Most bad-ass surgical specialty

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So my friend and I are having a civilized debate about what surgical specialty is the most bad-ass. I was arguing neurosurgery. What do yall think with regards to the title question?

*Disclaimer: I know there is going to be one smart person who says this, but I already know there is no right answer and this varies for each person. Thank you though and sorry I cost you maybe ~5-10 likes
 
Dr panda said:
How many people on pre med forum do you think have experience in surgical specialities?
You should probably go to residency/surgery forums.
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Well that's the thing, the question is not attempting to find the truth, and I would imagine a premed's ideas are much more in line with fantasy than reality, unlike that of residents or attendings who know that these specialties are truly not as glamorous as us premeds or regular society members believe it to be. Does that answer the question you posed to my question?
 
I work in the OR so I have seen most of the specialties. Trauma and vascular are pretty bad ass in terms of saving people who are actively bleeding: GSW, Aortic dissection, etc. The "Cross clamp the aorta and look around" attitude is wild. With that said, I've haven't seen one of those patients live.
 
mrwup said:
I work in the OR so I have seen most of the specialties. Trauma and vascular are pretty bad ass in terms of saving people who are actively bleeding: GSW, Aortic dissection, etc. The "Cross clamp the aorta and look around" attitude is wild. With that said, I've haven't seen one of those patients live.
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I have. We had a guy come in with a ruptured AAA, opened him up and cross clamped. Got him grafted and out of the OR and afaik he walked out of the hospital.
 
CT is the most “badass”. What could be more badass than starting/stopping someone’s heart? I think the coolest is ENT tho.
 
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pchemdestr8 said:
So my friend and I are having a civilized debate about what surgical specialty is the most bad-ass. I was arguing neurosurgery. What do yall think with regards to the title question?

*Disclaimer: I know there is going to be one smart person who says this, but I already know there is no right answer and this varies for each person. Thank you though and sorry I cost you maybe ~5-10 likes
Click to expand...
Define "bad-ass".
 
Perhaps it *is* colorectal surgery - who else can say that Barbie is their groupie? She’s always waiting for the perfect opportunity to visit the OR, I mean patients swear all they did was sit on the couch.
 
5-Year Residency at SGU:

Academic Pediatric onconeurosurgeon with additional training in CT and vascular surgery who is also a board certified PCP who can deadlift and squat 5 plates, bench 3, all for reps, while also able to cook amazing texas bbq and teaches at HYPSM on weekday nights, has 3 kids, stable marriage, active investor, and an instagram influencer on the side.

Also doesn’t put anchovies on pizza. FISH doesn’t belong on cheese and tomato bread.
 
Plastics...put in some fake boobs, call it a day and drive your Ferrari to the country club
 
I mean, shoving foot long rods into people's bones and then a few months later having them walk normal again is pretty badass.

However so is reconstructing someone's insides and having them be able to poop again. You never realize how great it is to poop until you literally can't.

Trauma surgeons might not operate as much as their ortho counterparts, but they quite literally save lives all the time.

In the past I would have said neurosurgery, but only before the era of Stealth Navigation. Imagine the cajones it had to have taken to cut into someone's brain with only a clinical reasoned guess as to where the lesion is. Also too much of neurosurgery now is spine.
 
AnatomyGrey12 said:
I mean, shoving foot long rods into people's bones and then a few months later having them walk normal again is pretty badass.

However so is reconstructing someone's insides and having them be able to poop again. You never realize how great it is to poop until you literally can't.

Trauma surgeons might not operate as much as their ortho counterparts, but they quite literally save lives all the time.

In the past I would have said neurosurgery, but only before the era of Stealth Navigation. Imagine the cajones it had to have taken to cut into someone's brain with only a clinical reasoned guess as to where the lesion is. Also too much of neurosurgery now is spine.
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What surgical field are you personally gravitating towards? Ortho?
 
Have to agree with trauma- it’s the one service I never almost fell asleep in the OR with, given how high-stakes the surgeries are. What those surgeons can do is incredible.
 
differentiating said:
Have to agree with trauma- it’s the one service I never almost fell asleep in the OR with, given how high-stakes the surgeries are. What those surgeons can do is incredible.
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Can you please explain more? My understanding was that trauma surgeons were mainly just glorified general surgeons... I initially thought trauma surgery was the most badass field as well, but then learned that often times these guys just stabalize the patient and send em to other specialists (like GI or CT surgeons). Are they like the ER docs of surgery? And if we are talking about high-stakes, how about CT surgery (let's forget the job market for this specialty at the moment)?
 
pchemdestr8 said:
Can you please explain more? My understanding was that trauma surgeons were mainly just glorified general surgeons... I initially thought trauma surgery was the most badass field as well, but then learned that often times these guys just stabalize the patient and send em to other specialists (like GI or CT surgeons). Are they like the ER docs of surgery? And if we are talking about high-stakes, how about CT surgery (let's forget the job market for this specialty at the moment)?
Click to expand...

I rotated at a level 1 trauma center for my surgery rotation, so the traumas they were dealing with were literally life and death - shooting victims, abdominal compartment syndrome, etc. Aside from perhaps neurosurgery, who would take head traumas, they were really the surgeons responsible for keeping people alive- the other surgeons would just stabilize later.

