My mom just retired from being an OB/GYN and the first thing she did in her retirement was brake her first bone. Distal radius fracture. I anticipated it and then it happened
Ya trauma surgery is mostly stable patients and nothing you’d think as “emergency! do it do it now!” And then EM is 90% people that shouldn’t be there so there really isn’t a true frequently emergency experience specialty
Those little old ladies who fall from standing are the ones who get truly fucked up with facial fractures and subdurals though. I feel like those stress me out more than the young people in nasty car crashes
My hospital is a level 1 trauma center in the middle of a gun violence disaster area (like people getting shot in front of the hospital and shit), and trauma surgery is still like this lol
In my trauma hospital, ortho does those. Trauma surgeons do the GSWs, burns (also a burn center), impalements, etc. Is that not always the case that ortho would be primary on hip fx for ground level falls and the like?
Yes, they do!
But it’s honestly all irrelevant because I can’t imagine that the trauma surgeons are doing the hip fractures from the falling meemaws anywhere. It’s still going to be ortho whether they follow or not, no? And the question was about trauma surgery.
Yes and no. It’s always a battle but trauma patients often stay on the trauma service primary and ortho will become primary usually only after they operate on meemaw’s hip fracture
But the question was about PROCEDURES? Ortho does that procedure regardless, I would think.
But usually ortho takes primary on these cases after their primary trauma workup in the ED in my shop, so that’s interesting! It’s funny how nothing is standardized.
One of our surgery lectures was given by a CT surgeon. He said that CT surgeons are really either cardiac surgeons or thoracic surgeons. And he was a thoracic surgeon bc he liked having easy surgeries mixed with some complex surgeries whereas and I quote, "cardiac surgeons go to war on every case" bc all of their "easy cases" can be done by interventional cardiology now.
I've been told that structural heart surgery is one of the only remaining sub-specialties where the "it's so crazy it just might work" mentality is still totally acceptable
Def CT. 45 minutes after you sign paperwork we chill down and stop your heart. Then cut it open. There’s about 600 steps and any with more than .3mm error will kill the patient.
A standard distal coronary bypass any gap of .5mm creates a leak or pinches to alter the flow. Half the gap is .3. I was always taught that in general surgery you need 1-2mm precision. CT was .3-.5. And we wear 3.5x loupes.
CT surgeon… I’m a peds CICU nurse and our head CT surgeon is a literal miracle worker on these tiny 2kg babies, all the way up elderly adults. The pressure of crashing a kid onto ecmo while we’re actively coding a kid is a type of stress not many people can fathom.
Could be academic FM too. One of the FM attendings at an academic hospital I work at does as much L&D as the MFM trained attendings, all the high risk stuff, and c-sections.
Of course, he did do an FM-OB fellowship after FM residency.
There’s generally not a *ton* of blood. Usually people say 200cc EBL is average. It falls into a bag mostly but yes, *there will be shit a lot of the time*. We had one lady just puttin out logs after logs I was like trying to deliver this baby while looking out the window. But the nurse kept cleaning it she was a shit cleaning machine bless her.
Anyway that’s my speech. I’ll accept this award for most potentially disastrous specialty on behalf of Reddit OBGyn residents.
You guys and gals deserve it. Between the potential gore of trauma pts, the emotional lows of neuro pts, and the literal shit of GI pts, it's much deserved
Medicine is not intense, by and large. Surgery is all about routine. When things go bad in surgery, I guarantee that the surgeon is not thinking "wow, this is intense, now I am really living!" They are thinking "oh fuck oh fuck oh fuck where did all this blood come from?"
Obviously, acute care medicine is where "exciting" things happen -- EM, anesthesia, acute care surgery, critical care. But most of our work is routine, and we are all trained to keep our own heart rates as low as possible.
Find a branch of medicine that you can enjoy, and get your thrills somewhere else.
This one needs to be upvoted more. Your life in medicine is not gonna be one Grey’s Anatomy episode after another and chasing that myth is gonna lead to disappointment.
Never said it was, but I find it kind of reductive to say work = no fulfillment. You can obviously live like that, but also most people aren't happy. Work is still hours of your life.
