This is actually the first time in my life that I haven’t known what to do with the next couple years, and I don’t know how to handle it.

Yesterday I had the (questionably brilliant) idea of asking Dr. French for advice. He is actually very cordial and friendly, even to “cretins.” He repeated to me everything I had thought of myself, of the differences between ob/gyn and surgery: one has lots of young patients, the other has mostly older patients, with a fairly high morbidity and mortality. Of course, being a surgeon, he thought his own specialty more diverse and challenging. When I mentioned that I want to work in a third-world country,  he exclaimed emphatically, “Well then, of course you have to do surgery, no question about it!” And looked up for me several articles about some surgery residency programs which teach “rural surgery,” ie more hand-on experience with subspecialties, and with simple orthopedics and gynecology. His opinion was that it would be easier for a surgeon to learn a little more about hysterectomies and Csections, than for an ob/gyn to learn more about general surgery. Which makes sense, but perhaps I should go ask the ob/gyns their opinion of that statement. . .

I have to say, the surgery department here, contrary to my set expectation, is much friendlier and more cheerful and the ob/gyn department. The residents seem happier (in spite of complaints about their schedule, or the girl I saw crying in the hallway) than the ob/gyn residents. I think it has partly to do with the attendings, and partly to do with the character of their chiefs. Now, of course, you can’t count on that being the same at other programs. I don’t think the atmosphere is inherent in the specialty. Also, the surgery attendings seem much more interested in encouraging me, even though I’ve admitted to only half-hearted interest in surgery, than the ob/gyn attendings were, although I said repeatedly that I wanted to ob/gyn.

But still: do I really want to spend five years dealing small bowel obstruction, and obstipation, and colostomies, and enteric fistulas? Even if after that I go overseas and spend more time with women. That’s the catch: If I spend any length of time in the US, I don’t think I really want to practice surgery in the US; ob/gyn, if I have to; but not surgery.

But, on the other hand, the more I become persuaded that women don’t need a lot of medical intervention in pregnancy or labor, the more pointless it seems to become an ob/gyn. I think I really wanted to be a midwife; but that isn’t an option now. What’s the point of studying all these high-tech interventions, if I’m going to be working where they aren’t available, and if I’d rather avoid them anyhow?

Alice, would you stop spinning in circles!

I think I will just have to apply to two kinds of residencies, and not let my right hand (surgery department) know what the left hand (ob/gyn department) is doing. Maybe by February I can decide better, and just not rank one or the other.

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