Specialties with surgical procedures?

[riderrapidash]

Hi, just had a question about residencies following vet school. I know it's a long way off, but I want to specialize in a surgical field (obviously could change) and want to know about all of my potential options. I know large/small/food animal surgery are all surgically focused obviously, but are there any other specialties where surgical procedures are common? An example I didn't realize was neurology- I didn't know it also entailed surgery on the brain, spinal cord and CNS. Would other specialties like ECC, cardiology etc. have surgical components at all? Sorry for the broad question, just exploring potential options for later on if I still want to specialize. Thanks in advance!

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[genny]

Hi, just had a question about residencies following vet school. I know it's a long way off, but I want to specialize in a surgical field (obviously could change) and want to know about all of my potential options. I know large/small/food animal surgery are all surgically focused obviously, but are there any other specialties where surgical procedures are common? An example I didn't realize was neurology- I didn't know it also entailed surgery on the brain, spinal cord and CNS. Would other specialties like ECC, cardiology etc. have surgical components at all? Sorry for the broad question, just exploring potential options for later on if I still want to specialize. Thanks in advance!

Cardio has one of the coolest surgeries ever - fixing a PDA!

Ophtho has a lot of surgeries.

Dentistry is a type of surgery in my opinion.

 

[genny]

Emergency may or may not do surgery, depending on whether the hospital you end up with has surgeons on staff or if they expect their emergency docs to cut their own GDVs.

 

[fdvet]

Emergency may or may not do surgery, depending on whether the hospital you end up with has surgeons on staff or if they expect their emergency docs to cut their own GDVs.

I'm just curious...why do people specialize in ECC when you can work as an emergency vet without specializing?

 

[genny]

I'm just curious...why do people specialize in ECC when you can work as an emergency vet without specializing?

why specialize in anything when you can be a GP and do it all?
you're asking the wrong person lol

I'd assume that people who specialize in ECC have some desire to be leaders in their field, and not just work as an emergency vet.
maybe @cdo96 could answer better than i can? if she's still around?

 

[katiemcat]

My current love affair is oncology but that changes daily and I probably won’t even specialize lol. I love everything too much.

 

[SocialStigma]

As others have mentioned, neuro, cardio, dentistry, and ophtho would perform surgeries relevant to their specialty. Criticalists would not perform surgery - they tend to manage the sickest patients in ICU only.

 

[that redhead]

why specialize in anything when you can be a GP and do it all?
you're asking the wrong person lol

I'd assume that people who specialize in ECC have some desire to be leaders in their field, and not just work as an emergency vet.
maybe @cdo96 could answer better than i can? if she's still around?

I think a big part of specializing in ECC is the “critical care” aspect - you can be a badass ER vet and stabilize or even fix some super sickies but a lot of ER isn’t necessarily critical care. It can be for sure, but it can also be GI upset, acute but not critical injuries, etc.

Critical care is more than just that emergency presentation, it’s managing those very sick cases past just surviving the initial catastrophe.

 

[cdo96]

full transparency, I’m a very very tired ECC resident, so any signs of aggression should be taken with a grain of salt.

I'm just curious...why do people specialize in ECC when you can work as an emergency vet without specializing?

why specialize in anything when you can be a GP and do it all?
you're asking the wrong person lol

I'd assume that people who specialize in ECC have some desire to be leaders in their field, and not just work as an emergency vet.
maybe @cdo96 could answer better than i can? if she's still around?

I think a big part of specializing in ECC is the “critical care” aspect - you can be a badass ER vet and stabilize or even fix some super sickies but a lot of ER isn’t necessarily critical care. It can be for sure, but it can also be GI upset, acute but not critical injuries, etc.

Critical care is more than just that emergency presentation, it’s managing those very sick cases past just surviving the initial catastrophe.

Trh said it best, in that the emergency aspect isn’t the fun part, isn’t the reason why we stay in the field (typically).

A criticalist is a jack of all trades, who needs advanced training in every single specialty. Not kidding, part of my boards are explaining the specifics for how you would temporary pacemaker an animal, or do a GDV repair, dystocias, paracentesis (needles in eyeballs for glaucoma). I could go on and on.

The criticalists at my internship hospital cut everything emergent with the exception of most chests and a back. It saves lives- and I’ve seen a dog live after traumatic hemoabdomen that got taken to immediate celiotomy that would’ve died in the time it takes the surgeon to get in to the hospital.

ECC is more than ER receiving and cutting- sure, we have a ton of ER receiving, but when I’m in the ICU, the only cases I see off the er floor are cases that will die in the hour of presentation without critical care. ECC is ventilators, is vasopressors. It’s managing anesthesia on an unstable septic abdomen surgery, who’s needing buckets and buckets of blood products to stay alive. It’s dialysis and charcoal hemodiaperfusion and all the other extracorporeal therapies.