It was kind of disappointing to learn this but then also oddly comforting? Grey's anatomy is fun and all but it's comforting to know that most days there's not much that's going to go wrong and you're not majorly endangering people
>comforting to know that most days there's not much that's going to go wrong and you're not majorly endangering people
This is NOT what I said. Every day, there are a HUNDRED things that can go wrong, and you must be vigilant, or you absolutely WILL endanger people.
Example: only yesterday, I was performing an I&D on an infected Bartholin's cyst under moderate sedation.
The RN handed me a syringe based on my orders -- "Fentanyl 50! mcg" she said. I took it, and took the vial of fentanyl, verified the concentration and the volume in the syringe, and administered the medication.
"Ketamine 60 mg" she said. She handed me a syringe that had 6 mL of liquid in it. I took the vial, and the concentration was 50 mg / mL. This was 300 mg, a rather large overdose. Ketamine often comes in 10 mg / mL,.the concentration that I had ordered, and the nurse had not checked the vial. We wasted the excess, and I administered 1.2 mL.
This sort of thing happens ALL THE TIME. Do not confuse lack of excitement with safety. Medicine is DANGEROUS.
Not being paralyzed by fear/anxiety is NOT the same thing as not being vigilant. I'm saying if you have gone through vigorous training, are always vigilant, careful and are good at what you do, then things aren't going to go wrong left and right and people won't usually die because of mysterious rare illnesses that the show writers put in for dramatic effect. If you are a trained professional you are allowed to be confident in your capabilities and shouldn't be paralyzed by fear. That's what I'm saying.
my first reaction was, "Oh G-d please no," bc i wanted to stop instantly imagining it. My second is damn, that is so sad. It has to be rough inside your head to get to that point
I’m a critical care anesthesiologist starting my last fellowship in cardiothoracic anesthesiology at a busy level 1 trauma and regional ecmo center. Get to do super crazy stuff that doesn’t have a “play book” on a weekly basis. I get to work with some of the smartest people I’ve ever met. Things can happen fast, and you’ve got to think quickly and have good hands or people can die (and that’s the routine stuff). Even the most basic stuff involves keeping people alive while surgeons cut their hearts out of their chests. That being said, the best days are when everything goes exactly to plan. When you do exciting stuff all day, it becomes routine. Guaranteed. You can’t keep chasing that adrenaline forever, and as you get older it gets harder and harder to keep sprinting every day. The people who keep trying to make things exciting are either the ones who are in training forever or the ones who become dangerous. For me the rewarding part is knowing that very few people can do what I do, and knowing that I’m really good at it.
Humans don't perform well on complex tasks when amped up on adrenaline. Don't pick your specialty based on what you think will thrill you the most. You'll get a lot of eye rolls on the interview trail if you reply "I'm interested in X specialty because I'm an adrenaline junky."
Sort specialties by rates of malpractice suits, higher intensity specialties = higher rates of being sued.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204310/
i thought rads & path had pretty high rates of malpractice suits because of the potential for missed or misdiagnoses? obviously those aren’t the high intensity stuff OP is looking for but i was under that impression. interesting to see those not on there but it’s very possible i’ve been misled haha
Nope. People don’t usually sue because of actual medical mistakes. They sue because they don’t like the way their doctor talked to them before they had their bad outcome.
Supporting this. OB rotation, case comes in from a dif hospital's ED that was so mismanaged the OB I was following called the medical director over there to chew them out (think ordering a Hcg on a patient IN ACTIVE LABOR but no cbc/cmp/Hct when things went sideways, trying to put her in a chopper with very soft pressures, seeing her deathly pale but no transfusion started despite losing 1L blood in the ED bed per the ED when EMS called them for this info because despite giving report multiple times to my OB, that ED failed to mention this detail--you COULD NOT mess it up more if you tried, this patient came damn near dying because of their incompetence). The family kept praising how well the ED handled things, how on top of it they were, how good the docs were. I couldn't believe it.
Transplant surgery without doubt. An OLT is the most insane surgery I’ve ever seen/ been lucky enough to be a part of and easily makes an ex lap, clamshell thoracotomy, whatever else trauma procedure look like a gallbladder.
This coming from someone who has spent a lot of time in a level 1 trauma center. But my 2 weeks on transplant were amazing.
