Asked my friend on which field to get into for medcels

[Jason Voorhees]

A user @4ever asked me for advice on which field to specialize in. If it was finance or tech I could have pointed him in the right direction but I am absolutely clueless when it comes to medicine so I casually asked an old friend on his opinion.

Just for context he's an Attending Physician who graduated from an elite residency program in the US. The top of the top and has seen the economics play out for his entire class and this is what he told me. Even I learned a thing or two about the medical field

If you're chasing the best combination of money, longevity, and lifestyle. You have to go procedural and patient facing to beat AI. Dermatology is still the lifestyle king if you can get in but it's obviously insanely competitive.

Plastic Surgery has one of the highest earning potential but the training is a grind. Residencies for plastic surgery are generally much longer. He also stressed that the money is made by owning the practice and doing elective cosmetic cash. pay work.

Ophthalmology is very good. It's precise, clean,and has a great work life balance but not very high paying. Another thing he recommended is Orthopedic Surgery and Interventional Radiology (IR). Ortho is an income machine and IR is the only smart move in the Radiology space it's procedural and less likely to be automated. He says to avoid Diagnostic Rads as a long term. One more underrated thing he mentioned was Urology.

You can also consider high prestige positions like cardiologist/neurologist etc . They are highest prestige and extremely high paying. Interventional Cardiologist and Neurologists are usually the ones making the most money in a hospital. The true money in medicine is usually in cardiology and neurology $600K+ easily and that's a low balling it but the path is very long and lifestyle brutal. 3yrs Internal medicine residency+ 3yrs Cardiology fellowship+ 1-2yrs Interventional cardiology fellowship and this is after med School. Also it has one of the worst lifestyles in medicine with heavy emergency call for STEMIs(heart attacks)

Basically you have to decide what you're willing to trade a decade of your life for Neurosurgery/Cardiology money or insane competitiveness for the Derm lifestyle.In conclusion if your scores are high and drive are elite focus on Plastics, Derm, or Ortho.If you want a fantastic balance with a procedural focus look at Ophtho, IR. The key takeaway is procedures rule the earning landscape atleast in
the US medicine

 

[Jason Voorhees]

@gonnabehappy @RealSurgerymax @imontheloose

 

[kababcel]

A user @4ever asked me for advice on which field to specialize in. If it was finance or tech I could have pointed him in the right direction but I am absolutely clueless when it comes to medicine so I casually asked an old friend on his opinion.

Just for context he's an Attending Physician who graduated from an elite residency program in the US. The top of the top and has seen the economics play out for his entire class and this is what he told me. Even I learned a thing or two about the medical field

If you're chasing the best combination of money, longevity, and lifestyle. You have to go procedural and patient facing to beat AI. Dermatology is still the lifestyle king if you can get in but it's obviously insanely competitive.

Plastic Surgery has one of the highest earning potential but the training is a grind. Residencies for plastic surgery are generally much longer. He also stressed that the money is made by owning the practice and doing elective cosmetic cash. pay work.

Ophthalmology is very good. It's precise, clean,and has a great work life balance but not very high paying. Another thing he recommended is Orthopedic Surgery and Interventional Radiology (IR). Ortho is an income machine and IR is the only smart move in the Radiology space it's procedural and less likely to be automated. He says to avoid Diagnostic Rads as a long term. One more underrated thing he mentioned was Urology.

