I hate procedures

[zegrated]

About halfway through MS3, and I've realized that I cannot stand procedures. I dread suturing, knot tying, intubating, performing biopsies, placing IV/art lines, etc. I much prefer the thinking and puzzle solving aspects of medicine so my motivation to learn and master these skills has been low to say the least. In addition I am terrified of messing up and humiliating myself and/or hurting the patient. For example, just had an anesthesiology elective rotation where my preceptor gave me multiple opportunities to intubate and I could not visualize the cords even once. I've watched knot tying videos hundreds of times over and I still screw up when trying myself. To make matters worse, we had suturing workshops and I noticed I have a slight tremor which makes fine movements incredibly frustrating - and it is not due to nerves, I have it whenever I try to hold my hand completely still. I was always the slowest of my classmates and had the ugliest looking closures during these workshops.

All of these experiences have discouraged me from entering any procedure intense field. I feel like so many of my classmates are like "omg yay procedurezzz" while I'd rather be doing anything else. I've even gone so far as to narrow down my specialty list to internal medicine (hospitalists don't do many procedures) and radiology (diagnostic of course).

I guess this post was mostly to vent, but does anyone else feel the same way I do? Or does anyone have any stories about hating procedures at first but then ending up in a more procedurally based specialty? Am I really off base eliminating many specialties off my list because of this? I know they get easier over time, but even if I were more competent I still think I'd prefer to sit back with a cup of coffee and chart on patients or browse uptodate articles. ¯\_(ツ)_/¯

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[DrBowtie]

About halfway through MS3, and I've realized that I cannot stand procedures. I dread suturing, knot tying, intubating, performing biopsies, placing IV/art lines, etc. I much prefer the thinking and puzzle solving aspects of medicine so my motivation to learn and master these skills has been low to say the least. In addition I am terrified of messing up and humiliating myself and/or hurting the patient. For example, just had an anesthesiology elective rotation where my preceptor gave me multiple opportunities to intubate and I could not visualize the cords even once. I've watched knot tying videos hundreds of times over and I still screw up when trying myself. To make matters worse, we had suturing workshops and I noticed I have a slight tremor which makes fine movements incredibly frustrating - and it is not due to nerves, I have it whenever I try to hold my hand completely still. I was always the slowest of my classmates and had the ugliest looking closures during these workshops.

All of these experiences have discouraged me from entering any procedure intense field. I feel like so many of my classmates are like "omg yay procedurezzz" while I'd rather be doing anything else. I've even gone so far as to narrow down my specialty list to internal medicine (hospitalists don't do many procedures) and radiology (diagnostic of course).

I guess this post was mostly to vent, but does anyone else feel the same way I do? Or does anyone have any stories about hating procedures at first but then ending up in a more procedurally based specialty? Am I really off base eliminating many specialties off my list because of this? I know they get easier over time, but even if I were more competent I still think I'd prefer to sit back with a cup of coffee and chart on patients or browse uptodate articles. ¯\_(ツ)_/¯

You're going to struggle getting through a diagnostic radiology residency hating procedures. The majority of non vascular interventional procedures are done by diagnostic radiologists.

 

[dpmd]

Lots of us hate stuff we aren't good at. Most will get good enough with practice though. Some just take longer than others and only you can decide if it is worth the effort or not.

 

[zegrated]

You're going to struggle getting through a diagnostic radiology residency hating procedures. The majority of non vascular interventional procedures are done by diagnostic radiologists.

Interesting, did not know that, thanks for the heads up I really should do a little more research into what residency for each specialty really entails. However I do think I could grin and bear doing a residency with some procedures if that meant as an attending I would not have to do many (or any).

 

[Roberie]

Yeah, we do quite a few procedures in radiology.

 

[ProfMD]

It's ok to not like procedures. You can find a career where you won't do them.

However, it sounds like part of your reason for not liking procedures is lack of confidence. Confidence comes with practice.