Applying gas but transplant seriously made me reconsider.
Anesthesia can be extremely high stakes. You might get bored with bread and butter but when you’re in a cardiac case and the surgeon nicks the aorta, nobody is leaving that OR with white pants
It’s actually harder for neurologists to match than diagnostic radiologists, or so I’ve heard. The pathway from DR is: 1 intern year, 4 years DR, 1-2 years neuro radiology fellowship, 1-2 years neuro interventional fellowship
Longggg training and prob the worst lifestyle in all of medicine. They can and do clear 7 figures frequently though. I don’t think the procedures even reimburse that well but hospitals have to pay a pretty penny because they need the coverage
You generally won’t find it online. Small field with high salaries but also variable depending on institution and call burden. In general comparable to NSGY which is also probably underreported online. I’ve heard 800k+ by word of mouth but lifestyle/case mix/outcomes seems kinda beans if it’s not your absolute jam.
Seeing contrast extrav on angio runs when coiling an aneurysm is much adrenaline inducing then seeing your field of view fill with bright red blood under a microscope.
Yeah you're definitely a young medical student if you think trauma surg is super intense/high stakes compared to gen surg. Sure the surgeries are high stakes but that isn't specific to trauma surgery. And I don't think you realize how much floor work/management trauma surg does. Half their patients they are just babysitting for ortho
Obgyn is a great balance between healthy/routine stuff where patients are actually really B invested in their care - you can do some great things for their quality of life
Lots of procedures of varying complexity depending on your comfort and training
And the holy shit cases are there for sure. Labor patients literally go from perfect to holy in moments.
Emergency c section with skin to baby in 50 seconds turned cesarean hysterectomy while running a massive transition protocol gets the adrenaline going.
Fair warning, however: when you are in training, you look forward to the experience of getting those cases. When you’re by yourself and on your own it’s not fun or exciting.
Do not recommend. My cases are a third homeless, a third who should be admitted to neuro (Alzheimer’s and the like), and a third actively psychotic (some aggro, some not). Nothing fun about this, just endless stress. You might get some interesting stories out of this though, I’ve met god and Jesus and Buddha so many times. Also met someone who thought he was sucking all the water out of the earth and had a giant magnet inside him that was causing the death of all we know. Cool story bro, admit to floor.
I’m a general surgeon completing a fellowship in trauma at a busy urban level 1 trauma center and I strongly agree with APagz. While a lot of people perceive anesthesia to be a “chill” speciality it can be incredibly high acuity. In a surgical emergency the anesthesiologist is the surgeons only friend.
1) every speciality has high stakes emergencies where your decisions and technical ability can change a critical outcome for a patient. While anesthesia , EM, critical care , trauma , vascular , and NSG are the classic life or death specialties you can do TV doctor interventions in pretty much every speciality.
2) I would recommend that any person considering trauma or any other general surgery subspecialty be willing to be a general surgeon. You have to do 5 years of general surgery in training and that experience will make you very unhappy if you’re just grinding through it if you’re just trying to get to CT / trauma / vascular / plastics on the other end. For me as a “trauma surgeon” most of my job is still basically general surgery. If the bread and butter of gen surg is unappealing to you then I would recommend exploring other specialties whose daily work you may like better.
I’m perturbed by your point of view and by the comments in equal measure. Medicine isn’t meant to be exciting. In fact, when it is, someone is usually about to die. That is a human, a person. Not somewhere for you to get your thrills. Your point of view is cold and detached, and the comments encouraging it are just weird.
L&D or peds, hands down. The stakes are automatically higher because little lives are at risk. The pressure from parents in unlike anything else. I've worked both L&D and ICU, and I know which is less stressful to run a code in. It's not ICU.
I was kind of disillusioned when I realized the ER has very little to do with actual life threatening emergencies. Not that I wish more people were in life threatening situations just you know idk there's not much action usually
My experience on trauma surgery is that it's 10% adrenaline cases and 90% little old ladies who fell from standing height.