Few DACVECCs want to be sole, primary ER doctors- the money just doesn’t add up. But there’s so much more to being an ER doctor than just cutting.

 

[sph417]

Surgery assistant here!

I’ve worked in so many specialities as a surgery assistant and all have aspects of surgery but obviously more then others. The obvious one is small animal soft tissue and orthopedic surgery - being a board certified surgeron. There you’ll have the most involvement with surgery.

The neurologists I have worked with are also neurosurgeons performing brain surgery’s to hemis to v slot. It’s a great blend of primary care but also the surgery aspect. Although there are plenty neurologists who don’t cut but some are just not interested! For ECC it depends. The ECC department at my hospital have a lot of the ER doctors and residents doing tons of wound closures or any smaller procedures. Additionally we even have our criticalist and one of the ER doctors cut for on call surgical procedures (the basics - such as foreign bodies or splenectomy’s). In my experience they won’t cut anything usually other than those type of procedures.

Dentistry has loads of surgery as well. I worked as a dental surgery assistant for a year and saw root canals and even insane jaw fracture cases. Optho also has loads of surgery involvement. Internal medicine although I guess not considered typical surgery have awesome procedures such as colonoscopy, endoscopy’s, rhinoscopys, foreign body retrievals, etc.

I think most GPs obviously have the general soft tissue procedures such as spays/neuters, wound closures and mass removals.

I think if you want full on surgery then small animal/large animal/equine surgery is the way to go. But if your looking for like a 50/50 Optho, Dent, Imed and Neuro I feel like are awesome specialties to get a blend of both.

It’s all about how much you want.

 

[battie]

Oncology has sub specialties: med, once, rad onc, and onc surg. There are boarded oncology surgeons. They just aren't super common I don't think.

 

[supershorty]

Oncology has sub specialties: med, once, rad onc, and onc surg. There are boarded oncology surgeons. They just aren't super common I don't think.

There aren’t very many surg onc fellowships at the moment, which is why. One of my thesis committee members is one. I’m very much intending to pursue one eventually

The ones I do know of require a surgery residency. I’ve been getting emails recently about surg onc internships though, which is cool and exciting.

 

[Trilt]

The criticalists at my internship hospital cut everything emergent with the exception of most chests and a back. It saves lives- and I’ve seen a dog live after traumatic hemoabdomen that got taken to immediate celiotomy that would’ve died in the time it takes the surgeon to get in to the hospital.

On the other hand, my hospital's criticalist probably hasn't been in an animal's abdomen for a decade. I think the only other vet in the hospital would have to, like, pass out or die mid-procedure before he'd be doing surgery haha.

He's fabulous for a joint tap, trach wash, and allllll sorts of tube placements, etc though.

 

[TheGirlWithTheFernTattoo]

Specialties that do surgery that I’m aware of:

Surgery (obvs), neurology (though I think there are medical only residencies out there), ophthalmology, therio (at my institution the plan is for therio to handle all the c-sections), interventional radiology (sort of, anyway. This can be surgery/ECC/internal medicine), +/- ECC.

ECC is hit or miss, I would say the majority of criticalists I know do not cut. I would love to cut, but there were very limited residencies that offered that. I think 1.5/5 places I ranked have cutting as part of the program.

In regards to ECC vs ER, I agree above with the comment on critical care being the reason to specialize. For me it is because I want to do dialysis/TPE and manage vent cases, which is not really feasible as a non-specialist. I like ER and would be perfectly content as an ER doctor, though. Financially you would really be better off doing ER (after factoring in lost income from residency years), at least in the current job climate lol.

 

[genny]

Specialties that do surgery that I’m aware of:

Surgery (obvs), neurology (though I think there are medical only residencies out there), ophthalmology, therio (at my institution the plan is for therio to handle all the c-sections), interventional radiology (sort of, anyway. This can be surgery/ECC/internal medicine), +/- ECC.

ECC is hit or miss, I would say the majority of criticalists I know do not cut. I would love to cut, but there were very limited residencies that offered that. I think 1.5/5 places I ranked have cutting as part of the program.

In regards to ECC vs ER, I agree above with the comment on critical care being the reason to specialize. For me it is because I want to do dialysis/TPE and manage vent cases, which is not really feasible as a non-specialist. I like ER and would be perfectly content as an ER doctor, though. Financially you would really be better off doing ER (after factoring in lost income from residency years), at least in the current job climate lol.

I always forget about therio. Too much effort put into stopping the babies.

 

[Crocodial]

No one has mentioned shelter medicine yet. I'm sure someone else can talk about this more and it's maybe not as lucrative as other specialties BUT they definitely have surgical opportunities (beyond spay/neuter/mass removal). At least worth looking into working with a shelter vet eventually to practice surgical skills. I know a current shelter vet that coaches GP doctors on their surgical techniques.