You can also consider high prestige positions like cardiologist/neurologist etc . They are highest prestige and extremely high paying. Interventional Cardiologist and Neurologists are usually the ones making the most money in a hospital. The true money in medicine is usually in cardiology and neurology $600K+ easily and that's a low balling it but the path is very long and lifestyle brutal. 3yrs Internal medicine residency+ 3yrs Cardiology fellowship+ 1-2yrs Interventional cardiology fellowship and this is after med School. Also it has one of the worst lifestyles in medicine with heavy emergency call for STEMIs

Basically you have to decide what you're willing to trade a decade of your life for Neurosurgery/Cardiology money or insane competitiveness for the Derm lifestyle.In conclusion if your scores and drive are elite focus on Plastics, Derm, or Ortho.If you want a fantastic balance with a procedural focus look at Ophtho, IR. The key takeaway is procedures rule the earning landscape atleast in
the US medicine

There's always some sort of sacrifice, it just depends if you are willing to give up certain stuff for a certain outcome, nice thread btw very high iq

 

[4ever]

Cool thread, thanks for asking. Will give a more detailed response in a couple of hours.
There are definitely similarities but also some difference between the US and European medical system.

 

[Jason Voorhees]

Cool thread, thanks for asking. Will give a more detailed response in a couple of hours.
There are definitely similarities but also some difference between the US and European medical system.

What are the main differences you'd say? I don't have much of an opinion because I'm not informed enough which would you say is better?

 

[kababcel]

Bump

 

[kababcel]

B

 

[RealSurgerymax]

A user @4ever asked me for advice on which field to specialize in. If it was finance or tech I could have pointed him in the right direction but I am absolutely clueless when it comes to medicine so I casually asked an old friend on his opinion.

Just for context he's an Attending Physician who graduated from an elite residency program in the US. The top of the top and has seen the economics play out for his entire class and this is what he told me. Even I learned a thing or two about the medical field

If you're chasing the best combination of money, longevity, and lifestyle. You have to go procedural and patient facing to beat AI. Dermatology is still the lifestyle king if you can get in but it's obviously insanely competitive.

Plastic Surgery has one of the highest earning potential but the training is a grind. Residencies for plastic surgery are generally much longer. He also stressed that the money is made by owning the practice and doing elective cosmetic cash. pay work.

Ophthalmology is very good. It's precise, clean,and has a great work life balance but not very high paying. Another thing he recommended is Orthopedic Surgery and Interventional Radiology (IR). Ortho is an income machine and IR is the only smart move in the Radiology space it's procedural and less likely to be automated. He says to avoid Diagnostic Rads as a long term. One more underrated thing he mentioned was Urology.

You can also consider high prestige positions like cardiologist/neurologist etc . They are highest prestige and extremely high paying. Interventional Cardiologist and Neurologists are usually the ones making the most money in a hospital. The true money in medicine is usually in cardiology and neurology $600K+ easily and that's a low balling it but the path is very long and lifestyle brutal. 3yrs Internal medicine residency+ 3yrs Cardiology fellowship+ 1-2yrs Interventional cardiology fellowship and this is after med School. Also it has one of the worst lifestyles in medicine with heavy emergency call for STEMIs(heart attacks)

Basically you have to decide what you're willing to trade a decade of your life for Neurosurgery/Cardiology money or insane competitiveness for the Derm lifestyle.In conclusion if your scores are high and drive are elite focus on Plastics, Derm, or Ortho.If you want a fantastic balance with a procedural focus look at Ophtho, IR. The key takeaway is procedures rule the earning landscape atleast in
the US medicine

As if it's a choice. A normal person cant just decide on a specialty. It is decided for them.

 

[Jason Voorhees]

As if it's a choice. A normal person cant just decide on a specialty. It is decided for them.

You got into plastic surgery so you must have had a choice and aced all your tests no?

 

[Finnishmogger]

You got into plastic surgery so you must have had a choice and aced all your tests no?

i don't think he's actually a doctor or surgeon so no probably not

definitely hard work tho

 

[Jason Voorhees]

i don't think he's actually a doctor or surgeon so no probably not

definitely hard work tho

My friend also told me being a doctor isn't easy. Making it to med school in itself in an achievement and then going through all it and not making any real money for almost a decade isn't for everyone. @4ever

 

[Finnishmogger]

My friend also told me being a doctor isn't easy. Making it to med school in itself in an achievement and then going through all it and not making any real money for almost a decade isn't for everyone. @4ever

yeah of course.