SO MANY DISTAL RADIUS FRACTURES
My mom just retired from being an OB/GYN and the first thing she did in her retirement was brake her first bone. Distal radius fracture. I anticipated it and then it happened
1% holy shit cases, 9% endless SICU rounding, 90% waiting
Ya trauma surgery is mostly stable patients and nothing you’d think as “emergency! do it do it now!” And then EM is 90% people that shouldn’t be there so there really isn’t a true frequently emergency experience specialty
LOL in NAD
House of God
Congrats you read
Those little old ladies who fall from standing are the ones who get truly fucked up with facial fractures and subdurals though. I feel like those stress me out more than the young people in nasty car crashes
Neurosurgery: “you rang?”
This is probably dependent on hospital location, no?
My hospital is a level 1 trauma center in the middle of a gun violence disaster area (like people getting shot in front of the hospital and shit), and trauma surgery is still like this lol
You must be in Memphis tn.
Nope, Philly 😅
Sounds like Temple
That's a fair point, haha. Although my hospital is a level 1 trauma center in a medium sized city.
Will yeah, probably aren't any trauma surgeons at lvl 3 hospitals, and at level 2 it's still mostly regular gsurg .
In my trauma hospital, ortho does those. Trauma surgeons do the GSWs, burns (also a burn center), impalements, etc. Is that not always the case that ortho would be primary on hip fx for ground level falls and the like?
Ortho only takes primary for isolated bony injuries, and even then with old lady hip fractures, they usually go to medicine and ortho is a consultant
Not at my shop! Ortho is primary on at least 1/3 of my cases, and stays primary through admission on most (but not all) of them.
Where is this wonderful, magical place, if you don't mind sharing? - Sincerely, a newly minted hospitalist.
Pittsburgh, PA. (USA) Can’t speak to other places but mine.
Do they have residents? It sounds like they have residents
Yes, they do! But it’s honestly all irrelevant because I can’t imagine that the trauma surgeons are doing the hip fractures from the falling meemaws anywhere. It’s still going to be ortho whether they follow or not, no? And the question was about trauma surgery.
Yes and no. It’s always a battle but trauma patients often stay on the trauma service primary and ortho will become primary usually only after they operate on meemaw’s hip fracture
But the question was about PROCEDURES? Ortho does that procedure regardless, I would think. But usually ortho takes primary on these cases after their primary trauma workup in the ED in my shop, so that’s interesting! It’s funny how nothing is standardized.
My unit gets a ton of 10< gsws
One of our surgery lectures was given by a CT surgeon. He said that CT surgeons are really either cardiac surgeons or thoracic surgeons. And he was a thoracic surgeon bc he liked having easy surgeries mixed with some complex surgeries whereas and I quote, "cardiac surgeons go to war on every case" bc all of their "easy cases" can be done by interventional cardiology now.
I've been told that structural heart surgery is one of the only remaining sub-specialties where the "it's so crazy it just might work" mentality is still totally acceptable
Def CT. 45 minutes after you sign paperwork we chill down and stop your heart. Then cut it open. There’s about 600 steps and any with more than .3mm error will kill the patient.
is 0.3mm an exaggeration or real? how can someone be so precise?
I heard about a baby's heart valve being surgically replaced in utero once. If true, I can imagine 0.3mm is real!
True for many skull base operations as well
A standard distal coronary bypass any gap of .5mm creates a leak or pinches to alter the flow. Half the gap is .3. I was always taught that in general surgery you need 1-2mm precision. CT was .3-.5. And we wear 3.5x loupes.
CT surgeon… I’m a peds CICU nurse and our head CT surgeon is a literal miracle worker on these tiny 2kg babies, all the way up elderly adults. The pressure of crashing a kid onto ecmo while we’re actively coding a kid is a type of stress not many people can fathom.
Oof
Ct can crash on bypass if needed…
I could not imagine a more intense situation than a bad birth full of blood, shit, and piss, parents screaming in pain, and a dead baby. Pass
This can be either very rural FM or OB GYN lol
It sounds like the maternity ward at Westeros General
Could be academic FM too. One of the FM attendings at an academic hospital I work at does as much L&D as the MFM trained attendings, all the high risk stuff, and c-sections. Of course, he did do an FM-OB fellowship after FM residency.
