Picking Between Surgical Specialties as a Medical Student

18 Nov 2020

By Alyssa Brown

“What do you want to be when you grow up?” Pediatric geneticist was my answer from high school through the first weeks of medical school. I had shadowed twenty physicians before medical school that ranged from surgical to non-surgical and specialized to primary care. I had stuck to wanting to be a pediatric geneticist. I loved genetics in high school and college. I liked working with pediatric patients, so I thought it would be the perfect field for me. 

My second week of medical school, my anatomy professor pulled me aside and asked if I was interested in surgery. I responded that I hadn’t thought about it. She said she would email a few surgeons to see if they would mentor me. By the next week, I was in the lobby of the children’s hospital nervously waiting to meet a pediatric surgeon. She floated in, and I was swept into her tornado of a day. Within the first hour, I was learning how to scrub in, and I was watching my first surgical case. I was enraptured. The day ended up finishing at 9pm, but I was sold. Funny, I no longer want to be a pediatric geneticist. I called my mom as I was leaving the hospital to tell her that I wanted to be a pediatric surgeon. I kept shadowing surgeons after that point.

I felt so much pressure to see everything I could. I didn’t want to miss any surgical specialty, in case I fell in love with it. I found it so stressful to see everything so that I could make the most informed decision I could about what I wanted to eventually do. During my first two years of medical school, I constantly snuck away to shadow as much as I could. It kept me grounded and made the information I was learning much more real. Halfway through second year, I started to ask around about what order I should try to have for my third year clinical rotations. I wanted to plan, so that I had the best chance of honoring my surgical rotation. It was suggested that I try to take Step 1, start with internal medicine rotation, followed by general surgical rotation third year. Most suggested doing internal medicine rotation first because many of the questions will overlap with the NBME Surgical Shelf Exam. I knew I wanted to honor the rotation.

After my surgery rotation, I knew I wanted to be a surgeon. There are so many types of surgery, though: general surgery, orthopedic surgery, otolaryngology, urology, cardiothoracic surgery, vascular surgery, obstetrics/gynecology, etc. I could enter many of these fields through general surgery residency, but others would require me to choose a different subspecialty residency. I wanted to be positive of my choice. I found surgeons in each of these areas during third year. Everyone is always passionate about their field, so it was easy to think you would really like the field when talking to them. I knew I needed to see the operations firsthand.

Orthopedic surgery was first. I thought I would like it because I had been a college athlete. I liked musculoskeletal anatomy. I shadowed two pediatric orthopedic surgeons. The day was fun. I really enjoyed spending time with them, but I still did not have a good feel for their everyday routine. I decided to shadow  another orthopedic surgeon for a weekend on-call. He had the perfect mix of OR songs and getting to hammer things is always fun. It was a late Saturday night, and we were fixing a tibia. When I was driving home later, I realized if I did orthopedics, I would never get to operate in the abdomen again. I decided to mark orthopedics off my list.

Otolaryngology (ENT) was next. I spent most of my summer between sophomore and junior year of college shadowing an ENT in Chattanooga. Also, I had been shadowing ENT during first and second year of medical school, whenever I was home on breaks. I liked the in-office biopsies and scopes. I also thought I would like the mix of pediatric and adult patients. The time in the operating room was fun. I especially liked thyroid surgery. When I came back to it for a short one-week rotation during third year, I realized it wasn’t perfect for me. I just kept coming back to the fact that I missed the abdomen.

I completed my obstetrics/gynecology rotation during January of my third year. I wrote about this experience previously in an AWS article, which you can find here. Choosing between general surgery and OB/Gyn was the hardest decision to tease out. I really liked female patients and the gynecologic surgeries, but at the end of the day, I couldn’t get general surgery out of my head.

I still remember the first time I saw peristalsis in the small bowel during an operation. I thought it was the most amazing thing I had ever seen, and I still do think it is amazing. The decision of what kind of surgeon you want to be after medical school is a difficult decision. It can often be clouded by discussions of work/life balance, being a woman, and lifestyle. I knew I wouldn’t be happy doing anything other than general surgery. I remember one general surgery resident saying, “if you can do anything besides surgery, do that.” I do not regret exploring so many different areas and fields – it brought me experience. In particular, I thought it was incredibly helpful to take over-night call in the areas that interested me. . You learn pretty quick which things you are excited to wake up for at two am on a Saturday

Remember, you have enough time to find your path. You will realize eventually what you love, even if you sometimes try to convince yourself out of it. Don’t let anyone scare you out of doing what you love.



Alyssa Brown grew up in Chattanooga, TN.  She went to Centre College for a B.S. in Biology and minor in History.  She fell in love with surgery after seeing her mentor perform an anoplasty during the first year of medical school.  She finished her third year of medical school in 2018 and wandered off the beaten path to get a PhD, before finishing her MD.  She is receiving her MD degree from the University of Louisville School of Medicine, and her PhD in Biomedical Engineering and Physiology at Mayo Clinic School of Biomedical Sciences.  She is currently working on research projects involving pediatric ulcer disease, diaphragm sarcopenia, and congenital diaphragmatic hernia. She has been a part of the AWS Blog Subcommittee and AWS Instagram Subcommittee for two years, and she has loved writing pieces for the blog over the past two years. During the pandemic, you will probably find her baking sweets and pastries that she saw on “Great British Bake-Off” or embroidering. You can find her on Instagram @Alyssa_b_futuremdphd and on Twitter @Alyssa_B_MDPhD.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

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