Do you have to have steady hands to become a surgeon?

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auburnO5

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Just something I've always wondered.

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Just something I've always wondered.

This has been discussed on SDN a lot.

What do you mean by "steady"? Do you mean exceptional hand-eye coordination - no, that's not necessary. Do you mean an absence of an essential tremor - yeah, that'd be helpful.
 
Just something I've always wondered.

Depends on what you mean by steady hands? If you're a total klutz with your hands, surgery would be tough for you. If your hands shake when you're nervous, your first couple of years in surgery training will probably be tough: consider beta blockers for yourself pre-op. But eventually you'll stop being so nervous, so it could work. If you're average like most people, you'll be fine in general surgery. There are plenty of opportunities to steady your hands by placing your wrists/arms against the body wall or whatever. Things like vascular surgery where you're suturing up carotid arteries, might be more difficult. Although I remember one older chief of vascular surgery who had developed quite a bad resting tremor, but he was still excellent in the OR and the guy people trusted with the complicated cases.
 
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Depends on what you mean by steady hands? If you're a total klutz with your hands, surgery would be tough for you. If your hands shake when you're nervous, your first couple of years in surgery training will probably be tough: consider beta blockers for yourself pre-op. But eventually you'll stop being so nervous, so it could work. If you're average like most people, you'll be fine in general surgery. There are plenty of opportunities to steady your hands by placing your wrists/arms against the body wall or whatever. Things like vascular surgery where you're suturing up carotid arteries, might be more difficult. Although I remember one older chief of vascular surgery who had developed quite a bad resting tremor, but he was still excellent in the OR and the guy people trusted with the complicated cases.

Thanks for your answer. :thumbup:
 
Technical mastery is a source of pride/arrogance in the surgical world. As an example, here is an actual evaluation form for residency.

M O T O R S K I L L S​
0 Not observed
1 Inept
2 Technically poor, but manages.
3 Average capability.
4 “Good Hands.” Rapid and precise.
5 Potential to be a surgeon.​

Apparently, being "rapid and precise" does not even grant you the "potential" to be surgeon! :eek:
Perhaps infinitely fast and unerring, bordering on the divine, would be good enough. :rolleyes:
 
I read it or heard it somewhere - may have been on SDN - that 99 percent of people (med students) have more than enough innate ability, dexterity, etc, to become a surgeon.
 
Steady hands? Yes...patience, dedication, and commitment? No, haha!
 
I sew for fun. It's helped steady my hands, become more dextrous, etc so far.
 
I'm reading the book complications atm, and the author said that its never really looked at and doesn't reall matter. Although I guess if you have serious problems.. then.. you know.
 
I'm reading the book complications atm, and the author said that its never really looked at and doesn't reall matter. Although I guess if you have serious problems.. then.. you know.


awesome book btw:thumbup:
 
"The surgeon as a skilled artist and craftsman
Surgery, like karate, can represent "one of the highest expressions of the skilled use of the human body"(25). The surgeon must possess the virtuoso and intuitive ability of a concert pianist. He must command mastery over his fingers, and perform surgery with the finesse of a maestro. His eyes probe the surgical wound searching for and avoiding signs of danger, while his fingers polish and sculpt the tissues like a master craftsman. The patient’s life is literally in his hands.
Surgical performance can be measured on the Likert rating scale which contains 17 items to be graded by tutors, or with methods and instruments proposed by Kopta(26) and Spencer(27). In an analysis of operative skills, it was found that academic predictors did not correlate or correlated negatively with operative ratings(28). Conversely, neuro-psychologic test scores of non-verbal cognitive and psychomotor abilities showed a significant positive correlation with the ratings. These neuropsychologic tests provide measurements of relatively innate, non-verbal abilities including visual-spatial perception, motor sequencing and fine motor co-ordination, and stress tolerance." -- Soh, K B K, Singapore Medical Journal, Job Analysis, Appraisal and Performance Assessments of a Surgeon - A Multifaceted Approach:
http://www.sma.org.sg/smj/3904/articles/3904ra1.html
 
i have hyperhydrosis (sweaty palms)... i don't think so
 
if you have a nervous twitch in your hand or arm, please avoid being a surgeon.
 