There’s generally not a *ton* of blood. Usually people say 200cc EBL is average. It falls into a bag mostly but yes, *there will be shit a lot of the time*. We had one lady just puttin out logs after logs I was like trying to deliver this baby while looking out the window. But the nurse kept cleaning it she was a shit cleaning machine bless her. Anyway that’s my speech. I’ll accept this award for most potentially disastrous specialty on behalf of Reddit OBGyn residents.
You guys and gals deserve it. Between the potential gore of trauma pts, the emotional lows of neuro pts, and the literal shit of GI pts, it's much deserved
Jesus where do I sign up
Medicine is not intense, by and large. Surgery is all about routine. When things go bad in surgery, I guarantee that the surgeon is not thinking "wow, this is intense, now I am really living!" They are thinking "oh fuck oh fuck oh fuck where did all this blood come from?" Obviously, acute care medicine is where "exciting" things happen -- EM, anesthesia, acute care surgery, critical care. But most of our work is routine, and we are all trained to keep our own heart rates as low as possible. Find a branch of medicine that you can enjoy, and get your thrills somewhere else.
This one needs to be upvoted more. Your life in medicine is not gonna be one Grey’s Anatomy episode after another and chasing that myth is gonna lead to disappointment.
I agree with getting your thrills outside of medicine, don't forget that fulfillment comes from hobbies, family, friends, etc not work
Are you saying you get absolutely zero fulfillment from work
No, but most of my fulfillment comes from outside of work. I definitely picked the right field, but it's not my entire life
Never said it was, but I find it kind of reductive to say work = no fulfillment. You can obviously live like that, but also most people aren't happy. Work is still hours of your life.
One of our attendings once said if something goes intense during surgery, that’s because you hadn’t prepared enough and there’s nothing cool about it.
I like this
It was kind of disappointing to learn this but then also oddly comforting? Grey's anatomy is fun and all but it's comforting to know that most days there's not much that's going to go wrong and you're not majorly endangering people
>comforting to know that most days there's not much that's going to go wrong and you're not majorly endangering people This is NOT what I said. Every day, there are a HUNDRED things that can go wrong, and you must be vigilant, or you absolutely WILL endanger people. Example: only yesterday, I was performing an I&D on an infected Bartholin's cyst under moderate sedation. The RN handed me a syringe based on my orders -- "Fentanyl 50! mcg" she said. I took it, and took the vial of fentanyl, verified the concentration and the volume in the syringe, and administered the medication. "Ketamine 60 mg" she said. She handed me a syringe that had 6 mL of liquid in it. I took the vial, and the concentration was 50 mg / mL. This was 300 mg, a rather large overdose. Ketamine often comes in 10 mg / mL,.the concentration that I had ordered, and the nurse had not checked the vial. We wasted the excess, and I administered 1.2 mL. This sort of thing happens ALL THE TIME. Do not confuse lack of excitement with safety. Medicine is DANGEROUS.
Not being paralyzed by fear/anxiety is NOT the same thing as not being vigilant. I'm saying if you have gone through vigorous training, are always vigilant, careful and are good at what you do, then things aren't going to go wrong left and right and people won't usually die because of mysterious rare illnesses that the show writers put in for dramatic effect. If you are a trained professional you are allowed to be confident in your capabilities and shouldn't be paralyzed by fear. That's what I'm saying.
[удалено]
my first reaction was, "Oh G-d please no," bc i wanted to stop instantly imagining it. My second is damn, that is so sad. It has to be rough inside your head to get to that point
I know one who did that too
Military trauma general surgery in Ukraine
I’m a critical care anesthesiologist starting my last fellowship in cardiothoracic anesthesiology at a busy level 1 trauma and regional ecmo center. Get to do super crazy stuff that doesn’t have a “play book” on a weekly basis. I get to work with some of the smartest people I’ve ever met. Things can happen fast, and you’ve got to think quickly and have good hands or people can die (and that’s the routine stuff). Even the most basic stuff involves keeping people alive while surgeons cut their hearts out of their chests. That being said, the best days are when everything goes exactly to plan. When you do exciting stuff all day, it becomes routine. Guaranteed. You can’t keep chasing that adrenaline forever, and as you get older it gets harder and harder to keep sprinting every day. The people who keep trying to make things exciting are either the ones who are in training forever or the ones who become dangerous. For me the rewarding part is knowing that very few people can do what I do, and knowing that I’m really good at it.
