Psychiatry and surgery

[Maybepsychmajor]

I want to become a child psychiatrist and I know I have to go to med school.Do I have to do surgery during my residency, i don't want to?

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[kalle001]

I want to become a child psychiatrist and I know I have to go to med school.Do I have to do surgery during my residency, i don't want to?

Residency is after medical school when you have chosen a specialty. So, no if you do a psychiatry residency you will not do surgery.

 

[ComputerGuy365]

I want to become a child psychiatrist and I know I have to go to med school.Do I have to do surgery during my residency, i don't want to?

Psychiatry is a residency which does not involve surgery.

 

[GUH]

The above two posters are correct.

However, you will have to participate in surgery and other things involving blood as a medical student before residency.

 

[ComputerGuy365]

The above two posters are correct.

However, you will have to participate in surgery and other things involving blood as a medical student before residency.

Yep, you will be touching cadavers, and doing a surgery rotation.
If you can't handle blood, you can't be a physician.

 

[mcatjelly]

Yep, you will be touching cadavers, and doing a surgery rotation.
If you can't handle blood, you can't be a physician.

This is not even true.

 

[ComputerGuy365]

This is not even true.

The last statement is a little rash I agree, but how so is the first line false?

 

[mcatjelly]

The last statement is a little rash I agree, but how so is the first line false?

First line is fine! Second is not great advice.

 

[ComputerGuy365]

First line is fine! Second is not great advice.

Thanks for letting me know.

 

[bee17]

Squeamishness is something that most people can overcome. I've dealt with it myself (and still do to some extent). The key is exposure. I don't want to be a surgeon, but I've shadowed several surgeons just to desensitize myself.

 

[frosted_flake]

Ortho surgery is the worst... hammers and chisels... NO!
Blood and other body fluids don't bother me the least bit.

 

[NontradCA]

This is not even true.

Yes it is. Blood, stool, urine, semen, pus, csf, bile, gastric juice, cerumen, various discharges.

 

[sloop]

This is not even true.

I'd say it's true. I'll probably apply to psych, but I have no problem with blood. You really cannot have a serious problem with blood and perform the duties of a medical student. You will be asked to draw blood, perform/assist with procedures, scrub in during surgeries, retract tissue, deliver babies/placentas, cut sutures, suction blood, etc. All med students do this stuff at some point in their training. This is not avoidable and if you try to avoid it, you will get called out for not performing the duties you are supposed to.

Try to explain to your attending on OB/GYN or surgery clerkship that you can't deal with blood and see how that works out for you . . .

 

[mcatjelly]

I'd say it's true. I'll probably apply to psych, but I have no problem with blood. You really cannot have a serious problem with blood and perform the duties of a medical student. You will be asked to draw blood, perform/assist with procedures, scrub in during surgeries, retract tissue, deliver babies/placentas, cut sutures, suction blood, etc. All med students do this stuff at some point in their training. This is not avoidable and if you try to avoid it, you will get called out for not performing the duties you are supposed to.

Try to explain to your attending on OB/GYN or surgery clerkship that you can't deal with blood and see how that works out for you . . .

Oh, I agree. But I don't think it's fair to tell someone who hasn't had a chance to become habituated to the down and dirty aspects of medicine that they're forever doomed. It's unlikely OP has been in many situations that involve blood and bodily fluids; there are opportunities to get over the fear!

 

[sloop]

Oh, I agree. But I don't think it's fair to tell someone who hasn't had a chance to become habituated to the down and dirty aspects of medicine that they're forever doomed. It's unlikely OP has been in many situations that involve blood and bodily fluids; there are opportunities to get over the fear!

I'm not sure about the extent of the aversion OP has to blood. If it's a mild dislike and he otherwise likes a lot about medicine, it is true he could get over that. On the other hand, I knew people in college and high school who would get dizzy or faint with prolonged exposure to the sight of blood. Whether this can be deconditioned or not I'm not exactly sure because specific phobias are not an area of personal interest to me. My guess is that people have tried CBT/ERP with some success but the question with something like a blood phobia becomes "how much energy are you really willing to put in to do this?"

