getting like upset about the things that we say .
Who gets upset ?
No , seriously , listen , everybody who listens to this show . Y'all need to stop taking things so seriously about what we say , and I think we need to have a disclaimer on this . Stop taking things so personal , yo Damn .
What's the matter ? I almost got hemmed up in the hospital once because by an orthopedic surgeon no , not by an orthopedic oh , I grilled you , almost hammered your ass .
Not by an orthopedic surgeon , but it's just like yo like chill , chill , like this is said in jest in truth . You know like , come on , like truth is said in jest , yeah , anyway , listen . Anonymous medical student . These are great questions to me .
It sounds like you want to go into surgery , so I'm just gonna keep it real too , go into surgery , or at least you know your ms3 . Make sure you do like a general , do a very traditional general surgery rotation yeah don't like .
I would start off by doing a very traditional general surgery residency where there's a hierarchy , right like you're working with residents , you get to see how they work with attendings and all these different things .
So you see like the most traditional , like basic form of surgery and then , if you want to do more , see if you can do like a one-on-one experience .
Yeah , that's what I was going to say . I mean , isn't the experience in surgery in the hospital very different than , like , let's say , a private practice general surgery ?
Um , so it depends , right . So , for example , if you just want to see like the surgeries , right , if you just If , you just want to see like the surgeries , right ? If you just want to see the surgeries , then yeah , like you possibly could just get by with shadowing a private practice surgeon , right ?
Yeah , but at that point don't you ?
But there are people who are like , yeah , I love . Like , for example , like I like GI , right , but I don't like GI that much that I want to go through internal medicine for three years and then go through another three years of fellowship Like hell , no , just to do scopes . I don't want to do that , right . So that's what I'm saying .
Like , yeah , you could go to surgery and love appendectomies and love doing gallbladders , but then you go through and you're like , wait , I got to go through all this with residency . I don't want to do this . That's what I'm saying .
It's good to see what your life is going to be in the next two years and also see what it's going to be like in the next five to seven years .
That's how I look at it , but I feel , so I'm going to say this . So I'm not a surgeon , obviously I'm not a general surgeon . I thought OBs are surgeons . I'm not a general surgeon , but I will say this . So my experience was obviously , in terms of residency , mostly in the hospital , like most residents , right .
Right .
You have a clinic month that you do . But even in that clinic month you know you might have surgeries to go to and things like that .
Or , excuse me , I have clinic days , not clinic month .
You have a clinic day Anyway , whatever , Anyway . So but when I was done and I was doing full scope OB , my day did not look anything like it looked when I was in residency , right , the day changed completely , spending most of my time probably about 80 , 85% of my time in clinic so that I could see outpatient .
You know , I could see outpatient OB patients , gyns , right , and then drum up patients for surgery who needed surgery , and then that 85 , the rest of that 15% was spent mostly in the OR , maybe every now and then occasionally in the ER and doing consults , but mostly in the OR . So most of my day was spent actually doing office work .
So I guess that's my question .
So what advice would you give to someone who's going into fourth year and they need to decide a specialty ? They're looking for rotations to do Right , like , for example , how about this Right ? Let's say someone says , yeah , I want to be , you know , I want to go into REI , right , so I want to help people with infertility , right .
Right .
And how you do REI in academics a system . It's a lot different than how you do REI .
REI is probably not a good . Rei is probably not a good . Ok , let's keep it for OB then .
But let's just keep it for OB . How do you ? How you do that , how you do that you know at an academic center , versus how you do that in a community based system ? Like , how do you ? What kind of advice would you give , because for me I think it'd be difficult , right ?
Like trauma surgery is practiced the same way . Yes , trauma surgery at an academic center .
But there are people who really enjoy the . They enjoy like the end product , but they don't want to go through the stuff . Right , if you don't let them get the experience of going through stuff in some form or fashion , isn't there a possibility that there could be a big ass letdown ?
It could , but that's what I'm saying , Like . So is MS3 wanting to go into trauma surgery specifically , or general surgery ? Because general surgery and trauma surgery they not the same thing and they are very different in terms of the settings .
Right , If you go into general surgery , you're probably going to have the experience that I just described , which is you spend a lot of time in your office because you got to drum up patients . Otherwise , who are you taking to surgery ? Nobody going to surgery .
You got to drum up patients in order to go to surgery , right , and see , you know , see the post-ops and pre-ops and all these people , right ? Whereas in trauma surgery , you're just sitting there waiting , just be like , all right , waiting for the next tragedy to happen , you know , so that I can get patients .
You're literally just waiting for someone to bang themselves up . So you know , it's just a very different setting .
I would say this anonymous med student make sure you give yourself the experience . Get the experience that you need . I would say , if you can do a traditional practice or a traditional rotation , do the traditional rotation .
If you have an opportunity in your fourth year to do something a bit more focused , like , try to get like a general , a generalist experience in whatever you want to go into . So if you want to do general surgery , then see what it's like after residency also . That's super important .
Also , Same thing with what you said with OB , because I didn't think about that right , Like you do OB in a hospital .
You've never done office , though .
Right , well , we do office , but it's not like- .
No , I mean as an attending .
I do office as an attending but it's not like anything .
Like you , right , but it's like we don't base .
Yeah , we rarely . We rarely drum up business in an office setting . It's very much what comes through the emergency department . Yeah , I'm talking about the traditional private practice model or hospital practice model Anonymous medical school medical student . Anonymous med student . Eight five six Thank you for writing in .
This is a dope question , this is a life question and listen , man , I'm telling you there's no perfect answer to this , but this is as real as you can get , like the question that they wrote . As real as you can get . We gave you an answer as real as we can get and anybody else who wants to . I think this person went through our website actually .
Yeah , I think so yeah .
So that's another way that you guys can reach out to us is by going to our website and looking .
DocsOutsideTheBoxcom .
That is true . That is true . Listen , y'all , we're going to have to jet on out of this . We appreciate everybody who writes in .
And this is what we enjoy doing , we enjoy expressing and the things that we've gone through to give you guys advice , because everything we say is correct . You just said that before you said everything that you said is not necessarily correct Now everything that you said is correct .
No , I said that in terms of talking about people like yo , like what we say is just .
No , no , no . Well , before that you were like you know . No , everything that we say can't be correct , but I'm going to keep moving forward . You thought I forgot .
It was minor stuff , right , like very minor stuff of S-Corp , but the majority of everything we say is correct .
Well , the algorithm shows that you guys do not listen all the way until the end , so this conversation is over .
Peace y'all Bye . You say something Renee , pretty please .
Hey , Alfred , hey .
Alfred , are you scared , alfred ?