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"The surgeon as a skilled artist and craftsman
Surgery, like karate, can represent "one of the highest expressions of the skilled use of the human body"(25). The surgeon must possess the virtuoso and intuitive ability of a concert pianist. He must command mastery over his fingers, and perform surgery with the finesse of a maestro. His eyes probe the surgical wound searching for and avoiding signs of danger, while his fingers polish and sculpt the tissues like a master craftsman. The patient’s life is literally in his hands.
Surgical performance can be measured on the Likert rating scale which contains 17 items to be graded by tutors, or with methods and instruments proposed by Kopta(26) and Spencer(27). In an analysis of operative skills, it was found that academic predictors did not correlate or correlated negatively with operative ratings(28). Conversely, neuro-psychologic test scores of non-verbal cognitive and psychomotor abilities showed a significant positive correlation with the ratings. These neuropsychologic tests provide measurements of relatively innate, non-verbal abilities including visual-spatial perception, motor sequencing and fine motor co-ordination, and stress tolerance." -- Soh, K B K, Singapore Medical Journal, Job Analysis, Appraisal and Performance Assessments of a Surgeon - A Multifaceted Approach:
http://www.sma.org.sg/smj/3904/articles/3904ra1.html
<------ Gags....
 
"The surgeon as a skilled artist and craftsman
Surgery, like karate, can represent "one of the highest expressions of the skilled use of the human body"(25). The surgeon must possess the virtuoso and intuitive ability of a concert pianist. He must command mastery over his fingers, and perform surgery with the finesse of a maestro. His eyes probe the surgical wound searching for and avoiding signs of danger, while his fingers polish and sculpt the tissues like a master craftsman. The patient’s life is literally in his hands.
Surgical performance can be measured on the Likert rating scale which contains 17 items to be graded by tutors, or with methods and instruments proposed by Kopta(26) and Spencer(27). In an analysis of operative skills, it was found that academic predictors did not correlate or correlated negatively with operative ratings(28). Conversely, neuro-psychologic test scores of non-verbal cognitive and psychomotor abilities showed a significant positive correlation with the ratings. These neuropsychologic tests provide measurements of relatively innate, non-verbal abilities including visual-spatial perception, motor sequencing and fine motor co-ordination, and stress tolerance." -- Soh, K B K, Singapore Medical Journal, Job Analysis, Appraisal and Performance Assessments of a Surgeon - A Multifaceted Approach:
http://www.sma.org.sg/smj/3904/articles/3904ra1.html

To the best of my knowledge, this is not tested in the US - there is no such screening pre residency, other than some incompetency that would show up in an MS3/4 rotation that would serve to discourage someone from pursuing surgery.

Frankly, it sounds like a lot of BS.
 
To the best of my knowledge, this is not tested in the US - there is no such screening pre residency, other than some incompetency that would show up in an MS3/4 rotation that would serve to discourage someone from pursuing surgery.

Frankly, it sounds like a lot of BS.

That's what I thought.
 
Not to steal this thread, but I read somewhere that if your left handed it might be hard to be a surgeon since the tools are made for "rightys". Any truth to this?
 
awesome book btw:thumbup:

Please, let us not blow up Atul Gawande on SDN. the literary world already does, not for his writing abilities but for the fact that he is a Harvard trained surgeon. He's publishing a new book every 6 months now? As a general rule, it is impossible to publish anything of quality that took only 6 months to produce.

At least he's not Dr. Oz though.
 
Not to steal this thread, but I read somewhere that if your left handed it might be hard to be a surgeon since the tools are made for "rightys". Any truth to this?

Good question, I'm a lefty too and never really thought of this.
 
i'm taking advanced sewing courses right now. these hands were made to suture.
 
In regards to left handed surgeons: http://www.bmj.com/cgi/content/full/330/7481/10-f

Please, let us not blow up Atul Gawande on SDN. the literary world already does, not for his writing abilities but for the fact that he is a Harvard trained surgeon. He's publishing a new book every 6 months now? As a general rule, it is impossible to publish anything of quality that took only 6 months to produce.

At least he's not Dr. Oz though.
Unless I'm missing something, 3 books in 7 years is not a book every 6 months. Is there something in particular that you don't like about the guy?
 
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I think the more important thing is to be coordinated on the gross level. I, for example, am a klutz. If it is there, I will likely trip over it. One would think this could be a problem in surgery. Granted, I can control it if I am trying hard enough... I did work in a wet lab with small glass stuff for three years and didn't break TOO many test tubes, but it is exhausting for me if I'm trying not to trip and drop something important. I don't think I would want to deal with that every day for the rest of my life where the consequence could be far worse than the loss of my time(lab), and is instead the loss of someone's life(surgery).
 