Medical school is four years of daily blood, guts, and bodily fluids. First year has cadaver lab. Second year has pathology and all the images involved with that. Third year, every clerkship except maybe psych and neuro (if you have that third year) will have you regularly seeing blood.

The other concern that I have is that people who are averse to blood, tissue or body fluids may not actually like medicine. These things are essential aspects of medicine. I know he wants to be a psychiatrist, but people forget that psychiatrists are doctors first. You can't practice good psychiatry without practicing good medicine and in order to do that you have to be comfortable with the gross stuff. Even as a shrink, you'll be consulted about capacity and mental status for all sorts of patients who might be on dialysis or have NG tubes, colostomy bags, or catheters. They might be postpartum with lochia spotting on their bedsheets. It's part of the job. It's not as much a part of it as it is with surgery, but it's still a part of it.

 

[mcatjelly]

I'm not sure about the extent of the aversion OP has to blood. If it's a mild dislike and he otherwise likes a lot about medicine, it is true he could get over that. On the other hand, I knew people in college and high school who would get dizzy or faint with prolonged exposure to the sight of blood. Whether this can be deconditioned or not I'm not exactly sure because specific phobias are not an area of personal interest to me. My guess is that people have tried CBT/ERP with some success but the question with something like a blood phobia becomes "how much energy are you really willing to put in to do this?"

Medical school is four years of daily blood, guts, and bodily fluids. First year has cadaver lab. Second year has pathology and all the images involved with that. Third year, every clerkship except maybe psych and neuro (if you have that third year) will have you regularly seeing blood.

The other concern that I have is that people who are averse to blood, tissue or body fluids may not actually like medicine. These things are essential aspects of medicine. I know he wants to be a psychiatrist, but people forget that psychiatrists are doctors first. You can't practice good psychiatry without practicing good medicine and in order to do that you have to be comfortable with the gross stuff. Even as a shrink, you'll be consulted about capacity and mental status for all sorts of patients who might be on dialysis or have NG tubes, colostomy bags, or catheters. They might be postpartum with lochia spotting on their bedsheets. It's part of the job. It's not as much a part of it as it is with surgery, but it's still a part of it.

If it is a true phobia with a vasovagal response it's not something OP has total control over, but there are absolutely therapies out there to help one overcome that fear response (namely, exposure therapies). And if it's just a dislike of being around them; again, there is something to be said for repeated exposure for anyone with a fear. I have a physiological response to injections (not blood, though) myself and whenever I encounter a nurse giving one at work, I don't let myself look away. So the magnitude of my response has decreased over time.

Anyway, you can be averse to bodily fluids and still like medicine. If there's a will, there's a way. And no matter what profession you're in, there's going to be SOME aspect of it you'd rather not deal with, but you do anyway because it's part of the job. So I think it's silly to write someone off from an entire career field based on their not liking one aspect of it.

 

[sloop]

If it is a true phobia with a vasovagal response it's not something OP has total control over, but there are absolutely therapies out there to help one overcome that fear response (namely, exposure therapies).

First of all, psychogenic syncope is not the same as reflex (I.e. Vasovagal) syncope.

I know there are therapies out there. I specifically mentioned Exposure and Response Prevention. I know this is something that works with OCD people but I just do not know how effective it is with specific phobias. I'm sure it has some efficacy, I just was asking whether this is something that is worth going through therapy for. You can easily avoid being frequently exposed to the sight of blood by choosing a different profession. It just depends how much it matters to the person and affects them.

And if it's just a dislike of being around them; again, there is something to be said for repeated exposure for anyone with a fear. I have a physiological response to injections (not blood, though) myself and whenever I encounter a nurse giving one at work, I don't let myself look away. So the magnitude of my response has decreased over time.

Anyway, you can be averse to bodily fluids and still like medicine. If there's a will, there's a way. And no matter what profession you're in, there's going to be SOME aspect of it you'd rather not deal with, but you do anyway because it's part of the job. So I think it's silly to write someone off from an entire career field based on their not liking one aspect of it.

I recognize that people can deal with certain aspects of professions that they dislike. I'm saying that having an issue with blood and bodily fluids is a problem because it's a big part of medicine. You are studying the physiologic and pathological human body. A major thing the body does is produce fluids like blood, etc. This is not like being a lawyer and disliking the email correspondence part of the job. This is like being a prosecutor and disliking the fact that anybody gets forcibly incarcerated.