 

[njtrimed]

Just an MS-1, but I thought hospitalists actually do a lot of procedures (?), based upon some interest group lectures. My understanding is that general internal medicine physicians and pediatricians in private practice in office-based settings do very few procedures, whereas almost any position in the hospital requires proficiency doing things ranging from lumbar punctures to intubations or central lines. I'm thinking that those far more experienced than either of us have it right: you just need practice. Maybe you'll choose a field that requires none of those skills, but honing them will only make you a better physician.

For what it's worth, one of the best (now attending) surgeons I know literally passed out in my OR over a decade ago, and swore she would never end up in surgery. I've heard similar stories from gastroenterologists and anesthesiologists I admire. Nothing wrong with choosing to avoid procedure-based fields, but don't count yourself out just yet. You may find that you're very good at something and want to do it...or not. This whole process is designed to push you past your comfort zone, so that you can choose a specialty without regretting what might have been.

 

[67552931811]

About halfway through MS3, and I've realized that I cannot stand procedures. I dread suturing, knot tying, intubating, performing biopsies, placing IV/art lines, etc. I much prefer the thinking and puzzle solving aspects of medicine so my motivation to learn and master these skills has been low to say the least. In addition I am terrified of messing up and humiliating myself and/or hurting the patient. For example, just had an anesthesiology elective rotation where my preceptor gave me multiple opportunities to intubate and I could not visualize the cords even once. I've watched knot tying videos hundreds of times over and I still screw up when trying myself. To make matters worse, we had suturing workshops and I noticed I have a slight tremor which makes fine movements incredibly frustrating - and it is not due to nerves, I have it whenever I try to hold my hand completely still. I was always the slowest of my classmates and had the ugliest looking closures during these workshops.

All of these experiences have discouraged me from entering any procedure intense field. I feel like so many of my classmates are like "omg yay procedurezzz" while I'd rather be doing anything else. I've even gone so far as to narrow down my specialty list to internal medicine (hospitalists don't do many procedures) and radiology (diagnostic of course).

I guess this post was mostly to vent, but does anyone else feel the same way I do? Or does anyone have any stories about hating procedures at first but then ending up in a more procedurally based specialty? Am I really off base eliminating many specialties off my list because of this? I know they get easier over time, but even if I were more competent I still think I'd prefer to sit back with a cup of coffee and chart on patients or browse uptodate articles. ¯\_(ツ)_/¯

Just do IM then primary care or endo, nephro, ID, etc etc. and call it a day.

 

[TooMuchResearch]

Just an MS-1, but I thought hospitalists actually do a lot of procedures (?), based upon some interest group lectures. My understanding is that general internal medicine physicians and pediatricians in private practice in office-based settings do very few procedures, whereas almost any position in the hospital requires proficiency doing things ranging from lumbar punctures to intubations or central lines. I'm thinking that those far more experienced than either of us have it right: you just need practice. Maybe you'll choose a field that requires none of those skills, but honing them will only make you a better physician.

For what it's worth, one of the best (now attending) surgeons I know literally passed out in my OR over a decade ago, and swore she would never end up in surgery. I've heard similar stories from gastroenterologists and anesthesiologists I admire. Nothing wrong with choosing to avoid procedure-based fields, but don't count yourself out just yet. You may find that you're very good at something and want to do it...or not. This whole process is designed to push you past your comfort zone, so that you can choose a specialty without regretting what might have been.

Depending on the practice setting, hospitalists may not do any of those things.

 

[sliceofbread136]

I agree. I'm in this to use my mind, not my hands. LP/intubations are fine because they are usually fairly fast, but suturing drives me up a wall.

 

[shoal007]

hospitalists at my community hospital don't do any procedures besides a rare code.

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[scootad.]

I was the same way in medical school. You get over it. Medical school isn't designed in such a way to truly master any particular procedural skills. When you decide on a specialty and become a resident/attending you will learn procedures better because you will be focused on learning a handful and repeating them hundreds of times, instead of a a handful of times then moving onto the next one like in med school, not to mention having to look over your shoulder at all times so as not to mess up to look good for a "honors."

I went into Rads and I now routinely perform biopsies, arthrograms, myelograms, lp, with no issues. And I was a MESS procedurally in med school.

You'll be fine.