 

[Jason Voorhees]

My friend also told me being a doctor isn't easy. Making it to med school in itself in an achievement and then going through all it and not making any real money for almost a decade isn't for everyone. @4ever

@Foreverbrad @imontheloose @User28823

engineers are better in this regard tbh

 

[imontheloose]

@Foreverbrad @imontheloose @User28823

engineers are better in this regard tbh

Engineering mogs.

 

[RealSurgerymax]

You got into plastic surgery so you must have had a choice and aced all your tests no?

i don't think he's actually a doctor or surgeon so no probably not

definitely hard work tho

Im learning Italian and I'll take SSM Concorso to enter either Plastic or Maxfac, which I already score high enough for when use English translated practice questions. Rn Im scoring high enough for Maxfac in a good placement (Rome, Milan) or Plastic in a mid placement city.

This is IF I want/need to work. Im thinking about quitting and just being a med device CEO and lifestylemaxxing. I'm kinda over all the work. It's fun traveling, partying, having time for hobbies like scuba, aquariums, creating things, starting other businesses etc. Surgery is also fun too..... Not sure what to do tbh

 

[Finnishmogger]

Im learning Italian and Ill take SSM Concorso to enter either Plastic or Maxfac, which I already score high enough for when use English translated practice questions.

This is IF I want/need to work. Im thinking about quitting and just being a med device CEO and lifestylemaxxing. I'm kinda over all the work. It's fun traveling, partying, having time for hobbies like scuba, aquariums, creating things, starting other businesses etc. Surgery is also fun too..... Not sure what to do tbh

Just do whatever you have passion for

 

[RealSurgerymax]

Just do whatever you have passion for

Partying in thailand then

 

[Finnishmogger]

Partying

then why not just do that

if you're financially good so you don't need to work

 

[iraqi]

A user @4ever asked me for advice on which field to specialize in. If it was finance or tech I could have pointed him in the right direction but I am absolutely clueless when it comes to medicine so I casually asked an old friend on his opinion.

Just for context he's an Attending Physician who graduated from an elite residency program in the US. The top of the top and has seen the economics play out for his entire class and this is what he told me. Even I learned a thing or two about the medical field

If you're chasing the best combination of money, longevity, and lifestyle. You have to go procedural and patient facing to beat AI. Dermatology is still the lifestyle king if you can get in but it's obviously insanely competitive.

Plastic Surgery has one of the highest earning potential but the training is a grind. Residencies for plastic surgery are generally much longer. He also stressed that the money is made by owning the practice and doing elective cosmetic cash. pay work.

Ophthalmology is very good. It's precise, clean,and has a great work life balance but not very high paying. Another thing he recommended is Orthopedic Surgery and Interventional Radiology (IR). Ortho is an income machine and IR is the only smart move in the Radiology space it's procedural and less likely to be automated. He says to avoid Diagnostic Rads as a long term. One more underrated thing he mentioned was Urology.

You can also consider high prestige positions like cardiologist/neurologist etc . They are highest prestige and extremely high paying. Interventional Cardiologist and Neurologists are usually the ones making the most money in a hospital. The true money in medicine is usually in cardiology and neurology $600K+ easily and that's a low balling it but the path is very long and lifestyle brutal. 3yrs Internal medicine residency+ 3yrs Cardiology fellowship+ 1-2yrs Interventional cardiology fellowship and this is after med School. Also it has one of the worst lifestyles in medicine with heavy emergency call for STEMIs(heart attacks)

Basically you have to decide what you're willing to trade a decade of your life for Neurosurgery/Cardiology money or insane competitiveness for the Derm lifestyle.In conclusion if your scores are high and drive are elite focus on Plastics, Derm, or Ortho.If you want a fantastic balance with a procedural focus look at Ophtho, IR. The key takeaway is procedures rule the earning landscape atleast in
the US medicine

Can you ask him his thoughts on becoming a orthodontist? Would be appreciated.