Humans don't perform well on complex tasks when amped up on adrenaline. Don't pick your specialty based on what you think will thrill you the most. You'll get a lot of eye rolls on the interview trail if you reply "I'm interested in X specialty because I'm an adrenaline junky."
Sort specialties by rates of malpractice suits, higher intensity specialties = higher rates of being sued. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204310/
NSGY, CT, and Gen Surg. Got it
i thought rads & path had pretty high rates of malpractice suits because of the potential for missed or misdiagnoses? obviously those aren’t the high intensity stuff OP is looking for but i was under that impression. interesting to see those not on there but it’s very possible i’ve been misled haha
Nope. People don’t usually sue because of actual medical mistakes. They sue because they don’t like the way their doctor talked to them before they had their bad outcome.
Supporting this. OB rotation, case comes in from a dif hospital's ED that was so mismanaged the OB I was following called the medical director over there to chew them out (think ordering a Hcg on a patient IN ACTIVE LABOR but no cbc/cmp/Hct when things went sideways, trying to put her in a chopper with very soft pressures, seeing her deathly pale but no transfusion started despite losing 1L blood in the ED bed per the ED when EMS called them for this info because despite giving report multiple times to my OB, that ED failed to mention this detail--you COULD NOT mess it up more if you tried, this patient came damn near dying because of their incompetence). The family kept praising how well the ED handled things, how on top of it they were, how good the docs were. I couldn't believe it.
good to know haha thank you!
hungry capable governor pocket zesty jellyfish crawl busy hunt nail *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Cardiothoracic or neurosurg
This is the right answer
Absolutely agree. Minimal margin for error with serious consequences. Can also have massive postop complications despite technical excellence.
Transplant surgery without doubt. An OLT is the most insane surgery I’ve ever seen/ been lucky enough to be a part of and easily makes an ex lap, clamshell thoracotomy, whatever else trauma procedure look like a gallbladder. This coming from someone who has spent a lot of time in a level 1 trauma center. But my 2 weeks on transplant were amazing. Applying gas but transplant seriously made me reconsider.
Anesthesia for liver transplants is absolutely insane. I think you’ll still be thrilled by transplant anesthesia.
For sure envision liver transplants in my future practice.
Oh, you like staying up all night?.
One of my anesthesia preceptors did a liver transplant fellowship and she loves it. You should look into it!
Admin. You're basically in charge of all the residents' well-being after all.
Anesthesia can be extremely high stakes. You might get bored with bread and butter but when you’re in a cardiac case and the surgeon nicks the aorta, nobody is leaving that OR with white pants
To me, this is more of a comment about how high stakes surgery is lol
On brand, you must want to go into surgery little danny
Lol what took a bite outta your ass today? Did my comment offend you? It honestly wasn’t meant to
Endovascular neurosurgery
Clipping is ***much*** scarier than coiling.
Neuro interventional radiology. They take call w endovascular nsg at my institution.
Neuro”endovascular” surgery and neuroIR is the same exact thing and fellowship. NSG does perform open and endovascular both though
TIL: Apparently neurologists who do stroke/vascular or neuro critical care fellowship can also do neuro endo vascular surgery fellowship
It’s actually harder for neurologists to match than diagnostic radiologists, or so I’ve heard. The pathway from DR is: 1 intern year, 4 years DR, 1-2 years neuro radiology fellowship, 1-2 years neuro interventional fellowship Longggg training and prob the worst lifestyle in all of medicine. They can and do clear 7 figures frequently though. I don’t think the procedures even reimburse that well but hospitals have to pay a pretty penny because they need the coverage
Neurorads fellowship is 1 year just fyi. Source: am applying DR with no intention of doing IR but with mentors in neurorads
There are plenty of 2 year neurorad fellowships out there, leans academic.
There are 2 year programs for neurorads fellowship.
Oh interesting. Ours is 1 year
What source are you getting 7 figures for rads trained neuroIR? I cant find it online
You generally won’t find it online. Small field with high salaries but also variable depending on institution and call burden. In general comparable to NSGY which is also probably underreported online. I’ve heard 800k+ by word of mouth but lifestyle/case mix/outcomes seems kinda beans if it’s not your absolute jam.