 

[Mad Jack]

About halfway through MS3, and I've realized that I cannot stand procedures. I dread suturing, knot tying, intubating, performing biopsies, placing IV/art lines, etc. I much prefer the thinking and puzzle solving aspects of medicine so my motivation to learn and master these skills has been low to say the least. In addition I am terrified of messing up and humiliating myself and/or hurting the patient. For example, just had an anesthesiology elective rotation where my preceptor gave me multiple opportunities to intubate and I could not visualize the cords even once. I've watched knot tying videos hundreds of times over and I still screw up when trying myself. To make matters worse, we had suturing workshops and I noticed I have a slight tremor which makes fine movements incredibly frustrating - and it is not due to nerves, I have it whenever I try to hold my hand completely still. I was always the slowest of my classmates and had the ugliest looking closures during these workshops.

All of these experiences have discouraged me from entering any procedure intense field. I feel like so many of my classmates are like "omg yay procedurezzz" while I'd rather be doing anything else. I've even gone so far as to narrow down my specialty list to internal medicine (hospitalists don't do many procedures) and radiology (diagnostic of course).

I guess this post was mostly to vent, but does anyone else feel the same way I do? Or does anyone have any stories about hating procedures at first but then ending up in a more procedurally based specialty? Am I really off base eliminating many specialties off my list because of this? I know they get easier over time, but even if I were more competent I still think I'd prefer to sit back with a cup of coffee and chart on patients or browse uptodate articles. ¯\_(ツ)_/¯

DR does procedures at many places- lone insertions and the like under fluoro. IM you can get away with zero procedures at a lot of hospitals.

 

[Mad Jack]

Just an MS-1, but I thought hospitalists actually do a lot of procedures (?), based upon some interest group lectures. My understanding is that general internal medicine physicians and pediatricians in private practice in office-based settings do very few procedures, whereas almost any position in the hospital requires proficiency doing things ranging from lumbar punctures to intubations or central lines. I'm thinking that those far more experienced than either of us have it right: you just need practice. Maybe you'll choose a field that requires none of those skills, but honing them will only make you a better physician.

For what it's worth, one of the best (now attending) surgeons I know literally passed out in my OR over a decade ago, and swore she would never end up in surgery. I've heard similar stories from gastroenterologists and anesthesiologists I admire. Nothing wrong with choosing to avoid procedure-based fields, but don't count yourself out just yet. You may find that you're very good at something and want to do it...or not. This whole process is designed to push you past your comfort zone, so that you can choose a specialty without regretting what might have been.

Plenty of zero procedure hospitalist jobs out there. All depends on the hospital.

 

[Pixiwoman]

About halfway through MS3, and I've realized that I cannot stand procedures. I dread suturing, knot tying, intubating, performing biopsies, placing IV/art lines, etc. I much prefer the thinking and puzzle solving aspects of medicine so my motivation to learn and master these skills has been low to say the least. In addition I am terrified of messing up and humiliating myself and/or hurting the patient. For example, just had an anesthesiology elective rotation where my preceptor gave me multiple opportunities to intubate and I could not visualize the cords even once. I've watched knot tying videos hundreds of times over and I still screw up when trying myself. To make matters worse, we had suturing workshops and I noticed I have a slight tremor which makes fine movements incredibly frustrating - and it is not due to nerves, I have it whenever I try to hold my hand completely still. I was always the slowest of my classmates and had the ugliest looking closures during these workshops.

All of these experiences have discouraged me from entering any procedure intense field. I feel like so many of my classmates are like "omg yay procedurezzz" while I'd rather be doing anything else. I've even gone so far as to narrow down my specialty list to internal medicine (hospitalists don't do many procedures) and radiology (diagnostic of course).

I guess this post was mostly to vent, but does anyone else feel the same way I do? Or does anyone have any stories about hating procedures at first but then ending up in a more procedurally based specialty? Am I really off base eliminating many specialties off my list because of this? I know they get easier over time, but even if I were more competent I still think I'd prefer to sit back with a cup of coffee and chart on patients or browse uptodate articles. ¯\_(ツ)_/¯

I am with you.
I have hated all procedures in medicine since day one in med school when were allowed to do sutures, in residency I avoided most intubations and central lines placements as I could, you can pick a specialty where procedures are almost null like endocrine, Rheum, etc....