Is it possible to hate body fluids and still like medicine? Maybe, but it's hard to imagine. It's generally not a good sign when you study a system but strongly dislike the things that system produces even when it is functioning optimally.

 

[mcatjelly]

This is such a ridiculous argument we're having (and I mean that in a nice way, haha).

First of all, psychogenic syncope is not the same as reflex (I.e. Vasovagal) syncope.

I know this is something that works with OCD people but I just do not know how effective it is with specific phobias. I'm sure it has some efficacy, I just was asking whether this is something that is worth going through therapy for. You can easily avoid being frequently exposed to the sight of blood by choosing a different profession. It just depends how much it matters to the person and affects them.

You're talking to miss mental health here. I'm aware of the differences between psychogenic and vasovagal syncope, but the thing with blood-injection-injury phobia is that it DOES produce a vasovagal response: heart rate briefly accelerates, blood pressure drops, and the combination of the two can lead to vasovagal syncope. If you don't believe me, look it up!

ERP is also the top treatment for specific phobias, and I'd argue that it's absolutely worth going to therapy for it if you love medicine, want to become a doctor, and have this specific phobia getting in the way of your aspirations!

Is it possible to hate body fluids and still like medicine? Maybe, but it's hard to imagine. It's generally not a good sign when you study a system but strongly dislike the things that system produces even when it is functioning optimally.

I definitely see what you're saying and agree with you for the most part, I just think it's a very black-and-white response to a gray situation.

 

[Mad Jack]

Yes it is. Blood, stool, urine, semen, pus, csf, bile, gastric juice, cerumen, various discharges.

Along those lines, if you can't comfortably put your finger in the bloody rectum of an elderly person, this probably isn't the right field for you op. During training, you will have to do everything from disimpactions to suturing to abscess drainage to taking samples from infected vaginas. The good news is that you get used to it though, for what it's worth. The human mind is versatile.

 

[sloop]

This is such a ridiculous argument we're having (and I mean that in a nice way, haha).



You're talking to miss mental health here. I'm aware of the differences between psychogenic and vasovagal syncope, but the thing with blood-injection-injury phobia is that it DOES produce a vasovagal response: heart rate briefly accelerates, blood pressure drops, and the combination of the two can lead to vasovagal syncope. If you don't believe me, look it up!

ERP is also the top treatment for specific phobias, and I'd argue that it's absolutely worth going to therapy for it if you love medicine, want to become a doctor, and have this specific phobia getting in the way of your aspirations!



I definitely see what you're saying and agree with you for the most part, I just think it's a very black-and-white response to a gray situation.

With regard to syncope, this is not as clear as you make it out to be. With your classical vasovagal reflex syncope, you have a fainting response to an activity that is discretely explained by a vasovagal response (I.e. Carotid pressure, defecation, valsalva). With phobias, this is much more complicated because there is likely a central contribution to the reaction and, depending on the patient and their history, there may also be a conversion component. In any case, you were presenting this as like "well it's vasovagal so they can't avoid it." That's not really the case here. It's not like this person would faint every time they defecate. They could just avoid blood and avoid the problem.

If this person can't be happy doing something else, sure. Do therapy. But don't kid yourself into thinking therapy doesn't have risks. It's not an easy or pleasant thing for someone to be systematically exposed to their phobic stimulus on a regular basis in hopes of achieving extinction. It depends on how much of a problem this is for somebody.

 

[gunnerdoc]

I want to become a child psychiatrist and I know I have to go to med school.Do I have to do surgery during my residency, i don't want to?

Your first two years of medical school, you'll be lucky if they let you touch a surgical patient. You will do a surgery rotation and you will be expected to be in the OR next to the table. You will probably be told to hold instruments, the camera, retractors, maybe even close up. This can be anywhere from four to twelve weeks. Afterwards, if you choose not to do surgery, you wiill never have to step foot in the OR again.

 

[Dharma]

Digging compacted poop out of someone's rectum with a gloved finger for an hour. Yep. Likely not going to be able to call yourself doctor until you go through that one. Rite of passage. Blood? That's easy. Blood doesn't smell... on its own...