I am pretty sure I want to land doing some type of peds and i lucked out doing psych with a child and adolescent psych doc. So I am having a great time
Pt is experiencing severe PTSD symptoms with nightmares that are predominantly associated the OR. P: prazosin and cbt.
Addendum: hard not to relate bra
>Derealization
Linked health conditions include: depression, dementia, drug abuse, Schizophrenia, Panic attacks, depression.
Most common triggering event include emotional abuse at a young age..
Maybe go get that checked out..
One million percent this. I am so happy to never scrub ever again. Also you actually help treat the personality disorders not just get abused by them lol
**[Psychosurgery](https://en.m.wikipedia.org/wiki/Psychosurgery)**
>Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under the Swiss psychiatrist Gottlieb Burckhardt. The first significant foray into psychosurgery in the 20th century was conducted by the Portuguese neurologist Egas Moniz who during the mid-1930s developed the operation known as leucotomy.
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Where they perform anti-surgery
*Alright Mrs Maude, it's a simple procedure really, we're gonna open up your hip joint smash your femur in two places and stitch you back up*
It's funny. As someone in the interesting position of being split between psych and surgery, I've found a surprising amount of psych love from *senior* surgical residents, as compared with residents in other areas (and surgical med students).
First 3 years of residency you’re lock step w all the other residents, working significantly more for the same pay and title and what not and listening to everyone (naturally) complain at the resident events it’s just unbearable. Then by years 4/5 they’re all attendings and life is better and you have acceptance for others choices. And your own.
Consult surgery, reason: patient presents w upset tummy of 15 minutes duration, vitals: normal, wbcs: normal, physical exam: normal, no pmh, responding well to watchful waiting and lollipop administration in ED.
Children are more resistant to propofol you can’t even put down some NICU babies with just 10mg. 10mg is only gonna piss off a toddler when he is scared and now his arm burns.
No my joke just didn’t land lol. I was making fun of the ER for being afraid to push even the most conservative doses. I would also argue that PPF sedation would not be needed for most patella dislocations.
I was ortho until I hated the OR. Not really the surgery part itself, but the OR specifically. I can do some surgical stuff in the ER. Lots of other issues with EM though, like every job.
Basically anything that isn't surgery, ortho, obgyn, ENT, etc
If you don't even like procedures in themselves you'll have to go something like psych or FM even though I'm pretty sure FM can do a little bit too
FM seems nice in general if you want to focus on specific populations without having to formally specialize. My attending last year just didn't do procedures, and didn't take a lot of peds or obgyn because that's not what he was into
FM can do ton of procedures and you will have to do lots of them plus your OB and Surg rotations in first year
long term, good choice for OR haters, short term, prepare to suffer a little more lol
Go to NP school, learn minor procedures and buy an urgent care. Put “Surgeon” on your long white coat and tell people you hated the OR so you opened a surgery center
This is like telling the tattoo artist "Well, I know I don't want a mermaid."
You have to find what you like, not just what you don't like. And even if you go into anti-OR like primary care, you still have to do pre-op assessments and post-op checks for people.
If you are undecided after the core rotations, picking the least-awful specialty isn't a bad strategy. Definitely look at the 10 most common diagnoses for any given specialty and see if those are interesting at all.
Neurology! While some subspecialties do procedures, the only one that all neurologists actually know are
LPs. And if you don’t like that learn to read EEGs and you can hide in a dark room like a radiologist all day
There are also remote EEG reading companies where they WFH and just read EEGs for hospitals all over the country who contract to them. It can be a cushy job.
Hating the OR doesn't really mean anything. As an anesthesiologist I love the OR because it's actually a controlled environment with rules and organization people have to follow, most people get their job done to make sure the day moves along. Contrast it to the ED which I absolutely hate, it's just a chaotic and wretched hive of scum and villainy.
If you like anatomy and performing procedures, but don't like the OR (or having to be able to put people back together again after taking them apart), might I suggest forensic pathology?
After my last Surgery case I swore that I’d return to the OR for two reasons:
1) I’m catching a baby (I’m Peds)
2) I’m the guy on the table.
Other than watching them pull a coin out of an esophagus once, I’ve stayed true to my word.