 

[Barrel Proof]

Have you considered Rad Onc?

 

[NWwildcat2013]

About halfway through MS3, and I've realized that I cannot stand procedures. I dread suturing, knot tying, intubating, performing biopsies, placing IV/art lines, etc. I much prefer the thinking and puzzle solving aspects of medicine so my motivation to learn and master these skills has been low to say the least. In addition I am terrified of messing up and humiliating myself and/or hurting the patient. For example, just had an anesthesiology elective rotation where my preceptor gave me multiple opportunities to intubate and I could not visualize the cords even once. I've watched knot tying videos hundreds of times over and I still screw up when trying myself. To make matters worse, we had suturing workshops and I noticed I have a slight tremor which makes fine movements incredibly frustrating - and it is not due to nerves, I have it whenever I try to hold my hand completely still. I was always the slowest of my classmates and had the ugliest looking closures during these workshops.

All of these experiences have discouraged me from entering any procedure intense field. I feel like so many of my classmates are like "omg yay procedurezzz" while I'd rather be doing anything else. I've even gone so far as to narrow down my specialty list to internal medicine (hospitalists don't do many procedures) and radiology (diagnostic of course).

I guess this post was mostly to vent, but does anyone else feel the same way I do? Or does anyone have any stories about hating procedures at first but then ending up in a more procedurally based specialty? Am I really off base eliminating many specialties off my list because of this? I know they get easier over time, but even if I were more competent I still think I'd prefer to sit back with a cup of coffee and chart on patients or browse uptodate articles. ¯\_(ツ)_/¯

I feel you. Your people are out there in your class but hard to find because it is socially awkward to state you hate procedures. Trust me... it doesn't go over well with classmates who like to talk about that one time they intubated or used the Bovie. I have a physical aversion to doing anything procedural and its just gotten worse as med school goes on.

I too would rather do a more hands off specialty. So far the specialty I have loved the most has been neuro and it sounds like you should strongly consider it. Surprised it hasn't been mentioned before in this thread. The only procedure they do is an LP (EMGs too but those are more just tests than an invasive procedure) and even LPs are often done by anesthesia or rads.

I noticed you didn't mention neuro in your post despite it being like IM but even less procedures. Do you not have a neuro rotation in MS3 or have you already ruled it out?

 

[DocWinter]

You don't need to like procedures. Just go into IM and sub specialize if you want to. Lots of people excel in that "brainy" aspect like you enjoy, no need to try and fit in a box you don't. Go IM and don't look back

 

[zhopv10]

Have you considered Rad Onc?

There are still procedures in rad Onc (brachytherapy) granted you don't necessarily have to do them as an attending but as a resident you will. That being said it can definitely be lighter in procedures than many fields.


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[evilbooyaa]

Lot of ability to be IM, including hospitalist vs specialization, with no serious involvement of procedures. If you like diagnosing, I think that or Neuro is your best bet; Rad onc will not be for you in that case.

 

[Wordead]

You are all totally fine with us creating internal medicine attendings that are not comfortable putting in an A-line? Throwing simple sutures? Biopsying a lesion? Are they consulting anesthesia or surgery every time to do these? Just go be a psych NP and be done with it, jesus christ. Be a damn doctor. And guess what - there are surgeons with tremors. There are a million ways to compensate. Nobody's asking you to sew vessels together.

Hey I hate dealing with blood pressure and diabetes so I'm just gonna go ahead and consult medicine for any patient that has those conditions no matter how well controlled. And I hate doing med recs so why doesn't medicine just be primary for all our patients. Newsflash guys - there are a lot of things you'll hate that you still have to master.

 

[Sardinia]

And guess what - there are surgeons with tremors. There are a million ways to compensate. Nobody's asking you to sew vessels together.

@Doctor Strange

 

[Sardinia]

Just go be a psych NP and be done with it, jesus christ. Be a damn doctor.