I think the more important thing is to be coordinated on the gross level. I, for example, am a klutz. If it is there, I will likely trip over it. One would think this could be a problem in surgery. Granted, I can control it if I am trying hard enough... I did work in a wet lab with small glass stuff for three years and didn't break TOO many test tubes, but it is exhausting for me if I'm trying not to trip and drop something important. I don't think I would want to deal with that every day for the rest of my life where the consequence could be far worse than the loss of my time(lab), and is instead the loss of someone's life(surgery).

In my lab I am always dropping and contaminating things. If I were to become a surgeon I am sure throughout my career I will make a stupid mistake at least once. Throughout a 35 year career a surgeon probably performs 5 or 6 thousand surgeries. So thats 5 or 6 thousand times I will be moving a sharp instrument over an open body. Its bound to slip at least once.
 
That's what insurance is for.
 
[YOUTUBE]http://www.youtube.com/watch?v=mSt1m4NFUl8[/YOUTUBE]
 
Bad humors of the brain :D
 
my hands tremor when i try to do something w/ precision.. i talk to a doctor abt it and he said its not permanent.. the tremor is reducing since im exercising the muscles in the wrist and hand according to this advice..

but im not doing this cuz i wanna be a surgeon.. im just putting this out there to let u guyz w/ shaky hand knowthat its not permanent
 
Please, let us not blow up Atul Gawande on SDN. the literary world already does, not for his writing abilities but for the fact that he is a Harvard trained surgeon. He's publishing a new book every 6 months now? As a general rule, it is impossible to publish anything of quality that took only 6 months to produce.

At least he's not Dr. Oz though.

Wow...you make it seem like he "H-bombed" his way to success.
 
In regards to left handed surgeons: http://www.bmj.com/cgi/content/full/330/7481/10-f


Unless I'm missing something, 3 books in 7 years is not a book every 6 months. Is there something in particular that you don't like about the guy?

let's just say he does not practice what he preaches. There are much much better books out there written by doctors who can write better and have more interesting things to say. But to each his own when it comes to books....
 
Some of these replies are unnerving.

I'm wondering how many of you have had serious surgery that actually required a lot of concentration and intense focus and attention to detail. . .or if you have had a child that needed this kind of person operating on him or her?

You don't know how serious and big of a deal it is until you need one, and you learn as a recovery nurse to trust the hands of certain surgeons over others--b/c you are the one recovering them. While there are many factors that can lead to problems and complications, I have learned how some surgeons trend in the OR and what that translates to for the patients. That's why I don't necessarily care if the surgeon operating on my loved one or me has the personality of an SOB, though it does add to unnecessary stress, etc. Mostly I want someone with the smarts, coordination, talent, overall surgical aptitude and skill--ESPECIALLY for a say my baby or child. On a baby, there is no room for sloppiness or heavy-handedness.

And truthfully, a lot of surgeons are pretty anal-retentive--highly fastidious. There's a reason for that too.

I have watched surgical residents and fellows have a very rough time of it in residency and fellowship. I get it, and that's why I cut them some slack when they are short tempered at times--to a point mind you. No one gets a free pass at being a total jack azz all the time--even if you have been run ragged and are so worn out you can barely see straight.

The truth is, not every can do it and do it exceedingly well, and in fact NOT everyone should do it. I don't pretend to think I possess the overall skill and talent and acumen needed for this. And I have one friend in particular who figured that very thing out during his residency. He switched to anesthesiology, and is doing quite well there and is very happy. It's not for everyone.
 
Some of these replies are unnerving.

I'm wondering how many of you have had serious surgery that actually required a lot of concentration and intense focus and attention to detail. . .or if you have had a child that needed this kind of person operating on him or her?

You don't know how serious and big of a deal it is until you need one, and you learn as a recovery nurse to trust the hands of certain surgeons over others--b/c you are the one recovering them. While there are many factors that can lead to problems and complications, I have learned how some surgeons trend in the OR and what that translates to for the patients. That's why I don't necessarily care if the surgeon operating on my loved one or me has the personality of an SOB, though it does add to unnecessary stress, etc. Mostly I want someone with the smarts, coordination, talent, overall surgical aptitude and skill--ESPECIALLY for a say my baby or child. On a baby, there is no room for sloppiness or heavy-handedness.

And truthfully, a lot of surgeons are pretty anal-retentive--highly fastidious. There's a reason for that too.

I have watched surgical residents and fellows have a very rough time of it in residency and fellowship. I get it, and that's why I cut them some slack when they are short tempered at times--to a point mind you. No one gets a free pass at being a total jack azz all the time--even if you have been run ragged and are so worn out you can barely see straight.