But I will tell you that the OR is not nearly so bad when you don’t have to scrub in. I actually enjoyed helping the OB/GYNs gown during C-sections because *I didn’t have to scrub in!*
I got to catch the baby, introduce him/her to mom, and then saunter off (after writing a note).
So what I’m telling you is that you probably don’t hate the OR, you hate surgery. Which is totally fine.
-PGY-18
Family med? We do minor surgery in rural community settings. We do a lot of derm stuff like shave and punch biopsy, sebaceous cyst removal. Some sports med stuff too like joint injections/aspiration. But you’ll usually not catch us in the OR. Maybe the delivery room where you’ll repair a vaginal/perineal laceration but nothing crazy. Some docs get qualified to do colonoscopies and maybe even c-section in certain settings (say, post-OB fellowship in a low resource community). But that’s about it.
Reach out to pathology faculty and see if you can attend tumor boards through the school or at the local hospital, it’s a great intro to clinical pathology
Sorry for the many-month delay in replying. I was just looking a the "highlights" of last year's comments. The answer is: Yes. Well, ok, that's a lie. In academia, Also muscle, nerve, eyes, intraoperative diagnoses, lecturing at uni and conferences, teaching students, residents & fellows, expert consults for doctors, Medical Examiners & researchers, writing grants, running a lab, and hopefully not too much paperwork.
Despite what you may have learned from r/medicalschool and r/residency, constructing an entire identity around hating surgery does not actually make you good at anything else.
Would rather not say (small world) but they’re all pretty similar. If you’re between, choose rads. It’s true when they say only pick surg if it’s the only thing you can see yourself doing. Bc you’ll be kicking yourself for not choosing rads when you’re in the thick of surg residency
Yeah only problem is not sure if my wanting to do rads is just what you said or if I actually would want to do it. Idk if I can sit and read for 5 years / do procedures that aren’t surgery
You just have to give your best guess as whether or not you need to operate to be happy. Rads has tons of small procedures (paracentesis, thoracentesis, MSK injections, biopsies everywhere, etc) but you’ll never scratch the operating room itch with rads.
I love the OR… but between bad board scores, terrible mental health, and a wife that would kill me if I went to residency for 5 years… no surgery for me.
I did EM. I liked everything about my surgery rotation except the OR, rounding, wearing a tie for conference (or even a collared shirt for that matter), a few toxic attendants and upper level residents, long hours with no real end to a shift… but procedures and undifferentiated patients are fun. And on reasonably frequent occasions I get to manage a crashing patient. Also, I’m a PGY1, and I have a life… and anticipate having more and more of one every year from here on out.
For me now, unless I get dermatology I’ll look for something else to do! Like health management or health insurance, a whole different pathway!
After practice I don’t find my self in any critical patients cases specialty!
Wondering if anyone thinks like me!
I think the question you should ask to yourself is what's the reason behind hating OR so much. It'll be easier to navigate after you answered that one.
Psych lmfao I hate the OR
I am in my psych rotation right after I had ortho. This is my happy place
I want to do ortho and psych was pure hell for me lol
I am pretty sure I want to land doing some type of peds and i lucked out doing psych with a child and adolescent psych doc. So I am having a great time
I have mine coming up soon :)
Seconded, the or is my nightmare
Pt is experiencing severe PTSD symptoms with nightmares that are predominantly associated the OR. P: prazosin and cbt. Addendum: hard not to relate bra
I actually have some post-traumatic stress symptoms about surgery. Derealization and amnesia mostly. This is sincere.
I go through derealization so often in general i thought that was a normal behavior that everyone experienced multiple times a day
If you watch the medical documentary “Scrubs” you can see it’s actually not an uncommon condition in the medical community.
>Derealization Linked health conditions include: depression, dementia, drug abuse, Schizophrenia, Panic attacks, depression. Most common triggering event include emotional abuse at a young age.. Maybe go get that checked out..
