I am at a complete cross roads of determining which sub-speciality to go into, or for that matter, if any at all.
I enjoy surgery (find it rewarding, it's great to switch up the clinical routine, and in general find operating 'fun'), however I am concerned about the stresses associated with surgery and post-op management. I am wondering if these stresses subside with further experience (it's early for me ...), or if it's a perpetual stress that we improve on managing. As far as long term career goals, minimizing stress is high on my priority list, in addition to overall job satisfaction with good earning potential, work/life balance, and ease of employment in a location close to home (unfortunately - located in an oversaturated market).
For example, I enjoy medical glaucoma - but am wondering if the complexity of glaucoma surgery would make it not enjoyable for me. Of course, it would come with the benefit of seeing many controllable glaucoma patients, but with that niche also will come challenging surgical cases filled with complications, etc. Alternatively, maybe I should go the uveitis or med retina route and minimize surgical exposure. Or just stick with comprehensive, and refer out cases that maybe considered more stressful - the comprehensive route worries me from a marketability and long term job security perspective.
I used to be in the same boat. I would get overly anxious the night before surgery; would think of all of the bad things that could happen; and would occasionally put some timolol under by tongue to calm my nerves on the day of my OR (which works by the way). But something happened after a few thousand cases: my skills just improved a lot and more importantly, I just became desensitized to the OR. Anything can become routine if you do it for a few years, which is probably a good thing in regards to the OR.
As for "marketability", "good earning potential", and "ease of employment in a location close to home" -- all of those things are better if you are operating and can offer a wide variety of skills. As an employer, it is just easier to hire someone who can do many things well, compared to a "one-trick pony." Of course, as you become more senior (and thus busy), you can start concentrating more on something that interests you. But at the beginning, you should try to do as much as you are comfortable with. I tell a lot of people that your first or second job is probably your most important in terms of ramping up your surgical skills. You want to go somewhere where you are operating a lot so you can become comfortable quickly. Let me know if you have any other questions.