 

[Jason Voorhees]

Can you ask him his thoughts on becoming a orthodontist? Would be appreciated.

Will ask

 

[RealSurgerymax]

then why not just do that

if you're financially good so you don't need to work

I have been but everyones judging my choices lol

 

[LTNUser]

Useful thread as usual,bookmarked because it'll be helpful for me

 

[Finnishmogger]

I have been but everyones judging my choices lol

don't listen to others, do what you want

 

[CD34]

A user @4ever asked me for advice on which field to specialize in. If it was finance or tech I could have pointed him in the right direction but I am absolutely clueless when it comes to medicine so I casually asked an old friend on his opinion.

Just for context he's an Attending Physician who graduated from an elite residency program in the US. The top of the top and has seen the economics play out for his entire class and this is what he told me. Even I learned a thing or two about the medical field

If you're chasing the best combination of money, longevity, and lifestyle. You have to go procedural and patient facing to beat AI. Dermatology is still the lifestyle king if you can get in but it's obviously insanely competitive.

Plastic Surgery has one of the highest earning potential but the training is a grind. Residencies for plastic surgery are generally much longer. He also stressed that the money is made by owning the practice and doing elective cosmetic cash. pay work.

Ophthalmology is very good. It's precise, clean,and has a great work life balance but not very high paying. Another thing he recommended is Orthopedic Surgery and Interventional Radiology (IR). Ortho is an income machine and IR is the only smart move in the Radiology space it's procedural and less likely to be automated. He says to avoid Diagnostic Rads as a long term. One more underrated thing he mentioned was Urology.

You can also consider high prestige positions like cardiologist/neurologist etc . They are highest prestige and extremely high paying. Interventional Cardiologist and Neurologists are usually the ones making the most money in a hospital. The true money in medicine is usually in cardiology and neurology $600K+ easily and that's a low balling it but the path is very long and lifestyle brutal. 3yrs Internal medicine residency+ 3yrs Cardiology fellowship+ 1-2yrs Interventional cardiology fellowship and this is after med School. Also it has one of the worst lifestyles in medicine with heavy emergency call for STEMIs(heart attacks)

Basically you have to decide what you're willing to trade a decade of your life for Neurosurgery/Cardiology money or insane competitiveness for the Derm lifestyle.In conclusion if your scores are high and drive are elite focus on Plastics, Derm, or Ortho.If you want a fantastic balance with a procedural focus look at Ophtho, IR. The key takeaway is procedures rule the earning landscape atleast in
the US medicine

Also cardio/neuro is much bigger responsability. You can fail to cure acne but you dont wanna fail to diagnose a stroke

 

[CD34]

I’ll specialize in endocrinology, high roi in terms of lifestyle-earnings-responsability. Hope ia will not take my job

 

[iraqi]

Im learning Italian and I'll take SSM Concorso to enter either Plastic or Maxfac, which I already score high enough for when use English translated practice questions. Rn Im scoring high enough for Maxfac in a good placement (Rome, Milan) or Plastic in a mid placement city.

This is IF I want/need to work. Im thinking about quitting and just being a med device CEO and lifestylemaxxing. I'm kinda over all the work. It's fun traveling, partying, having time for hobbies like scuba, aquariums, creating things, starting other businesses etc. Surgery is also fun too..... Not sure what to do tbh

What country did you graduate highschool and university in. Also what did u major in university.

 

[59H390]

I’m studying business right now but i want to double major in engineering honestly

 

[iraqi]

Will ask

Did he reply?

 

[JohnDoe]

I'm an aspiring medcel, thoughts?

 

[JohnDoe]

Partying in thailand then

Thoughts on 37 year old junior doctors? (Me in 7 years) is it too late to change careers at 29? I wanted to become an ITcel at first but A.I killed it for newcomers

 

[Jason Voorhees]

Did he reply?