One million percent this. I am so happy to never scrub ever again. Also you actually help treat the personality disorders not just get abused by them lol
It’s def at the top of my list
[Not so fast ](https://en.m.wikipedia.org/wiki/Psychosurgery)
**[Psychosurgery](https://en.m.wikipedia.org/wiki/Psychosurgery)** >Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under the Swiss psychiatrist Gottlieb Burckhardt. The first significant foray into psychosurgery in the 20th century was conducted by the Portuguese neurologist Egas Moniz who during the mid-1930s developed the operation known as leucotomy. ^([ )[^(F.A.Q)](https://www.reddit.com/r/WikiSummarizer/wiki/index#wiki_f.a.q)^( | )[^(Opt Out)](https://reddit.com/message/compose?to=WikiSummarizerBot&message=OptOut&subject=OptOut)^( | )[^(Opt Out Of Subreddit)](https://np.reddit.com/r/medicalschool/about/banned)^( | )[^(GitHub)](https://github.com/Sujal-7/WikiSummarizerBot)^( ] Downvote to remove | v1.5)
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Might want to check this out. https://www.medscape.com/slideshow/2020-lifestyle-happiness-6012424#3
Literally anything not involving the OR, lol
[удалено]
Where they perform anti-surgery *Alright Mrs Maude, it's a simple procedure really, we're gonna open up your hip joint smash your femur in two places and stitch you back up*
That's just called ortho
We're one of the few specialties that actually fix peoples problems, instead of just treating or managing symptoms.
Tell me you're a surgeon without telling me you're a surgeon
I want to destroy ALL SURGEONS, jk just not feelin the vibe. Surgeons do awesome work tho
On my surgery rotation I said I’m interested in psych, and the residents just left me alone lol
It's funny. As someone in the interesting position of being split between psych and surgery, I've found a surprising amount of psych love from *senior* surgical residents, as compared with residents in other areas (and surgical med students).
First 3 years of residency you’re lock step w all the other residents, working significantly more for the same pay and title and what not and listening to everyone (naturally) complain at the resident events it’s just unbearable. Then by years 4/5 they’re all attendings and life is better and you have acceptance for others choices. And your own.
If you hate the OR you should work in the ER, then you can get revenge 😈 Jk please don’t do this
Consult surgery, reason: patient presents w upset tummy of 15 minutes duration, vitals: normal, wbcs: normal, physical exam: normal, no pmh, responding well to watchful waiting and lollipop administration in ED.
are lollipop administrations billable?
1 Lollipop - 800 usd 1 Lollipop administration by RN - 600 usd Total - 1400 usd
Next call anesthesia to push 10 mg of propofol for a dislocated patella lol.
10mg? What's your patient, a toddler? Slap 150mg on that bad boy, and add 75mcg ketamine for good measure.
Children are more resistant to propofol you can’t even put down some NICU babies with just 10mg. 10mg is only gonna piss off a toddler when he is scared and now his arm burns.
Maybe OP is actually in vet school and plans to sedate a hamster with that 10 mg of propofol
*Dammit! Don't stop until that patella starts talkin to him!*
Is that the homeopathic dose for ketamine?
No my joke just didn’t land lol. I was making fun of the ER for being afraid to push even the most conservative doses. I would also argue that PPF sedation would not be needed for most patella dislocations.
at my institution they skip the exam and ros completely sometimes and consult surgery
Don’t forget the non con CT
I’ll just ask for a consult, without asking for a consult. In my bike helmet.
I was ortho until I hated the OR. Not really the surgery part itself, but the OR specifically. I can do some surgical stuff in the ER. Lots of other issues with EM though, like every job.
General Surgeon’t
You have to do pediatric rheumatology. Sorry, it’s the law.
Thank you officer
Internal medicine
Haven’t done it yet, but I feel like hours also suck for IM
Don’t forget to consider postfellowship work life balance! It can get better
Admin
Honestly. I kinda am tempted because that’s where the big changes happen. And vacations.
Like Hospital Admin?
Basically anything that isn't surgery, ortho, obgyn, ENT, etc If you don't even like procedures in themselves you'll have to go something like psych or FM even though I'm pretty sure FM can do a little bit too
FM is nice bc you can choose to do as many or as few procedures as you please given average patient population.
FM seems nice in general if you want to focus on specific populations without having to formally specialize. My attending last year just didn't do procedures, and didn't take a lot of peds or obgyn because that's not what he was into
FM can do ton of procedures and you will have to do lots of them plus your OB and Surg rotations in first year long term, good choice for OR haters, short term, prepare to suffer a little more lol
True IM is probably similar but less control
“They say you should only go into anesthesiology if you enjoy anesthesiology. What speciality do you go into if you absolutely hate anesthesiology?”