The truth is, not every can do it and do it exceedingly well, and in fact NOT everyone should do it. I don't pretend to think I possess the overall skill and talent and acumen needed for this. And I have one friend in particular who figured that very thing out during his residency. He switched to anesthesiology, and is doing quite well there and is very happy. It's not for everyone.
There is a minute fraction of peds surgery fellowships available relative to the general surgery pool, so they always get to pick the best.
 
And truthfully, a lot of surgeons are pretty anal-retentive--highly fastidious. There's a reason for that too.

I have watched surgical residents and fellows have a very rough time of it in residency and fellowship. I get it, and that's why I cut them some slack when they are short tempered at times--to a point mind you. No one gets a free pass at being a total jack azz all the time--even if you have been run ragged and are so worn out you can barely see straight.

always exciting to see a nurse showing some balls...:thumbup:
 
Depends. I watched a deep brain stimulation surgery done by functional neurosurgeon. There it was more about putting together a little device that you then turn a crank on to make it go in. No steady hands needed! Just a ton of little steps in putting together the device and making it go down.
 
my hands tremor when i try to do something w/ precision.. i talk to a doctor abt it and he said its not permanent.. the tremor is reducing since im exercising the muscles in the wrist and hand according to this advice..

Well I can't comment on your specific situation...but everyone has a physiologic tremor. This is not something that will go away if that is what is going on. It is worsened by stress, exhaustion, dehydration, caffeine intake (all things you are commonly exposed to in your medical training)
 
You don't know how serious and big of a deal it is until you need one, and you learn as a recovery nurse to trust the hands of certain surgeons over others--b/c you are the one recovering them. While there are many factors that can lead to problems and complications, I have learned how some surgeons trend in the OR and what that translates to for the patients. That's why I don't necessarily care if the surgeon operating on my loved one or me has the personality of an SOB, though it does add to unnecessary stress, etc. Mostly I want someone with the smarts, coordination, talent, overall surgical aptitude and skill--ESPECIALLY for a say my baby or child. On a baby, there is no room for sloppiness or heavy-handedness.

I think you are partially right, partially wrong. There are most definitely some surgeons I trust over others - ones I would go to if I needed help and ones I wouldn't let near my loved ones.

Where I think you are wrong? It's not their HANDS I trust or distrust. It's their heads.

The surgeons I trust are the ones with excellent operative judgment. They are the ones who avoid problems/complications - but it's not through some miraculous concept of "good hands", rather it is from knowing what to do and what not to do, having patience and fastidiousness as you mention, and keeping a cool-head when things do go wrong.
 
I think you are partially right, partially wrong. There are most definitely some surgeons I trust over others - ones I would go to if I needed help and ones I wouldn't let near my loved ones.

Where I think you are wrong? It's not their HANDS I trust or distrust. It's their heads.

The surgeons I trust are the ones with excellent operative judgment. They are the ones who avoid problems/complications - but it's not through some miraculous concept of "good hands", rather it is from knowing what to do and what not to do, having patience and fastidiousness as you mention, and keeping a cool-head when things do go wrong.

:thumbup:
 
It is all related. A technically proficient surgeon doesn't need to focus on their ability, it just happens. It's like the difference between when you were learning to drive a car and 5+ year later. Because you don't have to focus on that part you can then devote your attention to predicting and avoiding complications. You also avoid frustration if you are technically proficient which can lead to poor judgement.

Check-out Outliers by Gladwell and his theroy of 10,000 hours.
 
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also, check out How Doctors Think.

Great read and shows you there is a lot more to surgery than the hands
 
I think you are partially right, partially wrong. There are most definitely some surgeons I trust over others - ones I would go to if I needed help and ones I wouldn't let near my loved ones.

Where I think you are wrong? It's not their HANDS I trust or distrust. It's their heads.

The surgeons I trust are the ones with excellent operative judgment. They are the ones who avoid problems/complications - but it's not through some miraculous concept of "good hands", rather it is from knowing what to do and what not to do, having patience and fastidiousness as you mention, and keeping a cool-head when things do go wrong.



Sound clinical judgment is a given in all areas of medicine. I think there are special demands made on the surgeon--it's just par. Last I checked, lol, the hands were controlled by the head-->brain and NS.

I will say when my electrolytes are off I find I have more of a tremor on the right. I had a brain injury as a child, and since that time I notice it from time to time. But I think being overly tired, improper nourishment and dehydration--all of these have made it worse. Proper nutrition and rest seems to help it the most; but it is rare.
 
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