Did reply. His message

Hahaa no problem man. I love your questions. Keep them coming. Main advantages is that the path to become an orthodontist is shorter than most surgical MD paths, usually not more than 5 years.You also have zero emergency calls. Like I told you about plastic surgeons. Owning the practice and running a factory of elective care like braces, clear aligners is what makes you the most money.But the catch is Orthodontics income usually pales in comparison to the ceiling of the top MD specialties. Usually the very successful ones don't earn more than $300-400k this is nothing compared to surgical MD routes I mentioned earlier.

 

[Jason Voorhees]

Thoughts on 37 year old junior doctors? (Me in 7 years) is it too late to change careers at 29? I wanted to become an ITcel at first but A.I killed it for newcomers

Do you have the money for med school tho? You would also need to pre med before that

 

[iraqi]

Did reply. His message

Thank you.

How do you know this guy. Does be know your spending his message on org. And is he genetically high IQ or did he work and study his way up?

 

[Jason Voorhees]

Thank you.

How do you know this guy.

My cousin's classmate and close friend. He has known me for many years now. I've met him more than a few times and do talk for long hours when we do meet.

Does be know your spending his message on org. And is he genetically high IQ or did he work and study his way up?

Not sure tbh. I don't know him like that but he graduated the top of his class. He was a valedictorian.

 

[iraqi]

My cousin's classmate and close friend. He knows me well I've met more than a few times and he's known me for many years now.

Not sure tbh. I don't know him like that but he graduated the top of his class. He was a valedictorian.

How old ru?

 

[Jason Voorhees]

How old ru?

21 almost 22. This guy is older than me. I framed it as a anonymous request for a colleague looking to mentor someone, so he knows it's being shared without any personal details attached

 

[iraqi]

21 almost 22. This guy is older than me. I framed it as a anonymous request for a colleague looking to mentor someone, so he knows it's being shared without any personal details attached

did u finish uni? What did u major and what do u wanna be

 

[Jason Voorhees]

did u finish uni? What did u major and what do u wanna be

CS. Im a devops engineer and software developer.

 

[iraqi]

CS. Im a devops engineer and software developer.

U seem high iqcan i pm u

 

[Jason Voorhees]

U seem high iqcan i pm u

Ok but I might take some time to respond. I usually have a tab open and rot on .org continuously periodically checking i.

 

[iraqi]

Ok but I might take some time to respond. I usually have a tab open and rot on .org continuously periodically checking i.

Wait so do u rot on org or on another website

 

[Jason Voorhees]

Wait so do u rot on org or on another website

Usually do coding or watch a movie/TV show or YouTube video. Or rot on slack groups

 

[iraqi]

Usually do coding or watch a movie/TV show or YouTube video. Or rot on slack groups

im guessing coding is ur passion if ur coding on ur free time

 

[Foreverbrad]

@Foreverbrad @imontheloose @User28823

engineers are better in this regard tbh

Doctors have massive prestige which may make it worth it for foids.

Mechanical engineering is ultimate incel career, spend 8 months of the year on an oil platform with only men for well into six figure salary.

 

[AverageCurryEnjoyer]

Could you help me out bhai, Im currently in uni and thinking of teansferring to anothee one. Im in finance @Jason Voorhees

 

[AverageCurryEnjoyer]

Dms? Or discord

 

[Jason Voorhees]

Dms? Or discord

Dms.

 

[RealSurgerymax]

Thoughts on 37 year old junior doctors? (Me in 7 years) is it too late to change careers at 29? I wanted to become an ITcel at first but A.I killed it for newcomers

Go for it. It's not too late if thats what you rly want to do but most ppl dont find the reality of being a doctor fulfilling at all. (Its nothing like they imagined)

 

[4ever]

If you're chasing the best combination of money, longevity, and lifestyle. You have to go procedural and patient facing to beat AI. Dermatology is still the lifestyle king if you can get in but it's obviously insanely competitive.