 

[SportPonies]

No one has mentioned shelter medicine yet. I'm sure someone else can talk about this more and it's maybe not as lucrative as other specialties BUT they definitely have surgical opportunities (beyond spay/neuter/mass removal). At least worth looking into working with a shelter vet eventually to practice surgical skills. I know a current shelter vet that coaches GP doctors on their surgical techniques.

@vetmedhead

 

[finnickthedog]

I always forget about therio.

Clearly I haven't been around enough if you can forget about therio

 

[vetmedhead]

Clearly I haven't been around enough if you can forget about therio

omg I keep joking about how I'm the anti-thereogenologist and now the number of times I've had to actually remember therio is way too high.

I still consider it a success that the only C-section I've ever done was accidental though! And the cat was still spayed when I was done

 

[vetmedhead]

No one has mentioned shelter medicine yet. I'm sure someone else can talk about this more and it's maybe not as lucrative as other specialties BUT they definitely have surgical opportunities (beyond spay/neuter/mass removal). At least worth looking into working with a shelter vet eventually to practice surgical skills. I know a current shelter vet that coaches GP doctors on their surgical techniques.

Oh yeah, I'm in shelter med and the number of surgery junkies in this field is bottomless. There's obviously lots of HQHVSN (which can be fun in its own way), but absolutely tons of opportunities to do as many procedures as you're comfortable with (and have practiced enough to ethically do). I'd say amputations, enucleations, mass removals, fracture repairs, cystotomies, dentals, entropion surgery, wound management, +/- most GI/abdominal surgeries are fairly common depending on facility resources. I have several colleagues who also routinely do airway surgery, PUs, scrotal urethrostomies, and even TECA-BOs. There's quite a bit of CE and considerable personal time that went into those skillsets, obviously, but many folks are at places where tons of referral surgeries are a bit out of the question, but they're readily addressable problems and expensive enough to ask an adopter to do that they would present significant barriers to adoption, so lots of folks do what they can.

Pretty much the only part of the body nobody routinely gets into is the thorax, and that's because it's bad juju in there. And even with that being said, hell, I've scrubbed in on massive diaphragmatic hernia repairs. And I ****ing hate surgery 💀

(and honestly, if you do TNR long enough, you'll do a few of your own. with all of those community cats with unknown histories, you're bound to run into incidental diaphragmatic hernias in the middle of spays eventually, which is a blast because you basically open their abdomen and they immediately lose negative pressure in their thorax and start to die and you're just like 😬🥲)

The other bonus of being a surgery junkie in shelter med is somebody always wants you at their shelter. Especially when you get nerds like me who would happily let you take every single surgery in the facility and I can take extremely tedious medical stuff off your hands.

 

[finnickthedog]

omg I keep joking about how I'm the anti-thereogenologist and now the number of times I've had to actually remember therio is way too high.

I still consider it a success that the only C-section I've ever done was accidental though! And the cat was still spayed when I was done

I do think of you every time I have to spay during a c-section (which actually has only been 3 times) because I find it so challenging and I just imagine you'd breeze through it.

 

[vetmedhead]

Re: being lucrative, definitely true the pay is lower in shelter, especially when factoring in things like production on top of base salary. That being said, I tell everyone going into a shelter to not take less than six figures (even if a new grad), and you also qualify for PSLF at every 501(c)3 or government organization, which is like 99% of all jobs in shelter med lol

 

[vetmedhead]

I do think of you every time I have to spay during a c-section (which actually has only been 3 times) because I find it so challenging and I just imagine you'd breeze through it.

it's so much easier 🥲 I don't even remember how to do a C-section that's not an en bloc removal of the uterus lmao

 

[finnickthedog]

it's so much easier 🥲 I don't even remember how to do a C-section that's not an en bloc removal of the uterus lmao

Meanwhile I can do a normal c-section real fast but then ask me to spay it I'm like "Why is this uterus so big? It's in my way? Can somebody just hold it for me? I need some bigger clamps!"

Next time I have one, can you just magically teleport in and finish it for me?

 

[vetmedhead]

Meanwhile I can do a normal c-section real fast but then ask me to spay it I'm like "Why is this uterus so big? It's in my way? Can somebody just hold it for me? I need some bigger clamps!"

Next time I have one, can you just magically teleport in and finish it for me?

Would love to!

I like when it's all big because then nobody judges me for using hella suture and it's easy to see all the bits that usually make me grumpy

 

[fromthebox]

There aren’t very many surg onc fellowships at the moment, which is why. One of my thesis committee members is one. I’m very much intending to pursue one eventually

The ones I do know of require a surgery residency. I’ve been getting emails recently about surg onc internships though, which is cool and exciting.

Surg Onc internships are still intended to lead to a general surgery residency. The Surg onc fellowship is a subspecialty of ACVS. The other two small animal ones are Minimally invasive and Joint replacement. All require you to be DACVS first.