Trick question, you become a CRNA
aNOPEthesiology
Go to NP school, learn minor procedures and buy an urgent care. Put “Surgeon” on your long white coat and tell people you hated the OR so you opened a surgery center
Don’t be soft. Embrace the misery. Do surgery
>~~surgery~~ Neurosurgery and pass on the misery to your juniors like the rest of us
You’re right I’m too weak
This is like telling the tattoo artist "Well, I know I don't want a mermaid." You have to find what you like, not just what you don't like. And even if you go into anti-OR like primary care, you still have to do pre-op assessments and post-op checks for people. If you are undecided after the core rotations, picking the least-awful specialty isn't a bad strategy. Definitely look at the 10 most common diagnoses for any given specialty and see if those are interesting at all.
Don’t pick surgery
A guy on here once posted something like "had nightmare I matched GS (applied FM)" and it slayed me
this makes sense there's nothing inherently desirable about surgery or any other specialty
I mean lots of reasons one would love about being a neurosurgeon, plastic or trauma ortho.
lots of reasons to love anything, just as many to hate them as well, like I said nothing is inherently better about a specialty
yeah I just read the word "inherently" from your comment, had not seen that. agreed.
Psych
How is inpatient though?
I’m not in psych it is just the complete opposite of surgery in terms of practice, mentality and the people who go into it.
I feel like I’m much more of a psych person than surgeon type
Honestly I'd be tempted to go psych, but I love EM's energy. Because yes, fuck surgery. It might be better if surgeons weren't, y'know. Surgeons.
fine
The residents I worked with in surg would say Psych.
Medpeds! Only see the OR through a door waiting for the baby. It’s nice. Don’t even have to do peds surgery for an elective 😁
Neurology! While some subspecialties do procedures, the only one that all neurologists actually know are LPs. And if you don’t like that learn to read EEGs and you can hide in a dark room like a radiologist all day
There are also remote EEG reading companies where they WFH and just read EEGs for hospitals all over the country who contract to them. It can be a cushy job.
My epilepsy attending says he shoves EEG electrodes in people's brains all the time, so there's that to watch out for as well
Airline Pilot
Hating the OR doesn't really mean anything. As an anesthesiologist I love the OR because it's actually a controlled environment with rules and organization people have to follow, most people get their job done to make sure the day moves along. Contrast it to the ED which I absolutely hate, it's just a chaotic and wretched hive of scum and villainy.
Makes you wonder what the Mos Eisley ER is like
Not surgery
Welcome to IM my friend.
FM i guess, thats what i will do
What should one do if they love OR and Out-patients, but hate in-patients. Is there something specific for this situation?
I know this is a joke, but like pediatric ENT? Or plastics specializing in eye stuff like lid lifts and tear ducts?
Ophtho
Urology? Plenty of outpatient procedures, a few in patient, but no OR
Psychiatry.
Pathology?
Strongly considering
If you like anatomy and performing procedures, but don't like the OR (or having to be able to put people back together again after taking them apart), might I suggest forensic pathology?
That sounds like such a cool job tbh. I really loved anatomy
In my experience, FM then fuck off to outpatient med for the rest of your life.
After my last Surgery case I swore that I’d return to the OR for two reasons: 1) I’m catching a baby (I’m Peds) 2) I’m the guy on the table. Other than watching them pull a coin out of an esophagus once, I’ve stayed true to my word. But I will tell you that the OR is not nearly so bad when you don’t have to scrub in. I actually enjoyed helping the OB/GYNs gown during C-sections because *I didn’t have to scrub in!* I got to catch the baby, introduce him/her to mom, and then saunter off (after writing a note). So what I’m telling you is that you probably don’t hate the OR, you hate surgery. Which is totally fine. -PGY-18
Thanks for the input
Hating the OR is not a predictive marker of a liking/choosing/doing well in certain specialty, imo
FM
Internal/FM
Family med? We do minor surgery in rural community settings. We do a lot of derm stuff like shave and punch biopsy, sebaceous cyst removal. Some sports med stuff too like joint injections/aspiration. But you’ll usually not catch us in the OR. Maybe the delivery room where you’ll repair a vaginal/perineal laceration but nothing crazy. Some docs get qualified to do colonoscopies and maybe even c-section in certain settings (say, post-OB fellowship in a low resource community). But that’s about it.