Agreed, procedural specialties are usually paid better, less likely to be replaced by AI and more fun imo.

What are the main differences you'd say? I don't have much of an opinion because I'm not informed enough which would you say is better?

No pre-med.
You start medicine right after high school. Admission = grades + entry tests (pattern recognition / memory /cognitive abilities, sometimes science knowledge; then ranked compared to how all other participants performed). Then it’s straight to med school.

Residency = specialization.
After uni you pick your lane (surgery, derm, radiology, etc.). Most tracks are 5–6 years; a bit longer if you subspecialize (e.g., interventional radiology).

What’s competitive?
The fields with the best money + lifestyle mix tend to be the most competitive (shocker, despite med students always claiming that they aren't in it for the money or lifestyle). Same story in Europe.

How you actually get into competitive specialties:

• Connections > luck > profile > exams (rough order of impact? Depends on the chief physican and what he personally values).
• Build connections via internships/rotations (perform, be useful, leave a good impression) and research in the field / or related
• Exams matter, but they rarely beat a strong network + receipts
• the most competitive specialties tend to be Plastic Surgery and Dermatology
• location matters as well. Even less competitive specialties become competitive if you want to start in a popular, big city.

Germany salary reality:

• In hospitals, residents are roughly paid by seniority + hours, not by specialty.
  → A 4th-year psych resident ≈ a 4th-year neurosurgery resident.
• Pay is aight, not special. More “stressful” specialties often mean more hours = a bit more cash.
• Seniority = more room to negotiate. Salaries might deviate a bit more between specialties here. Not in a major way though.
• Special skills = more room to negotiate
• as a resident in a competitive field = no room to negotiate. All residents basically make the same
• Hours are long, salaries aren't really scalable
• Chiefs make good money, but they’re usually top experts/profs + managers/politicians inside the hospital

​

After residency: hospital → your own practice or stay in hospital to climb the hierachy?​

The move: Leave hospital → open/buy/partner in an outpatient clinic.

Why bother?

• Higher ceiling (PKV/cash pay, procedures).
• More control (hours, staff, pricing within rules).
• Scalable (more rooms, assistants, add-on services).

Nuanced reality of having your own outpatient clinic in Germany:

• Two pools of patients: public vs private
• Same work ≈ 1.8–3.5× revenue with private vs public (case/factor-dependent).
• Most patients = public → you must know the rules/budgets if you want to be profitable. Budgets are usually political / lobbying decisions and not always that fair
• Private/cash = no budget, faster payment—but you need demand + positioning. More like a "real business". Looked down upon by some.
• A mix of both is great imo but depends on specialty
• If you want to be a business, you'll have to deal with ruthless competition

What specialty to choose now based on this information?
You want procedural + outpatient-friendly + scalable + interesting

Negative example: Interventional Radiology can't be practiced in that outpatient setting very well. That goes for most very big surgical specialties like cardiothoracic, neurosurgery, etc. And since you don't even earn that much at the hospital for the intense work you do, unless you really like the field, specialties like cardiothoracic don't make that much sense to pursue here.

I could talk more about location, best countries to practice in, positive perspectives, challenges posed by investors, etc but let's see first if people are even interested in this.

Im learning Italian and I'll take SSM Concorso to enter either Plastic or Maxfac, which I already score high enough for when use English translated practice questions. Rn Im scoring high enough for Maxfac in a good placement (Rome, Milan) or Plastic in a mid placement city.

This is IF I want/need to work. Im thinking about quitting and just being a med device CEO and lifestylemaxxing. I'm kinda over all the work. It's fun traveling, partying, having time for hobbies like scuba, aquariums, creating things, starting other businesses etc. Surgery is also fun too..... Not sure what to do tbh

If you invented a surgery that has been performed by globally respected surgeons, why can't you get into a residency program in the US? I am aware that it's really competitive, but based on what we know about you, it's hard to believe that there are that many candidates with a much better profile than you.
Or is it all just step score based and program leaders don't even look at anything beyond that?