Every time I feel like I'm alone in the world and no one understands me, I will always remember that physicians must deal with the reality of having so much responsibility that being a psych NP is considered a cop out. "Can you believe it? Nancy prescribed the pt with Ambien 10 mg post-surgery instead of 5 mg. I wish I was a psych NP!"

 

[Doctor-S]

As posted by @Wordead, there might be "a lot of things you'll hate that you still have to master."

One of my classmates intensely disliked doing procedures. By his own admission, he wasn't sure of himself and lacked confidence when confronted with suturing, NG, ABG, IV placement, etc. Nothing seemed doable. Feeling frustrated, overwhelmed and anxious, he avoided practicing/doing procedures and became even more anxious and frustrated with himself, as well as with the practice of medicine as his chosen career.

Then, one weekend, he returned home and vented a hundredth time to his Mom and Dad.

His mother (a no-nonsense RN) basically told him to move it, or lose it; and said, if he didn't want to learn the basic skills of a physician, he might as well drop out of medical school. His father (a psychiatrist) agreed with his mother and reminded him that life isn't always jolly and fun.

So, the student asked a few MDs and RNs for some extra assistance and tutorial practices; and before the end of MS4, he was reasonably proficient with many procedures. Later, he matched to pediatrics. Just saying.

 

[ugagrad1116]

I agree that you might want to look into neuro. I just shadowed a neurologist and his residents this past week, and they said one of the reasons they loved neuro is because they hate procedures and love diagnosing.

 

[KnuxNole]

Depending on the practice setting, hospitalists may not do any of those things.

I don't do any procedures as a hospitalist. It depends on the job location, it is far from a requirement. It's great if you want to do them, if you don't, great, you can find your niche.

I am bad at procedures, they are my least favorite thing by far. That is why I am glad I didn't do a surgical specialty...med school and residency confirmed that!

 

[QuizzicalApe]

You are all totally fine with us creating internal medicine attendings that are not comfortable putting in an A-line? Throwing simple sutures? Biopsying a lesion?

These internal medicine attendings already exist. Many times, jobs advertise "no procedures" prominently; the attendings enjoy that if they hate procedures, the hospital enjoys it because it simplifies their insurance if they can offload all of the procedural risk onto designated teams

Are they consulting anesthesia or surgery every time to do these?

There will be generally be designated procedure teams.

Hey I hate dealing with blood pressure and diabetes so I'm just gonna go ahead and consult medicine for any patient that has those conditions no matter how well controlled.

This already happens.

And I hate doing med recs so why doesn't medicine just be primary for all our patients

This also already happens at many places under the logic that surgery makes money and floor management doesn't, so free up the surgeons to operate by making medicine do all the floor work.

 

[dpmd]

It is the culture at my hospital that the hospitalist adnits all patients and i just consult. i still do the medication reconciliation after i operated though.

 

[badasshairday]

Diagnostic rads do a decent amount of procedures and you will ha e to do IR I'm residency. But when you are done, there a lot of jobs out there that will require minimal procedures to none. And the procedures you may have to do will be things that all radiologists can do fairly easily and quickly i.e. LP, Paracentesis, thoracentesis. occasional thyroid biopsy or PICC maybe your toughest cases, but most places won't need you to do those if you have other procedurally oriented diagnostic or interventional rads.

 

[Wordead]

These internal medicine attendings already exist. Many times, jobs advertise "no procedures" prominently; the attendings enjoy that if they hate procedures, the hospital enjoys it because it simplifies their insurance if they can offload all of the procedural risk onto designated teams



There will be generally be designated procedure teams.



This already happens.



This also already happens at many places under the logic that surgery makes money and floor management doesn't, so free up the surgeons to operate by making medicine do all the floor work.

I know there are hospitals where this is the set up. That does not mean we should be graduating people who cannot perform the basics. Just like a graduating surgery resident should have mastery of basic postop care and how to treat basic medical conditions. What happens when that attending moves jobs? They can only work under those limitations? We can have a segment of medicine attendings that wont be allowed to work at a majority of hospitals. Great. Do we need to start certifying attendings that can do an ABG? We can add on some letters after MD to certify it.

We don't need to win the race to the bottom. Like I said, you might as well become a midlevel.