I personally didn’t find CT surgery very interesting or impressive, though I will admit that our CT surgeon being a jerk didn’t help with that impression. But I find surgery pretty boring on the whole, honestly.
 
pchemdestr8 said:
Can you please explain more? My understanding was that trauma surgeons were mainly just glorified general surgeons...
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And? They are general surgeons.
pchemdestr8 said:
I initially thought trauma surgery was the most badass field as well, but then learned that often times these guys just stabalize the patient and send em to other specialists (like GI or CT surgeons).
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No. They stabilize and then either take the patient to the OR or to the SICU where they manage them. Other specialties only get involved if they have injuries pertaining to those systems. Obviously if a patient needs a crani then neurosurgery will be on board, but then post op they will still be managed in the ICU by the trauma team (as the primary team. Neurosurgery will still be heavily involved). If they have a fractured pelvis then ortho trauma will fix it but then passes the patient back to the trauma team for further management and will follow them peripherally.
pchemdestr8 said:
Are they like the ER docs of surgery?
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Hell no. ER docs don't manage patients and they can't operate. Trauma surgeons do both of those things. Trauma surgeons run SICU's. Many trauma surgeons also have their own general surgery practice they run when they aren't on trauma call, unless they are at one of the major metro trauma centers and they literally only do trauma but this isn't terribly common.
pchemdestr8 said:
how about CT surgery (let's forget the job market for this specialty at the moment)?
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Eh. It's very intricate, but when I was on the CT service it gets very rote pretty quickly. For bread and butter CT it's the same steps over and over. Unlike the person above's experience our CT surgeons were really cool and liked to teach, but I still just couldn't get too worked up about it.
 
Urology. Dilating the corpora for penile prosthesis, gsw to the junk, IVC thrombus extending above the diaphragm, splaying opening the urethra for urethroplasties, hypospadias, bladder exstrophies, deconstructing penises for gender affirmation surgery. So on. Every surgical field is badass in its own way
 
Pepe18 said:
Urology. Dilating the corpora for penile prosthesis, gsw to the junk, IVC thrombus extending above the diaphragm, splaying opening the urethra for urethroplasties, hypospadias, bladder exstrophies, deconstructing penises for gender affirmation surgery. So on. Every surgical field is badass in its own way
Click to expand...

 
Pepe18 said:
Urology. Dilating the corpora for penile prosthesis, gsw to the junk, IVC thrombus extending above the diaphragm, splaying opening the urethra for urethroplasties, hypospadias, bladder exstrophies, deconstructing penises for gender affirmation surgery. So on. Every surgical field is badass in its own way
Click to expand...

Ah yes, the Wang Gang
 
ACS/Trauma general surgery, vascular surgery, or CT surgery. Watching the trauma surgeon manage multiple operative level ones at once was teulya sight to behold.

Vascular surgery fixes everyone else’s screwups and will touch patients no one else will all while anastomosing vessels with 10-0s under duress.

CT surgery crash to ECMO was pretty badass too.
 
This is definitely more of a discussion at lay person level rather than a physician one. Every specialty has their strengths and each one has their strong role models and natural bunglers that always seem to have complications. For whatever reason, I really found transplant surgery as a whole to be an amazing field. It's literally general surgery on steroids. I once did a case with a young junior attending, but you could already tell this dude was a rising star in the division. The details are fuzzy now but we ended up doing a simultaneous kidney-panc transplant, but his iliac went down with known stents inside. So we opened the iliac and thrombectomized it like it was no big deal. Within one case we did the full gamut of general and vascular surgery. One of those moments that made me seriously consider going into transplant long after I had left the rotation. In the end, find the thing that you are passionate about and be good at it. Cheers.
 
AnatomyGrey12 said:
Working on a congenital heart was described to me as "like suturing 1-ply toilet paper. That's wet."

They definitely are on the list. Might be the group with the best technical skills.
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+1

Most technically demanding by far. Repairing flimsy structures freehand inside a walnut. Some very devoted and talented people invest a decade of their life to master it and still fail.
 
Depends. NSGY has the most “laymen” prestige, Ortho has the most individuals that people would consider “badass”.
 
I'd say it depends more on practice set-up than lumping any one field all together.

Some neurosurgeons only do elective $pine, others do complex intra-cranial.
Some trauma surgeons are seeing very sick polytaumas and running a SICU, and others are being surgical hospitalists doing choles and appys
Some orthos do elective $ports, others are doing pelvis fractures and ex-fixes.
Some plastics do incredible reconstructions, others do boob$

So overall I think Cardiac is the most "badass" because regardless of how you set things up you will still be cracking open chests routinely.
 
pchemdestr8 said:
So my friend and I are having a civilized debate about what surgical specialty is the most bad-ass. I was arguing neurosurgery. What do yall think with regards to the title question?

*Disclaimer: I know there is going to be one smart person who says this, but I already know there is no right answer and this varies for each person. Thank you though and sorry I cost you maybe ~5-10 likes
Click to expand...

They are all great in their own way. The level of badassery is usually commensurate with the amount of torture you have to go through to get to become that type of specialist.
 
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