Keep in mind that your italian education won't be recognized in the US (if you plan on practicing there). From what I've heard from a girl who did internships there, italian residency programs aren't that great (especially in surgical specialties). Surgical residents apparently don't get much hands on, practical experience. Senior physicians perform most of the real surgery, residents do ward work, assist in minor ways. Maybe that was just her hospital / experience. But I would look out for that.

Did you study med + dentistry, or how can you start max fac there? And is plastics your ultimate goal? How do you like Derm compared to plastics? Depending on your skills, you can do quite a lot as a dermatosurgeon as well (no osteotomies ofc).

 

[RealSurgerymax]

If you invented a surgery that has been performed by globally respected surgeons, why can't you get into a residency program in the US? I am aware that it's really competitive, but based on what we know about you, it's hard to believe that there are that many candidates with a much better profile than you.
Or is it all just step score based and program leaders don't even look at anything beyond that?

Yes I could and I have a logger network even at Ivy League universities. Obv I could but I do not want to practice in US for many reasons.

• High liability,
• High hospital fees making the procedures I like (OBO, LF2/3) unrealistic. In Italy I could do for 60-80K (adjust for inflation) and keep 50K while hospital takes 10K, Hardware (Plates/screws) takes 10k, etc. Vs in America it would be $150K+ and hospital is taking 100K, hardware is taking 25K. Its ridiculous and not feasible for plastic surgery that requires hospitalization.
• Residency in italy is laid back ask with lots of time off compared to US and I am lazy and already have a nice life. I don't want to regress in comfort.
• I dont need prestige. My brand rides on being the best measured by the bottom line: results and super specialization. Obviously "Giant Implants" isn't relying on a facade of professionalism.
• I dont want to LIVE in the US for lifestyle purposes
• I dont want to pay US taxes. Now I have a system where I pay about 5% tax and it maxes out at 10% no matter how much I make. I might renounce citizenship and it can be 0%.

Im making the world work for ME, on my terms. Not going by convention.

This is IF I want to work at all. I am in a position to never work again if I wish. At least in the traditional sense, I would still create stuff (new inventions, run a company, etc)

Keep in mind that your italian education won't be recognized in the US

I am well aware. I would stay in Italy but I could get it recognized in 1.) Dubai, 2.) Australia which are places I am more interested in living in than US.

(if you plan on practicing there). From what I've heard from a girl who did internships there, italian residency isn't great (especially in surgical specialties). Surgical residents apparently don't get a really hands on, practical education.

Absolutely correct. It's a piece of paper allowing me to do it. But it's also very laid back and you are able to spend about half your time away. Plastic surgery residencies in Italy let you do 18 months of the 5 years abroad, which I would do Giant surgeries in Turkey with the surgeons I already work with, and get credit for them. I am already getting great experience in turkey.

It's not as if ANY residencies will be teaching the types of surgeries I am already working on. I just need the piece of paper.

Senior physicians perform most of the real surgery, residents do ward work, assist in minor ways. Maybe that was just her hospital / experience. But I would look out for that.

I already know about the Italian systems and have assisted in surgeries in italy. Theres the official rules and theres how things really are in italy. Unlike US, thats how most countries work.

Did you study med + dentistry, or how can you start max fac there? And is plastics your ultimate goal? How do you like Derm compared to plastics? Depending on your skills, you can do quite a lot as a dermatosurgeon as well (no osteotomies ofc).

Maxillofacial surgery is MD only in Italy and all latin European countries (Spain, France, Italy, Portugal) For example Alfaro, Pags, Ram are all MD only. No dental degree needed. Which I really like.

And I would never be a derm. Might as well skip the residency and open a cosmetic clinic under your GP license and do all the same exact things (Lasers, filler, botox)