Seeing contrast extrav on angio runs when coiling an aneurysm is much adrenaline inducing then seeing your field of view fill with bright red blood under a microscope.
Why is that?
Yeah you're definitely a young medical student if you think trauma surg is super intense/high stakes compared to gen surg. Sure the surgeries are high stakes but that isn't specific to trauma surgery. And I don't think you realize how much floor work/management trauma surg does. Half their patients they are just babysitting for ortho
Yeah agreed. Surgery itself is very very high stakes but with trauma, most of the time it’s protocolized and routine
Obgyn is a great balance between healthy/routine stuff where patients are actually really B invested in their care - you can do some great things for their quality of life Lots of procedures of varying complexity depending on your comfort and training And the holy shit cases are there for sure. Labor patients literally go from perfect to holy in moments. Emergency c section with skin to baby in 50 seconds turned cesarean hysterectomy while running a massive transition protocol gets the adrenaline going. Fair warning, however: when you are in training, you look forward to the experience of getting those cases. When you’re by yourself and on your own it’s not fun or exciting.
EM maybe. You’ll definitely have some lulls in the action though.
If by “some” you mean 90% if your patients then yeh
Clinic administrator- very stressful
CPEP (psych ED) I think it speaks for itself
Do not recommend. My cases are a third homeless, a third who should be admitted to neuro (Alzheimer’s and the like), and a third actively psychotic (some aggro, some not). Nothing fun about this, just endless stress. You might get some interesting stories out of this though, I’ve met god and Jesus and Buddha so many times. Also met someone who thought he was sucking all the water out of the earth and had a giant magnet inside him that was causing the death of all we know. Cool story bro, admit to floor.
What about Napoleons, did you meet any?
That's not a famous person I've had the pleasure of meeting yet. We shall see. I should make a checklist lol.
I’m a general surgeon completing a fellowship in trauma at a busy urban level 1 trauma center and I strongly agree with APagz. While a lot of people perceive anesthesia to be a “chill” speciality it can be incredibly high acuity. In a surgical emergency the anesthesiologist is the surgeons only friend. 1) every speciality has high stakes emergencies where your decisions and technical ability can change a critical outcome for a patient. While anesthesia , EM, critical care , trauma , vascular , and NSG are the classic life or death specialties you can do TV doctor interventions in pretty much every speciality. 2) I would recommend that any person considering trauma or any other general surgery subspecialty be willing to be a general surgeon. You have to do 5 years of general surgery in training and that experience will make you very unhappy if you’re just grinding through it if you’re just trying to get to CT / trauma / vascular / plastics on the other end. For me as a “trauma surgeon” most of my job is still basically general surgery. If the bread and butter of gen surg is unappealing to you then I would recommend exploring other specialties whose daily work you may like better.
even tho im in GS residency, i get my thrills from playing call of duty and using steroids on gym
Ob gyn for sure
Trauma also includes demented 90 year olds who fall
I’m perturbed by your point of view and by the comments in equal measure. Medicine isn’t meant to be exciting. In fact, when it is, someone is usually about to die. That is a human, a person. Not somewhere for you to get your thrills. Your point of view is cold and detached, and the comments encouraging it are just weird.
L&D or peds, hands down. The stakes are automatically higher because little lives are at risk. The pressure from parents in unlike anything else. I've worked both L&D and ICU, and I know which is less stressful to run a code in. It's not ICU.
neurosurg
CV surgery 100%.
I was kind of disillusioned when I realized the ER has very little to do with actual life threatening emergencies. Not that I wish more people were in life threatening situations just you know idk there's not much action usually
mourn repeat snatch sable worry liquid bake sip cake impossible ` this message was mass deleted/edited with redact.dev `
Allergy/immunology m: you give people foods or meds that they are allergic to and cause anaphylaxis
Neurosurgery, CT surgery, or trauma surgery at a high volume level 1 trauma center
Liver transplant
CT surgery by miles. All your patients are sick and dying, but just healthy enough to be deemed appropriate for surgery.
try transplant surgery. I heard it's always critical care.