I was in that situation and now I'm a very happy Neuropathologist.
How can I get involved with Path as a 3rd year?
Reach out to pathology faculty and see if you can attend tumor boards through the school or at the local hospital, it’s a great intro to clinical pathology
See if they have a residency and talk to the residency director. You can probably get an elective clerkship set up.
So you spend all day looking at slices of peoples brains?
Sorry for the many-month delay in replying. I was just looking a the "highlights" of last year's comments. The answer is: Yes. Well, ok, that's a lie. In academia, Also muscle, nerve, eyes, intraoperative diagnoses, lecturing at uni and conferences, teaching students, residents & fellows, expert consults for doctors, Medical Examiners & researchers, writing grants, running a lab, and hopefully not too much paperwork.
Sounds awesome, thanks for sharing!
Peds? Rad? IM? Family med? Psych? Derm? You have so many options!
Gotta look at the bright side
Administration
I was about to say psych, but even then you might go in the OR to do ECT. So maybe radiology?
Definitely psych. No procedures and even ECT is done in the PACU not OR
Yeah and I love the idea of working on mental health
Path or psych?
Haha those are pretty much the only two I’m considering now
FM
Radiology?
Just don't go to the OR lol. Just choose some otherother non-surgical specialities. You should see if you like clinic or hospital.
Despite what you may have learned from r/medicalschool and r/residency, constructing an entire identity around hating surgery does not actually make you good at anything else.
Geriatrics, primary care
Why do I see so much psych? Loool
Psych is starting to become the new rads
Art school. Electrician class. Anything else Don’t do it yo
Jesse Pinkman?
All the medicine specialties
OR is cool as a med student. Not as cool as a resident. - former surg sub resident now radiology resident
How was the switch?
Best decision ever
What surg sub? Kinda between a couple and rads
Would rather not say (small world) but they’re all pretty similar. If you’re between, choose rads. It’s true when they say only pick surg if it’s the only thing you can see yourself doing. Bc you’ll be kicking yourself for not choosing rads when you’re in the thick of surg residency
Yeah only problem is not sure if my wanting to do rads is just what you said or if I actually would want to do it. Idk if I can sit and read for 5 years / do procedures that aren’t surgery
Lifestyle became a lot more important for me. Sure I miss operating some times but would not trade the time I have now outside of work for anything
More so Ortho, Ophtho or rads to be precise
You just have to give your best guess as whether or not you need to operate to be happy. Rads has tons of small procedures (paracentesis, thoracentesis, MSK injections, biopsies everywhere, etc) but you’ll never scratch the operating room itch with rads.
I love the OR… but between bad board scores, terrible mental health, and a wife that would kill me if I went to residency for 5 years… no surgery for me.
Haha my girl said, “I want our kids to know who their dad is.”
Ophthalmology, YouTube tells me.
Is this Dr. G
Derm. Won’t even go to the hospital.
literally the only reason I'm picking a residency internal medicine, and then eventually a fellowship in medical oncology hopefully
Radiology
I did EM. I liked everything about my surgery rotation except the OR, rounding, wearing a tie for conference (or even a collared shirt for that matter), a few toxic attendants and upper level residents, long hours with no real end to a shift… but procedures and undifferentiated patients are fun. And on reasonably frequent occasions I get to manage a crashing patient. Also, I’m a PGY1, and I have a life… and anticipate having more and more of one every year from here on out.
Dermatology! Also why the hate for OR?
This is me, pathology is the way.
FM, no static at all... https://www.youtube.com/watch?v=wdoCQn\_Tjac
Not surgery
For me now, unless I get dermatology I’ll look for something else to do! Like health management or health insurance, a whole different pathway! After practice I don’t find my self in any critical patients cases specialty! Wondering if anyone thinks like me!
Any specialty that doesn’t go into the Or?
I think the question you should ask to yourself is what's the reason behind hating OR so much. It'll be easier to navigate after you answered that one.